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Home My WebLink About24207-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25112 Date JULY 1, 1997 THIS CERTIFIES that the building ADDITION Location of Propert~ 2275 PINE NECK ROAD House No. Street County Tax Map No. 1000 Section 70 Block 7 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 50 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 1997 ~ursuant to which Building Permit No. 24207-Z dated JUNE 23, 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 OCTAGON DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to MANUEL & MANUELA WENENDEZ of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 IFOI~H NO. O TO~"N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~.~ ~'- D ..~~ ~- ~? ~07 Z ate ..................... ~....., 19 ....... // ~~ =.~.=.~.~=..~.... ~....~../~.~ ................. ~ ...... . · ....... 1~ ............. ~ , ~ ~..'.'..~..~~.~..~~..,~.~ .... , . . .......... ........ .................. ........................................... ........ ~....~ ......................................... ~ ................................... ~-~)-.~ ...... ~,~,~,~,~ ........... ~..~...~..~.~...~ ....... pumu~nt to opplicotion d~l~ ..............................~. ~.~....., 19.~nd opprov~ by ~h~ Rev. 6130/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 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 o4 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 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 '!pre-existing" land uses: ,1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completsd 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-~xistin~ Buildinz - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 New Construction ........... Old Or Pre-e~xisting Building ................. , Location of Property.~..~.....~/, .MJ.~..~..~.~... ~f~. .......... ~ ?..~?~.~...~..~..,..~. ltl ........ House No. Street Hamlet Onwer or Owners of ~roperty ......................... ~ ................... . ...................... County T~x Map No 1000, Section...~. O ~'- ~ .......... Block .... J. .......... Lot.. Subdivision ............................... .. . . . Filed Map ............ Lot ...................... Permit No..?.~.~..~....Date Of Permit. ~ ~' ~ > .Applicant Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ................ .... .. .. Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: I'i ,llf4ti,I I1(I 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION2ND [ ] I~JSULATION [ ,FRAMING [~FINAL ~'~- .,~~ [ ] FIREPLACE & CHIMNEY REMARKS: ~)/~ ~ ~.~,, INSPECTOR FORM NO. TOWN OF SOUTHOLR BUILDING DEPARTHENT TO~N HALL ~LICATIO~ FOR B~ILDI~G Pg~IT INSTRUCTIONS BOARD OF REALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHEEK ..... ~ ................... SEPTIC FORM ................... NOTIFY: MAIL TO: .................... Date .... .~.//..~.~-., 192Z a. lhis application mst be ecmpletely filial in by ty~riter or in ink and sut~ittal to the hdlding Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ' b. Plot plan shc~ing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property mst be drawa on the dlagran daich is part of this application. c. The *ark covered by this application way not be ccr~ncal before issuance of Building Pennlt. d. Upon approvat of this application, the Building Inspector will issue a Building Pemit to the applicant. Such permit shall be kept on the premises available for inspection thru~bant the work. e. No building shall be occupied or used in ~hole or in part for any purpose dcatever antil a Certificate of Occupancy shall have bean grantal by the 'Building Inspector. APPLICA'rI~t IS l~t~rr/~ to the Building l)eparment for the isst~e o£ a Building Pemlt pursuant to the Building Zone Ordinance of the Tc~n of Suuthold, Suffolk County, Rew York, and other applicable Laws, Ordinances-or Regulations, for tim construction of buildings, additions or alterations, or for re~oval or den~litlan, as herein described. The applicant agrees to cc~ply with all applicable l~s, ordinances, building code, housing code, and ce~sary inspeTians. regulations, and to admit anthoriT~d inspectors on premises and in building forne :. ...