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Home My WebLink About22423-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RT~NT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23966 Date OCTOBER 19, 1995 THIS CERTIFIES that the building Location of Propert~ EAST END ROAD House No. County Tax Map No. I000 Section 4 Subdivision ADDITION FISNERS ISLAND, N~W ¥O~K Street Block 6 Lot Filed Map No. Lot No. H~let 4.2 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 13, 1994 pursuant to which Building Permit No. 22423-Z dated OCTOBER 31, 1994 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 DORMER ADDITION TO EXISTI~ ONE F~/~IL¥ DWELLING AS ~PPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JEFFREY & AMANDA SALZMAN N/A Rev. 1/81 FOI~M NO.3 TOWN OF $OUTHOLD BUILDING DEPAI~TMENT TOW~ HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDI N-° 22423 Z Date.. ,,,~.:~../ . ~./.. ........................................ 19....~./ at premises located at .............. ~ ............................. CountfTax Map No. lO00 section ........ ~ ........ Block ................ .~...,.., LotNo ........ ~.~.. Building Inspector. , and approved by the Rev. 6/30/80 Form No. 6 " TOWN OF SOUTHOLD · · TOWN Ib~LL This application must be f%lled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 fo~) 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn' statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Co~eraial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archi~ec~ or engineer responsiblm for the building. 6.. Submit Planning Board Approval of completed sitm pla~.requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and qpre-existing" 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 signed by the applicant. If a.Certificate of Occupancy is denied, the Building Inspector shall state ~he reasons therefor in writing to the applicant. Fees 1. Certificat~ of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swiping 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 5. Temporary Certificate of Occupancy - Residential $t5.00, Co~ercial $15.O0 ~'/7/95 Date ms~ruction ........... Old Or Pre-existing Building ................ ' East E~d Road Fishers Island N Y ion of Property , ' ' · House No, S~ree~ Hamlet or Owners of Pro~er~,, 'Jeffrey Salzman & wife 000, sac ion..A .......... .... 9 ........... ................. 'ision Filed Map Lot - No. 22423 ~ ...... Date Of Permit 10/31/94' A.=lican~ Z&S Contracting Inc. ' Dcpt Approval Underwriters Approval ng Board Approval t for: Temporary Certificate ........... Final Certicate..~ ........ 'bmitted: ~25,00 FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & :PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FOitM NO. 1 TOWN OF SOUTItOLD BUILDING DEPARTMENT TOWN tlALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a]c'..,; ............................... ~BuiJfiqng~F~ctor) / APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF IIEALTII ......... 3 SET~ OF PLA~IS .......... tURVE~ ................... CIIECK .................... SEPTIC FORH .............. IIOTIP~ CALL ................... tlAIL TO: a. Thisapphcatlon' must be completely fi' ed in by typewriter or in ink and submitted to the Building Inspector, with 3 ,ets of plans+ ac~:u~'0te plot plan to scale. Fee according to schedule. · [ lot pla. n showmg location of ot and of bt ildings on premises, relationship to adjoining premises or pnblic streets Ir areas, andglvmg a detailed description of layont of property must be drawn on tile diagram which is part of this appli- :ation. c. Tile Work covered by tiffs application may not be cSmmenccd beforq issuance of Building Permit. d. Uppn approval of.this npplicatim], tile Building Inspector will issned a Bnildh]g l'ermit to the applicant. Such permit hall be kept on tile prem'ses available for mspechon throngllont the work. .e. NO building shall be occupied or used in whole or in part for any Imrpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. ' APPLICATION IS IIEREBY MADE to tile Building Department for the issuauce of a Building Permit pursuant to the ~utldlng Zone Ordinance of tile To'wa of Southok, Suffo k County, New York, and other applicable Laws, Ordinances or {egulati6ns, for tile construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to cotnply with all applicable laws, ordinnnces, bnilding code, housing code, and regulations, and to ~dmit authoi'i~ed inspectors on premises and ill building for necessary inspections .... ' " (Sionature of applicant, 6r name, if a Corporation) (lvlailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Name of,owner 6f p ......... ,~ remises ............................................... (as on the trF roll or latest deed) If applicant is 'a corporation, signature of dnly authorized officer. (Nam~nd ti.tie of corpor'ate%fficer) Electrc a 1 s License No .................. :.... Ot ,er Trades L ce ,se No..