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Home My WebLink About22730-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24785 Date DECEMBER 5, 1996 THIS CERTIFIES that the buildin~ NEW DWELLING Location of Propert~ 3505 PEQUASH A~ENUE House No. Street County Tax Map No. 1000 Section 103 Block 12 Subdivision Filed Map No. CUTCHOGUE, N.Y. Hamlet Lot 07 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. 22730-Z dated MAY 4, 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 OWE F~MILY DWELLING WITH ATTAC~ED GARAGE, OPEN PORCH, AND WOOD DECK AS APPLIED FOR. The certificate is issued to RIVERHEAD BUILDING SUPPLY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RlO-95-0043-DEC. 2, 1996 UNDERWRITERS CERTIFICATE NO. N-402058 - NO~EMBER 4, 1996 PLUMBERS CERTIFICATION DATED NOV. 25, 1996- HARDY PLUMBING & HEATING ing Inspector Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N£ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date..~'../.~... ............................................. 19.~..~'. 22730 Z Coun~yTax Map No. 1000 Section ....... .~..~. ............ "~ ~ ~-~""BIock ....... ../~..~ .............. Lot No ..... .~....'./.. ............. pursuant to appllcation~.g~ted .......~,../~. ....................................... 19 ,.~.~., B.,dinglnspector. "~"~ '~/~/ Fee $. ..~ and approved by the Rev, 6/30/80 TOWN OF $OUTHOLD 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: Final survey of property with accurate location of all buiidings~ property lines~ streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/i0 of 1% lead. 5. Commercial buildiqg, 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. 7. 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~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - -..25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 Date ...I.~.~.~.I.~.~. ........................... ~ew Construction ~ Old Or Pre ex' t'n ........... - zs z g ~uz ~zng ................. 3ocation of Property....3 ..~..~.~.. ......... .~.~. ~.~.1~...~. ~.~ ...... .~..~..r.~..~.~ .~..~. ~ ........ . House No. Street Hamlet ,nwer or Owners of ,ount7 Tax Map No 1000, Section...l.O.-~ ...... Block ..... !.~. ........ Lot .... ~.~. ............... ¢ubdivision.~- .P..~'.~.~ . .¢~!~...~, ~.*..~ .............. Filed Map .~-1~¢. 1. -~.~-Lot ..... ~. ........ ; ..... · qealuh Dept. Approval .......................... Underwriters Approval ......................... llanning Board Approval ........................ .equesu for: Temporary Certificate ........... Final Certicate...~. ....... 'ee Subm~tted: $ .o~...~.,,.~..gp, .................. CO ¢,q TOWN OF SOUT~OLD OFFICE OF BUILDIHG INSPECTOR P.O. BO~: ~ 28 TO~VN H/.LL £OUTHOLD, N.Y. 11971 TEL. 763-1802 CERTIFICATION Building Permit No, (please print) P lum~e r ~/f~d? · (please prfnt)~ I certif.y that ..h. solder used '-n the water supply system contains l~ss than 2/10 of 1% lead. Sworn to befor~ me this Nora:" Pub'_ic~ ~.County Notary Public ~OMMISSION EXPIRE'8 ~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBO. FOUNDATION 2ND [ ] INSULATION FRAMING [/--]"I~L -~ FOU~DATION (1st) FOUNDATION { 2nd ) ROUGH FRAME & ~?LUMBING I~SULATION FER N. STATE ENERGY CODE FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY [ ]~/U~GH PLBG. [ ~ INSULATION REMARKS: ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ []FIREPLACE&CHIMNEY REMARKS: /') ~ ~' [ ] INSULATION ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. / [ ~/FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY / DATE 765.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ]~DATION 2ND [ ]INSULATION FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [ ]~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEy . REMARKS: ' ~ DATE INSPECTOR · ', FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 /BOARD OF HEALTH ......... Examined . ·., NAIL TO. Approved ................... Disapproved· a/c ' APPLICATION FOR BUILDING PERMIT Date ...