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Home My WebLink About22096-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23275 Date OCTOBER 11, 1994 THIS CERTIFIES that the buildin~ Location of Property 230 INLET LANE House No. County Tax Map No. 1000 Section 43 Subdivision ALTERATION GRMENPORT, NY Street Hamlet Block 5 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~%Y 13, 1994 pursuant to which Building Permit No. 22096-Z dated MAY 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 TO ALTERAN EXISTING GARAGE INTO TWO "FAMILY" ROOMS ATTACHED TO A SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to AMELIA MURPHY & JOHN CARROLL of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS INSPECTION SVC. 5388 PLUMBERS CERTIFICATION DATED Rev. 1/81 (owner's) VAN ETTON PLUMBING N/A AUGUST 8, 1994 AUGUST 22, 1994 uildi FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT ToWN HALL $OUTHOLD, N.Y. N-~ 22096 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ............................................ , ........................... ~~...~..."7.. ...................................................... Counh/ Tax Map No. 1000 Sectlon.......~.~. ............ Block ~'- LotNo. ..~....~..... pLlrsuan, to applloatlon dated ~...¢ Z.~.. , 19....~....~... , and approved bythe Building inspector. Fee ¢...,Z4~.~ ..... /~/ Building Inspector Rev, 6/30/80 Form No. 6 TOWN OF SOUTI~LD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCI TOWN OF SO, '-" ' 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: 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 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate 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 "pre-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 the reasons therefor in writing to the applicant. C. ' Fees 1. Certificate 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-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 $15.00, Commercial $15.OO Date ...'.~-?~; .~..~..../..~.f ~ew Construction ....... ~. Old Or Pre-~is~in Loe tion of Froperty.ii. .. . ...... ..... ............ House No. Street Hamlet Onwer or Owners of Property ................................. County Tax Map No 1000, Section ......... Block ................ Lo ....... 4 ........... Health Dept. Approval .......................... Underwriters Approval ......................... ~lanoing Board Approval ........................ llequest for: Temporary Certificate ........... Final Certicate....~.. .... , s,b.itted: $ ........................... . (5~6) 286-6~2 ELECTRICAL INSPECTION SERVICE, INC. 375 OUNTON AVENUE EAST PATCHOGUE, NEW YORK 11772 5388 Date 8'''~(~4 APPLICATION No. ON FILE ADDRESS: ~ 'rrl]et, ~ VILLAGE: ~ TOWN: ISSUED TO: JO~ll~ CEL~"~'oll / ~ INTRODUCED BY was examined on 8-8-°~ and IOulld ID b~ in compliance with tile National Electrical Code. LOCAT{ON BASE. ,~ Isl. 2nd 3rd Attic Pool __ DET. GARAGE HOT TUB FIXTURE I RECEPTACLES SWITCHES 1 I 10 5 DISHWASHER DRYER CLOTHES WASH. GAR. DISP. I RANGE I OVEN AIR. COND. SMK, DET, BELL TRAN. 2 SERVICE DISCONNECT .~. ~/President INSPECTORS Thomas Fisher Building Ivapector Gary Fish Building Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOVffN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P. Oi Box 1179, 53095 Main Road / Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 CERTIFICATION DAT~: Building Permit No. ~.O~ Z. OWner: (please print) (please print)' I certify that the solder used in the water supply system contains less than 2/10 of I% lead. umbers Signature) Sworn to before me this Notary Public, ~County 75/. ~ublic . JO¥CE M. WILKIN8 N~a~i~. S~te of New YOI~ mo-~zz46, SuflolkCoult~_..,. Term Expire~June12,19,~A u OH/,I£/q I'.~ INSULATION PER'N. Y. STATE ENERGy · ' CODE FIilAL ADDITIOH ~OM~IEHTS: 7Lq..~e2 BUILDING DEPT. INSPECTION DATE ~INSPI~,' 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [] FRAMING [,~NAL REMARKS: ~ ,~ INSPECTOR 7rd-180~ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] RO.~GH PLBG. ! FOUNDATION 2ND [ "'J' INSULATION [ ] FRAMING [ ] FINAL REMARKS: 7(4-'1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ R~~OUGH PLBQ. [ 1 FOUNDATION 2ND [ ] INSULATION FINAL REMARKS FORM NO. 1 ToWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~ ~., 19 i-~' _/~ TEL.;.765-1802 Examined . ^pproved ..... ¢/ ....... Disapproved a/c · · (BSlild~g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTII ......... 