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Home My WebLink About24337-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25250 Date SEPTEMBER 9, 1997 THIS CERTIFIES that the buildin~ Location of Propert~ 660 CHABLIS PATH House No. County Tax Map No. 1000 Section 51 Block 3 Subdivision Filed Map No. ADDITION SOuTuOLD, NEW YORK Street Lot 3.11 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3, 1997 pursuant to which Building Permit No. 24337-z dated SEPTEMBER 9, 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 DKCK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT HILTZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 FOlt, M NO. · TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 2433T Z Dote ................................... , 19 Permission is hereby granted to: .....3../..~...,~~..~.'......~i~. ............ ,o...~:~.~..-.....:....~... ....... ~_~.~..~ ........ ~..~.~ ....... z~.....~....~~ ...~.:~ ...... ~ ........... ~.~/..~ ......... ~?.......~~.. ....... ~., ........ ............................. ......................... .................................................................... County Tox Map No. 1000 Section ,......"~.Z ........... Block ..... . .~..,-~.,.~.. .... Lot No, ...~....~,.../../.. ........ Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTPiENT TOWN HALL 765-1802 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 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 "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 i. Certificate of Occupancy - New dwglling $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 - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5.~ Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date i 9f 5/.~2 .............. ~ deck New Constructio ........ Old Or Pre-existing Building ................. Location of Property ..... 660...Chablis. Path ........... ~QW~Q$$ ....................... .. ... House No. Street Hamlet Onwer or Owners of Property ~mlang 5oma~ i~.. . . County Tax Map No 1000, Section.~% .......... Block...Q~ ........... Lot...$:O3 ............... 8822 I~ Subdivision ........................... Fil Ch~rddoney Woods ......... ed Map ........... Lot ............. Permit No................Date Of Permit... .......... . .. Applicant...~..S~.~.~P~P.... ...... .. Health Dept Approval .. .. Underwriters Approval ............. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate..~ ..... Fee Submitted: $ ...... 2 ~.~ Q.~ ................. Inland Homes · ........................................ -- · · · · · ,~A' F- .z'~ ~-~-'.Q ~'~) APPLICANT · S.leqlo ~o~! peulolqo olop uJo4/ ~o SUO!IDA~$qo pl~.,'! uJoJI e.~o uoe~eq Sloodsse= puo sl/e~ /o suo!/O~Ol eq_L ~207 (~ .Z07 A ,p oved ..... £./f. ..... . ,,ZPe=it Disapproved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOU/HOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM · TOWN HALL 8OUTHOLD, N,Y. 11971 .29~:9~96. TEL.: 765-1803 CALL ....... MAIL TO: /~ B~il din, g' Inspector) APPLICATION FOR BUILDING PERMIT Date .... 9Z5. .......... , 199' INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strew_ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such porn- shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until ~ Certificate of Occupant shalI have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe{ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspections. ...... Inl~nd. Eomes..In¢ .................... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant in_owner, Iessee, agent, architect, engineer, general contractor, electrician, plumber or builde~ General Contractor Name of owner of premises . .I.n..l~d:..~.o.m.e.s. ...................................... e.~',f: ........ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Robert E Hiltz (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No... 'J.~j~.~.6..-.l{.I.. 0'CCUPgNCY or{ EIectrician's License No .............. ~; ...... v .... ~,', i ~. Other Trade's License No .......... ' ~ ~-.,, · , i .~. ~l~k - ~ 1. Location of land on which proposed work will be done~ ................... IM.L. ¢ONSl'ffil~'q~ll$~ .... ....... ............................ llouse Number Street I~'~. NOI .5..1 3.! .... County Tax Map No. 1000 Section ............... Block ..................0~ Lot .... ' ....., SubdivisionQ.h.~.~..~q.n~..~.Y...WgP.~.. B~..~gu.t. ilq~-~l.... Filed Map No. ~.8.~.~.~. ........ Lot .. ~...~'1. ~' .... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......................... '~ ',~,~ I'ffi~O~t' - 2, ......................... b. In ended us~ and occupancy ...................... ~~ ~.~ ........................... 3. Nature of work (check which applicable): New Building . ' .... Addition .......... Alteration ....... Repair .............. Removal .............. Demolition .............. Other Workq.~..'q..d.~.q .k... (Descrip~tionl 4 Estimated Cost $~1200.00 Fee .................................. ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number ofdweiling units on each floor ............. If garage, number of cars ..................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................. 7. Dimensions of existing structures, if any: Front....~3 .......... Rear ...57 ......... Depth.. 36 ........ Height ............... Number of Stories 2 .................................................... Dimensions 'of same structure with alterations or additions: Front ................. Rear ............... Depth ...................... Height ..... ~.~ ..... ......... Number of Stories ........ 4(5 ......... 8. Dimensions of entire new construction: Front ............... . Rear ............... Depth .;:..&./4:. . Height ...2.:5...~.t. ..... Number of Stories ................................................... 9. Size of lot: Front ..... 293 ............. Rear .... 258 .............. Depth ...~3.cj ............ 10. Date of Purchase ............................. Name of Former Owner .......................... ~ 1. Zone or use district in which premises are situated .................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...1'1.o. ........................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ff/~ 14. Name of Owner of premises Inland .Homes. . Address .... Phone No. Name of Architect ......... Address ................... Phone No ............. Name of Contractor . ]:h~f~[' :ff61~&/8 .... . Address .... : .............. Phone No. 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit may be required. PLOW DIAGRAM Locate clearly a~d distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions property lines. Give street and block number or description according to deed, and show street names and indicate who. interior or corner lot. See attached sketch iii i S.S '. .................... being duly sworn, deposes and says that he is the appl~ (Name olllllgl~lllsilning contract) (Contractor, agent, corporate officer, etc.) tffi,v~ ~,~ly authorized to perform or have perfo~ed the said work and to m~e ~d fil~ ~~~$ffitained ~ this application are true to the best of his ~owledge and belief; and tha work wflI be performed in the m~ner set forth ~ the application filed therewith. 5worn to before me this ........................ //ff Notaw Public, . ..... ~~~,C~unty