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Home My WebLink About25493-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26253 Date: 02/01/99 THIS CERTIFIES that the building ADDITION Location of Property: 735 GIN LA SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 88 Block 4 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 4, 1998 pursuant to which Building Permit No. 25493-Z dated JANUARY 25, 1999 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 EXISTING ONE FAMILY DWELLING AS APPLIED FOR AS BUILT The certificate is issued to ROBERT A & CAROL A. CLEMENTS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector 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. 25493 Z Date JANUARY 25 99 Permission is hereby granted to: ROBERT A CLEMENTS 735 GIN LANE SOUTHOLD,NY 11971 for CONSTRUCTION OF A 16 ' X 20 ' DECK ADDITION AS APPLIED FOR. at premises located at 735 GIN LA SOUTHOLD County Tax Map No. 473889 Section 088 Block 0004 Lot No. 007 pursuant to application dated DECEMBER 4 98 and approved by the Building Inspector. Fee $ 75 .00 Authorizbd Signatuffe ORIGINAL Rev. 2/19/98 TOWN ON' 5Uu1ttuL.L P n BUILDING DEPARTMENT TOWN HALL 765-1802 JAN 261999 APPLICATION FOR CERTIFICATE OF OCCUPANCY Th ,, £Elon must be filled in by typewriter OR ink and submitted to the building spe 0 o lowing: 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, dditions to oodwelling $25ng $25.00, Alterations to dwelling $25.00, Swimming pool Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - , 451t. 4. Updated Certificate of Occupancy - _$50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...J9J.. ? `.: . 1439. . . . .. . . . . . . . . . . . . . . ar Construction. .. .... .... Old Or Pre-existing Building... .. . .. . .. �S Gfou, ?. . .. . .. . .. . .. .. . . . .. . .. . . . . . tcatiou of Property...7 ......••. ••••"ol:.J � gE House No. Street Hamlet �ca3EFT ,¢. d Cgk�c / .. C' GEvvtE.vS . . . . . . .. . . .. . . .. . .. . . . . . . . ,firer or Owners of Property...... ...... ............ ,,ll runty Tax Map No 1000, Section. . . .V'2 . .. ....Block. . .7. •• - •• • •• •Lot. .?Z. . . . . .. . . . . . . . . . . tbdivision. Ay�1,9✓E� /fT �au: . . . . .. .. .Filed Map. a9� . . . .p. .Lot. .. . . . . . . . . . . . . . . . . . . . �zf,5!9, Date Of Permit. �:</e/?X. • • • •Applicant.�O !•�1+ " • • " " " trait No. . . .. . . . talth Dept. Approval. . . .. . . . .. . . . . . . . .. .. . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . .awning Board Approval. . . . . .. . . .. . . . . . . . . . . . . . :Quest for: Temporary Certificate. .. . . .. . . . . Final Certicate. . . . . . . to Submitted: $. . . .°? . . . . .. .. . . . . . . .. .. . . :( .( `' � . . . . . . . . . . . . . . . . . . . APPLICANT r >J Lor 1q 5 5Z�05' cc.,c, Mo cwc. ZQ DECK • ass Lb I 'STce.Y �U441E ' :4- LPQ( `r-L_ o , o N r V J ggD LAN ZPIPtr V AD5 GP LE sG90 N.52' 05' vo° I Z5.00 p? saes o � buevEr Fop. iZon,F vq. A� , (.A"pL A, �LEN1>;t h ANYN4NY tV� L SlAND4W�KI J.o • MAP 4FBAY laAVEN t. , AJUs=Y YO roc i N• �ava��N�Y 11971 o � , 6UAQA1.1 68 O. T O 4 i N6 A6 TOY912MM WYA PPEA 120�QrA dCnaa .A .r n4 Nrs ` SLG Pr�TRAGT �2v, DA7E,j Weed 1911997 ,ICALEo I'x Lo-r 1q 5 5z�05!5d'E ZS.Oo' ' di Lb couc� Gww �EGK ' 3ss -I=ZAU& 0 FL }iov 4 L14) � r� - }- 10 ui P ^ r y) S oBgD LA7y3 xPfPE Rv6 ;. LE 09` N.52' 05' 60' i z5,00 1 a 9? �t369 Of PN GW 4uevev a oo, '�fiE�t�►L�,S.