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Home My WebLink About22930-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANC~ NO Z-23878 Date SEPTEMBER 18, 1995 THIS CERTIFIES that the buildin% 740 WOODCLIFF ROAD & Location of Property. 2380 WEST~IEW DRIVE House No. Street County Tax Map No. 1000 Section 107 Block 8 Subdivision Filed Map No. ADDITION MATTIT~CK Fi Lot Hat, let 11 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 21, 1995 pursuant to which Building Permit No. 22930-Z dated JULY 21, 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 ADDITIGN TO AN EXISTING ONE FAMILY DNELLIN~ AN APPLIED FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 BEVERLY BOEHLE (owner) N/A /~ ~uilding InSpector / FORM NO.3, TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HAL~ $OUTHOLD, N.Y. N£ 22930 Z BUILDING PERMIT ITHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .. .............~-............. , CountyTax Map No. 1000 Section ...... Z..,~,,,,,,,~.,,, Block ......... ,~... ........... Lot No. .. ./.,../'.. .................. pursuant to application dated .............. ~~...,~ ........ 19,,..~,.~d approved bythe Building In~ Rev. 6/30/80 ~', TOWN OF SOUTIIOLD ~ . BUILDING DEPARTMENT . /~ '~'--. APPLICAT,ION FOR CERTIFICaTE'OF OCCUPANCY i,~ ~/~0~ ' ~A. zs app±icatton must be'filled in by,,typewriter OR in~ and ~b~itted~!to'the building :,, i~pector ~ith the fo~lO~'l~g: ~or new building ~r new use: P~' 1. 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). 3. Approval of ~lect~ical iestallation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains. less than ~/i0 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar b~tlding and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site ~lan requirements. B. For existing buildings (prior to April 9, 1957) non~conformfng uses, or building '.'pre-existing"land uses: 1.Accurate survpy of property showing all property lines, streets, buiiding and unusual natural or topographic features. 2,. A properAy completed application and a consent to inspect signed by the appliea~t. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. C~rtificate of Occupancy - New dwel%ing $25.00, Additions to dwelling $25~00, Alterations ~to dweilimg $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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 $. Temporary Certificate of Occupancy - Resideetlal $15.00, Co~ercial $15.00 Date .............................. ~ew Construction .......... o Old Or Pre-exist±rig Bnilding ......... ........ ---- tlouse No. Street Hamlet County Tax Map No 1000, Section ......... Block ............. Lot ............. . ...... Filed Map Lot Subdivision ...................................................................... Permit No .... Date Of Permit ........ Appltcast~. Health Dept. Approval .................... Underwriters Approval .................... g .... Request for: Temporary Certificate. ' ' ' ' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] INSULATION [ ,-~NJc [ ] FIREPLACE & CHIMNEY REMARKS: ~'~c~,.~ ~/'"'~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~]-"F~MI NG [ ] INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE FIELC~ INS~CTION REPORT DATE COMMENTS FOUNDATION ( IST) FOUNDATION (2ND) I~ ROUGII FRAME & PLUMBING [~$~LATIO~ PER ~. ¥. ADDITIONAL COMMENTS: ~0~ FORM NO. 1 TOWN OF SOUTHOLD j~ ~,tt~, g BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 Exami-ned . . 9 Approved Eg~.~, 9 ..~' .~Pc r nit No.~..~...~.~ / Disapproved a/c ..................................... MCTI~ FOR BUILDING PERMIT INSTRUCTIONS BOARD OF ttEALTtl · . . SURVEY SEPTIC FORH .............. OT i P'! CALL TO: a. Tiffs 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 ar,cas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ~. The work covered by tiffs application may not be commenced before issuance of Building Permit. ,d. Upon approval of this application, tile Building Inspector will issued a Building Permit to the applicant. Such permit sliail be kept on the premises available for inspection throughout tile work. e. No building shall be occupied or used in whole or in part for any purpose xvhatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to tile Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance qf. 