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Home My WebLink About15777-zNo Z20137 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date AUGUST 8, 1991~ THIS CERTIFIES that the building. Location of Property_ 10 HICKORY RD. House No. County Tax Map No. 1000 Section 54 subdivision ADDITION 8OUTHOLD Street Hamlet Block 06 Lot 14 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. i5777Z dated MARCH 19e 1987 ............... was issued, a~d conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to JEAN C. SWEENE¥ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 /lingInspector FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NM 15777' Z Permission is hereby granted to: .... .~~~...~.:~.:..!..!..~..~.~-.. .... ~ ~ at premises located at .../....~....~.~.....~-.. ......... ~ ............................................................ ...................... County Tax Map No. 1000 Section ['J'~)...~...~ ..... Block ....... ..~..,~. ....... 'Lot N ...~ .... pursuant to application doted ...... ..~.0~....~ ........ J).../-~ ................ 19..~..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that' the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer 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 buildings and "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 applicant. If a Certificate of Occupancy is denied, tho Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i~.00, Commercial $i5.00 hhr .......... Date ..... ~ ~ ...................... New Construction ........... Old Or Pre-existing Building ................. Location of Property ..... L~ .................... _~..'~'~ .......... ~."~.~. Onwer or Owners of Property ...... ~.~...-~-w.~.~..r~ ....................... County Tax Map No i000, Sectio~ .... .~..~ ...... Block..~ .... .~. ....... Lot. Permit NO..I~?.~. Date Of Permit.. ~././,I/.~/__ Applicant. K~..--~-..~f.'~i.~ ~;7.. ' ! Health Dept Approval Underwriters Approval ......... Planning Board Approval ..... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ...... .~..~??.~. ................ g~/r[~/ APPLICANT ¢o~ doit7 INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Superv/sot Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD July 25, 1991 Ms. Jean Sweeney 10Hickory Road Southold, N.Y. 11971 Re: Premises: #10 Hickory Road, Southold, N.Y. Suff. Co. Tax Map 91000-54-6-14 Building Permit Nos. 1679-Z, 15777-Z, & 14868-Z Dear Ms. Sweene¥: Please be advised that the above building permits are still open and Certificates of Occupancy have not been issued. In order for the Certificates of Occupancy to be issued a final inspection must be made and the enclosed applications filed with this office. A fee of $75.00 is also required, $25.00 for each CO. Kindly call this office so that we may set up an appointment for the final inspections. The Certificate of Occupancy for your garage addition has been mailed to Mr. Jacobs today. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE , ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~ULATION [ ] FRAMING [ ] FINAL DAT£ ?/~/~2 .... INSPECTO~~~ 765-1802 BUILDING DF. PT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND []INSULATION [ ,~F~MING []FINAL INSPECTOR~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FO~UNDATION 2ND [ ] INSULATION [ ~'~RAMING [ ] FINAL DATE ~2 iNSPECTO~× 765-1802 BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ FOUNDATION 2ND FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL DATE 'i , C! INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish ]Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD July 25, 1991 SCOTT L. HARRIS, Supetvisrn Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Ms. Jean Sweeney 10Hickory Road Southold, N.Y. 11971 Re: Premises: #10 Hickory Road, Southold, N.Y. Suff. Co. Tax Map ~1000-54-6-14 Building Permit Nos. 1679-Z, 15777-Z, & 14868-Z Dear Ms. Sweeney: Please be advised that the above building permits are still open and Certificates of Occupancy have not been issued. In order for the Certificates of Occupancy to be issued a final inspection must be made and the enclosed applications filed with this office. A fee of $75.00 is also required, $25.00 for each CO. Kindly call this office so that we may set up an appointment for the final inspections. The Certificate of Occupancy for your garage addition has been mailed to Mr. Jacobs today. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. GJF:gar Gary J. Fish, Building Inspector FORM.O., SURVEY TOWN OF 8OUTHOLD CttECE ::: BUILDING DEPARTMENT SEPTIC FORM TOWN HALL gOUTHOLD, N.Y. 11971 NOTIFY MAIL TO: Approved ...~ .°~-..e~l..IfJ.., 19~.. ?. Permit No, (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or 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 buildings, 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 auth°rized inspect°rs °n premises and in building f°r necessary inspe;7?~:~ z~- /,_ ~.~_~.. (Signature of applicant, or n~'~, 'i~ 'c~ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..Applicant.is,the.builder ...................................................................... Name of owner of premises .Jean.C, .Sweeney .......................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ..................... ~ ..... ) Suffolk Co. Lic.# 13~128-HI Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. #10 Hickory Road Southold, New York House Number Street Hamlet County Tax Map No. 1000 Section . 54 Block 6 Lot 1/4 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . $$ .ng~.~..Fa.q~. ~ 1. y .d. we.~l.~..rig ............................................ b. Intended use and occupancy ..$.aro.~.~.~bP¥~,.AOO~T~Q~ ........................................... 3. Nature of work (check which applicable): New Building .... ' Addition! ..... ~3~... Alteration ........ Repair Removal Demolition ' Other Work ., (Description) 4. Estimated Cost .... ~.. ~/~?~ ...................... Fee ........ ~ ............................. ~ (to. be paid on filing this application) 5. If dwelling, number of dwelling units...o.n.e .......... Number of dwelling units on each floor ................ If ga ag numberof none r e~ gars .......................................................... ......... i' ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............ ?. Dimensions of existing structures, if any: Front. 47 ! ........... Rear .... /*7 ~. ....... Depth ...25' .......... Height 16! Number of Stories one Dimensionsof same structure with alterations or additions: Front .Zl-7. ....... ' ....... Rear ...47.'.. D pth ~5.'. Height Number of 8t ' e .............. ' .......................... ones..QrI~l ................ 8 pth .- . Dimensions of entire new construction: Front .......... . ..... Rear ...... . ......... De ............. Height ............... Number of Stories ...................................................... 9. Size of lot: Front .. 42.'/.50: · earner, lot. · Rear. 179 !/121 ! ........... i, Depth .93'./.534..5' .......... 10. Date of Purchase ............................. Name of Former Owner, ........................... di h p side rial l 1. Zone or use strict in whic remises are situated .re n ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .BO 13. Will lot be regraded .. BO ........................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .J.e.aB..C:..S~y..e.e.n.ey .... Address 1. O .H.~q .kq..r7 .R.d. ~,. S. gu.C. ll~e No. 5.%~/.7.fi~x~3.~ ... Name of Architect ........................... Address ............. ~, ....Phone No ................ Name of Contractor Iltroshi H, Park A~,tm~ 225 Horsesl~6eDr. ~tgm~,,,, 1q,,516/734-7661 15. Is this property located within 300 feet of a tidal wetland? *~es ..... No ..... · If yes, Southold Town Truatees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ihdicate all set-back dimensions from aroperty lines. Give street and block number or description according to deed, and shgw street names and indicate whether interior or corner lot. gTATE OF NEW YORK '20UNTY OF...S.u.f. fp.l.k. ....... S.S .................... .I:ISrg$.h.i' I:I~. ]~ .rl~ .............. being duly sworn, depooes and says that he is the applicant (Name of individual signing contract) tbove n~med. . the c.oBtractgr te is ....................................................................................... (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 and file this tpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn tq before me tkis NOTARY PUDUC. State of }/~w York , ' ..... : No.,iZoTa?e, su~lkr~ty,~7 , ': : (Signature of apphca ) Term Exph~ M~.~I~ 3% 1L.Z.J ~6o ~