HomeMy WebLinkAbout25652-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26698
Date: 09/21/99
T~IS CERTIFIES that the building ADDITION
Location of Property: 7930 SOUNDVIEW AVE
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 59 Block 9
SOUTNOLD
( HAMLET )
Lot 13.1
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 16, 1999 pursuant to which
Building Permit No. 25652-Z dated MARCH 26, 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to WILLIAM JAROSZ & WF.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
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. 25652 Z Date MARCH 26, 1999
Permission is hereby granted to:
WILLIAM JAROSZ & WF.
7930 SOUNDVIEW AVE
SOUTHOLD~NY 11971
for :
CONSTRUCTION OF A DECK ADDITION FOR AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 7930
County Tax Map No. 473889 Section 059
pursuant to application dated MARCH
Building Inspector.
SOUNDVIEW AVE SOUTHOLD
Block 0009 Lot No. 013.001
16 1999 and approved by the
Fee $ 75.00
re
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-t802
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 i% lead.
5. Commercial building, industrial building, multiple residences and
and installations, a certificate of Code Compliance from ar,
responsible for the building.
6. Submit Planning Board ApprOval of completed site plan requi:
For ex~sting buildings (prior to April 9, 1957) non-conforming
'7pre-existing" land uses:
1. Accurate survey of property showing all property lines, stre
SEP .91 IB
unusual natural or topographic features.
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 Buildin~ - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ~ .......
New Construction ........... Old Or Pre-exis~ing Building.....~].~>.[~
.... ro ert-. ~. -~'' ' ..................
Location ox ~ p y .. · ·
House No. Street Hamlet
f
ty ~.z~/~ ~ --~.-.~.~.~'~'~'~' ..... ' ..................
Onwer or Owners of Proper ...................
i f ...............
County Tax Map No 1000, Section ............. Block .......... Lot.. K.~..~. .......
Subdivision .................................... Filed Map ............ Lot ......................
Permit No. ....Date Of Permit ...... can .... ' .......
Approval ~----~ Underwriters Approval .........................
Health Dept. ..-.... ................. ..
Planning Board Approval '..'iq ....
Request for: Temporary Certificate ........... Final C~erticate .....
Fee Submitted: $ ...... ' '::~
765-1802
BUILDING DEPT.
SPECTION
[ IUNDATION 1ST [ ] ROUGH PLBG.
[ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACK/&~IMNEY _ ~
DATE
~/ INSPECTO~~
/
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUG~PLBG.
[ ] FOUNDATION2ND [ ].~I~ULATION
[ ] FRAMING ~'~FINAL
[ ] FIREPLACE.~HIMNEY /~ /~
INSP
765-1802
BUILDING DEPT.
] FOUl 1ST
] INDATION 2ND
[ ] ROUGH PLBG.
[ ] INSULATION
[ ] FINAL
[ ] FIREPLACE & CHIMNEY
REM~
DATE NSP£CTOR
0NDA~ION (Is~)
UNDATION (2ND)
I)ATE
IsULATION PER N.
STATE ENERGY
· POP&f NO. I
TONN OF SOUTHOLD
BUILDING DEPART~dF. NT
TONN BALL
SOUTHOLD, N.Y. 11971
~L: 765-1802
Disapproved a/c ............
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CtlECK .........................
SEPTIC FORH ...................
NOTIFY:
CALL
NAIL TO: ..
a. l~his application mst be caupletely filled in by type~iter or in ii aed su~itted to ~ ~ildi~ Ins~tor
3 ~ts of pl~, ~a~ plot pl~ ~ ~le. F~ ~i~ to ~le.
b. Plot pla ~ l~tim of lot ~ of ~ildi~ m ~s, mlatio~ip m Mjoini~ p~ms or ~llc
struts or ~e~, ~ givi~ a ~tail~ ~ripti~ of l~t of ~ ~t ~ ~ ~ ~e diem ~i~ is ~rt of
als ~liati~.
c. ~ ~ ~ ~ ~is a~ltcati~ ~ ~t ~ ~ ~fore isle of ~ildi~ Pe~t.
d. ~ ~al of ~is ~li~ti~, ~ ~ildi~ I~ctor t~ll is~ a ~ilding Pe~t to the ~li~t.
