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Home My WebLink About15199-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCupANCY No E-23155 Date AUGUST 9r 1994 THIS CERTIFIES that the buildin~ ADDITIONS Location of Property PRIVATE ROAD (OFF KAST END ROAD} House No. Street Hamlet County Tax Map No. 1000 Section 10 Block 6 Lot 14.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore FI-~KS ISLAND r NY filed in this office dated Building Permit No. 15199-Z AUGUST 12, 1986 pursuant to which dated SEPT~MBERS~ 1986 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 A ROOF DECK ADDITION WITH STAIRS TO A ONE FAMILY DWELLING. The certificate is issued to ALEXANDER GASTON of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED (owner) N/A N/A N/A / ~ilding ~sp~ctor Rev. 1/81 FOlm~ NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) 15199 Z Permission ~s hereby gronted to' ot pr~mi~e~ I~t~d ~t ..................................................... ~ .................................................... ~un~ Tax Map No 1000 Sect,on pursuant to opphcat~on dated Building Inspector ~. IQ... BI ................ Lot No.../....~.... it ~'~ ~-~ ..... , 19~., and approved by the Rev 6/30/B0 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY OWN OJ:: SOUTHOLD -- Thzs application must be filled in by typewrmter OR ink and submmtted to the bumldmng inspector with the followzng: for new buzldmng or new use: 1. Final survey of property with accurate location of all bumldings, property lines, streets, and unusual natural or topographmc features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrzcal znstallation from Board of Fire Underwriters. 4. Sworn statement from plumber certifymng that the solder used mn system contazns less than 2/10 of 1% lead. 5. Commercial bulldzng, industrial build,rig, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsxble for the bu~ldzng. 6. Submit Plannmng Board Approval of completed szte plan requirements. For existing buildings (przor to April 9, 1957) non-conformxng uses, or buzldings and "pre-exist~ng'~ land uses: i. Accurate survey of property showzng all property lznes, streets, building and unusual natural or topographmc features. 2. A properly completed applmcation and a consent to inspect signed b~ the applmcant. If a Certmficate of Occupancy zs denmed, the Buzldmng Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certmficate of Occupancy - New dwellmng $25.00, Addmtions to dwelling $25.00, Alterations to dwelling $25.00, Swmmmmng pool $25.00, Accessory buzldzng $25.00, Additmons to accessory bumlding $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-ex~stzng Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certifmcate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.O0~ Coramerc~al $15.OO Date ...... f/. ~. ~-./~ ~(.... .................. .. New Coastruction ........... Old Or Pre-exzsting Building ................. Location of Property ...... ~.~.e|{~[.. .... ...~.~v.~. . ..D~..............~..i.~.~%.~(~.~. ........ . House No. Street Hamlet Onwer or Owners of Property... ~.l~.~.~.~..~.~.?......~.~ %..~..w~. ............ County Tax Map No i000, Section ............ .. Block ................ Lot ...................... Subdiviszon Fmled Map Lot ..... Permit No./.'~.~.~ .... Date Of Permmt ................ Applmcant.. ~.. ~.~. ~ ~.~....~. ~.~.~.. Health Dept Approval Underwrzters Approval .......... Planning Board Approval ................... .. .. . Request for: Temporary Certificate ........... Final Certicate ........... Fe b tted $ ~ ....... .... FIELD INSPECTION ~DATE ~ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION ~ER N. Y. STATE ENERGY ~. FINAL ADDITIONAL COMMENTS: FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined .~/~ , 19 ~'~ Approved~,.~. ..... 19~,~Permit No / D~sapproved a/c ......................... Received ........... ,19. (Building Inspector) APPLICATION FOR BUILDING PERMIT IN STRUCTIO NS a. This appbcatxon must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wit sets o/f~lans, accurate plot plan to scale. Fee according to schedule· .aS Plot plan showing location of lot and of bufldmgs on premises, relationship to adjoining premises or pubhc strc or areas, and giving a detailed descnphon of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by this apphcatlon may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Braiding Permit to the applicant. Such pet shall be kept on the prenuses available for mspecbon throughout the work· e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupat shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance- Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatmns, and admit authorized inspectors on premises and m bmldmg for necessary inspections, t · · ( - -natu re of applicant, or name, ~f a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build '~ox,~e '~xt~,p-r~q~ .v~. e:,~. ~...x6~..