Loading...
HomeMy WebLinkAbout22717-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCUPANCY No Z-23617 Date MAY 8, 1995 THIS CERTIFIES that the building ALTERATION Location of Propert~ 5750 NEW SUFFOLK ROAD NEW SUFFOLK NY House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 2 Lot 19 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Build~ng Permit heretofore filed in this office dated APRIL 10, 1995 ~ursuant to which Building Permit No. 22717-Z dated MAY 1, 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 TO ENCLOBEANEXISTING PORCH "AS BUILT" ATTACHED TO AN EXIST- ING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BARBARA & SHERWOOD COOPER of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLuMBERs CERTIFICATION DATED N/A N/A / ~uilding Inspector Rev. 1/81 FORM NO.3 T~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N_° 22717 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ~....:.~....~.~.~......~......~<~ ........................ .....~..../..~ ............................................................. .~.........~.~ ......... ~.....z,:~.;. . .~ ,o..~.~ ....... ~.....~,,,.~,. ....... ~.....~.~..-........,.~.~.~ ...... ~..,,,?~ ......... ~ ...... ~.....~~-- ......... ~......~:i~ ............. ~i'~',~';~,i~i';~;~'~i ................... .~..z~ ........ ~.....¥~.-,.~....~ ........................ .~,~-~...... ~~ ............................................. Courtly Tax Map No. 1000 Section....Z./.?. .......... BIock...~.~--~ .............. Lot No ..... ./..,~... ................ pursuant to application dated ........... ~ ....................................... 19...~,~., and approved by the Building Inspector. ~ee,....Z.~.:..~ .... Rev, 6~30/80 3. 4. 5. Form No. 6 TOWN OF SOUTIIOLD BUILDING DED~RTMENT TOWN IIALL 765-1802 ~kPPLICATION 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 from Hp~lth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical[ installation from Board of Fire Underwriters. 4.' Sworn statement from fplumber certifying that the solder used in system contaiFs less than 2/10 of I% 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. 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. Certificate of Occupancy on Pre-existing Buildin~ - $i00.00 Copy of Certificate of Occupancy - $20.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00~ New Construction ........... Old Or Pre-existing Building ....... Location of Property.. ~.~7~.-~. ....... ./~...n~...~?..~..~..zf.7.~...~..~. ........ ~'~. ~.~.~ ....... House No. Street Hamlet Onwer or Owners uf Property .... ~.~. *.~~~ ..... ~~ ................. County Tax Map No 1000, Section ..... ~.[~ ..... Block ...... ~. ....... Lot ....... ~ ............ Subdivision .................................... Fi 1 cd Map ............ Lo t ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval ...... ~.~ ....... ~ ..... Underwriters Approval[...~.~]~ ............ Planning Board Approval...~P.~ ........... Request for: Temporary Certificate ........... Final Certicate...~. .... Fee Submitted: $ ............................. BUILDING DEPARTMENT FEE SCIIF~DULE AMENDMENTS EFFECTIVE 12/30/92 S~INGLE FAMILY DWELLING 1) New dwellings, additions, alterations including deck additions to existing ~'"~dwellings - $75.00 plus .~0¢ for each sq. ft. of floor area in access of 850 sq.ft 2) Accessory buildings, additions & alterations to existing accessory buildings - $35.00 plus C.20¢ for each sq. ft. of floor area in excess of 500 sq. ft. FARM BUILDINGS Farm buildings, additions & alterations to existing farm buildings - $50.00 for each building MULTIPLE Hotel, motel, multiple dwellings & business, industrial and all other buildings including wineries. I) New buildings, additions & alterations to existing buildings - $I50.00 plus ~25¢ for each sq. ft. of floor area in excess of lO00 sq. ft. 2) Accessory buildings, additions & alterations to existing accessory buildings - ~35.00 plus .20¢ for each sq. ft. of floor area in excess of 500 sq. ft. ~OUFFOATIONS Foundations constructed under existing buildings - $75.00 ~2IMMING POOLS Inground Swimming Pool with fence enclosure - $150.00 Above ground Swimming Pool with required fencing - $50.00 All other struciures (i.e. fences, Satellite dishes, wood stoves, tennis courts) and additions & alterations to such structure - $35.00 DEMOLITION Demolition and/or removal and/or ~elocation of any building - $15.00 minium'and .10¢ for each sq. ft. in excess of 300 sq. ft. of floor area. SIGNS Ail signs except signs permitted by §]00-3]C (9) (a) shall be $].00 for each sq. ft. of sign area, with a minimum fee of $25.00 CERTIFICATE OF OCCUPANCY I) ~usiness buildings and/or business uses and additions and alterations thereto - $50.00 2) New dwellings & additions & alterations thereto - $25.00 -- 3) Accessory buildings & additions & alterations thereto - $25.00 4) Pre-Existing dwellings - $]00.00 5) Updated Certificate of Occupancy - $50.00 6) Copy of Certificate of Occunancy -_-$~.~, 7) Temporary - Residential - $f5.00 - C-~mmer------cial -~15.00 ~ Cellars, decks, attached garages and any habitable area shall be included in the calculation of floor area. * 6) Amended Local Law 26, December 21, 1993 · ~ ~ . TOWN OF SOUTHOLD Ii~;II ~ 06 , BUILDING DEPARTMENT i' ~ i , TOWN HALL L~,__.