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Home My WebLink About15774-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No~ Z-26876 Date: 01/07/00 THIS CERTIFIES that the building ADDITION Location of Property: 835 CRITTEN LANE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 11 Lot 3 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16, 1987 pursuant to which Building Permit No. 15774-Z dated MARCH 18, 1987 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to C. AUSTIN DAWSON & WF. (OWNER} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A Authorize~e FORm[ HO, B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~5774, Z Permission is hereby granted to: c" ~ .~...~..~..~...~...~.~.. .... ~..~ .............., ,,.,,.y.,~/.~...~ .... County Tax Map No. 1000 Section ....... C~..~.~,. ..... Block ......... I..l ......... Lot No .......C~....~ ............ pursuant to application dated ......~...c~.~L ...... ~..~4R ............. , Ig.~...-Z, and approved by the Building Inspector. Fee $,.'~.~**.:...~. Rev. 6/30/80 BUILDING~ TOWN 765~ 3JPPLICAT~gN.,~O~-~ERT ;OUTHOLD ~LALRTMENT [802 IFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buiL inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property l~i~ streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 fo 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contai less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar bui and installations, a certificate of Code Compliance from architect or enginee responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or building '!pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the appli If a Certificate of Occupancy is denied, the Building Inspector shall state t reasons therefor in writing to the applicant. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swim, ins pool $25.00, Accessory building $25. Additions to accessory building $25.00. Busimesses $50.00. 2. Certificate of Occupancy om Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - . .2~. 4; Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy ~ Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ................. Location of Property House No. Street Hamlet c, . . Onwer or Owners of Fropergy ................... · ...................... County Tax Map No 1000, Section.......... ~ ~-~ .... Block ..... ..tl........Lot...~.. ........ Subdivision .................................... Filed Map ............ Lot ............... Permit No.J~.~ ...... Date Of Permit... //P/...g~......Applicant... ..........-.--.-. .--- Health Dept. Approval .......................... Underwriters Approval .................. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: APPLICANT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ I FOUNDATION 2ND [ ] INFLATION [ ]FRAMING ~/FINAL INSP£~~ 765-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ~AUMN IDNA~ION 2ND ~F~NSAU~ATION ] FIREPlaCe& CHIMNEY INSPECTOR/~~/ OUNDATION ( 1 st ) OUNDATION { 2nd ) OUGH FRAME & PLUMBING L'fSULATION PER N, Y. STATE ENERGY CODE FI;~AL ~. . ADDITIONA'L COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 TEL.: 765-1802 .... 19 7. Approved ...'~..O~k...t~.. ! ~..., 19~. 7. Permit No./'.~'.~. ?.q .~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD Or n~,~ .... 3 SETS OF PLANS SURVEY ._,..~fi,- C ECK .V. oA... SEPTIC FORM ............. : NOTIFY CALL ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sbts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o.r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of bhildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable.laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins. l~qCti~ ',~_ · (Signature of applicant, or name, if a corporation) .... 7. /..rT. . .??. : ............... (Mailing address of applicant) .State whether applicant is owner, lessee, agent, architect, engineer; general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ALL CONTRACTOR'S MUST BE SUFFOLK COIINTY LICENSED Builder's License No ..... ~ ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .......... T~.'. ...~..~.~. .......... ~ · · .~ ......... House Number Street Hamlet County Tax Map No. 1000 Section . ~ ............. Block .~. .............. Lot. ~ ................ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ~.~. ~ ~ ..................................... b. Intended use and occupancy ........ ~.~ .~ ~...~ ................................. j. Nature of work (check which ap~licable): New Building ..... ' ..... Addition ~ .... .. Alteration .......... Repair .............. Remo*, al .............. Demolition .............. Other Work' ............... , t ..~/,,~.~ (Description) 4. Estimate Cos ................. Fee .................... .................. ' (to be paid on filing this application) 5. If dwelling, number of dwelling u~its ............... Number of dwelling units on each floor ................ If garage, number of cars ...... i ................................................................. 6. If business, commercial or mixed ~ccupancy, specify nature and extent of each type of use ............ . ......... 7. Dimensions of existing structures, if any: Front ......... ...: .~ .,. Rear .............. Depth ............... Height ...' ............ Numbe~ of Stories ./. ........................................... 2 ......... Dimensions'of safn~ structure withialterations or additions: Front ................. Rear .................. Depth ................. ..... iHeight ....................... Number of Stories ....................... -8. Dimensions of entire new cohstmction: Front .... ~t~.~. .' ..... Rear . ~.49. t. ......... Depth /,2: ........... Height ............... Numbe~ of Stories ..................... ; .................................. 9. Size of lot. Front -r~..~, ......... ! ........ Rear ................... .... Depth.~ ..................... 10. Date of Purchase .~ .~,.. [~.~..',, ............... Name of Former Owner .,.~t': .~.~.4 i~.f'~4~.~. ..... 1 1. Zone or use district'in v~hich premises are situated ....................... : ~ ........................... 12. Does proposed construction~ violate ~ny zoning law, ordinance or regulation: . ,/ZO ................... 13. Will lot be regraded .., tn[.O ...... ", ............... Will excess fill be removed from premises: . Yes' No 14. Name of Owner of premises ..... i ........... Address ................... Phone No. ?.6..5~ .,3..g..k~.... Nmne of Architect ............. i ............. Address ................... Phone No ................ Name of Contractor ............. I ............. Address .... : .............. Phone No ...... .. ......... 15. Is this property located with'in 300 feet of a tidal wetland? *Yes ..... O ..... *If yes, Southold Tow~ Trustee'~ Permit maybe required. ' PLOT DIAGRAM . Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block numb ;r or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK. COUNTY OF.. ¢$¢~¢¢/p,I [¢¢. ...... ?" , .... ¢.~ ~.c'~.'~3'.~,, .~g4~.~gP.~. '; . : '" being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named ' ~e is the .......................................................................... (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized',to perform or have performed the said work and to make m~d f'fle this ~pplication; that all statements contained in this Spplication are true to the best of his knowledge and belief; and that the ~¢ork will be performed in the manner set forth in the application filed therewith. ~worn to before me this ......... l (.o..4~.. ......... day of ..... ~tary NOTARY PUBLIC, Stc~to of New No, 4764227 Qualified in Suffolk County Commissian Expires ~arch 30, 19 (Signature of applicant)