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Home My WebLink About24362-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. C~RTIFICATE OF OCCUPAMCY No Z--25311 Date OCTOBER 10, 1997 THIS CERTIFIES that the building. ONE FAMILY DW~J.ING Location of Propert~ 76OO PECONIC BAY BOULEVARD BATTITUCK NY House NO. Street Hamlet County Tax Map No. 1000 Section 126 Block 11 Lot 13 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 18, 1997 pursuant to which Building Permit No. 24382-Z dated SEPTEMBER 307 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 A DECK ADDITION & ALTERATION TO A SINGLE FAMILY DWELLING "AS The certificate is issued to BUILT" & AS APPLIED FOR. ROBERT H. & KATHARINE S. KOCH (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H057077 PLUMBERS CERTIFICATION DATED Rev. 1/81 SEPTEMBER 24, 1997 SEPTEMBER 16~ 1997 ROBERT H. KOCH lt~*RM~ HO. J TO~'N 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) ~s~ z Dote ~...~.~. ....... /......z.~ County Tax Mop No. 1000 Section .......... Block .............. lot No ........ Z ......... pursuont to opplico,iom doted ..~..'.../....~... ........................ Building Inspector. Fe. Rev. 6130/80 TOWN OF SOUTHOLD DEPARTXEk~T BUILDING TOWN HALL 765-i802 kPPLICATION 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: I. 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 Underwritsrs. 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 amd similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: i. Accurate survey of property showing ail 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, ~he Building Inspector shall stats the reasons therefor in ~rriting to the applicant. i. 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 Buildinm - $i00.00 3. Copy of Certificate of Occupancy - ~ .25¢. 4. Updated Certificate of Ocoupamcy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... ~'/'~...?. ............................/~ New Construction ........... Old Or Pre-existing Buildi~g ..... ~ ......... ~ooa ion of e po ~o,~< /g~'" ~/~J f~a t Prop rty..7~. .................... ~ ............................................... Rouse No. Street Hamlet Connty Z~ ~p No 1000, Section .............. Bloe~.. /~ .Lot // -/~ ..... Subdivision ................................, .. . Filed Map......... .. .Lot ...................... Permit No ................ Date Of Permit ........... 2 .... Applicant ............ Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ...................... .. Request for: Fee Submitted: Temporary Certificate ........... Final Certicate ........... Town Hall, 53095 Main Road P. O. Box 1!79 Soutno~d, New York 11971 Fax (516) 765-I$23 Telephone (516) 765-1802 OFFICE OF THE BUILDING iNSPECTOR ' TOWN OF SOUTHOLD CERTIFICATION Building Permit No. (please print) (pl. ease prin%) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this / ,,~'~_...~, day of Notaz-f. Public, LINDA ~. COOPER Nota~ ~blic, S~te of N~ - ~225~, Surfak ~u~ ;erin ~ir~ ~m~ 31, 19 , ¢7 County THE NEIN YORK BOARD OF FIRE UNDERWRITERS ~<{?.;,~ ?~C~, [IUREAU OF ELECTRICITY r~ 85 JOHN STREET, NEW YORK, NY 10038 Date ~"[]]~'Ir~!~ :~ ~ ~?~ ~ppllcation No. on file ~'~ ?~ ? ~ /?? ~ ~")~0~ THIS CE~IFIES THAT ~ examined on :'t~:~i~ ~ ]7~ [99~ and found to be in complia.ce with the Na~onal ~evt~=l Code. OTHER APPARATUS: EXHAUST FANS DIMMERS THis certificate must not be altered in any manner; return to the offi~ of the ~ard if incorred. Insp~tors may be identified by their credentials. COPY FOR BUILDING DEPARTHENT. THIS COPY OF CERTIFICATE HUST NOT BE ALTERED IN ANY ~NNE~. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] I~L~LATION [ ] FFL~MING ,~*-'F'INAL [ ] FIREPLACE & CHIMNEY RE:MARKS :~~~g~.,~~,*~~ DATE/~/'////~ 7 INSPECT~ L~ND ~U~vE¥OI~ 8L:P q 8 lg97 CkDG. D~E ~T, Disapproved a/c FORM NO. I TOIJN OF SOUTIIOLD BUILDING DEPARTMSNT TOklR HALL SOUTIlOLD, N.Y. 11971 TEL: 765- ]802 BOARD OF HEALTN ............... 3 SETS OF PLANS ......... ...... SURVEY ........................ CIIECK ......................... SEPTIC FORH ................... NOTIFY: cALL ..... MAIL TO: .................. APPLICATION FOR BUILD'lNG PEI~IIT INSTRUCTIONS Date ...... a. 