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Home My WebLink About16517-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southoid, N.Y. CERTIFICATE OF OCCUPANCY No Z-20956 Date AUGUST 19~ 1992 THIS CERTIFIES that the buildin~ ADDITION Location of Property 10435 SOUNDVIEW AVE. & 915 DOGWOOD LA. SOUTHOLD~ NY House No. Street Hamlet County Tax Map No. 1000 Section 5.4 Block 5 Lot 35.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 6~ 1987 pursuant to which Building Permit No. i6517-Z dated OCTOBER 11, 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 FIREPLACE ADDITION IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LAWRENCE HERZOG (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 Building Inspector FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 16517 Z Date ..... C~. ............................... · ...... Permission is hereby granted to: ~.~. ............... t, ~ ..~. ............................................... ~.....~ ..... ~. ~.q...q ........ _ ..~.~.~ .. :...~,....:..~-.: ;L~ .. ....... .............. at premises located at ..~..,O....~..~...~......~~ ........ ~ .......................... coun~ Tox Ma~No. ,000 Sect,on ....... '~'"":"'5' .... B,~k .... .~...C... ........ 'or No....~.~..:..t ....... pursuant to clpplication dated ..... ,..~.....~....~,,.~. ................... 19.~.~.., and approved by the Building Inspector. Fee $..~..,:.~ ..... B'~ilding Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 ...,._.~TO.~_=..: .......... u ~_WN OF SOUTHOLD County Tax Hap No. APPLICATION FOR CERTIFICATE OF OCCUPANCY HATE ........... NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING---L~---VACANT LAND ........ HOUSE NO. STREET HAMLET 1000 Section ...... Block 0 Lot' Subdivision ....................... Filed Map ........ Lot .......... Health Dept Approval ................... Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: $ .................... rev. 10/14/88 Ae FF. ES: I. FORH NO. 6 TO~/N OF SOUTHO~D ~ ~ ~ ~ ~ BUILDING DEPARTHENT TOI/N HAL~ 765 - 1802 APPLICATION FOR C~RTIFICAT~ OF OCCLPPANCY INSTRUCTIONS This application must beifiled in typewriter OR ink and submitted to the BuiLdLn§ Inspector with the foLloOin§; for new buildings or new use: ~. Final survey of property with accurate Loeatlon of aLL buildings, property lines, streets, and unusual daturaL or topographic features. 2. Final approval of Hea~th Dept. o£ water supply and sewera§e-dlsposaL(S-9 form). 3. Approval of eLeetrlca~ installation f~om Board of Fire Underwriters. 4- Sworn statement from ~Lumber eertlfylug that solder used in system contains Less than 2/10 of IZ Lead. 5o Commercial bulldlngs, industrial buiLdlngs, muLtipLe residences and slmilar. buildings and iustaLldtlons~ a certificate o~ code compLianee from the Architect or Engineer responsibl;e for the building. 6. Submit Plann~ug Board ~pprova! of completed s~te plau requlre~ents. For exlsclu~ buildings (P:rior to April 9, 1957~ non-conforming uses, or build£ngs and ~pre-exlstln§~! Land uses: I. Accurate survey o£ property showing aL1 property Lines~ streets, buiLdin§s and unusual natural or topDgraphlc features. 2o A properly completed application, a ~onsent to inspeet signed by the appLieant and a certified abstra~ of title issued by a title company ~hieh shaLL show single and separate o~rnershlp of the entire lot prior tn April 9, 1957. . I£ a Cert~flcate of Occupancy is denied, the fluiLdln§ Inspector shaLL state the reasons therefor in ~rr~tin§ to the applicant. 3. Date of any housing eode or safety inspeeClon of buiLdln~s or premises, or ocher pertinent information ~equired to prepare a certlfleate. For Vacant Land'Certlflca~e of Occupancy: Io An application for vacant land Certlfleate of Oeeupaney shaLL be submitted, and a eer~ified abstract of tlt~e issued by a title company sho~in§ single and separate o~nershlp of ~he entire Lbt prior to April 9~ 1957 shaLL also accompany the application. If aiCertlficate o£ Oecupancy ~s denied, the Bu~Ldlng Inspector shaLL state the reasons therefor in ~r£1tlng to the appL~canto CERTIFfCATE OF OCCIPPA~CY - New D~ellln§ ~25.00, Additions to D~eLlinE ~25.00, ALteration to D~eL~in§ $25.00, Swlmmin§ PooL, $25.00. Aceessory building $25.00 Addition to Accessdry buildings, $25.00 -Bus£nesses 2. Cerc~flcate of Oceqpancy on pre-existing dweLLing - $100.00. 3. Copy of Certlflcat~ o£ Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate o~ Oecupancy- $20.00 5° Updated Certifleate of Occupaney- $50.00 6o Temporary Certlflc~Ce of Occupaney- $2~.00 Residential $50.00 Commercial ~ev° 10/14/88 FOUNDATION ( ls t) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST i ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [,g..]'"F'l NAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONgIST [//] ROUGH PLBG. FOUNDATION 2ND []INSULATION FRAMING []FINAL ~ x ' ~ 7~"1 DATE INSPECTOR. 3. Nature of work (check which applicable): New Building ..... · ..... Addition .......... Alteratig~ .......... Repair .............. Removal .............. Demolition .