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Home My WebLink About22721-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23774 Date JULY 17, 1995 THIS CERTIFIES that the building ALTERATION Location of Property 2515 HOBART ROAD SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 64 Block 4 Lot 12.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 10, 1995 pursuant to which Building Permit No. 22721-Z dated MAY 3, 1995 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 ON ROOF OF EXISTING GARAGE ATTA~D TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. THOMAS CUNNEEN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22721 Z Date ..~,, ,~, ................................................ Count,/TaxMaP No. 1000 Section ......_..~ Block .............. ~.,, Eot No ..... ~?-...'..f.Z ..... pursuant to application dated ........~.....~,../, ~ ............................... 19.. ,~,.~., and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD · BUILDING DEPARTMENT TONN HALL JUL 1995 765-1 8o2 ~ "fC~WN OF ~PLICATION FOR CERTZFICATE 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 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. 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. 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-existin~ Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $I5.O0., Commercial $15.00 Date ............................... New Construction ........ Old Or Pre-existing Building ................. Location of Property...'~.].~....~,~.~.,..~.. · .~.j"~.-~. ........... House No. Street Hamlet O nwer or Owners of Property.....~.~...U~/~. ................................... Coonty Tax Map No 1000, Sectiou ...... ~. .... Bleck .... ~4 ....... Lot../~,.l .............. S ubd i vis ion. ~¢.~"'~,~¢. f~ ....... Filed Ma p ............ ¢,ot... ~ ~ ............... Per nit No ~ f Per ~-' ~'~ ~ ~ · · .¢~.y~...~.Date 0 mit.~/¢~~. .... Applicant.. ~7,'~'~f~ .......... Ilealtb Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approw~l ........................ / Request for: Temporary Certificate ........... FiHal Certicate ..... ~.z.... Fee Submitted: $ ............................. ~~1~O~ ~ ........... ................... . .CO ~3 9 ~¢ APPLICANT FOU ~XJAT T~3N {l~t) FOUNDATION (2nd) ROUGH FRAME & :PLUMBING I~SULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL ,NTS. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [/~/,'Fi~NAL [ ] FIREPLAC)E,&CHIMNEY ~~ REMARKS: ~,~ ~ ' b, U0 L: lJ ~! I~ . FORM NO. 1 "U~% ......................~' TOWN OF SOUTHOLD ~ ; TOWN HALL , :, ~ I O~l~ ' BUILDING DEPARTMENT , ~,_~ ', SOUTHOLD, N,Y. 11971 ;', i, '"',[~i/~,-;~Ef;'i~' ......... TEL.: 765-1802 Ex=ined¢./?.. .... ~.:.., ~;, ~.~.' ' '. pproved ........... 1¢~.. Permit No. ~..~.. ?.~. Disapproved a/c ..................................... . . -- ' . tDuu'amo~pecl:or) ' APPLICATION FOR BUILDING'PERMIT B~ARD OF HEALTH ........ 3 SETS OF PLA~$ ........ SURVEY ................. CIIECK ...... s~:,-,-,-.~ c ;gR,', CALL . . . . MAIL TO: INSTRUCTIONS i a. Tkis 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 sti'eet: 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 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 Occupancy, shall 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 rq!~oval or demolition, as herein descr/b~d. The applicant agrees to comply with all apphcable taws, ordinances, buildingd~C/e., housing code, and regulations, and to admit authorized inspectors on premises and in b~ilding for necessary inspe~t/i~(~///~~ .-~.. · '/a.: .-. ' ' ' -- , (Sig~fay~re~of~ap.pJi?~nt.,~or name, ifa cor~;~-ation) ' (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general 'contractor, electrician, plumber or builder. Name of ownerofpremises.... (as on the tax roll or latest deed.) If applicant is a corporation, signature of duly authorized officer.' (Name and title of corporate officer) Builder's License No. ' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. Itouse Number Street Hamlet Co,mtyT x, p,o.,0OO eet,on ....... .. ¢.. .... :. /4,7 '- ........ ,o .......... :i... ' .......... (Name) 2; State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy .................................................................... k ( ' Additi .3. Natureofwor check which a cable : New Building .... :... on .......... Alteration . .'.-. Repair Rempval Demolition . Other Work 4 Estimated Cost ' · ' ............ : ......................... Fee ...................................... ! (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... / Number of dwelling units on each floor../. · If garage, number of cars .... /. .......... ' . ss, commercml or mzxed occupancy, specify nature and extent of.each type of use ...,~....d,~..~f ........ 7. Dimensions of existing struct'ures, if any Front. _~'.,..:g r~o, '/3 ;,~ ,;.?oa, ,;4.~ ............................. Depth .... ...... tazmenmons of same structure with alterations or additions: Fr~)~l~ ........................................ · Number of Stories ~ ' . 8. Dimension~e,.~.w constrUction: Front . Z~,.. ~.~ ...... : Rear ./~ ...... Depth o?o~k,- . -. 12. Does proposed construction violate any zoning law ordina~; '"r ~'' '.""~-"~'-' ' f-~5~ ........................... 13. Wall lot be regraded ~ O. ~.. ...... · ...... ..... ~-~,~ ..... ~.. ........ .~.. wm excess m, oe removed from premises: Yes Name of Architect ............................ Address ................... Phone No ..... i .......... Name of Contractor .......... i ............. Address ................. Phooe ~ ...... ' 15,' I.s this property within 300 feet ~'f' a tidal wetlan'd?' *Yes ...... No ~ ......... · If yes,'Southold Town Trustees Permit may be required. ' ......... ... PLOT DIAGRAM Locate clearly and distinctly all 5uildings, Whether existing or Proposed, and. indicate all set-back dimensions from property lines. Give street and block nhmber or description a~cording to deed, and show street names and indicate whether interior or corner lot. FATE OF NEW YORK~ . ~ ._ _, OUNTy OF '. ............................... ' ........ ' ........ being duly sworn deposes and that he is tile applicant (Name of individual signing dontract) , says )eve named. ~is the ' (Contractor agent corporate ........ ') ............................ : , , officer, etc. ' said owner or owners, and is duly auil~orized to perform or have performed the said work and to make and file this plication; thht all statements contained in this'application are irue to the best of his knowledge and belief and that the h )rk will be performed in t e manner set ~fort ~ in the applicati6n filed therewith. ~om to before me this ...... , .... ...... ...... 'tary Vu blic,O~-P-~-'~. ~. ~.,~u n t y · "E ENEO..O N .. ./////7 "._ - Notary Public, State of,Now York · · ./,/~'..~'. .......... ~ ................... No. 4951364 ' {-'/ ....... "' ' (Signature of applicant) Qualified in Suffolk ~nunty '/g ,,.~' ' . Commission Expires* MaE 22, 19 ~.'~'~ UN(~ a YOUNG 0