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Home My WebLink About23681-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24988 Date APRIL 18, 1997 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 30697 COUNTY ROAD #48 PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 73 Block 4 Lot 4.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 27, 1996 pursuant to which Building Permit No. 23681-Z dated SEPTEMBER 16, 1996 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 FIREPLACE ADDITION & WINDOW ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT GOBER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A it ing Inspector Rev. 1/81 FORK NO. f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 23681 Z Date ......... ...... . . ...1. .......................... >I9 Permission is hereby gran to: ... . .... ....... .... .............................. e,� ... �� ..4F40 ....................................... t . .. ... . . .. . - 1 .. .. . . . ........ .. ........ ... . . . . .. ... `... .. ..... at premises located at ................................................................. :- .. . ................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section .............. 19. Block ........�/......... Lot No. . ../.............. pursuant to application dated .................... 12�- - 2- ........ 19..FKA� and approved by the Building Inspector. Fee $...7 1 ........... ..... ..71.... .. f........ Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN MALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This dpplication must 'be filled in by typewriter' ORink and submitted to the`,building insoectot, with the following: for new,b.uilding .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. 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, 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. G. 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-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 . . . 1 ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . Location of Property. . . .�"�.�. .� .�. . . . . . . . . . . . . . . . . . . . . . . G . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. �Ub�rLr. . �J�{.: . . . . . , , . . . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . ./. . . . . . .Lot. . . . . /.4 . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . J Permit No. . . 3�g j. ,�';;Date Of Permit. .: .� p licant. f1�.✓.':C4i .h?S�! �. `�: 7�� Health Dept. Approval. . . ..`: `'. . . . . . . . . . . . . . . . .Underwriters Approval. .' `�: . . . . . .�ee)x�-�.� Planning Board Approval. . . ,`X:: J . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Fin,, erti e. 41/1 . . . . . Fee Submitted: $„ -- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . APPLICANT , 765-11102 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ NSULATION [ MING [ J FINAL [ FIREPLACE & CHIMNEY REMARKS: 6X7��',,,toJ DATE I � INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND1[ ] ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 7 /d X17 INSPECTOR r� rll,fl) trllil'L(.fION lo,rultI. DAT V (;Urirll,Ni:i w I_ POI IIJIIATI(1N ( IST) I FOUNDATION Zvi e� c IMMAI FRAHR b o 111.11HII I NC _ 11VOI1.AT I(1N IT-It N. Y . f�T STATE F N1;It(:Y COM", M", Oen nun I T I ONAI, UMM F,N I'; r' _. h BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLeINS . . . . . . . . . . TOWN OF SOUTI-101:13 SURVEY . _ . . . . . 21 BUILDING DEPARTMENT CIICCK . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FOR11 -,G ISOUTHOLD, N.Y. 11971 TC3"�^N OF �.Jt' ULO. ._., TEL.: 765.11302 1.10-1 FY : "� "](� CALL .,�✓.�.�� ( .� . Examined . . 19 � • • • . /� / MAIL TO . /�pprovcd . . . . . . . . . ., 19 �Y. I'criiiit No. ��ls . . . . . . . . . . . . . .; . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . (Building Inspector) APP CATION FOR BUILDING PERMIT // Date lkv�: : . .'.�-?. . . ., 19q�7. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector,with 3 sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plait showing location of lot and of buildings oil premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 permit shall be kept on the premiscs available for inspection througliout the work. e. No building sliall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy Tall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New. York, and other applicable Laws,Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with,all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. eN . . . fly C. . . .t tA C . . . . . . . . (Signature of applicant, or name, if a corporation) �?'. . ?x. . . �3 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . : . . . . �:p N: !'�� -C-) . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . RQ��c�.- . . . G--S� g�cR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If a�plic �C ' ?a ra ' ,;signature of duly authorized officer. . (Name and title of corporate officer) Builder's License No. . . .15�� . . .4. T. . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . .3 0� .�. . . . . . . . . . . . . . . . . . gin . o� . . . . . . . . . . . . . . . . � . . .,• . . . . . . house Number Street Hamlet County Tax h1ap No. 1000 Section . . . �. .� . . . . . . Block . . . . . . . . . . . . Lot . . . . . . ! ' . