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Home My WebLink About16490-zF. ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21011 Date SEPTEMBER 11, 1992 THIS CERTIFIES that the buildin~ ADDITION Location of Property 1160 PARADISE SHORE ROAD SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 80 Block I Lot 25 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 23, 1987 pursuant to which Building Permit No. 16490-Z d~i~d SEPTE~ER 30~ 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOHN & ETHEL McKEHNA Rev. 1/81 /Build~ Ih'spec~e~/ FO`n.M. NO. ft 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) Permission is hereby grarl~e~t~ . .................. ............ ~~.....~..,.%., ....... ;..:.~.~ ......... ~ ,.-V>~ _~.~J ~. ! . o, premises located ct ....~.J...~...b. ....... ~...~.....~.......~... ....... County Tax Mop No. 1000 Section ...... .(~.~...Q ...... Block ....... .?...~ ........ Lot No.....~.~'~.. ........... pursuant to application doted ..... ~..~..~.....~......~. ........ , 19.~.....'7., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 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. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% 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. 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: l. 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, the 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 - $I00.00 3. Copy of Certificate of Occupancy - $5.00 ever 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .../.O./.~.l~J ....................... ... . .. Xew Construction ........... Old Or Pre-existing Building....~. ............ Location of Property House No. Street Hamlet Onwer or Owners of Prope~ty....~.~..~.~..~..~;.J~h.~.(... County Tax Hap No 1000, Section ........... Block ............... Lot .................. Subdivision .......................... .. ....... . Filed Map ............ Lot ................... . .. Permit No.~.¢f~...Date Of Permit ................. ~.~..b .~.~ ... Applicant ............... Health Dept. Approval .......................... Underwriters Approval ..................... . . .. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.....~.. .... ?ce Submitted: $ .... qq777 ..................... FOUHDATION ( la t) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: Indian Neck Lane" Peconic, NY 11958 Robert A. Born Home Improvements~,)~¢~ ¢ ~ ~--~l~ ..-~--- ...... 734=59t6 , t-4 ~ ~- INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ J FOUNDATION ZND [ ] INS~j~TIoN [ ] FRAMING [i,~FINAL REMARKS: ~-~~ . ~ ROBERT A. BORN nONSUMER AFFAIRS LIC. 1t902~41 HOME IMPROVEMENTS "HAVE THE JOB DONE BY A BORN BUILDER" · REMODELING · ADDITIONS · ALTERATIONS · ROOFING · RE-ROOFING · SIDING · ITEPAIR$ · DECKS FREE ESTIMA TLS & INSPECTION 734-5916 PROPOSAL AND CONTRACT The undersigned contractor proposes to furnish all materials and perform all labor necessary to complete the fol. lowing: ............... .J..,I~a.~all..Z.Q~ir~...l£.::~L=ap...£.Q~z....4,.~.b~...A.'~paat .................................................................. .............. ..~.~I ~..~.~ 1L...~_.Ap.p.~.Oz...1 ~.!....hy....[.Q..~....C.C~...~ m ~.~c...ap~ rmx....L ~.~!....Q f/L..%.hs....e xi a ~Ln ff .................... ~.r.0..~ n ~...l~Y..e 1., ............................. ~. ........................................................................................................... :.. ............... 3.~.~.c~...~.~.l~...~.~.~.ck...~ ~.....~.he....~ xia.~..ha ~ a a. kle a a ~..~.ef.e ~:....%Q....~he ........ ..................... .4r~.~i~, ..................................................................................................................................................... :~ .... ............... ~.,D~2~..mk~m~.; ~mri~l...~l~mm, .......................................................................................... : .... ............................................................ kx.o~m~...~em~_.~.e., ................................................. ~ .................................. ............................................ : ................ ~.e.o~...~=zign.,~l=~.~...n~%.=..p~i~...~d...~n...~lgn, ....... ..................................................... 1 .......... .Q~m...~'.~...g~amn~g~ m...a~...w.u=~=~p ................................... AH of th~ovo work to ~ uomple~d in a substen~ and workm~Hke manor a~ording to ~and~d tot ~ ~um o~ .:I~..~.~m~.....L~_.~g~.~.~.~.....~...~G ......... ~ll~ ( L...~.9..,.~.~ ..........). Payments to bo made ..:::~.a9.~.$,~ ,.,~] QQs.O.Q. .~ na~x~a~l~.~t~ 1.0 .~a~a. 0f .Si aL ~ .......... ~..: .......... ~.~.~ ................. g ~ ............................................................... ................ ~l...R~m.~n$.,.,.,.~..~.,~..Ao...~a~k_p~==e~.e~, ........ : ........... U""L' ~ the w~rk to ~e value of ~D.~...RA~.~A~%~.~m~m.O ' ' ' --.