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HomeMy WebLinkAbout24433-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25569 Date: 03/05/98 THIS CERTIFIES that the building ADDITION Location of Property: 57455 MAIN RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 63 Block 3 Lot 21.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 12, 1997 pursuant to which Building Permit No. 24433-Z dated OCTOBER 27, 1997 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. The certificate is issued to ELIZABETH H BARNETT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Bui ing In ector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25570 Date: 03/05/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 57455 MAIN RD SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 63 Block 3 Lot 21.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 12, 1997 pursuant to which Building Permit No. 24433-Z dated OCTOBER 27, 1997 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 ACCESSORY GAZEBO AS APPLIED FOR. The certificate is issued to ELIZABETH H BARNETT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 7)�/0.,,/ Building Ins ctor Rev. 1/81 FORM NO.3 1 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) Date... OCTOBER.......27.......................... 19...97. . 24433 Z Permission Is hereby granted to: ELIZABETH H BARNETT ...................................................................................... ... PO BOX 596 .................................................I............I................. SOUTHOLD,NY 11971 .......................................................................................... to .......CONSTRUCT A DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR ... ............................ . ............................................................... .................................................................................................................................................................. ............................ ... .. .............................................................. . ............................................. ...........................................................................................................................................................I...... at premises located at...............5 455 MAIN RD SOUTHOLD .......... ........ . ........ .................... ........................................................................... ............................................................................ County Tax Mop No. ....,4.738.8.9 . Section ....9b .......... Block ......0003....... Lot No. ..0.2.1....0.0.3... pursuant to application dated .....SEPTEMBER 12............... 19.......97.... and approved by the Building Inspector. Fee$.........75.00 4..... .......... . . ......................... ui ding Inspector Rev. 6/30/80 rurm Vo. o .� TOWN OF SOUTHOLDx P` O BUILDING DEPARTMENT TOWN HALL MAR - 5 60 765-1802 BLDG.DEPT. k!TION FOR CERTIFICATE OF OCCUPANCY F 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 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 April 9, 1957) non-conforming uses, or buildings and "pre-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. C. Fees Y . 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 Building - $100.00 3. Copy of Certificate of Occupancy - .251�. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . .:��a��e. . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . .. . . Old Or Pre-existing Building. . . . . . . . . . . . . . Location of Property. . . 7 :5:�.. . . . .. !. .`.a�.IL4- L� : . . . . . . . . . . . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . .!:/./.� �.. . . . . = v - • • • • • • • • • • • • • • • • • • • • • County Tax Map No 1000, Section. . . . . . . . . . .Block. . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . .. . .. . . . . . . . . . .. . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. .LZ. .Date Of Permit. . 1 PJ.y 71e.e 7 .Applicant. ���.d.e�• • •'•'���'��� Health Dept. Approval. . . . . . . .. . . .. . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . i� 5L//3/ APPLICANT �� 5S6 9 - c 0 x= Form No. 6 TOWN OF SOUTHOLD Q v BUILDING DEPARTMENT /0„ I D TOWN HALL ts 765-1802 j)rr_?U H LO LICATION FOR CERTIFICATE OF OCCUPANCY A. ation 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 April 9, 1957) non-conforming uses, or buildings and '-'pre-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 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 Buildinz - $100.00 3. Copy of Certificate of Occupancy - _ .25V. