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Home My WebLink About23431-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~uu~ANOY No Z-24364 Date MAY 16, 1996 THIS CERTIFIES that the building Location of Property 200 LESLIE ROAD County Tax Map No. 1000 Section 97 Subdivision ADDITION ~:uTCHOGUE, N.Y. Street Hamlet Block 9 Lot 8 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 26, 1996 .pursuant to which Building Permit No. 23431-Z dated MAY 10, 1996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupanoy for which this certificate is issued is DECK ADDITIONTOEXISTING ONE FAMILY DWELLING "AS BUILT" AS APPLIED FOR. The certificate is issued to EDWARD L & JEAN M. FLI}IING (owners) 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 FORM NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 25431 'Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to://~ j'~/ Coun~/TaxMapNo. 1000 Section ¢7 Block ............. ~ ....... Lot No. ~ pursuant to application dated ....................... ~,'.~. ,~.. ....... 19..~..~. ....... and approvod bythe Building Inspector. Rev. 6/30/80 // 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 of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval~.f~m Health Dept. of Water supply and sewerage-disposal(S-9 form). 3. Approval of el~$~al installation from Board of Fire Underwriters. 4. Sworn statement f~O~mlumb~r certifying that the solder used in system contains less than 2/ 0 of 5. Commercial building, ind~f~ial 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 l'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. ~. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - .25¢ 4. Updated Certificate of Occupancy - ~50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ................... ~. · .,. ................. qew Construction ........... Old Or Pre-existing Building .... Location of Property....~.~..O. . ~/f~ ~.~. .~.~ House No. Street Hamlet Dnwer o~ Owners of Property ........................................ %ounty Tax Map No 1000, Section...Q..~.../....Block .... .~...~. ...... Lot ..... .~. .............. 5.~...~,.. ~ ~. ~q. ~..~ ............... Filed Map..%~' .~, ~ubdivision... Permit No ................ Date Of Permit ................ Applicant ..... .~ .... Health Dept. Approval .......................... Underwriters Approval ......................... ~lanning Board Approval ..................... .. . ~<equest for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. .., ............... ~ 2q3~ ~ APPLICANT 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] R~)/UGH PLBG. / [ I FOUNDATION 2NO [ ]//,INSU L~ATION f~.~ ~.~/~ [ ] FRAMING [/] FINAI~ /~ [ ] FIREPLACE & CHIMNEY REMARKS: ~/~/-*f~ /' ~/~. _ ~ I:UIJIll)/~ I I()11 (~ltl)) ~1~. Jean .F. leming 200 Leslie Rd. Cutehogue, NY 11935 FORH 1t(). I TO%4N OF SOUTIIOLD BUI1,DIItG DEPAR'I$1EHT 'I'O~N HALl. SOUTI1OLD, N.Y. 1197 I TEl,: 765- Ill02 BO^RD OF IIEALTII ............... '"" 3 SET,q OF PI.ANS ............... ~ SURYEY . .~. .................... ~cd~~ .. ~.~. ................. SLrPTIC FORH INSTRUCTIONS NOTIFY: HAIl, TO: .................... ......... 7.&.g./.5/./. ............. a. 'lids applicatio~ ,ust be co,l)leCely filled in by tyvewriter or in lek and ~{~itt~ to the ~dldit~ Ins~ctor with 3 ~ks oF plans, ~rate plot plan to ~ale. b. Plot plan M~i~ l~atio~ of lot m~ oF {xdldi~s ~ pr~i~s, rela~i~mhip ~o ~joioing p~i~8 or i~blic struts or areas, a~ giving a ¢~tail~l ~scripti~ oE l~t of pro~rty ,~st I~ drmm ~ the dia~ ~,id~ is ~rt of this al~licati~. c. ~e ~)rk c~r~ I~ this a~licatiis~ v~ r~t l~ caam~l I~fore is~e of ~ildi,g Pe~it. d. II~ a~al of this a~licati~,, the {klilding lns~ctor will ism~ a l~ildi~ Pemit to the a~licanr. ~ch ~mit Mmll {m kept ~: tl~ pmui~s availM)le for inslmcti~ thr~{~t the ~rk. e. ~ }~dldi~ ~all I~ ~¢a~pi~l or u~ in ~le ~ in ~rt for m~ ~rl~ ~mt~er ~tll a ~rtiflcate of ~<y ~mll have }~n ~t~l by Hm ~dlding lns~tor. A[~.]~'I'I~ lB IEI~{~ k~lg to H~ ~fildi~ l~I~rta~nt For the isstm~e of a ~fildlng Pe~it ~rm~nt to the ~ilditg r~ O~li~m~<e of ~ 'l~ of ~tl~ld, ~gulati~s, for tim ~stn~ti~ of Ixdldlt~s, mkliti~8 or alterations, or for ~al or d~lition, as I~rein ¢~ri~. 'lira applicant agr~s to co~ly red, latins, az~ to atuit aitl~riz~l ins~tors ¢x~ proai~s a~l in ~ilding for ~cesaa~ ins~ti~s. ute . (~[ail i~B mktress o~ a~licank) State ~hether al~)licant ia c~,~er, les~e~, agent, erdfitect, engineer, general contractor, electrician, i)lt~0l~r or Ixlilder. (blare a~l t~tle of COrlmrate officer) ~dlders L~censo I~o .......................... Plu~l~r8 Licen~ ~ I. I~ati~ of lam ~ add, p~ Dame lit~ber Street Heal et Co,nty 'lax l%p Ho. lO00 Section ....0...~.~. ..... s~,aivi~i,~, ...~{~a.m.e.~ ................ ~i~ ~p ~,.~Z.g.Z .....,~ ..... ( ......... 2. 8tare e~istlrg u~ arfl ~ca~mmy of p~i~s~ t~m~l inkelx~ use m~l ~CUlm~my/ of p~ c~st~ction: a. ......... ...... .................................. b. Inte~ u~ a~l ~c~lm~y ............................................................................. h I~llure o1: lank (cheek ~tddl al~Plic.hle): Ixk.~ Ikdhli.g ~kli~ iou ~ AILeration If Barage~ ~tnl~r of tara ...................................... If I~mis~a~ t~mz~rclal or mi~l {~eulm~my, ~l~cif~ ~ml.ure as~l extent oF eachltylm of use ...................... llin~nsicms o~ m~m srnmture with alterari{mo or ~g~lition~: F~ont: .......... ~ .... I~ar ............... l~pth .................... I~il~tt .................... ~dmr of Storlea .... L .......... PI,OT I)IAIIRAH j t~lelJler interior or eor~r lot, DATE' ~ N~OTtFY B t. IFL~ I ~L[.O~ING ~NBPECT~ON~: tHOUT REQUIRED 4. [ FU';AL CONSTRUCTION MUST jgE COMPLETE FOR C.O. A~I. CONSTRUCTION SHALL ~EET THE REQUIREMENTS OF THE N,~ STATE CONSTRUCTION & ENERGY COOES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ER~OR~ HELENE D, HORNE Notary Public, State of New York No. 4951364 Qualified in Suffolk County /~"? I;ommission EXpires May 22]':t'.~ ~_~/' YOUNG & YOUNG SURVEY FOR: EDWARD £. FLEMING g ,/~AN LOT NO. I, "BAY HOMES'- PECONIC · ow~ o~ $OUTHOLD SUFFOLK CO., N, Y.