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Home My WebLink About22002-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. · :K-TIFI~ATE OF OC~uFANCY No ~-22988 Date MAY 10, 1994 THIS CERTIFIES that the building. Location of Propert~ 6620 HORTONS LANE House No. County Tax Map No. 1000 Section 54 Subdivision ADDITION SO~THOLD, NEW YORK Street Hamlet Block 3 Lot 14.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6, 1994 .pursuant to which Building Permit No. 22002-Z dated APRIL 8, 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~T.T.ING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 NICHOLAS & JOAN MURRAY N/A N/A Building In~ FOgM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT IOVi'N ~ SOUTHOI.D, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Dote .................. ...~../....C~.. ................................ 19....~....../~- 22002 Z Permission is hereby granted to: ...... .. z;.~~....4.. ......... .../...,..y.... ....... (./.?..~./ ............. to....~.......~. ,~./~(...,d~. .......... ~ ....... ..~..~..C../.< ........ ./.~...5).~..../..,~../..~..~.?.. ............ ~ ....... ~ .................... ..?./..~..~ ........... ~,,~..,.'~ .......... /~./.~../~& .......... ~..~~ ................... at premises located at ............ .~....~....?.~ ....... ./....~..~....'f?~..~.~..'.... ~.'~.. ........................................... OounlyTax Map No. 1000 Section ...... ,,~,.,~.,..~,.. ....... Block ........ ~,,-~., .......... LotNo ..... /~.:.,~., .......... pursuant to application dated ................. ~.. ........................... 19.....?.....~..... Building Inspector. Fee $,,,..~..,,~.:,~ ...... and approved by the Rev. 6/30/80 Form No. 6 TO~N OF'SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: i. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all p$operty 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 C~rtificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwal~ling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessbry building $25.00. Busimesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $100.00 3.Copy of Certificate of Occup~qcy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commerciai $15.00 Date . J./ ......... ; ............... Construction ........... Old Or Pre-existing Building ................. ocation of Property .................. · ......... House No. Street Hamlet nwer or Owners of Property, ,,, .. .. ... ..... .................. · .... .. ounty Tax Map NO 1000, Section....~,N. ...... Block....¢.~ ........ Lot.../.~.~[5. ............ ubdivision .................................... Filed Map ............ Lot ...................... ~rmit No..~..~..~....Date Of Permit. .~.~. ..... Applicant.~.~...~.~./.~...~.. ~alth Dept. Approval ............... .Underwriters Approval .................... Lanning Board Approval ............. ' ~quest for: Temporary Certificate .......... Final Certi~ate~''~ Submitted: $....~ .~..~ ?Y~P , , ...... . ........... C O ~ ~ ~ ~ APPLICANT 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION ZND [ ] IN/.SU[~TION FRAMING [~ FINAL /Ii INSPECTO~~ CO, fTS FOUNDATION (2nd ROUGH FRAME & -PLUMBING 3. INSULATION PER N. STATE ENERGY CODE ADDITIONAL COM~ENTS: 765-1~02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSeT ION FRAMING ,~]XFINAL REMARKS: ~'~ Aoh' 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined ......... , 19 ApproYed ..... ~.~.~. ...... , 19 ?~ermit No. · .c~- · · ·O. .~. . · Disapproved a/c ..................................... Received ........... ,19... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This 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 areas, and giving a detailed description of layout of property 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 wkple or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ~k,.~ APPLICATION IS HEREBY MADE to the Buil{ing Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold:~uffolk 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 inspeAticn~"~,-~ ) ~.,~' r'fl ,.~ (Signature of applicant, 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 3. . .q' .... ~. ~ ...................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... }. 3 J .O....~ .( ........... Plumber's License No ........ ~.. ,~.. ............ Electrician's License No ....... ' I i Other Trade's License No ...... 1. Location of land on which proposed work will be done .................................................. ..... .................... ........ ................ House Number Street Hamlet County Tax Map No. 1000 Section.. ,~. ~. ........... Block .~. .............. Lot../.~.z .~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... [~ :[ ... -. · · .~f~. --¥k ....................................... b. Intended use and occupancy ..... .~. ~..~.~ ........................................................ 3. Nature of work (check which applicable): New Building ..... './. ~. Addition.. ~ ....... Altera~on ~ .~. ........ Repair .............. Removal '. ............. Demolition ........... ;.. Other Work .~3~.'-~..~ ....... 4. Estimated Cost ....... r. ............... ........... Fee ... k ............... - .......... (to be paid on filing this application) dwelling, number of dwelling units .............. ._ Number of dwelling uniti on each floor ............. }'. 5. If If garage, number of cars ~ ............................................ ~ ............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... ! ...... D~pth ............... Height ............... Number of Stories ............................ i ........................... Dimensions of same structure with alterations or additions: Front ............ i .... Rear .................. Depth ...................... Height ...................... Number of Stories ........... 8. Dimensions of enlire new construction: Front ... l .&. t. ........ Rear .. J.~ !..ii ...... Depth ...J. Height ............... Number of Stories ............................ I ·,;/: ...................... 10. Date of Purchase .. Name of Former Owner ~.~..C~. l'.~x}~rq'erl .......... 1 I. Zone or use district in which premises are situated ......................... i ........................... 12. Do'es proposed construction violate any zoning law, ordinance or regulation: ...~,~.~. ...................... 13. Will lot be regraded ..... },~.t~... '.~ ........ . ....... Will excess fill be removed from premises: Yes 14. Name of Owner of premises . . .1~..°..rer~..~ ......... Address ............... i... Phone No..~.¢.~.-.t.q.l~.~. .... Name of Architect ......... ;... ............... Address ..: ........... i .. Phone No ................ 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 sho~ street names and indicate w~hether interior or corner lot. ~TATE OF NEW YORK, S.S 2OUN, TY,-OF ................ .... .'..~. ~ ................ being duly sworn, depo~ es and says that he is the applicant (Name of individual signing contract) tbove named. te is the ......................................................................... (Contractor, agent, corporate officer, etc.). ff said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this tpplication; 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. ;worn to before me this applicant) ~ Term Expires Juno 12, 19312 r APR - 6 I~ ? i APPROVED AS NOTED NOT.:¥ BUILDING D,:,'A.TMENT AT 765-1802 9 AM TO 4 PM FOR TIlE FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED~ FOR POURED CONCRETE 2. RouGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE ,REQUIREMENTS OF 't'HE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR8 OCCUPANCY OR USE IS UNLAWFUL WITH01JT CERTIFICATE OF OCCUPANCY E. W~ CONTRAOTOR SF. AWO0~ DRIVE N.Y. 11971