The URL can be used to link to this page

Home My WebLink About14868-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20145 Date AUGUST ~5, 199~ ....... THIS CERTIFIES that the building. Location of Property 10 HICKORY ROAD House No. County Tax Map No. 1000 Section 54 Subdivision ADDITION Street Block 6 Filed Map No. SOUTHOLD,.N.Y. Hamlet Lot 14 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 6, 1986 pursuant to which Building Permit No. 14868-Z dated MAY 12, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to JEAN C. SWEENEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED __ N/A N-056951 - FEBRUARY 6, 1989 Rev, 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1~868 Z Permission is hereby granted to: ~.~..~..~.~.....~.,....~..* ............ ....~....,?..~..~ ................................................. ..~.~.~.....s..:~......!.:..t.~..~ ............. vt premises located at ..../..D.. ...... ~..~.~.....]-~.c~ ............ .,~~.(~ ............................... COUnt"/ Tax Mop No. 1000 Section ...... .(~.......L{, ...... Block ....... .~. ............at No ........................ pursuant to cipplicotion doted .... ~..~...~ ........................... , 19,.~..(,R, and approved by the Building Inspector. Fee $....~....:..~ .... 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: I. 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: I. 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 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date ...... .. ~..~/f./. ..................... . .. Location of Property.../~...~.~.~. ........................ ]~t..~. ~ ....... House No._ / Street Onwer or Owners of Property....~-~..~.~ ............ County Tax Map No 1000, Section .... ~,~.l~lock ..... ~... iiiii1231111>i :.iiiiiiiiiiii Subdivision .................................... Filed Map ............ Lot ...................... Permit No.../.~. ?. ~ f ..... Date Of Permit..~.//..~/.~.~...Applicant....~. 7..~...~.~..~.'..,..~, Health Dept. Approval .......................... Underwriters Approval ........................ . Planning Board Approval ........................ Request for: Temporary Certificate .......... Final Certicate ....... Fee Submitted: $ ............................. ~J ~~ ~~?~..~. CO ~0f~ APPLICANT ' THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY F],:)~,RII~E¥ 06, J ~aSJOHN~ STREET, NEW YORK, NEW YORK ~06792~6/~6 Daf~ ~pplication No. on file THIS CERTIFIES THAT o~y the electrical equipment ~ ~scribed be~w and intr~uced by t~ applicant ~med on the a~e application number in the premises of inthefollowingh,ca$io~ ,~ O~se~ ~ IstFL ~ 2nd Fl. 8ectlon Bilk Lot ~s examined on and found to be in compliance with the requirements of this Board. 2, ' :1 2, AMT. K.W. OIL H,P, GAS H.P, A~T NO. A,W.G OTHER APPARATUS: RANGES SPECIAL REC'PT. R [COOKING DECKS [ OVENS [DISH WASHERS E TIMECLOCKS BELL UNIT HEAT S I- TRANS SYSTEMS V I C E EXHAUST FANS ,AMT. , HP. DIMMERS NO. OF ~ S E NO. OF NEUTRALS METER w 4w NO'OF CC'COND' A'W-G NO, OF HI-LEG A-W G A W G E~UIP. 2w l~'3w 3,6'3 3~' PER~' OF CC, COND, OF HI.LEG Of= NEUTRAL 420 I~(tN,~ELL J t~~/ This ce~ificate must not be a{tered I COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY/,AANNER, F1E~LO INS£JECTION FOUNDATION (1st) COMMENTS FOUNDATION ROUGH FRAME PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gar,/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, Saperv/so¢ 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 91000-54-6-14 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, SOUTHOLDTOWNBUILDING DEPT. Gary J. Fish, Building Inspector GJF:gar 7GS.'1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~[ ] ROUGH PLBG. DATE INSPECTOR, 7~5-1802 BUILDING DEPT. INSPECTION [~ FOUNDATION 15T [ ] ROUGH pLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS: ~ ~ 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: DATE [ ] FINAL INSPECTOR Examined...~q~[..2. .... , 19 ~.G. Approved .....~. c~ .~.~..., 19~. Permit No. I .q.~..~.~..'~... Disapproved a/c ..................................... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 APPLICATION FOR BUILDING PERMIT Received ........... , 1 Date . .FFtX .6.t.h. ........... 19 .8.6. 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 authorized inspectors on premises and in building for necessary inspectio s., (Signature of applicant, or name, if a corporanon)~ .P...O....B.O.X..3.2.82..C.u.t.c.h.o..g~.e.,..N.e.w..Y.o.r.k. )).9.3.5 ....... (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. S~eeney '*i~as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...~6.1.8. .................... Plumber s License No ......................... Electrician's License No ....................... Other q[rade s L~cense No ...................... Location of land on which proposed work will be done .... Residenoe .of. .Jean .G...Sweeney .................. /~) Hickory Road Southold, New York House Number Street Hamlet County Tax Map No. 1000 Section .5.4. ............... Block . .6. ............... Lot ......... 1/4 ........ . . 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 Single dwelling house. b. Intended use and occupancy SAFIE [ !.9 ...................................... 3. Nature of work (check which applicable): New Building ..... ~ ..... Addition .:~ ..... Alteration .......... Repair .............. Removal .............. Demolition ........... i"' Other Work ............... . (Description) 4 Estimated Cost .$I,.0.09.9.0 ........................ Fee ..... ~ ................ ~ (to be ipaid on filing this application) 5. If dwelling, number of dwelling units . .o.n.e ........... Number of dwelling uni!s on each floor ............... If garage number of cars ' 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... . 7. Dimensions of existing strnctures, ifany: Front .47.' ...... Rear .47!...: ....... Depth .24 ........... Height ............... Number of Stories ... one ..................... ! ............................ Dimensions of same structure with alterations or additions: Front .47J ...... Rear ...? .............. Depth .ZS.' ................... Height ............ . .......... Number of Stories. 9.n.e .... ~ ~ ............ 8. Dimensions of entire new construction: Front . .~.../..~-? ...... Rear ...~.../.Z! ...... Depth ............... Height ........... Number of Stories one . 92 7:[34.5 9. Size oflot: Front 42'/50' corne.r, lot: ............ ....... " '' ........... ............................................. i Depth ...................... 10 Date of Purchase Name of Former Owner. 11. Zone or use district in which premises are situated ...... Residential ........ , ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: NO..: ............................ 13. Will lot be regraded JxlO ......................... Will excess fill be removdd from premises: Yes No 14. Name of Owner of premises J..ean .C.. $.w~ney ..... Address }tJ_..c.ko.ry..Rp.a.d' .S..TI~... Phone No. 7.6.57.3.3.3.2 .... '. '. ': Name of Architect ........................... Address ............... .... Phone No. Name of Contractor .H....P.a.r.k. ................. A~r--~225 lloseshoe Dr; CTC~ ?)~-~66i ....... . ,~uu ~ ................ .... rhone No ................ 15. Is this property located withinl,00 feet of a tidal wetland? *~Yes ..... No ..xfi~... * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ihdicate all set-back dimensions from property lines. Give street and block number or description according to deed, and sho ~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF...~Et~O ~.~q~ .... S.S .[~.~'o.~,. [4~,¥. ~b~.vN .~l,v~.. ............... being duly sworn, deposes and says that he is the applicant (Nam e of in dividual signing contract) above named. He is the ....~>.~..~..vY4.~.~,C:. .......................................... ~ ............................ (Contractor, agent, corpor~ate officer, etc.') of said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............ ........... dayof.. .... 19/' ' . , Notary Public, ...~.~..%'~)~ii.~.'A."Co~ty "' :; ~,' '[}}}:? (Signature!*f applicant) · . 470787~ Su~ ~ ~ Term ~. ~ ~, IL.~6/ i \1 '1~. O, .~0~ CU'fCHOGUE, N. ¥. 119~