�4� A, CLEM5N �6 ANV60 W. LrWANn4:)w6Ki LOT' 16 MAP 4F BAY L1AV64 SAND JUQYrVO roc 1 o �okn ,N�y! !1471 GUA2A>1 66b O. M6WALagjT O 4 1 N6 A DATF, MAaeI4141,1997 CCALE� 1'•a M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLAC S CHIMNEY G 77 REMARKS: `-J DATE o I? INSPECT FIELD=INSPXCTION REPORT a__=DATE _=s__xs_xxx__=sx===x=xsx=x=xxxxxCOM!!La-rNTS=x======xs=xxsxx== FOUNDATION OST) _N N --f�I► ill II N FOUNDATION (2ND) Irr- �N _ "p b aasaxeaxxxaxxxx=ax=xoxxa=�===xxxsa�xx=xe,=x=sa ___-----_--_--xc=xsxxx=========x==ex=xxaaax II jj � ROUGH FRAME & I� N PLUMBING jj N II IN if aa:aau=ax---aaxaxaaasaxal�axxax=x�_��s=xx=xx�ex�xxa-�axxxaaaaaaaaaaamaaaaasaaaaaaa � INSULATION PER N. Y. y STATE ENERGY u CODE I q if �N xaaxx�� 'Sxaaaaxxxxaxaaax �-s�aa �xas��asaaa�_a saasxxxax x¢asaasaxaaa u N H N N i{ I� q FINAL 11 N saaasssaa��-��sasx--a=--iFsa_sa��-amaeaaaaaxaxaaaaaa�+�-azaa-��ffis=aa�axxasaa:saaasa=aaa ADDITIONAL COMM MS: a:aamaxaaasaasaaaxxaxxaaxxsxaxxa:xaaaaaaamsasxxaa aaasaaasxmaxxxxaaaaxmaaaaaxaa=aaxaaaa x � Z4 r� BOARDOF HEALTH ............... FORM NO. 1 3 SETS OF PLANS ... .. .. . .'..... . TOWNOF SOUTHOLD SURVEY ......... ............... BUILDING DEPARTMENT. CHECK ......................... TOWN HALL SEPTIC FORM ....... . . ... . . ..... . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL 7G�.3a(5; , , ,.. Examined.. MAIL TO:. ..... .. .. ... .. . . . . ' �� 19. �? G.:✓. APprov :... , 19 c� Permit No. C �� 73 ......... ✓>t... �� 'usHocD.a. y'..!�9z/.. Dia/c .................................. 6 UL5 VBnilaing tor) 0 p D APPLICATION FOR BUILDING PERMIT DEC - A 1998 BLDG.DEPT. INSTRIICTIONS N OF SOUTHOLD a. This application most be completely filled in by typewriter or in ink and submitted to'the Building luspector wi 3 sets of plans, accurate plot plan to scale. Fee according to sd*dule•relatiaoshi ro cin remises or Public b. Plot plan showing location of lot and of buildings cc premises, p• adJ iag P Pub streets or areas, and giving a detailed description of layout of property crust be drawn on the diagram which is part of this application. c. The work covered by this application may rot be canmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a of Permit to the applicant. Such permit shall be.kept on the premises available for inspection threµgiwut the work. cate of e. No building shall be occupied or used in%hole or in part for any purpose whatever until a Certifi cc occupsocy shall have been granted by the Building Inspector. AppLICATiCN 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, bowing code, and regulations, and to admit authorized inspectors an premises and in building for necessary inspections. r (Signore of applicant, or name, if a corporation) I ............... ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer,'general contractor, electrician, plumber or builder . ..................... �w'✓ ........................................................ ....................... A!r°6FCT . e 4<0 A . L Evn E vTs................... Name of owner of premises ... ................... ...............T.... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ...................................................... (Nae and title of oorporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. Location of land on which proposed work will be done...�j� ................... ........... G.. .. m.a w 4� .... . /9.. / .............................. 7 r? L y . NO.4/?........: .:. Haslet 3 5.............. . .........street..... . House Number County Tac Map No. 1000 Section ....Fg........ Block ....0 Y ....... lot ...0Z........ Subdivision ... �A vE✓ ........ Filed Hap.No. Lot ..! ......... ............... (Name) of construction. 2. State existing use and occupancy ot.premsses,agd''intended use and occupancy proposed a. L+Scisting use and occupancy �ES�. ::.:.......................................................... b. Intended use and occupancy'•.................:....::.::.................................................. le : New Euildi .......... Addition ....... .. Alteration ... I. Nature of work (check ulddr appli 'Cab ) n8 ,�o�K.i co, Repair ............ Removal ............. Demolition ............ Other Work �$�J�:....... ....0000 (Description) i. Estimated Cost .. 3000................ ...... fee .............................................. (to be paid on filing this application) units ............ Number of dwelling units on each floor ................ 5. If dcxllirg,.rrumber of dwelling IfWage, amber of eAra .......T.............................. specify nature and extent of each type of use...................... 6. If business, commercial or mixed Qcc TmXy, 7. Dimensions of existing strvaturesi1 if any: Front................ Fear ............,... Depth ................. Deight ......................... 'sober of Stories ...................... Dimensions of same structure with, alterations or additions: Front ............. Rea Depth ......0000.......... height .................... Number of Stories ............ y o1 y , Height ............. truction: Front .....7?Q....... Rear ............... to ...M........ n .. +� / Nmber of Stories ..................... !F 8. Divans ora o entire rens coos gin _ 9. Size of lot: Front a S .�,...•••• Rear .....�P?.S. ........ Depth ......!.'?,S. S...ER.JE� ..Aw 7Y 10. Date of Aschase ..:�J 9 7 ..... Name of Forcer Owner ...........................................,- ...- . • �.� 11. Zone ouse sdistrict in which . premises are situated ..........0.................. .o 12. Donaproposed ............................. propconstruction violate any zoning tact, ordinance or regulation: ...................0000. 13. Will lot be regraded ...........?........ Will excess fill be removed from premises: YES NO 14. Names of Owner of premises ... 0:..0........0....0.... Address .............................. Phone No. ............. Name of Architect ..................... Address ...........0.................. Phone No. ............. Name of Contractor .............;....................... Address ...............................Phone No. ............. 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ...!�.... *IF YES, SWMD TOWN11iD5 r1F83 MR=MAY EE RO(gm. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether eudatirg or proposed, and indicate all set-beck dimensions from property lines. Give street ad block number or description according to deed, and show street owes and indicate whether interior or corner lot. SEE A-rFA-cr4-Cb -.-j A4 N9s STAIR Cr NOW ss� ODUNry OF . . .. . ..... 0 000. ........ ...................being duly sworn, deposes and says that be is the applicant (Nome of individual signing contract)' on above named, lie is the .... ..........1i............. ..... . ............................................... (Contractor, agent,'corporate officer, etc.) of said owner or owners, and is dulyj authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and b6lief; and that the work will be perEonmed in time manner set forth in the 57 N filed therewith. Sworn to before me this Notary PuNo,State of New Yerk; � /� - No, Suffo5 Suffolk L/—.. ,,hq,9�,,• puali6ed Im SuNoM County day of Comm tsaio Aires MaY 26,19y Notary Public .%� �� ' . l................................... . (Signature o£ Applicant) a i OCCUPA'.NCY OR USIE NIS UNLAVI4UL EQ17-35- HOUT lCURTIFICAT E 0 52 OF ,CXJU uta;0'Y b ) oc 1n5k 1 7° FoNce Q )01 1 0 2x2. 12 � 9er S��e e� Ce�ch ! In } �x1d `L a p + CIL .- - -ti /-o0f � n EV �l — -- - P4 - _ 6 LQ-) o - — -------- ------- -- 2 X /o F/OGc JCS 5�5 Cvef16 apa+ }) e C )moi ANK�A3 NGEEa 3 �x, "on" su1Lowe AT a7MitoW02wlw9e iwtTO MOPM Fon THE f FOi„N)X" M - TM REOUIRED FORPOUR OCONCRM I iIONBM - PR%MM & PLUMBING S. NS(Lmm 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. C 5 < c� CAATE CONSTRUCTION SHALL MEET CONSTRUCTION &REQUIREMENTS OF TENSGY DES. NOT RESPONSIBLE FOR d SIGN OR CONSTRUCTION ERRORS as �5 _ y;�� a� � baf �� rti � Is -- - - 14 -- - = u - Tap