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Home My WebLink About22860-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~UumANCY No Z-23794 Date JULY 25~ 1995 THIS CERTIFIES that the building ADDITION Location of Propert~ 285 SMITH DRI~FE NORTH SOUTHOLD NY House NO. Street Hamlet County Tax Map No. 1000 Section 76 Block 1 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated J~NE 16, 1995 .pursuant to which Building Permit No. 22860-Z dated JUNE 28, 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 ON THE REAR OF A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MATT~9; J. FARRELL of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM NO.$ TOWN OF sOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERM)"[ Mu$'T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) .......... ........................................ 22860 Z Permission is hereby grgc~ed to: /" , . r~,~.. ~.... ~~. ,~Z ,,~,~ ..~.~..~...?. .......................................... ...~....,.~.......~..y..:......~..¢..~ .................... to.. ~ .r....~.. ...~ ....... ..d... ........ ~.~. ...... ~z~ ........... ~~ ............ ~ .......... ............ /2~...Z~,z~ ........... ~ ....................................................................................................... ~, premises located ct ........... ,~...~......~./...~.../.. ........ ~.~.:.....~.~..~.. ............................. ................................................... ~..,.~J... ......................................................... co~ox Mop No. ~ooo sect, o~.....2~. ........... ,,oc~.....~/.. ........... ,otto ..... ,,2.~/. ............. Building Inspector. ~ee~ ....... .~.,~..'..~... Rev. 6/30/80 l,'orm l'lo. 6 TOWN OF SOU'['IIOLD b'UILD1NC I)EPAI{TtIENT TOUN IIALL 765-1802 AIq'LICA'FION FOR CERT[FICATI,: OF OCCUPANCY A. Tills applicatiou must be filied it] by typewriter OR ink and submitted to the building inspector with cbc followiog: for uew buildiug or new nsc: 1. Final survey of property with accurate locat~oe of all buildings, property lines, streets, and unu~;ual natural or topographic features. 2. Final Approval from Health Dept. of ~eaLer Supply and sewerage-disposal(S_9 form). 3. Approval of electric~uI installation from Iloard of Fire Underwriters. Sworn statement from/plnmber certifyiug that the solder used in system conLairs less tbao 2/10 of 1% lead. 5. Co,unercial building, , and installatiot~s,~a industrial building, multiple residence~ and similar buildings certificate of Code Compliance from architect or engineer responsible for tb~ building. .6. Submit Planning Board Approval of completed site plan requirements. B. ~For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-exist~ng 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 sigued by the applicant. If a Certificate of Occupaucy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of O~cupancy - 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-existing guildine - StOO.O0 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential~$15.00., Co~lercial $15.OO' Ne~z Con~tructlo[~ ........... O~d Or Pre-existin~ B~ ildi~ ~] ........... ~treet Ilamlet Ilealtb Dept. Approval ...................... Underwriters Approw~l ......................... 21arming Board Approval ........... Request fo~: Temporary Certificate ........... Fiual Certicate.~. ...... ROIJGll FRAME & ?l,UffBlffO INSULATION PER N. Y. STATE ENERGY CODE FINAL TIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION ] ROUGH PLBG. [ ] FOUNDATION 1ST [ ] ~'TION~ [ ] FOUNDATION 2ND [ [ ] FRAMING [ /~FINAL [ ] FIREPLACe)CHIMNEY REMARKS: ~ DATE _~ I NSPE~ 765-1802 BUILDING DEPT. PECTION [ ] 1ST [ ] ROUGHPLBG. FOUNDATION 2ND [ ] INSULATION ~/~RAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE P.O. Box 55" Peconic, N.Y. 11958 (516) 765-1119 JUN I 6 1995 TO¥TN uF . OU~%'~O .... ,,.. ,, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... BOARD OF HEALTH ......... ~...~3 SETS OF 'PLANS .......... ---~ SURVEY . .................. ~-~ CltECK .................... SEPTIC FORH .............. '"' 7¢x.-/././? CALL .......... MAIL TO: Date ................... 19... INSTRUCTIONS t a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 .ets of plans, accurate plot phil 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 appl/- :ation. 