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Home My WebLink About23503-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26839 Date: 12/15/99 THIS CERTIFIES that the building ADDITION Location of Property: 1365 JOCKEY CREEK DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 2 Lot 19.12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1996 pursuant to which Building Permit No. 23503-Z dated JUNE 14, 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 ADDITION TO AN EXISTING ACCESSORY SHED AS APPLIED FOR. The certificate is issued to RICHARD L & DEBORAH CONRARDY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Insp 201or Rev. 1/81 1 Fossa xo. s 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° 23503 Z Date ......... .................../..d..................., Permission is hereby granted to: .............Q........... .. .... �1 y:..97/ to .... ., <.... i ..... ...... . ..................... at premises located at ........./.. .. ........ ... .... .. ........................... .. ................................. ..........� . .... .. * le..�Y.........11t0.71.................... .................................................................... ........................................................................................... County Tax Map No. 1000 Section ......../.. ........ Block ......A.......... Lot No. ..,,1A9®.l� pursuant to application dated ..................1`..1...1.7.........., 19J6? and approved by the Building Inspector. Fee $..a .......... .. ..... . .... .. ......... . . .... .. Building Inspector Rev. 6/30/80 �� c1�rnn� L + .' o � �1. pCon�w�r� , corm 1 1365. nn pp qq Guz� P4 � '..•._�.'.._�' �� TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL �) SFp 0 765-1802 BLDG.DEPT. L'I ION FOR CERTIFICATE OF OCCUPANCY WN FS UTH�I� A. This application must be filled in by typewriter OR ink and submitted to the buildin; 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 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 buildin 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 an "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. C. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - 4. Updated .Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . .. . . . . . . . .. . . . . . . . .. . . . . . . . . . . . . New Construction. .. . ..... .. Old Or Pre-existing Building. .. .. . . . . . . Location of Property.. .1 �'6 .. .. .. .. oc� Y..ClZr!c f -!J�L . . . .. .4., ."?`f 1 . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. . . .. . . . . . . . . .. . . . . . . . . ... ...n. . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . County Tax Map No 1000, Section. .7P. . .. . . . .Block. . ..F.. . . . . . . . . . . .Lot. . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . .//. . . . . ..Filed Map.. . . . . . . . . . .Lot. . . . . ...n. . . . . . . . . . . Permit No. ..3.�3. . . . . . . .Date Of Permit.Y. . 9A. . . . . . . .Applicant.Kil'a//i. . ... Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . .. . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee` submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: Ile, I DATE 12- 1/31 _INSPECTO 3. Nature of work (check which applicable): New Building . . . . . . . . . , Addition . X Ale&) " Repair �t & • 4•,t, . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition : 'P.. ., _ ... . . . . . Ot�;er Work . . . . . . . . .4� . . . . - 4. Estimated Cost . . . . . 1POd Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be aid on filing tYti's5pplication.) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwellingun,tss on each . If garage, number of cars . . . . . , flooi . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions Qtf'existing structures, if any: Front . -151. . . . . . . . . . . Rear . . . . . . • . . . Height . . �% . . . . . . . . Depth . . ./. '� . . . . . . . . g �• • • • • • . , . . . . Number of Stories . . . . . . . . . . 'F'ront ' . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . 1 4. . . . . . Depth . . . . .)If. . . . . , . . . . Rear . . . . . . . . . . . . . . . . . . . . . . . . . Height . . .`'� . . . . :. . . . . . . . : . . Number of Stories . . . . . . . . . . . ' 8. Dimensions of entire new construction: Front . .LL . . . . . . . . . : Rear . . .1.L . . . . . . . . . Depth Height . . l`1, . . . . . . . . . . Number of Stories . . . . ... . . . 9. Size of lot: Front . . . IJ i . . . . . . . . . . . . . . . Rear . . . y . . . . . . . . . . 10. Date of Purchase . . . . . .)q,f i, . • Depth , . . . . . . . . . . . . . . . Name of Former Owner J1tifi,,ykN" ,S ,jSEPN, �A�4y 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . ' ' ' ' ' ' 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . 13. Will lot be regraded . g ��'" " " " " ' g • •es • • • • • • • • • • • . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises R.i�HQ(Z/E, , �" uezp(Uj�. • • , Address )j"_,X9(Xr , Wa.®9 Phone No. Y t • 76d= rl. . Name of Architect �41U ,K0{ (mss. . . . . . . . . . . . . . . . Addres�b.+A+n%� e;1(AR. .