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Home My WebLink About23169-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25358 Date NOVEMBER 12, 1997 THIS CERTIFIES that the building Location of Property 6620 HORTONS LANE House No. County Tax Map No. 1000 Section 54 Subdivision ALTERATION SOUT~OLD, N.Y. Street Hamlet Block 3 Lot 14.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 1, 1995 pursuant to which Building Permit No. 23169-Z dated DECEMBER 8, 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 CONVERT ATTAC~ED GARAGE OF EXISTING ONE FAMILY DWELLING INTO LIVING SPACE AS APPLIED FOR. The certificate is issued to NICHOLAS MURRAY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE DATED SEPTE~IBER 9, 1997-- H2531 PLUMBERS CERTIFICATION DATED NOV. 4, 1997-PRCONIC PLUMBING & HEATING Buil~g Inspec~'~ Rev. 1/81 FORM NO.;, TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HAU. $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL COMPLETION OF THE WORK AUTHORIZED) ................................ 19..~ ......... 23~69 Z CountyTax Map No. 1000 Section ........ ,....,~... ......................................................... pursuant to application dated ...................... . ..~...~,..~.. ...... 19......~..~,~.., and approved bythe Building Inspector, Fee $..,.. ,~...~...... ,.~..., Rev. 6/30/80 Ao NOV Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 tPPLICATION 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: i. 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). Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% load. 5. Commercial building, industrial building, multiple residences' and similar buildings and installations, a cortificate 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 Vpre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completod application and a consent to inspect signed by the applicant. If a Certificato of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Cortificato 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-~xistinR Buildin~ - $i00.00 3. Copy of Certificate of Occupancy - ~ .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ................. Location of roperty... .&2 ...... ........ ..................... ,. .... House No. Street Hamlet Onwer or Owners of Property.. County Tax Map No I000, Section ......... Block ............. Lot ......... ~. .......... Subdivision .................................... Filed Map ............ Lot...~ .................. Permit No~ ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (5t6) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD CERTIFICATION DATE: Building Permit No. Owner: /~/~ (please print) / Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~ day of .~//?{/~,j~/~XO , 19 ~7 Notary Public, C~_//~_/~//C County BARBARA STEPNOWSKI Notary Public. S~ale of New Y~k No. O1ST4~,4~732 Ouai~fied i,~ wu,;;,,, Counly Commis.,ion E:;~[rc,~ ~;";. 30, 19 ~ ~ DATE: ~GE: ADDRE~: I, gSUED TO: ELECTRICAL INSPECTION SERVICE INC. 375 D UNJ~N A VENUE EAST PA TCHOGU~NEFI~ YORK 11772 (516} 286-6642 9/9/97 H2531 ,APPL~ TION No. ON FILE $outhold TO~N: $outhoM Nicholas Murray IN'TRODUCED B¥: Above 9/9/97 LIC No: and found to be in comp~ance with the NaBonal Elect~cal Code LOCATION: Base.. I st x~c 2nd 3rd A~c Det. Garage Hot Tub Pool OTH/~R A?,~ E"I.ECTRICAL SURVEY HAS BEEN ~ADE OF THE EXPOSED ELECTRICAL EQUIPMENT IN THE PREMISES NO ¥1SUAL DEFECTS FOUND BUILDING PERM1T No. BLUE ORIGINAL YELLOW COPY PINK COPY OFFICE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ULATION [ ] FRAMING [//] FINAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ '] ROUGHPLBG. [ I~Ns~LATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] RO~H~PLBG. [ ~_~iSULATION [ "] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE~~,/~ INSPECT~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 2ND [~]~SULATION ~:~..~ [,~RAMING [ ] FIREPLACE & CHIMNEY REMARKS: ~*~-~-~ ] FINAL DATE INSPECTOR I:()lH'll)^'t* [ Ol,f ( I ,'~'1' ) J:(JU I'I[)A'[' I Off INSlII.A'I'H)II ]'I~.R ti. ¥. (:OI)i~. I? I rial, Al)I) 1~'i' I OItAI, COHHI~N'I'$: If copper tubing i$ uaed for water distributing CERT, f~iCA~ ~: OF:' G C C UPA/~ Y SUPPLY SYSTEM CA~WVO~ EXC~:yD 2/10 o[ I% LEA~ ~DE OPENINGS FOR IENC¥ ESCAPE AS iD BY PART. 714 I rE BUILDING COD PRO~ EMEI REQUI i~,Y, ST , Li,,_u '- 1199,5 , FOnM NO. 1 3 SETS ToWN OFSOUTHOLD , SURVEY BUILDING DEPARTMENT CIIECK ToWN HALL SEpT!C sOUTHOLD, N.Y. 11971 Or PLANS .......... fOltH .............. H^IL TO: a. This application must be col~q~letely filled iii by typewriter or iii iuk and submitted to the Buildb~g Inspector, wllh 3 ~sets of plan% accurate plot plau to s6ale. Fee according to schedule. b. Plot plan showing location 0f lot and of buildings on pre roses, relationsldp to a(qoinlug premises or public sheets or areas, and giving a detailed ~esc~iption of layout of property must be drawn on tim diagram which is part of fids appli- Cat[OII. i c. The work covered by t ds app cattou may oot be commeuced before ~ssuance of pudding t emut. d. Upon approval of this al~plidation, the Building luspector will issued a Buildiug l'enuit to the applicaut Such permit shall be kept on the premises availaSle for inspection throughout tim work. e. No budding ~hall be occu?