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 whatever until a Certificate of Occupancy :. hall have been granted bE the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York. and other applicable Laws, Ordinances or ~egulations, for the construction of build/rigs, additions or alterations, or for/~moval or demoFtion, as herein described. ?he applicant agrees to comply with all applicable laws, ordinances, buildin//code, housing code, and r~,g~lations, and to dmit auth°rized inspect°rs °n premises and in building f°r necessaT;i~ C~ ,~...~ ,, ~' '~ '" ' ' ' (~[-all~ng address of applicant) ............ grate whether applicant is owner, lessee, agent, architect, engineer, ge~nerat contractor electrician, plumber or builder. f applicant is a corporation, signature of duly authorized officer. " .. NOTIFY BUILDING DEPARTMENT AT 76E-1802 9 AM TO 4 PM I~OR THE .............................................. FOtiOWING INSPECTIONS: (Name and title of corporate officer)__,..___.__,..,, 1. FOUNOATION - ~.~:( 0l.;[;UP~ffiIJ¥ OR FOR VOUREO CONCR~E · Builder's License No ..... ~ ~. · - 2. ROUGH - FRAMING &' ptJJM~iiNtI~, USE IS UNLAWFUL ,. lumber's ioenseNo ................ WITHOUT CERTIFICATE: - BE COMPLETE Eleotricia 's License,o .............. OF' 0CCUPAN('Y ALL CO.mUST'O.".S"A L # 'THE REQ01REMENT~ O¢. THE~ N,Y, Other Trade's License No ...................... STATE CONSTRUCT ON CODES. NOT REsPONSIBbE? .i. ocatJon of land on which proposed work will be done, DESIGN OR CO, NSTRUCTJON ERRORS House Number Street Hamlet County Tax Map No. 1000 Section .... 7~ .......... Block .... .~.! ........... Lot....~..' ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy 3. Nature of work (check which apphcable): New Building ......... f~Addition .j~[.. Alteration .......... Repair .............. Remolval .............. Demolition ...... ......... Other Work ............... .~.' .~. ~.O.t] ~..~. " (Description) 4. Estimated Cost ............................ Fee ................................ ...... i (to be paid on filing this application) 5. If dwelling, number of dwelling t~nits ............... Number of dwelling units on each floor .............. · If garage, number of cars ..... ~ ................................................................ · 6. If business, commercial or mixed]occupancy, specify nature and extent of each type of use ................... 7. Hlmenmons of exmt,ng structure~, if any: Front ............... .R. ear ............. Dep. th ............... eight ............... Number of Stories ......................... ' i Dim i f iih It ti dditi .................... ens ons o same structure w a era ons or a ons: Front Depth ' Height ................. Rehr .................. 8 .......................................... 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 ............ i ........ ' ......... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. D°es pr°posed construction viola~e any zoning law, ordinance or regulation: ..,~/~... ....................... 13. ,W, ill lot ~b~regrade~d .......... i .................. Will excess fill be removed from premises: Yes 14. marne ox owner oI premises .... i ................ Address ................. Phone No ................ Name of Architect ........... i ................ Address ................... Phone No ................ Name of Contractor . .......... i ................ Address ................... Phone No ................ 15. Is this property within 3Q0 feet of a tidal wetland? *Yes ........ No.~ ...... · If yes, Southold T~wn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block mlmber or descriptioh according to deed, and show street names and indicate whether interior or corner lot. ......... ~. '. ~' '.~~ .......... ~[.., ,.~ffi&.a~y s.worn,~ deposes and says that he is the applicant (mame'o~ in~Vmual signing contract) bovenamed. ' " ' ;: '[ (Contractor agent corporate officer etc ) ................. said owner or owners, ~d is duly au:thorized to perfom or have perfonned the said work and to m~e and file this ~plication; that all statements contalne~ M this application are true to the best of his knowledge and belief; and that the ork w~l be perfomed in the m~ner setlforth in the application filed therewith· ,yom to before me this D .... · .......... ...... NoIaw Public, State of New York . ~ w...-. . ' No, 4951364 Qualified in Suffol~ Coun~ ~ / / Comm~io~ Ex~os ~av ~, qS~ ~ / /