>~ ........... Other Wgrk · ~ ........... 4. Estimated Cost. ~ ..................... / ......v.lt~O,/. ~2e0-~x~l¢~l~.~x*-~ .......................... 5. If dwelling, number of dwelling units .... ~..x ..... Number of dwelling units on each floor ................ If garage, hum bet of cars ......................................... ........ . ......... ~ .............. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .,.,: :... ~.'. (. .......... 7. Dimensions of existing structures, if any: Front ............... Rear .... ,. ,. ...... ,.,. Depth ............... Height ............... Number of Stories ...... ~ . ~... '.* 7 ............ '..' ...... :.. ) ~ ~. '~ .". 7. ........... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... -' -8,Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Si~e of lot: Front ................... (... 'Rear ....................... Depth ...................... 10. Date of Purchase ............................ Name of Former Owner ............................. ! 1. Zone or use district in w? ;eh premises are situated ..................................................... 12. Does prop0sed construction*violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ..... · .............. Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15o Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... · I~ yes, Southold Town Trustees Permit may_ be 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ..................................... . ............ being duly sworn, dep~e.'s and says that he is the applicant (Name of individual signing contract) above named. (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 this application; that all statmnents contained in this application are true to the best of his knowledge and belief; and that the work wil,1 be performed in the m,'mner set forth in the application filed therewith'. Sworn t6 before me this ~.~70'~7&~ r,o~/~q (//' (Si~,r~ of applicant)' · ~ ' k~ ~ ~ · BOARD 0E, H LTH ...... ~' " 3 SETS OF PLANS ....... : ~ ,'FORIV] NO. t SURVEY .- ...: ...... ,.: , ¥',,,-",:,, ILDI'N~ DEPARTMENT S~PTIC ~'- · ......... : ' ' '" ' ' 8OUTHOLD, N.Y. 11971 ' ' ,' -:. "', ' TEL.: 765-180~' ' ;,- ~vprove~, . .[~ .... 1 . Pe~it No .... .. ~ .... Disapproved a/c, ' ......, ..................... : ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date Ioll INff[RUgTIONS ~. '['~s ~ppJJc~flo~ mus~ be completely Q]Jed J~ by ~pewtite~ or in ink ~nd submitted to the BuHdJn~ [nspectoL with sets~o[ plans, ~ccu~ate plot plan to ~cale. ~ee acco~dJnB to schedule. b. Plot pl~ showb~g location jof lot and of buildings on premises, relationship to adjo~ing premises or pubic streets or areas, and givMg a det~led description of layom of property must be drawn on the diagram which is pa~ of this appli- cation.. c. The work cowred by tMs a~plication may not ~e commenced before issuance of BufldMg Permit. d. Upon approval of this application, the Building Inspector will issued a BuildMg Pe~it to the app~cant. Such sh~l be kept on the premises available for Mspection throughout the work. e. Nb building shall be occupSed or ~ed in whole orin p~t for any purpose whatever unt~ ~ Ce~ificate of Occup~cy shall have been granted by the Building Inspector. ~P~ICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a B~lding Pemit pursuant to the Building Zone Ordinance of the Tbwn of Southold, Suffolk County, New York, ~d other applicable Laws, OrdM~ces or Re~ulatiohs, for ~he construction bf buildMgs, additions or alterations, or for removal or demolition, as harem desc~bed. The applicant agrees to comply ~ith all appficable laws, ordinance% bufldMg code, housMg code, ~ulations, and to admit aut;hofized Mspecto~ on premises and M buildMg for necessa~ in ' tions. (Mailing address of applicant) I J~ ~, St/re whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builde[. .... ........................................................................... . .......................................... '. ~ [ (as on the tax roll or latest deed) If applicant is a corporation) signature of duly authorized officer. ~ (Name and Utle of co.orate officer) · ALL CONTRACTOR'S ~U~T, BE SUF,FDLK COUNTY L[CBNSED Builder's License No, ..[ ~;~,0.~. · ~: ........ Plumber's License No ..... ~ ................... an's Li e N I Electrici cens o ....................... Other Trade's License No.. i ................... 1. Location of l~nd o~ whzo reposed work will be don .......................... t - House Number i Street Hamlet County Tax Map No. 1000 Segtion ...... ~ ~. ...... mock ..... ~ .......... Lot ....d}~< l ........ Subdivision .............. .............. ' ......... Filed Map No ............... Lot ............... ~ (Name) 2. State existing use and occupaficy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy, I ' ~ ; ...... ' I b. Intended use and occupancy ........................................ ......................... [.