~ .j.O. ......... "~ . " ' INSTRUCTIONS a. This application must be completely filled in byltypewriter or in ink and submitted t0 the Building Inspector, with 3 lets df 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 publ/c stkeets or areas, and giving a detailed description of layout of property muir 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 South01d, 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 describbd. 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/i~ections. // /~ · .... :: ...... -- -- (Signature of applicant, or name, if a corporation) .tS. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . 07. ............................................................................... NJme of owner of premises '~ ,.0~1~.~.~4r~.. 1~. .... .'~...L~7~..,..~..~....~..O.~..~. ! }t. ...... ' ................ : ..... (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..~..0...~.4..0. .... ~.~. ........ Plumber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet cotmty Tax Map No. lO00 Section ...I.~ ........... Block ...... ~ ..... :... Lot. ~ .............. (Name) 2: Stat~ existing use and occupancy of promises and intended use and occupancy of proposed construction: · 3. Nature of work (check which a'Pplicable): New Building ... ~ ..... Addition .......... 'Alteration .......... Repair .............. Renioval ~ .............. Demolition .............. Other Work ............... '~ (Description) d E'timated Cost .' ........ .~.~0,~10.~.' ................ Fee ~ (t ppli ) i ' o be paid on filing this a cation 5. If dwelling, number of dwelling units ...."~ ......... Number of dwelling units on each floor · If garage, number of cars .... i .... [.*~ ............. 6. If business, commercial or roi.x., occupancy, specify nature and extent of.each type of use ........ 7. Dimensions of existing strnctur~s, if any: Front ............. ight , · .............. Rear .............. Depth ...... He ............... Number of Stories .................. ' ....... Nith ...................................... Dimensions of shme structure alterations or additions: Front ............. Rear pth i ight ....................... De .... ' ................. He .......... . ........ ;.. Nmnber of Stories ...................... 8. Dimensions of entire new construction: Front ..... :~'."1 .....; Rear .... ~..'1 ........ Depth . .,~."'/ .......... Height ...... I ~ ...... "Number of Stories ....... [ ............ 9. Sizeoflot:Front...~l~[ i. --.- . Rear ...... [q.J i i i ii'l~i~".'~'~.'~'>i ............. 10. DateofPurchase ..... ~.'li~[~.~il i.'ii .................... ....... Name of Former Owner . .~1~..~)~ol0.~r.... ~ .'~4..~.'l'i.. 11. Zone or use district in which pr{mises are situated ....... ' .... 12Do d i la ......... ........... iai ..................... . . es propose construction rio ate any zon ng w, ordina ce or regula on: . 13. Will lot be regi'aded . ' ............................... ..... ' ' ' ' ~'fli' 'a~. · ..... '~ .... Will e~/&ess fill be removed from ~remises: y~ 14. marne oIOwner o~premises .~..~x: .p..o.L~.~30.~' .'-4~,,Addre~'t.~.O,~,~ '54., '1~1~ ~, -, · · ............... Address . .. Ph ~ 'Ii, . . .... one No ................. Name of Contractor 0~01g.~. t , .~. ~d~ ^~ .... t~'~s~l,,,,,~ ~,, ,. 'r> l,,. ~ .... , __._ 15.' ~.u ~nxs prope.rcy w~tn~n ~ou teat of a tidal wetland~ ,v~o * ,. ~ ......... · If . . · ~ .......... au..~% ..... · yes, Southold Town Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly all i buildings, Whether existing or proposed, an& indicate ail set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. J STATE OF NE.W.,YORK, (Name of individual signing contract) above named· being duly sworn, deposes and says that he is the applicant (Signature of applicant) . He is the , , , ] , (Contractor, agent, cor~porate officer, etc.) , of said owner or owners, and m duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this'application are true to the best of his knowledge and belief; and that the work will be performed in the manner s6t forth in the application filed therewitk. ' ' Sworn to before me th'is I