~&~ .~g. Location 6r land o~ which proposed work will be done. ' ............ Ilou~e ~umber Street llanffet Cou'tv Tux Map ~o.'1000 Section ...'M Block ~ Lot Subdivision ........ . ............................. Filed MapNo. ~ .-.. ........... Lot ............... (Name) "...?.'::.-~ 2.1 ~ State existing qse and occnpancy o[ premises aad intended use and oecnpancy {)f proposed constrnctlo~: a Existing use and occupancy c~z'e¥)'~. ~/ ~ 3. Nature, of work (cheek which ,applt~nble): New IJttihling Addition .......... AHer~tiou .... :.. ............ . wo, ............... 4. E~timated Cost ..~ ~ ~ ~'; ~ ;.~. ~ -- ~.~ (Desc~ption) ............ : .... ; ......... Fee , ' I ' (to be paid on filidb~ thls application) if dwelling, number og dwelling uni~ Number of dwelhng umts oll eac 5. s. h floor ................ . If garage, number of ears ...... ~ . 6 ifbusinfss cgmmerelal or m xed oc~t-~ .................................................. 7 Dimensions o{`ex'stmg'stmctures . ~ .... ~,.spechy nature and extent of each type of use ' i~any: Front .................... Rear Depth tlelght Number of Stories Dimensions ....................................................... Depth of same stntctur~ with alt~rntions or additions: Front ................. Rear .......... ~ ....... ] Dimensions 0f entire Number of Stories ...................... I, leigbt ...................... ' new constn~cti~ ~ Front ' Rear ...................... .............................. Depth ............... He]gilt "' ' ~ ~umber;ofStories ) Size of lot: FrGnt .................................................... ' Date of Purcllase ............. ' ........ Rear ........... Depth ' ' ............. ~ ............... Name of Fomler Owner I Zon~ or u~ district in which premises ar~ ' situated ~ Doe5 proposed const~uCtiou violnte tiny zoning law ..................................................... ordiuqne~ or regslation: Will lot b~ regrnded i ' ' · .... , ............................ ............................. Will excess fill be removed from premises: Yes No Name of Owner of premises [ Ad bess Name of Arcblt;et ": ................. ' ................... Phone No ..... ............ .............. Address .................. Phon~ No ............. Name of ContraCtor ........ i ..... Address ................... Pl~on~ ~o ......... ' ....... , . 9If' yea, Southold Towd Trustees Permi~ may be required. . ': [ P LOT DIAG RAM Lo~at~ clea~y and dishnctly,MI buildings, w ether existing or proposed, and indicate all 5et-back dimensions from 'opyrty lines. ~lve street and block number or descriptio6 according to deed, and show street n~es and indicate whether tenor or corner lot, ' '~GB-'~80J ~:~ AM ~'0 4 P~FOB THE , FOLLOWING ~NSPECTIONS: '}, FOUNDA*NON -' '~VO REQUIRED FOR POURED CONCRETE '~, ROUGH -, FRAMING & PLUMBING 3, ~NSULATiON 4. ~qNAL, CONSTRUCTION MUST BE COMPLETE FOR C.C. ALL CONSTRUCTION SHALL MEET '~'~E 8EQUIREMENT8 OF THE N.Y. STATE CONSTRUCT}ON & ENERGY ~ODE$. N~ RESPONSIB~ FOR DESIGN OR CONSTRUCTION ERRORS ATE OF NEW YORK, S.S )U~I'Y OF ............. ; .... ........... ": .................. being dui7 sworn, deposes and says that bo la th~ applicant (Name of individual signing c~ tract) DYe ~anled.' ' (Contractor, agent, corporate offieor, etc.) ~said owner or owners, and is duly authorized to perform or have perforated the said work and to make and ~li~atJon: that all statements contained ]In this npplication nr~ tru~ to the best of his knowledg~ and belie{'; and that the .ok w{]{ ~}e)~erfo~ned m alto m~ner s~ln the app ication filed tlmrewith. ' om to oe/or~ this ~ qfl , ...... ............... No 4606559 I '"~ // (S gnature of applicant) Ou~llfl~oln Suffolk County ]" . .