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Home My WebLink About22023-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OOuuwANCY No Z-22966 Date APRIL 27, 1994 THIS CERTIFIES that the building Location of Propert~ 195 FIDDLER LANE House No. County Tax Map No. 1000 Section 36 Subdivision ACCESSORY GREENPORT, NEW YORK Street Hamlet Block 2 Lot 6.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 12, 1994 ~ursuant to which Building Permit No. 22023-Z dated APRIL 26, 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 SHED "AS BUILT" The certificate is issued to JEANNE GENOVESE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A -- / ~ Buikding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22967 Date APRIL 27, 1994 THIS CERTIFIES that the building Location of Propert~ 195 FIDDLER LANE ~ouse No. County Tax Map No. 1000 Section 36 Subdivision ADDITION GREENPORT, N.Y. Street Hamlet Block 2 Lot 6.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 12, 1994 pursuant to which Building Permit No. 22023-Z dated APRIL 26, 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 F~IILY DWELLING "AS BUILT" The certificate is issued to JEANNE GENOVESE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTI~OLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22023 Z Date ................ ~.~'....~... ............................ Permission Is hereby granted to: ...... :~/.~....~.z.?~ ....... ~.,. ..................... to ...... ~,..~..~...~ ......... ~..~~....~......,c..;~ ........ ~.....~.~... .... .~.~.~.~ ......... ~......~..z..~ ........ ~......~...~.....~.: ................ ....................................................................... .................................... ~/- ~,,Z., ./..... LctN Coun~yTax Map No. 1000 Sectlon_..,,)..~(~.. ............. Block .......................... o o ......... ~ ................. pursuant to application dated ........... ..~.~...Z.~... ........... ..................... 19...,~....~......., and approved bythe Building Inspector. ~ee S., ,Z'/.~.~... ' ~peotor Rev. 6/30/80 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 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 Upre-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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date...~. ~.(i New Construction ........... Old Or Pre-existing Building ................. Location of Property ............................. House No. Street Onwer or Owners of Property... i-..~..O~..~..~. ~O.O.~.~.~ _. ........... ~'.~.. . 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 ........... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and 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 Vpre-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. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Oc~anhy - Residential $15.00, Commercial ~i5.00 Date · New Construction ........... Old Or Pre-existing Building ................. Location of Property ......... ~ ..... ~ r.~.~--~-~GA' ................ House No. Street Hamlet Onwer or Owners of Property..~~'-'~................~~ ............................. . County Tax Map No 1000, Section ........ Block... Lo Snbdivision . . Filed Map Lot ..................... Permit No .z~...z~./. ... . ,.. ........... Date Of Permit ................ Applicant ....................... Health Dept Approval . Underwriters Approval ..... Planning Board Approval ......... 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS~ON FRAMING [~]/FINAL REMARKS: DATE r ~ ~0~ dO NN~Ommv'' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTII ......... SETS OF PLA;;S ......... SURVEY .................. CIIccK sE ::c ;oN:, . Examined ..~ ....... 19.~ CALk. F. ~.T~/pJ... Approved ..~. , . ~TO: ' .... ....... 19~Permit No ~" Date ............. , 19... INSTRUCTIONS a. TI~s application must be completely filled Jn by ~pewdte~ or in ink and submitted to tho BuJld~g Inspector, ~ith 3 sets ~ plans, accu:ate plot plan to scale. Fee according to schedule. , 'b. Plot plan show~g location of lot and of bufld~gs on premises, relationship to adjoining premises or public streets ~r areas, and giv~g a det~led description of layout of property must be d~n on tho diagram ~hich ~s pa~ of this appli- cation. o. ~e work covered by t~s application may not bo commenced before issuance of Building Pe~it. d. Upon approval of this application, the Building Inspector ~H1 issued a BuUd~g Pe~it to the appUcant. Such pe~t sh~l bo kept on the premises arGUable fo~ ~spoction throughout the ~otk. - e. No build~g shall be occupied or used in ~hole or in p~t for any purpose ~hatevet un~H a Ce~i~cate of Occup~cy shall have been grated by ~o BuJld~g Inspector. APPLICATION IS HEREBY ~ADE to tho Bufld~g Dep~mont for the issuance of ~ B~Id~ng Pe~Jt pumuant to the Bu~ldJng Zone Ordnance of the To~n of Southold, Suffolk County, No~ York, ~d other appUcabIo ~ws. O:d~ces or Regulations, for tho const~ction of bulldogs, additions or alterations or for removal o~emolition as h0reM d ' T~o appU~ant agrees to co~ply ~ith aH applicable laws, ordinances bull ~ code ho''x;j ..... " , _. escrowed. ao~it autho~zed Mspectom on premises and ~ bulldog fo~ necessa~ ins o , ~ ;~uu, arm regmauons, Rna to ' -- - <Sig :ure of a~nt, ~ name, if a corporation3' State whether applicant is owner, lessee, agent, architect, engineer, gener~ contractor, elec~~6~'builder. ......... . .................................. .................................. (as on tho tax roll or latest dey~.l$~ ~ ~ TO If applicant is a corporation, signature of duly authorized officer. FOLLO~N~ IN$~N~ l, FOUNOATION - ~ REQUIRED ........................... · ................... FOR ~UR~ (Namo and t/tie of co.orate of, cer) O~CY ~ '. R--H- ~IN" ). INSU~ON . Plumber's'License No ................... CONBTRU~ION $HALL MEET ~E REOUmEMENTS OF Electrician's License No .................... 0E.~ STATE CONSTRUCTION & ENERGY. CODES. NOT RESpONSISLE FOR Other Trade's License No ...................... DESIGN OR CONSTRUCTION ERRORS. l. Location of land'on which proposed work w/Il be done. Zg~ rLd{ ey · · · ~,~' ..................................... or~ NY Hou umber , Street Hamlet County Tax Map No. 1000 Section .. 9.~, 0.~ ........ Block .. 9200 Lot.. 0D.$..000. dM ' Subdivision ........................... File ap No. ; ..... 005 000 (Name) ........ Lot ............... State existing use and occupancy of premises and in tended use and occupancy of proposed construction E isti d ' On fatally dwe'&l~ng shed deck b I d d d ' One famL~y d~LZL~g,'shed deck 3. Nature of work (check whichlappl cable~. ',, - . ,. · ~. ,,ew ~uuaing .......... Auuition terat on ...... Repmr .............. Rc!moval ........... Demolit on . e'- ~,g~'~- . ' 4. Estimated Cost . . ' · . · .............. Fee ............ )' .% ............ , (to be pai[~i~pplication) 5. If dwelling, number of dwelli6g units ........ . ....... Nt/mber of dwelling units on each floor ..... · If garage, number of cars .... i ........... · ......... 6. If business, commercial or m ed occupancy, specify nature and extent of each type of use ....... 7. Di~nensions o! exlshng struct res, if any: Front .........' ......Rear .....Depth Height ............... Number of Stet es ......... . ........ ' .............. ' .......... Urc l'w ............................... Dimensions of same struct . ith alteratious or additions: Front ........ Depth I Rear ......... : ........... Height ................................. Number of Stories ' ' 8 Dimensions of entire ...................... · new Conitruction: Front Rear .................... Height . .' ........ ' " Depth Nt~mber of Stories ....................... '" ......... ; ........... 9 Size of lot: Front ........................................... ......... : ........... Rear .......... 10. Date of Purchase ~ ....................... Depth ...................... ; " Name of Former Owner Il Zone or use distri0 i ...... ' ................... · which premises are situated ........... ' ......... ~ .................... 12 Does proposed construction violate any zoning law ordinance ' 13 Will lot be regraded , or regulation: 14 Name ....... ~ .................... Will excess fill be removed from premises: Yes ' No of Owner of premises ' , . . . . .' .......... Address Nan A~ch~tect ........ Phone No Name of Contractor ....................... Address ................... Phone No ................ 15 Is this property withinl300 feet of a tidal wetland? ~Ye ' Phon~No .......... · ................. Address ................................... · If yes Southold]Town Trustees Permit may be requi;ed No ' . PLOT DIAGRAM Locate clearly and distinctly ai'l buildings, whether existing or protSosed, and. indicate all set-back dLmensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ; . STATE OF N]~W~OJiK,;. ,. ,' '..~ "?" ~ '(N:~ of in'dividufiisi~n' . .~ ~~ %~,y sworn, neposes and says that he is the applicant abov~ named .... , · , . ' (Contractor ageht corporate officer ' ' ' ~ ............... ' · · i , , , etc. of Said owner or owners, ~d is duly guthofized to perfom or haveperfomed the said work and to m~e and file this application: that all statements contaihed ~ this application are true to the best of his knowledge and belief; and that the Work will be perfo~ed in the manner s~et forth in the application filed therewith. ~wom to before me this llth ........................ day of i rtl ~. uffolk ' ~ . ~'o~ hc ................ l ....... ~ ...... County 1. [ I~l ( / ] Notary P'L~bhc, Stat~) of New.~k . . . ~ I~&k I~I~n~ ~ - No 52,1419486 /77 ......... t.v ...................... ~ - x~ V ~ ~ : Qunhfmdir~SuffolkCounty ~ [[ / (Signa~ureofapplicanD , w Commmsmn Expires May 31, 19~ ~ / ' ' .00