The URL can be used to link to this page

Home My WebLink About25654-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27458 Date: 12/12/00 T~IS CERTIFIES that the building ALTERATIONS Location of Property: 370 TERRY LA SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 65 Block 1 Lot 6 subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 4, 1999 pursuant to which Building Permit No. 25654-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 INTERIOR ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ~e certificate is issued to WILLIAM & PATRICIA MOORE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF I{EALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/a N/A /~ho r i/~ d Signature Rev. 1/81 FORM NO. 3 TOWN OF $OUTHOLD 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. 25654 Z Date MARCH 26 99 Permission is hereby granted to: WILLIAM & PATRICIA MOORE PO BOX 23 MATTITUCK~NY 11952 for : CONSTRUCTION OF INTERIOR ALTERATIONS TO A SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 370 TERRY LA SOUTHOLD County Tax Map No. 473889 Section 065 Block 0001 Lot No. 006 pursuant to application dated MARCH 4 99 and approved by the Building Inspector. Fee $ 75.00 ature ORIGINAL Rev. 2/19/98 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 toca%toTr-of'~ll ~bn-iidi~gB-~Operty 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 oS 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 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 qpre-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, 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 New Construction...~. ...... Old Or Pre-existing Building ................. Location of Pro err House No./ Street Hamlet Onwer or Owners of Property....-.,w....~f..~..- ........................................... County Tax Map No 1000, Section...~'~ ...B~ock...~ .Lot.....~. ......... Subdivision .................................... Filed Map ............ Lot ...................... Permit No..~.A~Y~...~...Date Of Permit.~.-J~n Health Dept Approval Underwriters Approval · Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate..~ ....... Fee Submitted: $ ........................ ~g~'5 ~ ~ / APPLICANT co 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~.A-TI~N ~I ] FRAMING I~]'~FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ ~D INSPECTION I~PORT DATE gNDATION (IST) DNDATION (2ND) -FORH NO. I TONH OF SOUTDOLD BUILDING DBPARTHENT TONN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 P, LgG. DE~q. INSTRUCTIONS 3 SETS OF PLANS ............... SURVEY ........................ CtlECK ......................... SEPTIC FORI4 ................. . . NOTIFY: CALL HAIL TO: .................... Date ................ ,19 .... a. This application mint be eempletely filled in by type~itar or in ink and set.fried to the Building Inspector vfi 3 seta of plarm, aecurate plot plan to scale. Fee according to schedule. b. Plot plan ~wing lecatie~ of lot and of i~ilding~ an premises, relationship to adjoining premises or pablic streets or areas, and giving s detailed descriptioa of layout of property mist be draan an the diagram which is pert of this application. c. The ~ork covered by this application my not be cameeced before issuance of Building Pemlt. d. Upca approval of this applicatino, the Building Inspector ~ill issue a Building Pezmit to the applimt. Such permit slmll be kept an tim premises available ~or itmpectian thronghcot the work. ~ e. NO building shall be occupied or used in ~nole or in par~ for any ixn-pose dmtever tmtil a Certificate of Occupancy stroll have been granted by tim Building Inspector. ., APPLICATI(]U IS he~o~u~ ~ to the Building Depertn~nt for the issuance of a Building Pemit pursuant to the l~ilding Zone Or~inance of tim Tom1 of ~outbold, Suffolk ConoLT, ge~ Yozk, and ocher applicable Lines, Ordinasces or lC-~ulatiean, for the coastn~:tino of buildln&s, additio~ or altaratlons, or for removal or demolition, as herein described. The applicant agrees to canply wlth all applicable la~s, ordinances, lmilding code, housing cede, and rngulations, and to ~it antt~orized inspectors no premises and in building for necessary ig~pectians. .......................... (Signature of appllenot, or n~e. ~f a corporation) ......... ~ ~ z~. . . ~. ~ / K . .