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Home My WebLink About24277-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25208 Date AUGUST 19, 1997 THIS CERTIFIES that the buildin~ Location of Propert~ 1050 SMITH ROAD House No. County Tax Map NO. 1000 Section 98 Subdivision ADDITION PECONIC, NEW YORK Street Block 3 Filed Map No. Hamlet Lot 2E Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 26, 1997 pursuant to which Building Permit No. 24277-E dated JULY 28, 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 ON SOUTH SIDE OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. YVETTEVLAHOS (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMEERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO. fl TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2427T" Z Permission is here,y ~~""' ~ ~,,~~~ . .,/,~m~,~',,.~/,~-- .......... ,/,z~,,~ ,o .~~......~.~..~.~...~~.~../.~~ ...... ............ ~ ~ ................................................ ~ ~.'.....~ ~ ~ .................... ~.~'.~ ~'. ....... ~ ~ ~ ~.) ...................... ~. ....... ~.....~...~ ~ ~' un Tax Ma No 1 e n c~ L ~ Co ty p . 000 S ct,o ....... ~.:..:. Block ...................... ot No ........ ~.. ...... pursuant to application dated ............... ..'~~...~...~......., 19...~...~.~ and approved by the Building Inspector.~ // Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD ~~~1 BUILDING DEPARTMENT TOWN MALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A'. This application must b~ 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 De.pt. of water supply and sewerage-disposal(S-9 form). Apprqval of ~lectrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains l&ss than 2/10 .6f 1% lead. 5. Commercial 'building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer ~esponsible 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, buiiding 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 ko the applicant. Fees 1. 'C~rtificate of Occupancy - New dwelling $'25.00, Additions to dwelling $25.00, Alterations'~? dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, 'Additions to ~ccessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy dn Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $I0.00 4. Updated~Certificate of Occupancy - $50.00 5. ~emporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........ .~. Old Or Pre-existing BuildinM.. · H6use No. Street Hamlet Onwer or O~ners of Property ............................................... Coonty Tax Hap ~o 1000~ SeetSon .......... Block ............. Lot Subdivision ~ Filed Map Lot Permit: No. Health Dept. Approval ................... Underwriters Approval. .............. 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] I~LATION [ ] FRAMING [,~ FINAL [ ] FIREPLAC~& CHIMNEY DATE ~//~;~.,~-* INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOU~ATION 1ST [ ] ROUGH PLBG. RANM,DNAGT'O* * [ ] FIREPLACE & CHIMNEY REMARKS'- DATE ~/~/~J // I NSPECTOR~,~~~ -/ ~J 1: ; L,, r'~- .,, TOWN Of SOUTHOLD !~fi ' ""'"~ 997 ': BUILDING DEPARTMENT ~ i, ~ ~ ! SOUTHOLD, N.Y. 11971 !I "~.~"'~';~. '"'~' ~ _ TEL.: 765-1802 Exam in~ ~ ~., 1%f~'._ : Bi,al I ro~fd a~ :: .............. ~ .......... INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter or in ink and submitted to tim Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relaUouship to adjoining premises or public streets or areas, and giving a det~led description of layout of property must be drawn on the diagram which la part of this appli- Cation. c. The w~rk c~vered by fi~s app~icati~n n~ay n~t be c~nnnenced bef~re issuance ~f Bui~ding PermiL d. Upon approval of this application, the Buildiug Inspector will issued a Building Permit to the appHe~t. Such pe~it s~all 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 a Certificate of Oceup~ey shall have been granted by the Building Inspector. . APPLICATION IS HEREBY MADE to the Bnildi0g,D~partmeut,,for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southol~ Suff~ik"~o~'fit~ ~ew York, and other applicable ~ws, Ordnances or Regnlations, for the constmctmn of buddings, addflions or alteratmns~ or for removal or demoli~on, as here~ described. The applicant agrees to comply with all applicable laws, ordigmnc.es,:building code, housing code, and regulations, and to admit authorized inspectors on preinises and i~(~dilding for neeessa~'ifispections. .~ ~. ........... (Signatur~ of applicant, or name, if a corporation) . ~.~.~.