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . �.� . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . .� . . . L// _ 1 r Location of Property. . . .�;7,� .S. . . . . . . . /. 1 : . . `. . . . . . . d[.�:�. :`:o. . . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . .�. .. .. .. ...�.�: . .. . ..�.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . .Block. . . . . .) . . . . . . . .Lot. . . . . . .t; : . . . . . . . . . Subdivision. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . , Permit No.� . . . . . . . . .G: .Date Of Permit— ! 7. . .Applicant. HealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . PlanningBoard Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . FeeSubmitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2'x�� /i/ co 3, APPLICANT Z _255?0 - C 0 jA'3 M-iso2 suiLnINc DE". INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULA [ ] FRAMING [ AL [ ] FIREPLACE & CHIMNEY REMARKS: DATE ld' 71NSPECTOR T65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ NAL [ ] FIREPLACE 8 CHIMNEY REMARKS: 1-79 b DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION 187' [ } RONQN PLBQ [ ] FOUN TION 2ND [ ] INSULATION [ INQ [ ] FINAL DATE �I ! INSPECTOR M-isoz BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FQUNDATION 2ND [ ] INSULATION v1 FRAMING [ l FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 1117- 6 f 7 -INSPECTOR�� P'11:1{1_,114:i�Gt:11U11wI1Pl'UII'I'w I)�l•t:�, �-_-_..-' ..,- _ illT,i _. rl `-, 1'1I111111A•I 11111 ( 1!.I ) � •,,, `jtV �l �qy 7f Illllllill 1°II�I11: ('1.1111111 ►I(! � -q l/ r Y --_+..------w-------w_---w -- -ww. .......wrt ww.....----.--.....-------------�_--- --w_..w w..__w----ww.. I ll!7111.A•1'1(111 I'I:II If. Y , !:'I ATR 1'.III:RIIY (:1)111( ----------- ----- �- ._ ------ --------------------- -- ---__--_-- l 77 IF I IIAI. .. -------- ____________________^--__-w___-__--------- ---_-- Alli►1'f ---- - NII(----: ----_.-_. __._-4<------- , 6im" 6J )Ep �1 O v . I'I - 1 , BOARD OF HKA1;I'II . . . . . . . . . . . . . . . FORM N0. I 3 Si;'PS 0(r PLANS . . . . . . . . . . . . . . . TOWN"OI' SOUT1101.1) SURVEY . . . . . . . . . . . . . . . . . . . . . . . . B ILT>�1NG D(?PARTMENT CHECK • TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . { 7SOUT)lou), N.Y. 11971 �• '` SEP I I�� TEL: 765-1807 NoTTFY: CALL . . . . . . . .�S. . 3 g� 1'747111 ned........©� :., I9'e� '1 .�.,... r�.._...,�,.,�jTO: . . . . . . . . . . . . . . . . . . . . //'' MAIL Approved....elcl 7...., 19�.7 Permit No. ..1-1� 3 3 .................................... Disapproveda/c .................................. .................................... ...................................................... .. . ..... (ilei 1 n I lector) APPLICATION FOR iUILDING PERMIT Date. . . . . . . . . . . . . . . . 19. . - - INSTRUCTIONS a. 'Il1is application must be completely filled in try typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to scileclile. b. Plot plan slx7wing location of lot aril of building s on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property mast be drawn on the diagram which is part of this application. c. The work covered bry this application coy not be ccrmnc_ed before ismiance of iuilding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection thrauglxxut the work. e. No Wilding shall. be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall. have been granted by the Building Inspector. APPLICNIJUN IS 11EW-,11Y WE to the iluilding Department for the issuance of a Building Permit pursuant to the Building 7.one Ordinance of the Town of SouOxAd, Suffolk Camay, New York, and other applicable Iaws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal. or demolition, as herein clescril4. lle applicant agues to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit autlx)ri7ed inspectors on premises and in building for necessary inspections. Bill to MUM .... ..lo�:.��. ...... (Sigrlatur of applicant, or nam, if a corporation) / p zd 3. _, � no y4mo (Mail.ing adclress.of applicant) #IR AIM ruder-alit t State whether appl.ic Mqjbofolj,muL, architect, engineer, general, contractor, electaiciAn, plumber or Wilder. QGv,g IifN�NUO� ......................... ..Mum .................. Alam of (7wU77777emise s �K'.................... .. .w... .............. TOUM M13Uw"* qs„pRl#r tax roll or latest deed) If applic.auL a-S , # choly autlloriml officer. NA 314T, ,;,10 ETHW3RIl_Of33R ,,,,............ (Nam and i".` ISuilders license No. ......................... P1lmlers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. i,ocation of land on which proposed work will be dome.......................I....................................... .... ............! �t:�iU..