HomeMy WebLinkAbout25223-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26482
Date: 05/25/99
THIS CERTIFIES that the building ACCESSORY
Location of Property: 870 VILLAGE LA MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 114 Block 6 Lot 16
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 21, 1998 pursuant to which
Building Permit No. 25223-Z dated OCTOBER 14, 1998
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 ACCESSORY ABOVE GROUND SWIMMING POOL AS
APPLIED FOR.
The certificate is issued to DANIEL KLECK
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
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.
25223 Z
Date OCTOBER 14, 1998
Permission is
hereby granted to:
DANIEL KLECK
870 VILLAGE LA
MATTITUCK~NY 11952
for :
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING ACCESSORY ABOVE
GROUND SWIMMING POOL AS APPLIED FOR.
at premises located at 870
County Tax Map No. 473889 Section 114
pursuant to application dated AUGUST
Building Inspector.
VILLAGE LA MATTITUCK
Block 0006 Lot No. 016
21 1998 and approved by the
Fee $ 35.00
- ~yn~/Inspc~ctOr
ORIGINAL
Rev. 2/19/98
BLDG. D El:q'.
TOWN OF SOUTHOLD , ,,~J
APPLICATION FOR CERTIFICATE OF OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
This application must be filled in by typewriter OR ink and submitted to the buildinl
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.
Commercial building, industrial building, multiple residences and similar buildi~
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
Submit Planning Board Approval of completed site plan requirements../
For existing buildings (prior to April 9, 1957) non-conforming uses, or ~uildings an
'!pre-existing" land uses: ·
1. Accurate survey of property showing ali 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
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~ - $t00.00
3. Copy of Certificate of Occupancy - . .25~.
4. Updated Certificate of Occupancy - 450.00
5. Temporary Certificate of Occupancy - Residential $15.00,. Commercial $15.00
-t
ua e .....~ .... ~ ............................
New Construction.~... Old Or Pre existin Buildmn ..
· , - · g ' g .......... , ....
Location of Property ...... .O~f.."~..~5~. .....~.~:~.~.~.'~..~.~.. AK ~/~ ~)U
house No. Y tie;7' ........... ?' ...........
Onwer or Owners of Property ..................
county No 1000. Seetion.. .Z ....... .......... Lot../
Subdivisiou Filed Map Lot
Permit No ................ Date Of Permit ........... Applicant .....
Health Dept. Approval ................. · .... .... Underwriters Approval ........................
Planning Board Approval ........... , ........... .
Request for:
Fee Submitted: $ ......... ~
Temporary Certificate ........... Final Certicate~.. .......
APPLICANT
:OUNDATIoN ( 1 s '1:, )
FOUNDATION (2nd)
ROUGH FRAME &
.PLUMBING'
I~SULATION PER N.
STATE ENERGY
CODE
0
'FINAL
LDDITI~
cOMMEN'
OOCUPANCY OR
USE IS UNLAWFU~ ' , .,;:: ~,
~!ITHOUT CERTIfiCATE ~' :_~'~'
FOLLOVVI~ IN¢ -
1 FOUNDATION - TWO
FOR POUREO
ROUGH - FRAI~I~ &
~ INSULATION ~
~NAL - CONSTRUCTION MUST
,. COMPLETE FOR C.G.
'~NSTRUCTION SHALL MEET
~HREMENTS OF THE N.Y.
-~r: ~'RUCTION & ENERGY
q ~:qPONSIBLE FOR
"IMMEDIATELY"
~)rj~
bo!
765-1802
BUILDING DEPT.
NSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING
[ ] FIREPLACE & CHIMNEY
REMARKS: ~~
[ ] ROUGH PLBG.
[ ] I~ULATION
[ ~J/FINAL ~
DATE ~~/~?
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [/.~I~AL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
////~/~'/,
I,//v
INSPECTOR
L_ TOWN QF $OUTHOLO: ' ' / ~
TOUH OF $OUTilOLI)
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