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Home My WebLink About22777-zNo E-24305 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCcupANCY Date APRIL 24, 1996 THIS CERTIFIES that the building Location of Property 225 MARION LANE House No. County Tax Map No. 1000 Section 31 Subdivision ADDITION Block 8 Filed Map No. EAST MARION, N.Y. Street Hamlet Lot 12 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 4, 1995 pursuant to which Building Permit No. 22777-Z dated M~Y 19, 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 2ND FLOOR DECK ADDITION TO EXISTING OWE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUSAN E. LONG SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A FORM NO.$ TOWN OF $OUTHOLO 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] Dote ............ i~.~..~...../..~ .................... 22777 Z Permission Is hereby granted to: ~..~.....~. ..................... .~ ......................... ...~.~,...~.~.....~ ......................................... ,~ ..~....~./..~,~..~.~,,4./..?~ ~' ', ,o...~.'...~....~......~...~..~.....~.~ ...... ~....: ....... (. ~.~ ./.~....~.~.-.~.~.,,/. .............................................................................. CountyJax Map No. 1000 Section ............. .~.....J/.,.. Block ........ ~ ............ LotNo.../....~...~, ,~,,.. ........ Building Inspector. Rev. 6/30/80 Building Insp~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 L~ TOWN OF SOUT~-~O!.D ~.~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ammammm to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: ~----~L~t~ns ~25.0-7-~POOLS $25 OOALTERATION $25.00 1. Certificate of occupan~- Ncw Dwelling $25.00, Accessory '$i0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50,00 3. Copy of certificate of occupancy '' $ 5.00, ove~ 5 yea~s $10.00 4.Vacant Land C.O. $ 20.00 '~/~'~'/~--'---J-~ 5.Updated C.O. $ 50.00 Date .................. Newcons t~ructi°n. . Old or Pre-existing Building ............ Vacant Land ............. House No. Street I Hemle~' Owner or Owners of Property .. ,~..~, .~, ~.~,., .,~, .'...~. ,~. ,~.. ,~. ............................... County Tax Map No. 1000 Section .... .'~./ ........ Block ..... ~. ......... Lot...l...e.~'. ........ "~ubdivision .~Q~,~,, ~ ~U r(~] ~.j .E.~. ,~ .~m-., ,Filed Map No, .Lot No. Permit No..~..~..~Z.~'?-.. Date of Permit ~-~'l].e~/~',3~..Applicant ~-~J~'..~../~t~J...~.,.. ~,~.0..~..~. ......... Health Dept. Approval ....... .~./.~¢~ ........... Labor Dept. Approval ./¥/,~. ................ ......... ~.//~. ......... Planning Board Approval . ./~.//~'. .............. Underwriters Approval Request for Temporary Certificate ..... /~(/.~. ........... Final Certificate .. ~ ................ Fee Submitted $..~:~.... ...................... Construction on above described building~. ,~ ~ ~L~x^ o/and permit meets all appti~d, es,,and regulations. Rev, 10-10-78 FIELd_ IN$?ECT~ON REPORT =DATE ~ = _ ............... ~_____l~_~ .................. ¥OUNDATION (]ST) FOUNDATION (2ND) ROUGH FRAME & PLUHBING INSULATION PER N. Y. STATE E I'~ERG'Y CODE FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONIST [ ] ROUGH PLBG, [ ] FOUNDATION2ND L ] IN~I~ATIoN [ ] FRAMING [~ FINAL [ ] FIREPLACE & CHIMN,~.~ REMARKS: (/~~ 6 DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INS~ULATION [/~NAL [ ] FIREPLACE & CHIMNEY DATE INSPECT~ FORM NO, 1 " TOWN OF SOUTHOLD lqA¥ - 4 1995 BUILDING DEPARTMENT TOWN HALL - +' ;,'V:' SOUTHOLD, N.Y. 11971 .,, , ,~ r,~'t ", j TEL.: 765-1802 ,,roved 197. erm,t No ........... )isapproved a/c ..................................... ¢'LICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. Date.. 19... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 et~ of plans, accurate plot plan to scale. Fee according to schedule. - b. Plot plan showing location of lot and of buildings on premises, relatio ~ship to adjoiuing premises or public streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :atiom?)' c. The work covered by this application may not be cbmmenced before issuance of Building Permit, d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall 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 w, hatever until a Certificate of Occupancy ;hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, N~w York, and other applicable Laws, Ordinances or ?,egulations, for the ~onstruction of buildings, additions or al~cerations, o~ for removal or demolition, as herein described. fhe applicant agrees to comply with all applicable laws, ordinances, building code housing code, and regulations, and to ldmit authorized inspectors on premises and in bnilding for neces~?