'lhis application must be, cav~letely filled in by typc~iter or in ink and suhnltted to the Pzdlding Tns~ctoi 3 ~ts of pl~, ~mraCe plot plan to ~ale. F~ acco~i~ to ~le. b. Plot pl~ M~i~ l~tlm of lot ~ of ~ildi~ struts or are~, ~ givi~ a &tail~ &~riptlm of l~t of pro~r~ ~t ~ dr~ m tie diem ~dd~ is ~rt this a~l icati~. c. ~ ~ c~r~ ~ fids a~licati~ ~ ~t ~ c~ ~fore is~ce of ~itdi~ Pemlt. d. giro a~ml of Calm af~licati~, ~mit ~mll be ~pt ~ fl~ ~ms ~ail~le for in--tim thra~mt tim turk. e. ~ Imildi~ ~mll ~ ~i~t or ~ in ~mle or in ~rt for ~ ~ ~mt~er mtil a ~rtiflcate of ~ M~all I~ l~n ~t~ ~ ~ ~ildi~ I~tor. ~I~ IS I~t~*Y ~ t:o tim ~ildi~ ~r~nt for fl~e isle of a ~ildi~ Pemit ~r~nt to the ~ildi~ ~ ~di~ of t~ T~ of ~tt~ld, ~ffolk ~ty, ~ Yo~, ~ ot~r a~limble I~s, ~di~es or ~latlms, for tie mt~tim of t~fildi~, {~ri~. ~m a~li~t ~s to ~ly wi~ all a~licable l~s, o~i~es, ~ildi~ ~, ~ing c~e, a~ r~lati~s, ~ to ~it mO~ri~ i~tora m ~i~s ~ in ~ilding for ~es~ insteps. ....... ................. (Si~ture of a~li~t, or ~, ii a ~ration] (~ili~ ~ress of a~lic~t) State ~lmttver applicant is o, mer,, lessee, agent, architect, engineer, general .......... g..W.~. ¢.Y. Name of o~er of premises ...... F...~ ......... c (as off Ova tax x~)ll or latest deed) If applicant ia a corporation, signature of duly auttmrlzed officer. Builders License No ........................... Pl~bers License No .......................... Electricians Licease No ...................... Other Trede's License No ..................... t. & ~. Iq#aL. COlklI'q~UCllON MUST lie COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEi~' THE REQUIREMENTS OF THE liTATE CONSTRUCTION & ENER~IlP CODES. NOT RESPONSIBLE DESIGN OR CONSTR~CTION ~ lx~catian of land on al, id, proposed work will be dram.....~..~..C).../~....~.¢..C. ~.~. J.C-.'..__.~.~. ........ Dome llad~r Street Itanlet ~ivisi~ ...................................... Fil~ ~p ~ ................ l~t ............... State ~isti~ ~ ~ m~ o~ ~i~s ~ in~e~ ~ a~ ~ of p~ ~st~ti~: a. F~istit~ ~ ~ ~ ............................................................................. .. ........ ....... ...................... 3. F;Rure o~ ~ork (ctu~ck ~hich applicable): ~ I~{ldi~ .......... ~iti~ ..... ~... altera~io~ ...~ ...... l~l~ir ............ ~al ............. 1~}1 iti~ ............ Other ~ .................................. {~rlpt i~) 4. Est i~mt~ ~st .......... h.. t~ .... f~ .............................................. (to ~ ~id ~ filing this a~licati~) If ~rage, ~l~r of ~r8 7. Ditmnsi~s of ~isti~ stnmt~s, if any: ~t ................ ~ar ............... ~ptl~ ................. I~i~t. ....................... . ~r of Stories ..................... Dim~i~ of ~m st~re with nlterati~a or ~itJona: Front ............... ~pth .................... t~i~t .................... K~dmr of Stories ............... 8. Din~nai{xm of enti~e ~ mt~tio~: lk~t ................ ~ar ............... ~pth .............. I~iO~t ......................... ~mr of Storiea ..................... s. ot: ..... .......... ...... Z .g. ....... pth ....... gg. ...... I0. I~te o~ a,rd,a~ ..... ~2~.( ......... ~ o~ l~o~r m~r ........ ~ ......................... II. ~ or u~ district in ~ddt, pr~[~ am si~t~ .............................................................. 12. ~s ~ro~ ~mr~tlm ~i~lare a~ ~i~g 1~, o~i~me or re~latim: '. ...... ~.Q ............. I~. ~ill lot ~ ~r~ ....... ~0 ......... ~ill ~ss fill I~ m~ ~ o[ ~ddt~t .................................... ~rees .............................. ~ ~ ........... 15. ~ of Cxmtraetor ................................... fiddress ............................... H~one ~ ........... this proI~rty within ~00 feet of a tidal wetland? * ~ .......... NO .......... · IF YES, 8CI/T[[~I'I ~ll~l ~ll~Jfi~l~,'~ PEI~IT H&Y I~ ,RE~JIRILD. PLOT D][ AC:RAH Dacate clearly and diatieetly all buildinga, ~hether exiutit~g or propo~ed, and indicate all rmt-lmck dlrmnsions fTc~ property lines, give street and block nmt~er or d~acription according to deed, and ~1~ street hanes and ir~licate ~hetber interior or corner lot. .................... beirtg duly .sx~or~, delx)sea a~xl rays that he is tl~e al~)l leant UNDA J. COOPER Notary Public, StYe of New York , Term ~ir~ ~ 31, 1 ~ (Sig~ala.-e of ^pplierat) (Gontractor, ngent, corl~orate officer, etc,) ()IT raid c~er or ~er,~, m~l is duly ~thoriz~l to t~rfonn or h~e [~rforn~ the ~id ~rk at,l to rake a~J file tl~is alq)l icatitm; that ail statamnts c~talm~ in this nl~>llcati~m are tn~ to the Imst of his ~l~ and Imllef~ that the ~k will Im ~rfon~ in the ~mnner ~t forth in Om al~lleatkm fil~ ~m to Imfore m this ......