�lu&PA{"�• phone No. a''C -dy,Q Name of Contractor ZW . . . . . . Address . . . , . . . , , . . Phone No. . . • . • 15. Is this property within 300 feet of a tidal wetland? * ' • " " " ' • • *If yes, Southold Town Trustees Permit may be required. No. . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. .Uf.UGy" pD"p0 PROPIX�G'A KLocs X66 pRoPEa*7 , i Ste, NouSG s as 10 MACETL 1us 1'I2ad -Ty 100 1 SbCKE% Uccle i5a TATE OFF .yrl� /r 'OUNTY OF . '1�9nZ1 l6/ S.S �, " t" . '� •� •`r. r`7. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) / )ove named. eisthe . . . . . . . . . . . . . . . . . �C (1Yt�2..r . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this iplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the ark will be performed in the manner set forth in the application filed therewith. vorn to before me thiis7 ..7W-.day of. . . . ... . . .'. . . . ., 19 )tary Public, . . . . . . . .f... ��\J7� • • . . . . Cowtty CLAIRE L.GLEW Notary Public,State of New York ( . ,t 7, No.4.878605 Qualified in Suffolk County (Signature of applicant) Commission Expires December 8,19 T i BOARD OF REAL.T11 . . . . . . . . D FORM NO. 1 �3 ` SETS OF PLANS . . . . . . . . TOWN OF SOUTHOLD -w SURVEY . . . . . . �ti:7 Q BUILDING DEPARTMENT —CIIECK . . . . . . . . . . ... . . . . . M TOWN HALL SEPTIC FOltrl . . . . . . . . . . . . .DEPI SOUTHOLD, N.Y. 11971 BLDG 4 TEL.: 766.1802 NOT i Py sra TOWN OF S UT 0 CALL . . . . . . . Examined . . . . , 1' 'f HA I L TO : Approved . . . . . l ., 1 ermit NC42? . . . . . . . . . . . . . . . 11 . Disapproved moved a c , . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . (Building Inspector) A it Al'"lUN FOR BUILDING I'ERI'JIIT Date . . . . , . . . . .. 1914 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale, Fee according to schedule. b. Plot plan showing location! of lot and of buildings on premises, relationship to adjoining premises or public stiee or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app] cation. I 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 pernr sliall 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 Occupant shall have been granted by the Building Inspector; APPLICATION IS I1L;REBY MADE to the Building Department for the issuance of a Building Permit pursuant to It Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction Iof bulldings, aclditions'or alterations, or for removal or demolition, as herein describe( The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and 1 admit authorized Inspectors on premises and fn build ng for necessary inspecti5yys.,_ n J (Signature of applicant, name, if a corporation) (Mailing address of applicant) Statewhetherapplicant is owner,,, lessee, 'agent, architect, engineer, general contractor, 'electrician, plumber or builder ,(,�- wkfv�_, . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . 0441IWA. .Pm. . .p tedf.,�µ' . ��te�►2oy (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorfied officer. (Name and title of cor Iorate fficer , • • • • • , • plorate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . .!!, . . . . . . . . . . , . . . . . . . . Electrician's License No. . . J . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . 1 . Location of land on which prognosed work will be done. . .1��47. .q._4 4Y. 4?' . .A?. . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . .J�a' '��. . . !r . , fe. . . . .. . . . . . . . . . . . .ra,;r*V . . . . . . . . . Ilouse Number Street lianilet County Tax Map No. 1000 Section . . 47.0 . . . . . . . . . . Block .07�e O®, . . . . , . : . . . Lot . Subdivision . . . . . . . . . . . . . . i . . . . . . . . . . . . . . . . . . . , , . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . • . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: I a. Existing use and occupancy! . , .SfJCRGE ,-r-c*, ®. . . . . . , b. Intended use and occupancy . .. >1/21�<4FAI. . ..�.'�.v&i ,,C. . . C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . •I f�jj L- T� _ 12_t 12 L,Uyly- A 5 K`(LI rTrl-( old w/ spa-eGrT QU s ,gLoc L I,ik, cc0&5hhrn ", 2� TRIHolI° rol - wl� d Golk�[loTlol� — xiiilc� /Y nLy's o p Lw.l- �Lr� coa¢s . z, GOFJffz.IETC ro r--,f aGoo I/SI orl a -ro I - lshlD 1 qPi — z M 1 —T � 12'x36;' U ct"IIERSCERTIFICATE -,fir--� o� sena _ v iL X h'riIJ R ED AS N0 REQUIRED JD DATE; B.P.H d FEE: J BY: NOTIFY BUILDING DEA ENT A � w 1 n 765-1802 9 AM TO 4 HE O �1 a tv ' -i, F IFOUNDATION OFOLLOWINGINSPECTIONS: I x y m O FOUNDADATION TWO REQUIRED N a FOR POURED CONCRETE , 1 .�ti IhT 1, - v` a 2. ROUGH - FRAMING PLUMBING -- ----- - -- - --- o 3. INSULATION I�epglns5 PLOP /a�'r�GUEs = l 0 Lj Q 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET -- THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION S ENERGY — CODES. NOT RESPONSIBLE FOR `� `• - - j 'N h N DESIGN OR CONSTRUCTION ERRORS - - - --]JN %2PLYWO. � I�rzj6v� I /y� _ 11 -8"r7` GHRF it ��K 7� L,♦1. DGl�rt' X21 2"p al oil _0fl�CCUPANCY OR12'� Ex 'sT��GUSE !S U�ELA�NFUL -- V>ITHpUT CERTIFICATE OF OCCUPANCY , _D F �rl�ss �c,L�s I I� IS Ib FEL'P CfLIJSLI W/ EKI��Ca� �"— I�k�pGC2 yJrY+i9 S Gl.i I -r' 4° A ,. �G\`'ZERED AR�h 1, 9WFI R{ OK 1 ��PaTd� �� . o �� zl,pl • �/,fn _II U.. 1/�.n c I S 1 9 `� / ¢F �� p .. �fe u7 -1 c14 .yJ