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Home My WebLink About27215-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27810 Date: 07/16/01 THIS CERTIFIES that the building ADDITION Location of Property: 915 PRIVATE RD #31 (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 77 Block 3 Lot 16 SOUTHOLD Subdivision Filed Map No. __ Lot NO. -- conforms substantially to the Application for Building ,Permit heretofore filed in this office dated MARCH 13, 2001 purs~t to which Bul]ding Permit No. 27215-Z dated APRIL 5, 2001 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 AN EXISTING ONE FAMILY DWELLING Ag APPLIED FOR. The certificate is issued to ALICE J HUSSIE of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF ~EALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO. 3 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) PERMIT NO. 27215 Z Date APRIL 5, 2001 Permission is hereby granted to: ALICE J HUSSIE PO BOX 1491 SOUTHOLD,NY 11971 for : CONSTRUCTION OF A DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 077 pursuant to application dated MARCH Building Inspector. 915 PRIVATE RD #31 Block 13, 2001 SOUTHOLD 0003 Lot No. 016 and approved by the Fee $ 75.00 ~ AuthoUed Signature Rev. 2/19/98 ORIGINAL Form N~. 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: 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. 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. B..~ For existing buildings (prior to ''.'pre-existing" land uses: April 9, 1957) non-conforming uses, or buildings and 1. 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 i. 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 Buildin~ - 9100.00 3. Copy of Certificate of Occupancy - ~ .25~D 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ................. f ty ~..~,5.~ C¢)£~ ~'. ['~ ~3~'~{~d~ ~ ~ Location o Proper ................................................................ House No. Street Hamlet Onwer or Owners of Property ................ .v~ .................................. .. .... . County Tax M~p No 1000, Section ..... .~.~.~ ..... Block ....... D ....... Lot ...... ~.~ .............. Subdivision .................. Filed Map ........... ~t ..... ,...~.~... ? ......... Permit No.~.~.~.J.>~.~.']]~e ~'~'~]].?/./~.~./~.l .... Applicant.]....~-~ ~- ~~. .q-~mL~.~-~ ........ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board AppKoval ............ ....... · -- a '''''Fin 1 .~/..... Request for: Temporary Certificate ........ Certicate ..... Fee Submitted: $(~,~ '~ ~.~ ~.i~ ...................... i ~ ~!~.~.~.~..~ ......... ............... APPLICANT Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-1823 Telephone(631) 765-1802 BUILDING DEPARTMENT TOWN OFSOUTHOLD July 11, 2001 Alice J Hussie PO Box 1491 Southold, NY 11971 RE: 915 Private Rd #31, Southold To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file- X× The check is (not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 27215-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ]FRAMING ,/~ [~]'~NAL [ ] FIREPLA//C~ & CHIMNEY REMARKS: k,.~- /'-) ....... DATE E~O 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONIST [ ] ROUGHpLBG. i]] ;Op~MNiDNAGTION 2ND [[ ~ATION DA'~ /- INSPECT~)R CODE BUILDING DEP~T~ TOWN ~L SOUTHOLD, ~ 11971 TEL; 76~1802 PERMIT NO.~ '~ I~UII~DI.NU FI~KNIII AI:'PLICA'I'ION CHECK_LiS' Do you have or need the following, before applyinl~ Board of Health 3 sets of Building Plans Survey. Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 ,, Approved 4[ Disapproved APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a, This application MUST be completely filled in 1>~ {ypewriter or in ink and submitted to the Building Inspector with. 3 sets of plans, accurate plot plan to scale. Fee according to sot/edule, b, Plot plan showing location of lot and ofbuilding~ o...n'premises, relationship to adjoining premises or public streets or areas, and waterways. 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 issue a Building Permit to the applicant. Such a permit s,hall be kept on the premises available for inspection througho.ut'the work. e. No building shall be occupied or used in whole or ir~ part for any purpose what-so-ever until a Certificate of Occupan !?_issued 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?o{mty, New York, and other applicable Laws, Ordinances or Regulations, for the c'onstmction of buildings, additions, orMtemtions or for removal or demolition as herein described. The applicant agrees to cokiply with all applicable laws, ordinandes, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for ne~cs.s '.ar~. inspections/ · ,, (Signature of applicant or name, ifa corporation) '" (Mailing address of applicant) Statewhether applican s~.s?Wner,:_..::_)er~essee, agent, architect,., engineer,, general contractor, electrician, plumber or builder Nameofownerofp~'emises /~ LI C-~'- J. t/ U ~,C 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) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Locatiog of land' on .w~hieh proposed work will bi done: House Number Street County Tax Map No. 1000 Section Subdivision "Block ,-~ ...... ~c ~.,., 'LOt.":)~',J ~ Filed Map No. Lot ., ~.,~,. ,.^~om~ u~c uno ouuup~mqy o~ premises and Intended use and occupancy of proposed construction; a, Existing use and occup~cy ,,, /h iiJ~'-/K { 63 Cs--,. ~. Nature of work (check which al~plicable): New Building .... Addition t/'"' Alteration Repair Removal. I Demolition O~her Work 1. Estimated Cost¢' 5-CDt0 I Fee ;. if dwelling, number of dwel ~ng units ~,.:' - If garage, number of cars ~'~ ,. If business, commercial or mixed o ' ! ccupancy, specify nature and extent of each type of use. r- . . - ' Dimensions of existing structur~s, ifan: ' , y Front ~8 Rear Depth ~ 7__ Height_ ~Number of Stories Dimensions of same structure with alterations or additions; Front Depth iHe~ght Number of Stories :. Dimensions of entire new construction: Front ,1 ;~,,. [ )(~R arO~ ~. e Depth Height ~ Number of Stories. . Size of lot: Front 0. Date of Purchase 1. Zone or use district in which premises (Description) (to be prod on filing this app ication) Number of dwelling units on each floor 2. Does proposed construction viol~ .Rear ~ O Depth ! fiFO Name of Former Owner are situated 3. Will lot be re-graded 4. Names of Owner of premises Name of Architect ' ' Name o f Contractor 5. Is this property within 100 feet of · [F YES, $OUTHOLD 6. Provide survey, to scale, with acc 7. If elevation at any point on proper TATE OF NEW YORK). SS: :OUNTY OF ) any zoning law, ordinance or regulation: ' ,,~ //~O Will excess fill be removed from premises: Address Phone No. Address Phone No... Address Phone No. a tidal wetland? *YES NO rOWN TRUSTEES PERMITS MAY BE REQUIRED rate foundation plan and distances to property hnes. y is at 10 feet or below, must provide topographical data on survey, being duly sworn, deposes and says that (s)he is the applicant above named, Signatur lApplicant 0'qame of individual signing contrac ' ¢)He is the ' (Contracior, A~ent, Corporate Office}, etc.) f said owner or owners, and is'duly auth, ~rized to perform or have performed the said work and to make and file this application; ~at all statements contained in this applk ation are true to the best ofh~s knowledge and belief; and that the work will be ~rformed in the manner set forth in the >lication filed therewith. Jl ~ ~ . ~ '~ ~ . 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