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Home My WebLink About21973-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCuumANCY No Z-22954 Date APRIL 20, 1994 THIS CERTIFIES that the building ADDITION Location of Property 620 LONG C~K DRIVE House NO. Street County Tax Map No. 1000 Section 55 Block 4 Subdivision Filed Map No. SOu'r~OLD~ N.Y. Hamlet Lot 7 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MB_~CH 21, 1994 pursuant to which Building Permit No. 21973-Z dated MARC~ 29, 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 DECK ADDITION TO EXISTING ONE FAMILY DW~LT.ING "AS BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A /,~uildi~Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF No Z-22955 Date APRIL 20, 1994 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 620 LONe CREEK DRIVE SOuT~OLD, NEW ~OEK House NO. Street Hamlet County Tax Map NO. 1000 Section 55 Block 4 Lot 7 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MA~CH 21~ 1994 pursuant to which Building Permit No. 21973-Z dated M~RCH 29, 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 ACCESSORy STORAGE BUILDING "AS BUILT" The certificate is issued to GEOI~E D. & KA'£~R~N T. SORNAUER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A ' ~ 7 ~lding Inspector Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAU, SOUTHOLD, N.Y. N_ BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDI 21973 Z Permission Is hereby granted to: ~. ~.~......~..,...~.o~.~. ~.~ ....................... ..b..~....~......C....~...~....~.~.~ ............ ..~.,.~,~ ...... ~Z:....:......xx~z4 ................ , , ~.,,~ ........... ~ ....... ~x~......~..,..~ ........ z~ ...... ~ ....... ~....~.,:..,'~ . . .~/. ~/.,,~ ~. . . . . ~ . . . . . ~ . ~ ....... ~. . . . . ~.r~ ~ ........ . ./. . . ./. . .~. . . ~ ......... ,~-r. : . ~ ..~D:'..../...~ ...... ~ ~ ~,'z,~" ~ "" ............................................................. o,,,e~,,~,o~at~a, ..................... .;..~......~...~.....~, ...................................... ................................................................... ~,~,~ .............................................................. CounIyTax Map No. 1000 Sectio.......'-~.....~... ........... Block.....,.~.~"~ ............ LotNo ....... (~.2.. .............. Building Inspector. ~ ~...16.0.......?,,~. and approved by the Rev. 6~30~80 Form No. 6 BUILDING DEPARTblENT TOWN HALL APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the~-GTl'~TI~ 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. , 6. Be 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 $15.00 New Constructien ........... Old Or Pre-existing Building.~ .............. House No. Street Hamlet County Tax Map No [000, 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 ........... Fee Submitted: $..~..~.~.. . . .................... . . Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the 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 i. 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 $15.00 Date .... ~..?/~. ............................. . . . New Construction ........... Old Or Pre-existing Building.~ .............. Location of Property ......... ; ........................................... House No. Street Ha~et Onwer or Owners of Property..(~C'~.G.~.. ~.A ~.~;~ .... 4. :..~W~a.'~ ......... 7 County Tax Map No 1000, 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 ........... Fee Submitted: $ .~.~.-~ 5- o 2= Af$ 5 .... A P ICAN 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [, ]/~SULATION FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 BETS OF PLAI'tS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. COLt. ...... ` ................. APPLICATION FOR BUILDING PERMIT Date..3./~. ( ............. 19 ?.~ INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 areas, and giving a detailed description of layout of properW must be drawn on the diagram which is part of this appli- cation. c. The work covered by this 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 shall 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of 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 inspec~ons. -- (Si°nature oYapplicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ................................................................................ Name of owner of premises ,.?~.~.~ ~ d~.~ ~' ~..'.'.'.'.'.'.'.'.'.~-..4~.$..~.. ,..~ ...... . . ................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. APPROVED AS #OT~ .............................................. (Name and title of corporate officer) FEE: 1/0. NOTIFY BUILDING DEPARTMENT AT Builder's License No .......................... 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: Plumber's License No ......................... 1, FOUNDATION - 'BNOREQUIRED FOR POURED CONCRETE Electrician's License No ....................... 2. ROUGH - FRAMING & PLUMBING 3 INSULATION Other Trade's License No ...................... 4. FINAL CONSTRUCTION MUST t3E COMPLETE FOR C,O. 1. Location of land on which proposed work will be'done. ALL CONSTRUCTION SHALL MEET .................... TRE' 'FfEOUIREMENTS' OF' ~ 'N.~ ~.~Q_¢, .~'d.<,/42', '~'~ ~'.~d~ ~-,-,~5~TATE CONSTRUCTION & ENERGY ...................... · ~..~.. ............. ,~ .c....7../-4.. ',',~OI~S'. ' 'NOT' 'RESPONSIBLE ' FOR House Number Street rl~(~N OR CONSTRUCTION ERRORS County Tax Map No. 1000 Section ~ ~' Block ~ Lot. ,/ ................. SubdMsion ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Repair .............. Removal .............. Demolftion .............. Other Work ............... .~' (Description) 4. Estimated Cost. ~..~'.d. '. ............................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ............... ~ ...... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... I0. Date of Purchase ...~./Y>! ...................... Name of Former Owner .,Z-O.$~'~.,9....,~/~'.,qP'.R ......... 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ~o .............................. 13. Will lot be regraded .... g/~ ..................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~h~ ................ Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No~( ........ *If yes, Southold Town 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 number or description according to deed, and show street names and indicate whether interior or corner lot. h¢in§ duly sworn, deposes and says that he is th~ applicant -Ie is the ......................................................................................... (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. :7.: ~'o / ' tary Publ~ ~'~ '~.¢ ..... County O.a~RE L. ~' . ............. ~...~....c~ .................. ~ ~1~ ~ ~ U~ / (Signatu~ of applicant) ~ O~l~ in S~k ~u~ ~mi~n E~wes ~m~ 8, 19 ~r