~.::::;,_:.,4,' .: ........ i~ SOUTHOLD, N Y 11971 L~O~N OF SOUTHOt.[?I TEL.: 765-1802 Approved ..... '.F/~ ..... , ]9~Pe~it No..~ Z:Z~ Disapproved a/c ..................................... " . · . . (/Bd~'fng Inspector) ,Sc APPL,OAT,ON INSTRUCTIONS /3 SETS OF SURV£Y SEPTIC FORM CALL .............. HAIL TO; a. This application must be completely filled in by Wpewriter 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 sfi'eet or areas, and giving a detailed description of layout of property mu~t 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 permi 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 O¢cupan% 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 o~ 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 inspectms on premises and in building for necessary inspections. -- (Signature of applicant, or name, if a corporation) . (Mailing address(~pJ~g-~), · State wh~ther applicant Js owner, lessee, 'agent, architect, engineer, general contractor, elect~'ic/an, plumber or builder. © ~ ~J...VAe~ · 'APP~ AS NO~ . ...................... ............. ............. · · (as ~n the. tax'~l~ ~; i;t}~'~mmi,O' o. PaRT~t.* ~Y" If applicant is a corporation, signature of duly author~2ed officer. (Name and title of corporate officer) Builder's License No .... ~..'~r. Plumber's License No ....... Electrician's License No ..... Other Trade's License No ...................... FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH ~ FRAMING & PLUMBING 3. INSULATION 4, FINAL - CONS:TRUCTION MUS~ BE COMPLETE FOR C',O. ~ ALL' CONSTRUCTION SHALl., M. EET, . THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ~RROR~ 1. Location of land on which proposed work will be done ................................. ~ ................ 75-° ..... - ' ' % .- ' ........... ......................... ................ House Number Street Hamlet County Tax Map No. 1000 Section i (t7 Block Z ' Lot ( q Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Nmne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~~ ~ ¢~ '~[ ~ ' ' .... f ........... ~,~*? '. ~'~'~ h' .............. b. Intended .se and occupancy ..... %'¢ ~C~ C~b~ 14~J~(' ~'; ~' , ''3 YJ'~' k ( ) Additi ' ,3. Nature of wot check which applicable: New Building . ]...: .... on .......... Alteration Repair .............. Remgval .............. Demolition ..... : ...... ~r0Vpr~ .......... .~. ~-LY-D ' ip 4. Estimated Cost ~' ,.0~ (Descr tion) ......... : ................... Fee . . . i . (to be paid on filing this application) 5. If dwelling, number of dwelling 9nits .............. Nun~ber of dwelling units on eacl~ floor ............ · If garage, hum bar of cars ..... i ............. ...... ' ................. . ....................... 6. If business, commercial or mixed occupancy specify nature and extent of Dimensions of existing structures if any: Front ' each type of use Height Number of Stories ............... Rear .............. Depth ............... Dimensi~ ............ ' ................................................... of shme structure, wiih alterations or additions: Front Rear Depth ' Height ............................ ~ ....... ' Number of Stories ' ' · Dimensions of entire new constrUction Front ....... ' ' Rear Depth Height Number of Stories ........................................... '~' 9 Size of lot: Front · . ........ ,.~.. ....... ~.. Rear.. Depth I0 Date of Purchase .......................................... ; ' Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction viol te any zoning law, ordmance or regulation: .. Will 16t be d · .~ .......... } Will 14 N f Oregrade ....... ~;~ ....... excess,fill be removed from premises: Yes No · ameo wnerofpremises . .., ........ Address .....KI~.. ~.q~.~p{ I<.~ Phone No. .7 B. ~(. N f A hit ' · · amc o rc act ................... ' Add ' ' '' Name of Cont ......... tess .................. Phone No ......... rector ·. · ' Add ' ' ' ': .... Ph e N ' 15 I.s this property within 300 feet of a tidal 'wetland? *Yes ........ No ......... '' - TO ' *If yes, Southold wn Trustees Permit may be required. · ~ PLOT DIAGRAM Locate clearly and distinctly all ~uildings, Whether existing or proposed, and. indicate all set-back dimensions from property Hnes. Give street and block n~mber or description according to deed, and show street names and indicate whether interior or corner lot. rATE OF NF.~-YO~, /~" ..... ~/~L~.. '.ffT.(e~. aD..~....)(,~.~..ff.5~....~., being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ..... ~ove named. (Contractor agent, corporate officer etc ) ....................... said owner or owners, ~d is duly aui~ofized to perfo~ or have perfomed the said work and to m~e and file this plication; that all statements containedi M this'application are true to the best of his knowledge and belief; and that thc >rk will be perfo~ed in the m~ner set forth in the applicati6n filed therewith. /om to beforeme thisF . RI t GLOW ' ' Suffolk ~u~ ~ualif~d ~n _ I~ ' ' ~ignature of apphc~t) · Commission txm*es B~cembet ~ ~ ' , ' ' '