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HomeMy WebLinkAbout14054-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17197 Date AUGUST 15, 1988 THIS CERTIFIES that the buildin~ Location of Property 1770 STARS ROAD House No. County Tax Map No. 1000 Section 022 Subdivision SOUND CREST WOODS ACCESSORY EAST MARION Street Hamlet Block 04 Lot 17 Filed Map No. 5315 Lot No. 12 conforms substantially to the Application for Building Permit heretofore filed in this office dated June 13, 1985 pursuant to which Building Permit No. ' 14054Z dated Jume 18, 1985 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 ACCESSORY SATELLITE DISH IN REAR YARD. The certificate is issued to WILLIAM & AMELIA HUKILL (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building Inspector~ Rev. 1/81 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) N~ 14054 Z Permission is hereby gr<~nted to: · ..I.~.3.~......~.........~¢.. ................................ ~.~....~.~.....~,..~: .................. ,o..~~ ....... ~..~~.?.~.~.~....~....~.....~...~ ~at premises located at ......L"/..~.~....~..~....~ ........... .~....~:/,~.....~"~.....~...~ ................. County Tax Mop No. 1000 Section ..... ..~.....~::..,.~..... Block ...... ..~....~. ....... Lot No ....... .~...-~. ........... pursuant to. application dated ...... .~,..~ ...................... , 19....~.., and Building Inspector, Fee $..R~.. .................. approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S~9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industtial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pm-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic featu/res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupamcy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancv $ 5.00, over 5 years $]0.00 5.Updated C.O. $ 50.00 Date .... ............ NewConstruction ...... Old or Pre-existing Buildlng ............ Vacant Land ............. o ation of Proper .. .......... ....... . ..................... House No. Street I~amlet Owner or Owners of Property ..................... County Tax Map No. 1000 Section ... ~ ......... Block ............... Lot .... ~'. ........ Subdivision..~'4;:~¢-¢..~.X~/..~..~.~'~../~../~?~?'4~..~*. ...... Filed Map No. ~'.~../~ .--..Lot No.../. ~ ...... // Permit No. I,L~¢:~?-,. Date of Permit ~/Z~,~.'~pplicant , ,~,/,~//,-~,, ,'~, .... .'"~..~.>L/~.. ..... Health Dept, Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... Rev. 10-10-78 F~ELD ~NSPECTION FOUNDATION {1st) COM~ENTS FOUNDATION 2. (2nd) ~ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION I* ]FOUNDATION 1ST []ROUGH PLBG. []FOUNDATION 2ND []INSULATION []FRAMING ~]FINAL REMARKS 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 xamined Approved...~.M"I~ .I..~. , 19~c. Permit No..J.q..~..~.q...~. Disapproved a/c ..................................... Received ........... ~19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ff~,a/~ -/~'- ~$~ 19 INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 necesi~?.i~t.5~/.n~...~,/.~ ............... (Signature of applicant, or name, if a corporation) . . :. '.?. .;. ?. ?. . . . . . . . . :. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................... (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 .......................... Plumber's License No ......................... Electrician's License No.. ~..~:.~..~. ......... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. / '7 7~ e.q'7)~5 House Number Street Hamlet County Tax Map No. 1000 Section ..... ~ .~ ...... Block .... .~.~ .......... Lot .... 1 ~ ............ S~bd~vJsio~ ..................................... ~iled ~ap No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................... : .' .............................. b. Intended use and occupancy .'~ 32J~t~ ~'~ ~'~ ......................... ~Y~ ~,:t'~ '~ ':b~',~g~ ~'~ ..................... 3. Nature of work (check which ~ ~plicable): New Building ..... ' .....'Addition .......... Alteration,. ,, ........... Repai? ., ............. Removal .............. Demolition .............. Other,Work f3~ ~... ....... 4.. ' i edCot ..... -;-.0~ ......................... Fee ............... i '~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ...... : ......... If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurbs, if any: Front ............... Rear .............. Depth ............... · ' Number of Stories Height ....................................................................... 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 Storie~ 9. Size of lot: Front .......... [ ............ Rear ...................... Depth ...................... 10. Date of Purchase .......... l ................... Name of Former Owner ............................. 11. Zone or use district in which premmes are s~tuated ..................................................... 12. Does proposed construction violate any zoning law, ordinance Or regulation ................................ 13. Will lot be regraded ........ l .................... Will excess fill be removed from premises: Y~es No 14. Name of Owner of premises ~. ;.~.~.v~... ~..~..L. ~.~.... Address Pti. ......Phone No. ' Address~.. Phone No Name of Architect ......... i .................................................... Name of Contractor ........ ~ .................. Address ................... Phone No ................ 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. . , b/sm VQ APP~,O?~D AS NOTED NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CON'STRUCTION MUST BE C©MPI.VTE ~OR C. O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR J --'"---'--~ -- D~'$1GN OR CONSTRUCTION ERRORS. STATE OF NEW ¥O~K, ~u ] ,, ~, ' , .... ~(~: AA~ ......................... being duly sworn, deposes ~d says that he is the applicant (Name of individual sighing contract) He is the ........ ' ....................................................... [ (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is d~ly authohzed to perform or have perfumed the said work and to m~e ~d file ~is application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfumed in the m~ner set forth ~ the application filed therewith. Swum to before me this Nota~ P~blic ............ ~..~~~ County ~ ~-~ ~ d ~w Y~ z L~gnature OI appnc~o