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 inspections. .~...~..%..&b..~...t:4..e:~..7..' .~/..,~..¥ .... ,..r,).c. ..... ..... (Signature of applicant, or name, if a corporation) .?:o.: ..~.~ .... t .q .c?..?~..-~e~.e...~..'(..,... · ' ' " (Mailing address of applicant) State whether ~pplicant is owner,' iessee, agent, architect, engineer, general contractor, electrician, plmnber or builder. .. ~e~.~.~.~..,....Cc~x...¢-~....-~...e,,. . ...................... · ' · 1~6'~'. ~ ~oeh~ e · . ........................ Name of owner o~'p~emises ' ' : , (as on the tax roll or latest deed) If applicant is ff'corporrttion,' si~f~atU:rc of duly authorized officer. · .P.~.t.~.....~.~..~..v.!.~...b~.q..-.....P..e,.~. ~ ~*'"~'"~?~" Bn ffers Uce nse No....S-..S..S...¢. .... IA.t ...... Plu nber s License No ......................... Electrigian's License No ....................... Other Trade's License No ...................... 1. Location of land on ~vhich proposed work will be done .................................................. · .q....~o. .......... ~ .o.o..4..c...t..i.¥.~.~. .............. ~.4....~.. {.iv.?..&.. ......... [louse Number Street Hamlet Comy*a~aapNo. '000~ection .... 1.O...'7 ........ B,oc~ ...... .E. .......... Lot ...... I1 ........... Subdivision .............. ~ ............. Filed Map No .... ~ ..... Lot... · .~. ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....~. i ,(~.~.;,.-f,.(~J-~...i~..-.~....~..t~..(-(i..~fi ........ ;"~'"'; ..... b. Inte.ded use and occupancy ...6. i..~.LTz...~z~..'d.~./A.w~.(i.~.....~/. ~. ~<x..ae. cx. .... 4. Estimated Cost '~OO Q . O C) Fee '*' :' (to be paid on filing this application) 5, 'f dwelling, nuxnber of dwelling units. ~.. 75..~_.. :: ~y;~r.~[ ~,.vy, ~ ~i.t~ y: e~c~ ~o~ : .............. . If garage, number of c~s .......... . ... 6. If business, com~nercial or mixed occupancy, specify nature an~qxte~t of each type of nse ............. 7. Dimens ons of ex st ng structures, it any: Front..[~.~ .~..g~r~g~,. ............. Depth ....... Height ............... Number of Stories ........................................ Dimensions of same structure with alterations or additions: Front 5~.~.T. ~ ~ ~d~ ~ '~'C~; ' ' ' Depth ...................... Height .... ~ ................. Nnmber of Stories ...................... 8. Dimensions of entire new construction: Front ~~} .... Rqar ............... Depth ............... Height ............... Nu[nb~er of Stores ....... [ ~ '~ ~ ........................... I ........... 9. Szeoflot Front [~Q'~ .... Rear 1~ O Denth 10. Date of Purchase .... ~...[ %..{...~ ..... Name of Fomer Owner .~.~[~.q~. ~.O~{~.,... 11. Zone or use district i t w tic t premises are situated ......... ~. ~ .~Q.' .............. }0 ................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .~ .~ .- .................. 1:,. Will lot be regraded ...... ~ ~..' ................ Will exce~ll be removed from premises: Yes 14. N~e of Owner of premises ~, ~¢.~[~ ....... Address '~. ~~.'. Phone No ................ N~te of Architect ........................... Address ................ d ' Phone No ................ Nmte of Contractor ~9.'.~...I.~: ....... Address ~'Q .~.~ .tS[ ~. ~q~ne No. ~ ~Z Is th~s property w~th~n 300 feet of a tSdaL wetland? ~Yes ........ No.~... ~I[ yes, SouChold Town Trustees Permit may be requLred. PLOT DIAG ~I Locate clearly and distinctly ~1 buildings, whether existing or proposed, and indicate ~I set-back d~ensions from property lines. Give street ~d block number or description accord~g to deed, and show street nines and indicate whether interior or corner lot. APP NOTIFY ?e64eoa FOLLOWING INS~ECllONS: 1. FOUNDATION - TWO ~REQUIRED 4. FINAl. - CONSTRIJ~'ION MUST 'rim II~mlREM~iT8 OF 11~ #.Y. BTATil ~(XJ~I11UOlIOM · ~i~II~Y STATE OF NEW YOP, K, S.S C~Y OF .......... ,. ...... ...,..~.'~.~.'.[i...~. ~ .~. ~..~. :'-~.{~.~ .,~,. :.~ .L...' . .... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. £ (Contractor, acent, corporate officer, etc.) /. o,' said owner or owners, and is duly au~mrized ro perform or ha~e performed the sa~d work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before ine this ~o. ~22~,~b1~ S~eSu~ ~ ~ ' - -~ (Signature of applicant)