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Home My WebLink About23156-zNo ~-26091 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date DECEMBER 22, 1995 THIS CERTIFIES that the building ADDITION Location of Property 255 BREITSTADT COURT SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Sectioq 70 Block 9 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NO%~MBER 20, 1995 ~ursuant to which Building Permit No. 23156-Z dated DECEMBER 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 A DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. ROBERT & JUNE CHUTE (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A /Bulldlng FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTH~IZED) Date .......... ~/~..~ ....................... 19..~...~ N.o, 23156 Z Permission Is hereby gran.~c:l/~o: .~ / __ . / ,'~ / /~,. ~ CounlyTax Map No. 1000 Section ........ ,,?,..~... ....... Block ....... ~ ............... LotNo...~...../~... ................. pursuant to application dated ................. :~ ........................19....~,.~ and approved bythe Rev. 6/30/80 Form No. 6 TOWN O? SOUTHOLD BUILDING DEP.%RTY~NT TOW~ ~!LL 765-L802 .~PPLiCATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by ~ypewricer OR ink and submitted to the building inspector with the following: for new building or new usa: Final survey of property with accurate location of al! 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 !ess than 2/i0 of L% lead. 5. Commercial building~ ~ndustrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for ~he building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, i957) non-conforming uses, or buildings and 'Bpre-exisuing" land uses: !. Accurate survey of property showing all property lines, streets, building and 2. A oroper!y completed 2oolication and a consent uo inspect sit-ned by aha applicant. If'a Certificate of OcCUpancy is denied, the Building inspecror shall state ~he reasons therefor in writing to the applicant. C. Fees !. Car~i£icata of Occupancy - New uwel!~-ng $25.00, Additions to Alterations to dwelling $25.00~ Swimming pool $25.00~ Accessory buildin~ $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Prs-~xistinK Buildin-~ - $100.00 Ce ..... cat~ Occupancy $20.00 3. Copy of ~"~=~ = of . - 4. Updagad Certi£icata of Occupancy - $50.00 5. Temoorary' Ce_~_fzcat-~~~' = of 0ccuoancy· - .~esidential $i5.00, Commercial $!5.00 Bate ..... ~..~. ~. ~/..~.~.. ................ New Construction ........... Old Or Pre-existing Building...~. ............. Location of Prope$~y. ~.~..~. ~- '~~ ~ ....... ~ '~'' ~ :~" ..... ~ouse No. $ Cree~ Onwer or Owners of Property.. . - .......................... cou=y ~-. ~a~ No ~000, Seotion...7.0. ........ gloo~ .... 7 ........... Lo=. ~ubdivision...~~.':'. ~.,'~..~ · -~- - .......... ~iled ~ap..q ~. ~.e.. +o~. #.. ~.~. ............. ~.e=_-n Dept. Approval .... f'~.-~- .............. Underwriters A¢¢r~va~- ~,~ ~ ..¼ .~.~.. __~nn-ng Board Approval· :'. ........... Fee Submitted: ~AP PLiCA~NT REPORT FOD~tDAT ~ON (IS'l') DATE COHHEHTS FOUNDATION (2ND) ROIJGll FRAHF, & PI.IJHP, [ NC] INSIII.A'rTON I'ER N. Y. STATF. ENERGY CODE II FTNAI, AI)DIT [ONAL COHHENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING ROUGH PLBG. ]IN~~N [~INAL [ REMARKS: ] FIREPLACE & CHIMNEY DATE / ~"~/~NSPECT~ APP, RQV, ED ~,8'NOTED L NOTIFY BUILDING:' DEp~rA'I: 765-'1802 9 AM'~ 4 PM FOR THE FOLLOWING INS,p, ECTIONS: ' ~1;~ FOUNDATiO~ { :.-! TWO RE~L~ .... · FOR POURED ~NCRETE- 2: RoLiGR ;/FR~I~G & PLUMBING 4. FINAL; ~', CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT~ OF THE N,Y, STATE CONSTRUCTION &; ENERGY CODES., NOT;? RESPONSIBLE, FOFt: DESIGN OR C~NSTRUcTION ERRORS' ', ., -'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 Examined .., 19 ~ Disapproved. j a/c e ..................... ~- ' ~"//(Build~ ............ ........ "1~'~[-'~' :'-'"~ ~t?~"' ~ ~,~/~ .~ '''~'~' ' '~ :? ]"~'~f '[ ~" / "' ~ ~ ' '' ~ ~' ~L- ~ ~ ; [~t ~ .~ ~ ...... ~ '~'~' '''~' ~ ~ng Ins " , ~f~ .......... ~'..d~ '~ II '~; ~1.~95 ~,F~LICATIONFORBUILDINGPER~IT .'-: Z ..................... INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 streets 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 BuildingPermit to the applicant. Such permit shall be kept on the promises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until g 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 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 inspectors on premises and in building for necessary in~12{,,~ ~,~. '. (Signature of applicant, or name, if a corporation) .......... . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ow ro, r m,s (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....~..~...~.-. ~ ~..~..~. ~ ......... ..... ............. ......... .................. House Number Street Hamlet CountyTax Map2.~~O. ........... Block O..?. ............. ~ Lot..-~..'~d~.~ Subdivision .... ~TP...O'AX~ ....... Filed Map No..~ .... Lot....--q-.'.'.'.'.'.T~.. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~.....O~.. ~.LT~ .~...-. '.' ,; [ .,...: .· .: , .,. , b. Intended use and occupancy ................................... , ? ......... ... ,?:. ................ 3. Nature of work (check which hpplicable) New Building .... A. ddition .......... Alteratiojk [..~.. Repair .............. Removal .............. Demolition ........... Other Work.. L/.de~.de~ ..... 4. Est~ated Cost ............................... Fee ..................................... ~ ~ (t g thi ppli ) ~ 0 be paid on illin s a cation 5 If dwelling number of dwelli~g units ~ Number of dwelling units on each floor If garage number of c~s ~ 6. If business, commercial or mi~ed occupancy, specify natur9 and extent of ea~ type of use .. ~ ................. 7. D~ensions of existing structures, if any Front ..... ~. ( ·. Rear 6 d . . Depth ~ ~ ......... Height ~ ... $~mber of Stories .... /.~.T .... . ..... ~"~.' . ~..~ ......... D~ensions of same structure ~with alterations or additions: Front ................. Rear .................. Depth .................. , ... HeiSt ...................... Number of Stories ...................... ~-~8. Dimensions of entire new con~tmction: Frank :~ ....... ~ .. Rear Depth ............... 9. Size oflot: Front ...... ~...., .... ~... Rear .... [.~ ....... Depth ../.~.O .............. 10. Dat,'of Purchase .'....[o/[~[.~.~ .......... ~ame of Fomer Owner [~ .~~ ....... 11. Zone or use distdct in which premises are situated... ~,~~ ..... j ...... / ..... .................. 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~ ..................... 13. Will lot be regraded ....... ~. ~ ............ Wall execs fill be removed from premises. Yes 14. Nme of Owner of premises . tess . .... .' Phone No.. ~Tm .. Nme of Architect ........................... Address ................... Phone No ................ Nme of Contractor. ~. ~ ~-.... Address ~. t ~.'.~. ~ Phone $o.~3 ~:A ~. P~T DIAG~ Locate cle~ly ~d dist~ctly ~1 bufld~gs, whether exist~g or proposed, ~d. indicate ~1 set-back d~ensions from prope~y ~nes. Give street and blo~ k number or description accord~g to deed, ~d show street nines and indicate whe~er ~tedor or corner lot. OF.. 29. h. ' (Name of individual si~ing contract) above named. of said owner or owners, ~d is ddly auth~~om or have perfo~ed the said work and to m~e and file this application; that all statements con~ained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith.. Sworn to before me th~ i / h ............~~3'' Y ~~i ................. ' ''' N~wPublo, State of New Yofk ' [ ~d_ Qualified in Suffolk C~un~ ~ (Signature of applicant) ~mmi8slo~ ~pires D~oem~r 8,