~.o. .¥,. ~ ~. .~. . n /~. (Marling address of applicant) State whether applicant is muer, lessee, agent, architect, engineer, general centractor, electrician, plumber or beilde~ Na~e Of owner of premises '~0~,'C£0~ (as on the ~a~ roll or latest deed) If applic~t is a corporatio?~ signature of duly authorized officer. (l/m~ and title of corporate officer) Builders License No .................... .. . . . . Ph~bers Liceese No .......................... Electricians License No ...................... Other Trade's Liceese Ho ..................... I. l~catiee of lsed on ~hich propesed ~ork will be doee ........... ~ .................................................. .... .......... .... .... ...... ........... No. ...... ....... l ........ ........... S~bdivimie~ ...................................... Filed ~ No ................ I~)t ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ~sting -- ~ oc~ ..... £.~.S.~...~. ~:~ ...... f.( ................................................ b. Intr~4,~l use and oecupeecy .... /. V~. .z?.~/~,~. . ....... ~ ........................ ~. /. ................. 3. Nature of ~ork (check ddd~ appl!~cable): Ne~ Building .......... Mditioo .......... Alteration ....... Repair Removal : .. Demolitioo Other l~ork (to be paid m filing this applicatioa) 5. If rk~elling, number of d~elling iunits ............ limber of d~elling units oo each floor ................ If g~r~, ~r of ~rs ................... 6. If htmsiness, t'~rcial or mh~'d cccupsecy, speciO na~ur~ ~ extent of each ~ of use ...................... 7. Dmens~ms of existing 8tructures, ~r any: ~root~.. ............ ~ar ............... Depth ................. Beight. .... . .* Nmber of Stories ........ Dimensions of same structure .vfith alterations or additioos: Froot ............... l~ear ............... Depth .................... Be~aht .................... l~r of Stories ............... 8. Di~ensiuns of * ' Fret . l~ear Depth .............. entire ne~ co~stntctloo: .............................. t~isht ' Ii, be f st ' ~t ......................... , r 0 orle8 ............. . ....... 9. Size of lot: Front i .. Rear .............. Depth ........ . . I I. Zone or use district in ~hich pr~nises are si~ated .................................................. ~ ............ 12. B0ea proposed coastrectioo violate any z~ing 1~, ordinance or regulation: ........................ 13. Nill lot be regraded , Nill e~:ess fill be removed ~c~ premises:~. ~ NO 14. l/~ea of O~ner of p,~ises ........................... .~idreas .............................. Phone No ............... ~ of Architect. ...................... ... .. . .. ... . . Nldreas ............................ . . Phone No ............... ~ of Contractor ............. i ...................... /kldress ............................... Ph~e No ............... 15. Is this property ~ithin t00 f~e( of a tidal ~etland? * ~ .......... I~D .......... PLOT DIAORAH locate clearly and distinctly all buildings, ~tber existi~ or proposed, and indicate all set-back dimensions property lines. Give street and iblnck ~t~ber or deseriptioo according to deed, and sh~ st~t nines and i~ticate ~aether interior or corner lot. .................................. being duly ~m, ~s ~ ~, that ~ (~ of i~ivi~ si~ing ~tract) l I~ i~ the ...... ' (~trector, ~nt, ~rate officer, etc.) of ai(~t~ ~rs, ~ is ~ly ~t~ri~ to ~rfom or h~ ~rfo~ tim mid wd ~ to m~ ~ file this a~lica~ion; ~nt ~11 sealants c~t~i~ in ~is a~llcati~ are t~ ~o ~e ~sC of his ~1~ flint ~e ~ ~ill ~ ~rio~ in tbe~ ~r ~t forth in ~e a~li~ti~ fild ~. ,gram to before r~ this I ..... ./¥,~ ....... day of Notary Public LINDA J, COOPER{ Notary Publ c, State of New York. 22563, Suffolk COunty Term E~ires Dec, ember 31,, ~ -