~q .... ~e euUm ~ount. of con~a~ to ~ aid within ..... ~ .: __ ~A~.Z ........ ' Any chan~ ~rom ~e above~atlons revolving extrR cost o~ matetlal or labor will ~nly ~ ex~uted Upon wtkten orde~ ~or them. ~ers will ~ ~tra charges 1oF chan~ All agreements about changes must be madelin writing. Please note;Bid to be accepted ! 10 days from above date. TO THE Contractor You are hereby authorized to furnish all materlais and labor req;,ired to ~0mplete the work mentioned in the above proposal, for which l (We) agree to pay the amount mentioned in the proposal according to its terms.. ACCEPTED BY BUYER(s) on ............ ---'7 Approve~. ,~ · .~.., 19'~. ?. Permit No. 1.[*.1{?.O. ..~. ~u~ 'I ~-- ~-~ BOARD OF HEALTH ...... 3 SETS OF PLANS .~.... 'FORM NO. I SURVEY .......... '[OWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL T 0 :-~c~t~ Disapproved a/c ' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. 19 .,. INSTRUCTIONS m. 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 i'ssuance 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, mad other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applica, nt 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~s/_~ (Signature of applicant, or~ame, if a corporation) .. .... .... (Mailing address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... . ................................................ Name of owner of premises ...~. P,]. J~..~, .~..'.¢')..~./~. ..... ~. (' ?-'.....~.U ~.c{..~,./~....~..~. ..... ~"~.,. ~.~.c' ./~. ~.'.1~...~ ....... (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 .......................... Plumber's License No ............... , ......... Electrician's License No ....................... Other Trade's License No..~3..~.~. ·~. ./?. ~ .... House Nmnber Street Hamlet County Tax Map No. 1000 Section ...~..~...C~. ......... Block ..... /. ............ Lot .... Subdivision ..................................... Filed Map No ............... Lot ........ (Name) State existing use and occupancy of premises an&intended hse and occupancy of proposed construction: b. Intended use and occupancy .................................... - ..~,.w..~- ,~ ..-.;, .~.; ................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteratio¢~...___.... .... Repair ...... RemOval ........... Demolition .............. Other Work...~"... [ (Description) 4. Estimated Cost .!$~./~-90 ' co. Fee ........... * (to be paid on filing this application) 5. If dwelling, number of dwelling bnits ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commercial or. mixed occupancy, specify nature and extent of eadh type o'f use ~ i.. ~ .'. [ ............. any: Front ........ ........ Rear .............. ,.,, ,-~ . ..~. Depth.. ............ Number of Stories ~-, .. ~ ~ Dimensions'of same ~ or additions: Front ................. Rear .................. i Height ...................... Number of Stories. construction Front ~. f...... Rear ~.t . Depth Number of Stories .................................................. 'r .... : ...... .....'.' Rear ./OO 'r' .... Depth ..... 1 ~.5"/. ......... ........... . ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated .................................................... 12. Does proposed construction vic!ate any zoning law, ordinance or regulation: ....... .ti.C). .................. 13. Will lot be regraded ..... .t~...,'. .................. Will excess fill be removed from premises: Yes I4. Name of Owner of premises ...~ ................. Address ................... Phone No ................ Nmne of Architect ......... ~i ................. Address .... . ............... Phone No ......... ... ....... Name of Contractor .~.~.~. ~..~.o..~. .............. Address .~.Op!~.,~..~.¢y.lc..c.~. ..... Pho~. ~/.¢. 773. y...~. ~!.~. 15. l.s this property located !within 300 feet of a tidal wetland? *Yes ..... ~ ..... *l.f yes, Southold Town TrUstees Permit maybe required, PLOT DIAGRAM Locate clearly and distinctly all~' buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. OF 0¢Cu N¢ t ' AP~RO¥~ A8 766.1802 9 AM TO ~UNDATION '~0 ~R ~URED CONCR[~'fE ~UGH FRAMING & ~SULATIO~ ~ COMPLET~ FOR ' ' ~; CONST~UC~ON T~ REQU~MENTS ~ ~A~ CONST~C~ON ~ ~ CO~S~C~ON COUNTY OF. ~c~~....~7. ~ S.S ....... .............. (Name of individual sigging contract) being duly sworn, deposes and says that he is the applicant above named. He is the ................... : .................................. . .................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thisl application; that all statements coniained in this application are true to the best of his knowledge and belief; and that thei work will be performed in the manner set forth in the application filed therewith. Sworn to before this Notary Public .... ~~ .'.~2uniy ~i Nle,~_te ef NawYork -- (Signature of apphcanQ _ -. o. 4~79606, . I' ,,a~,nm~m~on E~lre. ~ember 8, ~ *~¢