�................ . Q.l .................................... Rause Nlrmier Street lbarmlet County Tax Map No. 1000 Section .....(<A...... illock .......3....... moot ..... Subdivision ...................................... Filed Ftp No. ............... Lot ............... (NOW) 2. State existing use and occupa►xy of premises and it erxleduse and occupancy or proposed construction: a. Existir>I; use <rrxl occupancy ...� .. lE�C.�% 44Ol ............................................ h. int erxlcd nse and occxrpcmncy .. �!!�._T •GC.� l� Qu!. - >! "til io- J UA rmrlaN wVw two 1. N pure of work (dii:ck witidl al4)1 icable): New Ikli lding .......... Acklit ion -•••• CeraLiun . Itepllr lialloval ............. DOW!iLicxl ............ Other Wo)k 4. ISLillklt&l Cost ....� ............... fee .............................................. (to Ix! paid oil filing this applicaLioo) :i. If (krel l iull, umber of tkell iry; units ............ Umber of cAvel l ing units oil each flcx)r ..... ........ ... If garage, rnnl)er of cars ...................................... 6. If Ixlsirxas, coin ercial or mixed cx:culkllx.y, sl)eci fy Ikl(Ille i)IKI exlenl: of each type of use......... ..... 7. Uiulensions of existing structures, if any: !?null....... . .. ...... Itear ............... I)eplll ................. Ik:ighL ............. Umber of Stories ...................... I)inlensious of Sault: sNnketure with alleraLions or :Kklitions: l�rcxlt hear ............... Ik�p(I1 ................. ... Height .................... axiber of Stories ............... fl. 1)illlelisioil's of entire new conslnr_t.iOn: 1rr011L ................ hear ............... i)eptlt .............. Ileigllt ......................... Umber of Stories ..................... 9. Size of lot: Hint .................... Itear Depth .................... 10. Date of Ntrchase ............. Matte of: Fouller (1.nxsr ..... ...... ............................. If. "L.cxle or use district in wltidi prauises are situated ............. ................................................. 12. Does prolx)sed construcLion violate any ztmdog law, ordinalK_e or regulat.iou: ........................ 13. Will lot be regrat6l .................... Will excess fill Ile rumvexl fmil prenises: YES Np 14. Mies of Owner of premises ............................ Acklress .............................. lilone No. ........... N:nxe of. Ardlitecl: .................................... Acklress ............................. RKxle a-) ....... .... Mime of Contractor .................................. Acklress ...............................I'I►one I*) ........... is this prolx:rty within 300 feet of a tidal wetlatxl? * YES .......... 11) .......... *IF YI:S, -(X111111) 11AM -IR11S111?S PEId1Cf MAY lits 1t13( IKIJ). PLOT DIAGRAM Icx:ate clearly arxl disriKOy all Imildings, whether existing or proposed, and imlicate all seL-back dimensions frcro proparty lines. Give street arxl block rrnler or description according to deed, and show street rullrles alxl iRylicale +dletfwr interior or corner lot. FM s ONO"� '�'�'"' '� OCCUPANCY OR 76 , &,.10 MM 4 M Nle M USE IS UNLAWFUL FOINM� . WITHOUT CERTIFICATE: t OF OCCUPANCY 3. P""AAMN 4. FINAL - OWN -mm BE COMPLIM NO CA, ALL CONSTRUCTION •MALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION i ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS cxa1NlY1cx ....• `� — l .........Ix!i n,, du) sworn .c!e x>us alxl says Y 1 Sys LhaC he it; the app!icanl. Mille of hxlividual signing conLracL) illx)ve nivied, Ile is the ((cnrtracto ,genC; y c..rlx>ra(e officer, eLc.) of said uwcler or owlx!rs, :)cul <luthorized Lo lx!rforlu ha or vexer lf �d orlll- the said work alxl to uklke and file this applicaLim; Lhat: all. statements couLained in (Itis application are tn)e Lo the beal: of his knowledge mKI lxtl.ief; atxl That the work will Ix performed in t_he skinner set forth in the application filed (l►erewitll. iAn)nl to Ix —� II i I r �I n 4 LRI FA I W1 Ali i�l I � SII is Imo_ Imo; r—� - � �_• _ ,;s5, � � -> rte. as + � •a � s' -30 49a f #� U e ` itz x bit t K t s� i F - -117 jf- x 7A IZTY �I f � Af•'§. �1� � ��Y is -' S �'S� jyF �. .+"s 17 -" - 44 -"L^> irz i F F� I i a dD < NM THIS SURVEY IS A MIDIAMM Of e ,. - Y r 7209 of THE PEW YORK siwt II- MQ �JIM OF THS SUETY m" 7 it ,v-- -''=. ... .. ;-• .. <., -.E tarm sure eYOR s`rttc�s�1 oR .54L.P7. #JOSSJ SEAL.S4'•ALL-NOT CE CO.HSMEM '. ; z 3 BE 71.VALD iRLc ' • -';ti:: 'a;-'� '�-.r-- -AF.,�� •: - -p ":;� i. .. .. ..... "..,' <yfa y�'.. -:.-y - 4�� �hvt�A t ". i.-.. ?xjELY iO"TFE f Soli Fo2.W801A THE slAEVr i ,AsrARu^f:AND ari e!i fi�EAI�'-ro'THf x �