~ APPROVED AS nOteD ......... . ' ' ' 7 ' N~eofownerofpremmes ~V~i~~ ~~ . F~E'~BY. ~ , (as on the tax roll ~T~d~NG 'D~P~~ If appbcant ~s-a'~tmn, mgnature of duly autho~zed officer. 765-1802 9 AM TO 4 PM ~Oa TH~ (Name and title of corporate officer) Builder's License No ~.~. ~ Phimber's License No. ...MJ~ ......... Electrician's Lice.rise No. qP9. ....... Other Trade's License No /4/tA .... Location of land on wtuch proposed work will be done.. House Number Street County Tax Map No. 1000 Section . C~/.O... . Subdivl~on ......... FOLLOWING INSPECTIONS ]. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 12ROUGH. FRAMING & PLUMBING 3.INSULATION 4FINAL CON'STRUr'TION ~/tJST BE C~MPLP-rE FOR C 0 ALL CONC;TRi/CTtON THE REOt.qr~rNT$ $~ALL STATE CONC.Tqt iC.Ti.gN COr~Eq hr".'r R~Spc~ re,,-,. · . o staN ? CO. S'rRU¢60 ,, Block . Hamlet ..... Lot. .Iq, ! .... 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 . ~,J x,~,Vv,, e X" ~ .x~x.~_, .--..~..e-~.~..,},L~. c,_\.~ .~.~-O.c~. ,I b Intended use and occupancy ...... ~'~.~V~ . [e~-~.~b.. ~ .~.~qr'~ ~..C.. 3 Nature of work (check which applicable)' New Building Addition .r~ ~ ~.. Alte~Tau~d--,, . . Repazr .......... Removal ........... Demolition ..~ ......... Other Work .......... /~. ~r __ (Description) 4. Estimated Cost ...... ~ ~.O.O.. . ....................... Fee ............................... * (to be paid on filing this apphcation) 5 If dwelling, number of dwelhng units ............... Number of dwelling units on each floor If garage, num bet of car~ ................... 6 If business, commercial or mtxed occupancy, specify nature and extent of each type of use ............... 7. Dtmensmns of existing structures. ~f any. Front...'~ .... Rear . ~2~ ....... Depth .... (.~ t. ..... Hetght .. (.O. c . Number of Stories D~mensmns of same structure with alterations or addmons Front . .-- ......... Rear...---. ........ Depth ................. -..,. Height ........ .-- ........... Number of Stones ..... '-. .... ~ ....... 8 Dimensions of entire new construction: Front . '~.~ .... Rear .. ~'.~. ..... Depth ...~. ....... ttelght ~- . Number of Stones '-' 9 Size of lot Front ................... Rear .................. Depth ................... 0 Date of Purchase ........................ Name of Former Owner ........... I Zone or use d~strict in whmh premises are s~tuated .............. , ....................... 2 Does proposed construction violate, any zonm~ law, ordinance or regulation ./5~.~, ..................... 3 Will lot be regraded .~,~e.~.':'..M .~N.~'~r, .... Will excess fill be removed from premises. Yes 4 Name of Owner of premises ~[~'~'~.q[~C .~.%,~..~ Address ............ Phone No ............ Name of Archttect ........... ~ ........... Address ............... Phone No ............. Name of Contractor ."q~o%'~ ¥"~'. ?;::~, .O~.~-. ~ .~x.. Address '~ <i: .x~, .~,'~. ,%~.~,,, Phone PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and. indicate all set-back dunenslons -operty hnes. G~ve street and block number or description according to deed, and show street names and mdtcate whett tenor or corner lot. ATE OF NEW ¥OR_..K.,_ OUNTY OF . '!?~-.37q.L..~... S.S '3%¼ ........ (Name of individual signing contract) bore named · being duly sworn, deposes and says that he is the app (Contractor, agent, corporate officer, otc,) f said owner or owner~, and is duly authorized to perform or have performed the said work and to make and fi )pbcation, that all statements contained in th:s application are true to the best oflus knowledge and belief, and tl ork will be performed m the manner set forth m the application filed therewith vorn to before me this ................ day of ............... ....... .~..q(~vo.t .~,. County Pubhc MAI~Y El. ' .... ' ........... ~a~,~r ~uc. ~r~ 0~ ~ ~ (Signature of ap