~ ~11 ~.~ ~ ~ ~s ~il~le ~r i~ti~ ~$t a ~rk.
'e. ~ ~ildi~ ~11 ~ ~i~ ~ ~ in ~le ~ in ~rt for ~ ~ ~at~r mtil a ~rtificate of
,aI~ IS ~ ~ ~o t~ ~ildi~ ~nt for ~ isae of a ~ilding Pe~t ~t
~ldi~ ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~er ~li~le ~, ~i~es or
~a~i~, f~ ~ mt=tim of ~ildi~, ~i~ia or alterati~ r~al or ~, ~ ~rein
&turin. ~ a~li~t ~s to ~ly da all ~i~le l~~s, ~ildiq~ ~ing
(Si~e o~ ~lle~t, ~ ~, if a m~ratlm)
....... ~~ z~_ ~ ~. ~af? Z/...
~ili~ ass of ~licmt)
State ~r ~lJeat i~les~, ~t, a~it~t~ e~J~t, ~ral atr~tor, el~tricia, pl~r or ~i]der,
........................... >.~...; ............. r ~/._7Z. ...... 7.._~ ....................................
~ ~: ~:~ ... ~ .............. : ..................................
(~ ~ ~ t~mll or lat~st d~) .
If ~li~t is a ~rati~, si~ of ~ly mt~ri~ officer.
(~ ~ title of ~te offi~r)
Plata ~~ ~.
EI~Li~ ~ ~ ~ ..
~r ~s Li~ ~ ....
I. ~tim of 1~ m ~i~ ~ ~ ~11 ~ ~ .... ~ ........ ~ ..... .~ ......... ~..., .........................
.... . . . : ..... .... ..........................
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b. ~t~ ~ ~ ~ ..............................................................
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5. If ~lli~, ~r of ~lh~tm~ts ............ ~r of ~lling traits ~ ead~ ~r ................
If ~rage, ~r of cars ..... , ................................
6. If ~i~ss, ~rciat or ~ ~, ~ci~ ~ture ~ at~t of ead~ ~ of ~ ......................
7. D~ns~s of ~lst~ st~m~s, if ~: ~t ................ ~ar ..... ~pth .....
Ibi~t ............... [ ~r of 8torles
Di~i~ of ~ st~m~ ~(h alterati~ or ~itions: ~ont ............... ~ar ...............
~pth .................... ~i~t .................... ~r of Stories ...............
~. Di~ns[~ of entiro ~ ~t~t~m: ~t .......... ~ar ........... ~p~
}~ .~. ~.: ............ ~ o~ s~o~i~ .....................
I0. ~te o[ ~dm~ ' ~ o~ Fomr ~r .......................
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~ o~ ~tr~tor ............. i ...................... ~ress ............................... ~ ~ ......... .....
,
~m~r intorlor or cmr lo~.
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........... '-* ............................... being duly s~m, deposes and ~s tha~ he is tim
(~ of i~ivi~l si~i~ c~tract)
,~ i~ ~,,~ .................. ...... ~.~:~. ..............................................................
(~tractor. ~ut, con.rate officer, etc.)
of ~id ~r or ~rs, a~ is ~ly ~bori~ to ~rfom or h~ ~rfo~ ~m ~id ~ m~ to m~ ~ file this
a~l. icati~G ~.t all star--nra c~ta[~ in ~s a~licati~ are t~ to ~e ~st of h{s ~1~ a~ ~[ie[~
that the ~ will ~ ~r[on~l in the ~m~r ~t forth in ~e a~licati~ fil~
~m to ~fo~ ~ ~is
....... ~.~. ....... a~ o~...~,~.~Ai .... ,~..~.. '
N,Y,
~ ~ 3D View of Your Deck
7,930. $cu~v,Lew AvG.
~cuzl[eL~, ~y 11971
3D View of Your Deck
3D View of Your Deck
7950 Saun~vl~o Ave.
$~u~J~,~, NY 11971