'l SETS OF PLoX;IS .......... SURVEY ................... ClIECK .................... SEPTIC FORH .............. t:oT~'~: ldtc~e L I/Si~Zr' c^L,- .... .4z-7-77 -?- ~/. 7 .... HAIL TO: , a. Tiffs application must be completely filled in by typewriter or in ink and submitted to thc 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 6f layout of property must be. drawn on the diagram which is part of this appli- cation. c. The work covered by tiffs application may not be commenced 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 by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ?,egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. l'he applicant agrees to comply with all applicable laws, ordinances, building code, housing codg,).nd regulations, and to ~dmit authorized inspectors on premises and in building for necessary ......~/~c~_ _ _ ~~~..: ~ .~.: .--.....~: ............... i ...... (Signature of applicant, or ~n- -,~ff a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.. 'f applicant is a corporation, signature of duly auth~orized officer. (Name and title of corporate officer) Plu b rsLi nsc No .... ~.. ................. Electric, Jan's Licenle No .... .~./. ~./.-...~.-'.-' .... Other Trade's License No ..................... · Location of land on which proposed work will b;'done ......... · ............................ ....... ltouse Number Street Hamlet County T . lap No. lO00 S=tion ..... ........ B ock' 'Lot. Subdivision ..................................... Filed Map No ............... Lot ........... (Name) State existing use and occupancy of premise~a~d intended use and occupancy of proposed construction: · a. Existing use and occupancy ....... . '.~..~ .... , ........................... ~ ......... ..... .3. Nature of work (check which applicable): New Building .......... Addition ..... Rcpair .............. Removal .............. Demolition ......... er Work .............. ~[t?/2, r.) ' ' ' ~ ~ : ~(Diescription) Estimated Cost .... /'.~./.q.t?.~. :.O. .................... Fee ..................................... 4. / (to be pa~~cation) 5. If dwelling, number of dwelling units ..... ~. ........ Number of dwelling unit~ o . If garage, number of c~s ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structure% if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... D~ensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... 'HeiSt ...................... Number of Sto~es .............. 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Npmber of Stories ............... r ..................... ' ..... ' ....... 10. Dat~ of Purchase ... ~f~.~ ................... ~Sf~/r Owner 11. Zone or use district in which premises are situated ......... / .......... · ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~. m~ ~o~ ~,~a~d ...... ~ ................. m~ ~ n~ b~ ~o~ [4. Nme of Owner or premises ~. ~'~ddres~)P.~ .... ~Phone No. ~Z.e. r ~.~. Nme of Architect ........ ,..~.~./~ .~ ...... Address . ~ ....... , ......... Phone No ................ Nme of Contractor . ~~.~ ...... Address .~:~ ~?~.~hone No. ~: ~ Z ~.. 15. Is chis property within 300 Epee of a t~dal wetland? *Yes.' ....... No.: ........ · If yes, Southold To~ Trustees Permit may be required. PLOT DIAG~ Locate clearly ~d distincdy ~1 build~gs, whether exist~g or proposed, ~d. indicate ~l set-back d~nslon$ from property Hne~. G~ve street ~d block number or desc~ption accord~g to deed, and show street n~es and indicate whcther ~te~or or comer lot. 'TATE OF NEW YQ.I~. ' S S :ou~v or.. ~ LX4:/%¢,-._.,...., ' ~- J. .r ...... : ....... ....... /~. ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) love named. is the ........................................ (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~licationl that all statements contained in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set forth in the application flied therewith. om.to before me this ~ ' · · ........... · ry Public...-.<'.//:~'{'q.'~..~..~''' .Co,nty / _ .NOT _AgY ~_~g'~(~ df N.Y. .............. ' ....... // N~ 4725089, $i,'h)l (~a~Y, (Signature of apphcant)