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed h1ap No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Namc)� 2. State existing use and occupancy of premiscs and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . .Qn.e.. . . . . M<< . . . . . . . . . . . . . . . b. Intended use and occupancy oyl. . . l � 4� . . .`. if � .of . . . . . ... �. 0 ' (� CQ . w ow s L) PZ-aJv-d, 4D Qrsort`vS t. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . Y. . . . . . Alteration . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Den►olitior► ..'. . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) Estimated Cost . . . . . . ..��. . . . . . . . . . . . . . . . . . . . . . . . . . Ice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . (to be paid on filing this application) If dwelling, trunrbcr of dwelling units . . �.: . . . . . . . Nunrbcr of dwelling units on each floor . . . . . . . . . . . . . . . . ifgarage, number of cars . . . . . . . �. . . . . . . . . . . . If business, commercial or mixed occupancy, specify nature and extent of each type"of use . . . . . . . , , , , , , , , , Dimensions of existing structures, if any: I-rout . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . Dimensions of sane struclurc with alterations or additions: brunt .4-�fLA 4- . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . IIcigl►t . . . . . . . . . . . . . . . . . . . . . . Nu inber o`f-Storics . . . . . . . . . . . . . . ... . . . . . . Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . Height Nun ber of Stories // Size of lot: Front . . . . . .23.1. .E Q. . . . . . . Rcar . . . . . . . . . . . . . Ucpttt .r4:.�. . . . . . . . Dateof I'urchasc pjat Fonncr Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zone or use district in which prerrrises•are situated . . . . . . . . . . . . . , , , , . , , , , , , , , , , , , , , , , , , , , , , . . . Does proposed construction violat ati any zoning law, ordinance or regulon: . . . .0.i�) . . . . . . . . . . . . . . . . . . . . . Will lot be regraded .. . �. . Will excess fill be removedfrom premises: Yes o Name of Owner of premises . . . ! H ... . Address .4.E�. �l�tGe No. 7 3�"��?�7 Narne of Architect . . . . . . Address . . Phone No. . . , Namc of Contractor * fAJL . . . . . Address"TRP LqQ. V.C.-.P�. . . Phone No. 7,1M.-. . � Is this property within 300 feet o[ n tidal weLland? *ye;,, , , , , , , No. . . . . . . . . *1f yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from :)perty lines. Give street and block number or description according to deed, and show street names and indicate whether crior or corner lot. x'I'L• OF NEW I'ORK' S S im OF . . . . :r beim; duly sworn,deposes and says that lie is the applicant, (Namc of individual signing cot ract) .,e named. stile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . ( untractor ant, corporate officer,etc.) aid owner or owners, and is duly author —to perfornr or have performed the said work and to make and file this ication; that all statements contained in this application are true to fire best of his knowledge and belief;and that the will be performed in tite nranncrsct forth in file application filed therewith. it to Before nre this . . . . . . 17 : . . . . .day of. . . . . . . . . . . . . . . . ., 19 ry Public, . . .0.'` : V!!! /' ":' . . . . County • . , • . • JOYCE M.WMNS (Signature of applicant) Notary Public,State of New Yak No. 4952246,Suffolk CM Term Expires June 12.1 7 S" C LAY FL L)E Iv'-o I WgLI,S M�n, 2'-v" A�ovc NEAEZcsT AP ROVED AS NOTED SEATichk of 5TZUGTUR.E DAlt B.P.# �36 Sl WIT I i D D'' FEE:-7?r !3 . N NOTIFY BUILDING DA E 765-11802 J AM TO 4 OR THE -F OWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE LEAD �t.AStiING 2. ROUGH - FRAMING & PLUMBING . INSULATION As •REg , 4. FINIAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CNSIFtlt ?N--SHLL MEET TI-IE REouiREMEN't5 OF'',.-THE. NX STATE CONSTRUCTION gi ENERGY CODES. NOT fESPONSIBLE FOR DESIGN OR CO RUCTION ERRORS WALL, TES AS FZ0, 'Mwl!l1ERS tRI1fICAtE P, 0 IQ FUL f*OOTINGr TO E�E MIN. 3b" , .ow FIN�St{EDr� ° GRADe AN D 5DY10 � Cl-" � �� SIZE Z4 \ SCALE: II= �•QII APPROVED BY \ i / L G DRAWN BY �W DATE: t DRAWING NUMBER CHARRETTE PRO-FORM 92OPP PRINTED ON 920H CHARPRINT VELLUM i I 2-2x a p 4 1� ,f ALL �tJ'.)::C✓:�- - '-:i ,,A I SCALE: ��." - I /O � APPROVED BY N BY DATE: DRAWING NUMBER FlOt� -C CNARRETTE PRO-FORM 92OPF PRINTED ON 9M CNARPRINT VELLUM _ONG ISL A ND SOUND AFF�G� tiwc rH S pAr� I b�54,.E s6,00 92, 1 ST ONE JETTY STONE JETT YZ JSTEPS O B`yrF ----- -- - -- 00 SCM FD ^� ----- I� LIL 130Si Ar.'E r- �,MRCh'• 0 i%'Z STORY yClp✓ � �- \ �O Rilrf RFSIpE*Cf �B r %f GAgAGEIUMDf F; ��' 7'OVERHANG "O r ty POLE �, 's . 3i iN�s 2 I 4 7 UNDERWRITERS CERTIFICATE REQUIRED: ,.� OCCUPANCY OR � I "� " �� I ; 11 E �IS` UNLAWFIJL WlH'Ot1T CERTIFICATE i1- a OFOCCUPANCY -1- 17— APPRQVED At iOTED FEE', BY. _ x' '' ! NOTIFY.BUILDING DEPARTMENT AT 7 i _ ... - T65'16I� 8•AM -TG-�4 PM FbWTHE FG INSPECTION$' - I _ { . l, 1 Fb(lNDATION TWO REQUIRED r FOR POUflED CONCNETE 2 ROUGH FRAMING 0 PLUMBING r 1 j r— I I` Nr IN - 1 Y I A FINAL CONSTRUCTION -MUST 13E COM�(Eh FOR b. ALL CONS7HUCT ONC SHALL MEET THE' . THE PWNSE'tMgNNT$ OF THE NY 1 } STAT6ObTION & -ENERe. Y 1- RE$OONSIBLE 'FQRCQI1 DESIGN: QR CONSTHUCTION ERPIGAS + - r ' k Al