~.. .~, ' __ ' (Signatur~ of applicant, {Jr name, if a corporation) ., 73 . .q. ¢.. . t, t A m . V. . 17 3 7 (Mai~ing address of applicant) t State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C:>.W. N F.- 1~.. ....... ' ........................ Nameofowlierofpremises .~¢~.~']....~Y~.~JD b,~.,/[,~(.~; e' ' '~ ............. 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 ...................... Location of land on which proposed work will be done, .c~... ~'~.[.07'~.. ~)~.~.l~..i.. ]E}i~[~.'~.. .~.~1.6.~. .. :~.~. ~ .................... ~ ~ t o. ~. . L ~., ................ E.~.s T. .~.~. to.~ ......... House Number Street Hamlet County Tax Map No. 1000 Section ................ Block ............... Lot .... : ..... .~*5~. ga~.'(~an~)~']i'~1'~. .[~.. Filed Map.. ...... No...., ............ Lot ............... Subdivision State existing use and occupancy of premises and intended use"~nff~ccfi~aocy'Df~ proposed construction: a. Existing use and occupancy I ,~; ~, '.~ .......................... b. Intended use and occupancy .A. ~. .' ............................. 3. Nature of work (check which applicable): New Building .......... Addition . ~ .... Alteration .......... Repair .............. RemoiaI Demolition Other Work 4. Estimated Cost. <~.1~. ' ~ ~ I ..... Fee ..... : / (to be paid on filing this apt/lication) · ii awe[,ing, number of dwelling ugits, .... g/~ ......Number or dwelUng nnits on each floor.· N/~ ....... · If garage, num bet of cars ...... ! ~./.,Pt ..... ~. ........................................ .'~ .......... 6. If business, commercial or mixed pctcupancy, specify nature and extent of each t e of nsc ........... 7..D.u.n.en. slons of existing structuresl if any: Front . (O 0. ~. Rear /~-f~ ~P I~o'~f/~'~t' '' Dimensions of s.ame structure wtti~ alt~rati i s ddih De th t. ' ~ ' .3~x:~ 'OhS:Front ...~.,,~l .... Rear · · ~' ............ ~ bet fStorms ......... 8. Dimensions ofe,~/t!re new construction: Front ... /V/~ Re~ at ?~L .... 1'~' ....... 11. Zom or use district in which'premises are situated... ~. F~.[. b.{~l~ .'17.1.~..L-. ............................... 12. Does proposed construction violatb any zonin~ law ~,~-,- .... -~ ~- 2~;~;Tng;;u:f~p ~L~ :: ~,.... Will excess fill be remov, ed from premises: Yes No 15. '"J''J .... i ........... Phone No ................ ...................................... Phone No ................ Is th:Ls property within 300 feet of a tfdal wetland? ~Yes ........ No..x~ .... ~I£ yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end, indicate all set-back dimensions from property lines. Give street and block nu~nber ' · ' . interior or coruer lot. I or descnphon accordmg to deed, and show street names and indicate whether occUPANCY OR USE IS UN WFUL WITF OUT CERTIFICATE OF O ]CUPANCY 7ATE OF NEW YORK, -- )UNTy OF .St). V.F.0.c..~... s.s ............. S ~ ..q A.D. ~.,..g. (Name of individual signing c~ 3ye named. ?~P~PJlOVI~O AS NOTIFY BUILDING I~'~ 765-1802 9 AM TO 4~R THE FOLLOWING INSPeCTiONS: I. FOUNDATION "~0 REQUIRED FOR POUREDCONCRETE 2. ROUGH , FRAMING & PLUMBING 3. lhSULATION 4. FINAL CONSTRUCTION MUST BE COMPL~E FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES· N~ ~ESPONSIBLE FO8 DESIGN OR CON8ISUCTION~RROR8 .... · ~-<~ ...... being duly sworn~ deposes anti says that he is thc applicant retract) is the .......... i~. ' (Contractor agent corporate officer etc) ............ said owner or owners, and is duly aut mrized to perform or have performed the said work and to make and file this ~[~cation; that all statements contained In this application are trne to the best of his knowledge and belief; and that the will be perfomed in the manner set f~rth in the application filed therewith. om to before me this I a .............. day of.. ...... 19