HomeMy WebLinkAbout23909-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24895
Date FEBRUARY 7, 1997
THIS CERTIFIES that the building ACCESSORY
Location of Property 1260 BUNGALOW LANE
House No. Street
County Tax Map No. 1000 Section 123 Block 2
Subdivision Filed Map No.
MATTITUCK, N.Y.
Hamlet
Lot 17.1
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 6, 1997 pursuant to which
Building Permit No. 23909-Z dated FEBRUARY 6, 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 STORAGE SHED "AS BUILT" AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
FRANKLIN A. SCHOLL & WM. P. SCUOLL, JR.
N/A
N/A
Rev. 1/81
FORM NO. 4
TOWN OF SOUTEOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24894
Date FEBRUARY 7, 1997
THIS CERTIFIES that the buildin~ ADDITION
Location of Propert~ 1260 BUNGALOW LaNE
House NO. Street
County Tax Map No. 1000 Section 123 Block 2
Subdivision Filed Map No.
M~TTITUCK, N.~.
Hamlet
Lot 17.1
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 6, 1997 pursuant to which
Building Permit No. 23909-Z dated FEBRUARY 6, 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 WITH RAMP ADDITION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR "AS BUILT".
The certificate is issued to
FRANKLIN A. SCHOLL & WM. P. SCBOLL, JR. III
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
¢ //ldi/g Inspector
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
fTHIS PERMIT MUST BE. KEPT ON THE PREMISES UNTIL FULL
COMPL~ION OF THE WORK AUTHORIZED)
N.° 23909 Z
Date February ~,
....................................................... ,
Permission is hereby granted to:
, ,..P. ,a..u.!....A. :., .,C.a~..i.n..i..t..i..:...A..t. ?..y, ...a.../?... ~L!.E ..~, ~. Scholl) P.O. Box 992
Southold, N.Y. 11971
CONSTRUCT A DECK &I~ITit RAPIP ADDITION TO EXISTING 01~ FAMILY DI~ELLING
AS APPLIED FOR "AS BUILT" & ACCESSORY STORAGE SIfteD "AS BUILT"
. 1260 BIINGALOI~ LAN~ ~IATTITUCK, N.Y.
at premises located at ............................................................................................................................
County Tax Mop No. 1000 Section ........ !.2..3. .......... Block ....... .2. ............. Lot No ...... 1.7..:.! ............
pursuant to application dated ....... EEBRIIAR.Y..6 ............................. , 19...92., and approved by the
Building Inspector.
Fee $ ......,7,,~,.,..Q,Q...~
35.00 (sago)
Rev. 6/30/80
~LiCATION EOR C~2T~GA~. O[ OC~/J~-~N'C-
This appiicacion must be filled in by ii, aw-ricer 0R ink and submitted to the building
Luspeccor ~ich the fol%owing: for saw building or new use:
Final survey of properu7 with accurate location of al! bui!dings~ property lines,
s~reets, and unusual natural or topographic features.
2. Final Approval from Eeal~h Dept. of ,~atar supply and sewerage-disposal(S-9 form).
Approval of electrical installaclon from Board of Fire Underwriters.
Sworn statement from plumber certifying that the solder used in syst~e couzains
!ess chart 2/10 of 1% lead.
5. Commercial building, industrial building, mulciple residences and similar buildings
and installations, a certificate of Code Compliance front archi[acu or engineer
responsible for the building.
6. Submit Planning Board Approval of completed size glen requirements.
For exisnin~ buildings (prior to April 9, I957) non-conformJu~ uses, or buildings and
Vpre-~xisting" land ~ses:
I. Accurate survey of propers/ showing al! property li~es, streets, ~ui!di~g and
unusual natural or topographic features.
2. A properly completed application and a consent ~o inspect si~o-aed by ~he applicant.
if a Ceraifica~e of Occupancy is ~enied, the Building lnspec~or shall sta~a ~he
reasons ~herefor in w~%:~ng to the applicant.
C. Fees
i. Certificate of Occupant7 - New d~e!ling ~25~00, Add!=ions to dwal!in~ $25.00,
.Llcaranions co dwelling S25.00, S~g pool $25.00, Accesso~f budding $25.00,
kdu_=~ons ~o accssso~ bui!d~ $25.00. Bus,asses $30.~0.
2. Certificate of Ocaup~c7 on Pra-~xis~ 3u~d~m - $100.00
3. 'Copy of Certificate of 0ccupanc7 - ~ .25=.
'=. Ugdacad Certificate of Occupancy - $50.00
5. Temporary Car~ificace of Occupancy - Rasideu=ial
Subdivision .................................... Filed ~ap ............ Loc ......................
Perm!.' .Yo ................ Date Of Permit ................ App!icam~ .............................
Dept. Approval .......................... Undergo!tars Approval .........................
Planning 3oard Approval ........................
for: Temporary Cartlficate ........... Final Carti~~
765-£802
aPPLiCATION YOR cF-RT~_=_C~,_~ OF OCCJP3~CY
This applicaclion must be filled in by fiXed, ricer Ok ink and submitted co the building
.,~sp~9~y%~h ti.e following: for new building or ~ew use:
i. Final subbed'of proper~y w%ah accurate locaclon of ail bui!dings~ proper~y lines,
s~ree~s, and unusual ~acural or topographic features.
2. Final Approval from 5eai%h Dept. of .~atsr supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Unde~-r±tars.
s. Sworn scaremen~ from plumber certifying tha~ ~he solder ~sad ~n system contains
!ess zhan 2/!0 of 1% lead.
5. Commercial building, industrial bnilding~ multiple residences and sim~i!ar buildings
and installacions, a car~ificaza of Code Compliance from architect or engineer
responsible for the building.