~.T~k._.5 ............... " (gignattrre of applicant, o~r_~, ~f a corporation) .l ........ .......................... ,-%: " (Mailing address of applicant) State ~bether applicant i lessee, agent, architect, engineer, geseral contractor, electrlclan, phmber or builder. game of(xme . ~ . ..~ ~y .................... (as on the tax roll or latest deed) DATi~:~..~. If applicant is a corporation, signature of duly antberized officer. ,. FEE._ /? ~ ..................................................... ?~,-m0i ~ AM ,0 ~ .M ~0~ ,~ (Nane and title of carpora~e o~flc~r) ~ ~ ~[~"'F"['" ~1~ ~j FOLLOWi~G WITHOUT CERTIFICATE ~';ORFOUNDAT~ONpouRm CONCRETa' WVO .EOUmE~ OF 0CCUPA~Cy 2. Rou~. - mA~mO & PLUmm~ Builders License No .......................... 3. =NSULATION Plts~bers License go .......................... 4, FINAL CONSTRUCTION MUST Electricians License No ...................... BE COMPLETE FOR C.C. ALL CONSTRUCTION SHALL MEET Other Trade's License NO ..................... / 4/] ~ T~ REQUIREMENI~ OF THC, NV- Ranse Nmt~r Street Ranlet c~ T=.~NO. mOO s~tian ..:7.e ......... m~k .... ~<~... ....... ~ot ....~.O ........ Subdivisian ........... .~.¢F..~,.,. .................. Filed mpm ................ lot ............... 2. State ex[sting us~ and occupancy of pr~tises and inteadal use and occupancy o[ proposed construction.' a. ~x~stlng u~ aad secumnc. ..... ~-...l:× ............................................................. b. Intended ase and occupancy ..... ~,-. . .': .... · ................................. ~,,~ ~¢~,~AD,,.~, .~*~*~ ..... frml pro[x~rty lines. Give street m~l block ~0hetlmr interior or corner lot. 3. r~z~lu~e ef ~rk (check whicl~ i · applicable): Nc~: lkdhling ..... hnklitic~ .......... Alteration .......... l~lmir ............ ]~al .l ..... l~lition Other ~ ~ ~rlpt i~) 4. Eat i,~t~l C~st ...... ' ......... ~ .......... f~ ................. , .................... . ........ ~ (Io lm ~id ~m filing this a~licati~) 5. If &~lllng, ~s~t~r of · t If garflge~ t~f~r of cars 6, If laminess, tmt~rcial or mi~l ~m~lm~y, s~cify tmture m~l extent of each t~lm of use 7. Di,mnsiom of ~isti~ strt~txlres, if any: Prime . ~L ~ar ~ ~g . ~pth %q . ''~ ................... 4.. ~mt~r of 8terie~ ....... ( l)ismnsi~a of arum atn~t~re ~ilh alterati~ma or ~itions: Front ............... l~av ~pth ' thi~l~ ....... .................... ~t .................... ~i~r of Stories ........ 8. Diumnai~ of entire ~ ~a~t;im~: Fret ..... !f ......... ~ ..... I~ ........ ~va, .... (~ ....... 9. ~i~ ,,e ~ot. ,~ ..... /...~ .......... ,~ ..... Ze~... mpa, ............... I I. 7~ nr u~ district in xllid~ ~r~isea are si~t~l ~- ~ O 12. I~s prol~l (~mt~ti~ violate any ~ming l~m, e~linerme or regulatt~: ..... 13. Will lot Im regr~d ........ ~ .... Will e~ess fill I~ r~ fr~ pr~d~s: YES ~ of Ard~iteet ........... ! . ~ress 1~ ~e of C~tr~tor .......... .~ . ................... ... ~lresa ............................ ... I{Ione ~ .............. , 15. Is this pm~rl:y within ~ f~t of a tichl xmtlal~l? ~ YF~q .......... ~ ..... PI.aT DIAGRAM l~ate clearly a~ diati~l:ly ~ll Ndldi~s, ~mther existing or pro[~l, m~l ilxlicata all ~t-I~k dimnaion~ re,imf or ~riptitm acco~ing to ¢~1, a~ dl~ otreet re, ms a~l i~icate 0~ o ~o*° r Oe~f~,U ........ ~ ............ Iming duly sworn, delx)Ses end says that he is tile applicant (l*ll~ of iz~ivkhml signing c(mtroct) ~ I~ i, Ute ............................ ({~tractor, agent, cprl~rate efficer, etc.) ' ' ' ' " Y ~ ' ' I ' l-': ~ the ''d ~rk mgl Lo n~ke apl)licatiea; that stl st:at~mnt, c(mtait~l in I.hls a )pi icatinn are t. rl~ tn the Imst of his k Ihat t.he ~rk will Im ~rfonl~l nl the?~mner set fort.h ~u the appl ~cnt~en f~Jc~ t.lmr~tth. F~)rn t~)lmfore me this ...... ........ '(Sigrwfl~(re of Appticnnt) -