~d or used m whol or iu part for any purpose whatever until a Cemllcate of Occupaucy shall bare been granted by the Bmlqmg Inspector. APPLICATION IS IIEKEBY M~ADE to the Building Department for the issuance of a Building Permit pursuaut to the Btdldb~g Zone Ordinance of the T6wn of Southold, Suffolk County, New York, m~d other applicable Laws, Orth ~m~ces or Regulations for the const~ctlo ~ Cf buildings add t m s or ?eratlons or .for removal or demollttou, as betel ~ described. The applicant agrees to comply with a 1 app cable Jaws, ordinances, building code, housing code, aud regulabons, and to 'z admit a Ithorl .ed hlspectors on premises and in bnilding for necessn~ iosp~tion% ..... g,., ............. (S¢gnature of app cant, or name, if a corporahon) (Mailing address of applicant) State whether applicant is ownerI lessee, ageut, architect, engmee , general contractor, electrician, pluulber or builder. &4 ..................... (asontlet x ~ , If apphcant's a corporatiou, signature of duly auH~ot bed o[ficer. (Name aud title of corp;orate officer) Builder's License No ......... Plum her's IJceuse No. Elect ca,sLice seNo...~ ................... Other Trade's License No.. i ................... Location of lartd on which prqposed work will be done .................................................. ................. ................. llouse Number i Couuty Ta× Map No. 1000 Sebbon Street Hamlet .......... Block .................. Lot; .......... Subdivisiou ................................ Filed Map No ........... Lot .............. Slate existing use and occupaflcy of premises and intended use and occupailcy of proposed construction: a. ~xistiug use aud occupancy ....................................................... 3. Nature of work (check which applicable): New Boilding .......... Addition .......... Alteration Repair .............. Removal ..... , ........ Demolitio. .............. Wo, kCt · ' (Description) 4. Estimated Cost ... , , Fee (to be paid on filing this application) 5. If dwelling, nnmber of dwelling units ............... Nnmber of dwelling nnits on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of nsc ..................... 7. Dimensions of existing stmctnres, if any: Front ............... Rear .............. Depth ............... lfeight ............... Nnmber of Stories .............................................. Dimensions of same structure with alterations or additions: Front .......... .................. Rear .................. iD)eptb ...................... Heigb,t ........ .............. Nt nber of Stories ...................... 8. ~ imenslons of entire new construction: Front ........... Rear .............. Depth ............... l Ieigb t ............... Nmn bet of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase .................... . ......... Name of Former Owner ............................. I 1. Zone or nsc district in whicb premises are situated ......................... . ............................ 12. Does proposed constrnction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ................... '. Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ [5. ts this property within 300 feet of a tidal wetland? *Yea ........ No ..... *If ye~, Southold Town Trustees Permit may be required. .... PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and allow street names and indicate whether interior or corner lot. rrATF, OF Nm~WO~/~ ×/. ~ ~ ............. ~.~ ~ ~...~.~.~ .... being duly sworn, deposes and says that ho is the applicant (Name of individnal signing contract) there named. is th~ ............................ ~~ .................................. ~ontr~ent, corporate officer, etc.) ............... said owner or owners, and is dnly authoriz~ perform or have performed the ~aid work and to make and file this 4~plication; that all statements contained in this application are true to the beat of his knowledge and belief; and that the york will be performed in tim manner ~et forth in the application filed therewith. iwom to before me tbls~~ ~ Count ~o. 4870505 .............. ~.< ;'ct ~.. 7.~.. ...... Ou~llfied in Suffolk CounW ~ ~mmissio~ Expires December 8, 19~ (Signature o[ applicant)