6. Submiz Plann~ Board lpprov~ of completed size plan raquir~en~s.
For existing buildings (prior to April 9, i957) non-conforming uses, or buildings and
'7pre-=--xisging" laud uses:
1. Accurate scl-ye7 of propers/ showing al! proper~y !~--nes, s~ree~s, bui!din~ and
unusuai na~urai or ~opographic feat-ares.
2. k proper!7 completed application and a consent to inspec~ sit, led by ~he applicant.
if a Certificate of Occupa~lcy is denied, the Building .'inspector shall scats the
reasons ~herefor in ~-ri~ing ~o the applicant.
C. Fees
A-Iterations to dwelling 525.00, S~ng pool $25.00, iccesso~
Additions ~o accesso~ 5uild~ S25.00. 3us~esses $50.00.
2.Carcifica~a of Ocaup~c~ on Pra-~isc~ Bu~d~ - $I00.00
3.Dopy of Cercificata of Occupant7 - ~ .25~.
4.Updated Car~ifica~a of Occupana'/ - $50.00
5.Temporary Certificate of Occupancy - Rasiden~i~
.... .....................
~o~o~ o~ ~=o~rw ........ 12.~¢.. ~ --~R¢.e~.~.. ~&~ ........ ~.~.~.~. .............
co=:y 00o, .... .... A ......... fY:.( ..............
Subdivision .................................... F~_!ed .w_ap ............ Lo~ ......................
Peak-mia No ................ Dace Of PermiC ................ Applicant .............................
Eea!sh Dept. Approval .......................... Unde~-r±cars Approval .........................
Planning Board Approval ........................
Raquss: for: Temporary Car~iflca:s ........... Final Carulc~~
~.~ ~, v ,?
FORM NO. I
TOWN OF SOUTROLD
BUILDING DEPARTHENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL: 765-1802
~.~. i..~.t ~ ......... ~o~.'.?.
Appro~a..:.~l.O. ......... IO.g..~ Pe~it NO. ~2-~On-~---
Disapproved a/c ......
(su~lding Inspector)
BOARD OF IIEALTI!
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
NOTIFY:
CALL ·
HAil, TO: ....................
APPLICATION FOR BUILDING PERMIT
'Date ................ ,19 ....
INSTRUCTIONS
a. ~his application ~st be campletely filled in by typewriter or in ink and sel~nitted to the Building Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to sche&fle.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public
streets or areas, and giving a detailed description of layont of property m2st be dram on the diagram which is part of
this application.
c. The work covered by this application may mot be ctmmmnced before issuance of B~ildlng Permit.
d. Upon approval of this application, the Building Inspector will issue a Suildlng Permit to the applicant. Such
p~tmit shall be kept on the premises available for inspection throughout the work.
e. No beilding shall be occupied or used in whole or in part for any purpose ~J~atever tmtil a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATIC[~ IS I~ I~ to the Building Department for the ismmnce of a Building Permit pursuant to the
Building Zone Ordlnan~ of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinm~ees;or
Regulations, for the co~structlon of buildlng~, mdditloms or alterations: or for .r .~ ..al or demolition,
~ ~h~t ~he an~llcant anrees to ca~vly with all applicable laws, ordznances~ildlng code,~houszng cc~e,
~c ..... r~ ~ -- - .... tlons
~ ~..:¥. ~.=~.JV .............................. t.
/~ ~Z/~ W /-~ A L} ~WL-f-- · · . ........................
Natm of a~er of premises .¢ .~.-. .......................................................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of dely authorized officer.
(ll~ne and title of corporate officer)
Builders License No ..........................
Pl~bers License 1/o ............... .. .. . · . -- --
Electricians License l~ ......................
Other Trade's License No ..................... L~- ~
I~cation of land on ~hich proposed ~ ~11 ~ ~..' ..........................................................
...............
~ ~ ~. ~ ~=~..../~ ...... ~ ...... ~ ........ ~= .... ~.z~.~. ....
~iv~ai~ ...................................... ~i]~ ~p ~ ................ ~ ...............
a. ~st~ ~ ~ ~ ..... ~ ...... > ......... ~ ...... · ............... :: ...........................
3. P;]ture of work (clmck sifich apl}ticsble): htm~ I~fil¢ling .......... Nklitlon .......... Alteration ..........
~ (~ 'p~' )
4. Esti~mt~l C~st ' I . fee
(to ~ ~id on filing this a~lleati~)
if garage, tudor of e~r. ..... I .................................
6. IE Nmi[mss. ~relal or mi~ ~oJ~y. e~elry tml;ur~ al~ extent of each t~ of u~ ......................
7. I)in~n,i~m off ~isting ~tnm~t~s. iff ~ny: Fret ................ ~nr ............... ~pth .................
I~i~t ........................ i. ~dmr of Storle~ ......................
DJn~nsi~m of s~m stttm~ro width nlter~l:i~, or m~itjons: Front ............... ~ur ...............
l~pth .................... I~i~t .................... ~dmr o[ Storie, ...............
I0. l~*to of ~rclm~ .............. [ ....... ~ off Fonmr ~mr ........................................
~I,0'1' I}Ifi~llfi~
~i~tl~r interior or eo~r
............................................................................
alqfi tcntt(~; thnt al.t
Lhat the ~rk wltt Im ~rfou~l in I:h~ trot. mr ~t Forth in the ul~l. le~l:i~* /11~ tlmr~lth.
i
~rn to tmf~re ne
Notary Public, Siate of New Yof~ ~ --,,. .............· r -'
No 5246{ 8265
CommiSsion Expirs~ April