( ~ ..... ~: ..... I.(~ ........... (Mailing address of applicaat) State whether applicant is owner, lessee, agent, architect, engineer, geueral contractor, electrician, plumber or builder. ......... ........................................................... Name of owner of premises ..1~, .g. ,~...~ I'~..,../~. ) ....... : ........................... (as on tile tax roil'or latest deedy If aPl~~nature of duly authorized officer. ~ (N~tle of corporate officer) Builder's License No .... ~.?~'~..~.. /.-/:,~'~..: ..... '" l~lunlbcr's License No. ~ ,~ d,, Electrician's License No ....................... : Other Trade's License No ...................... Location of hind off which proposed work will be done ............................... ., .................. · [ 05_0 ................... ~-. ~m ~ ~. ¢.~.~..% .... ,....~..~. ~-,u, ~: ..................... ltouse Number Street Hamlet Cou,,ly'ra~la,,~o. IO00Sec,io,, ..... ~..~. ........ Block ...3 ............. ~ot. q. 1' SubdMsion ..................................... Filed Map No ............... Lot ............... (Name) Slate existing use and occul~aHcy of premises and intencled usc and occupancy of proposed construction: a. Existing use and occupancy ...~. ~, {~.. '%~'[[~'W' ...... ' ............................... ~.'n,~n~,,~n~o~,,,,a,,~ ..t.:~.,..l~ ~1,,~ '~~ property lines. Give street and block interior or corner lot. 3. Nature of work (check which apphcable): New Building .......... Addition ........ [Al'teration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... · . ~ ~ ,~ ~ (Description) 4. Estimated Cost .... ~.~.~. ~. i Fee i ....... (to be paid on filing this application) 5. If dwelling, number of dwelling tinits ............... Number of dwelling units oil each floor ................ If gara. ge, number of cars ..................................................................... 6. If business, commercial or mixedioccupancy, specify nature and exteqt of each type of use .................. 7. Dbnensions of existing structure~, if any: Front ............... Rear .............. Depth ............. IJeigbt ............... Numl~er of Stories ...................................................... 'inlensions of same structure wi~h alterations or additions: Front ................. Rear .............. D.eptb I leigh,[ .~. · .-:'.~ Number of Stories 8. Dnnensionsofentirenewconstr4ction._~k[~../;~.... Rear ............... Depth ............ tleight ............... N tn nb ~k c~f~61rFesc~ 7...../d ............................... 9. Size of lot: Front ............ .~ ....... ""~;ar./ ................... Depth .................... 10. Date of Pt rc iasc . anco ~ .............. N fFomter Owner ........................... 1 1. Zo ~e or use d strict in w ~ c ~ pre n scs are s rusted .ff~.~ ~ 12. Does proposed co lstructio ~ vie alte any zoning law, ordinance or regulation: .. p:3..O. ........................ 1 3. Will lot be regraded ~h)0 ....... I .................. Will excess fill be remov, ed fro n premises: Yes No 14. Name of Owner of premises'/'r~C4..k~& fb/M'.e<. ..... Address [~-5'O~..~ .t..Y'~.~.~. .....Phone No.~'l./e.'7~C2'd. · :',~l, tect ...... , ..... i ................ A,Ulress .~..Cp..~.: ~ ......... rho~e No ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back d~in~ensions from m~ber or description according to deed, and show street names and,ln~!lcate whether OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPRDVED AS NOTED FEE: NOra ^T 765-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . ~0 REQUIRED FOR POU~ED CONCRETE 2. ROUGH ~ FRAMING' ~ PLUMBING 3. 4. FinAL CO~$'TRHCTION MUST BE COMPLETE FOR CO, ALL CONSTRUCTIGN SHALL THE REGUIREMFNTS~ O~ THE,,N.y, STATE CONSTRUC'~O'N & ENE~L~'- CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTR~C~ION ERRORS STATE OF NEW YOP, K, COUH:F¥ OF .................. .... ............... (Name of individual signing, cffntract) above named. ! beiug duly sworn, deposes and says that he is the applicant lie is the ........................ ' '~"~"L" '"'~D"x' ": ..................................... ' ........... /' (Contractor, ~ent, corporate officer, etc.) said owner or owners, and is duly .a'u-~. '.z.ed to perform or have performed the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowledge and belief 'and thag the work will be performed in the manner s~t forth in the application filed therewith. Sworn to before~pe this .............. day ..... , 19 (Signature of applicant)