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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25783 Date: 06/19/98
THIS CERTIFIES that the building ADDITION
Location of Property: 1330 SALT MARSH LANE PECONIC
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 68 Block 3 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 25, 1994 pursuant to which
Building Permit No. 22054-Z dated MAY 11, 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 SCREENED PORCH ADDITION To AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to ANTHONY D. HUGHES
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Insp for
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED) /
N Date j( 19...
22054 Z
Permission Is hereby granted to:
........1 P~c9C~..: v~3e?.
to ...~~cr sr . 9 .........~f',........J'
Y..:..'S. .fi^.~......
/ ? o°~'-,~°, ......I..
at premises located at /.~S 7? c G~/ ~?1s
f• ""4d~i~
County Tax Map No. 1000 Section /W,,,U Block ........®3......... Lot No........ !e;~
pursuant to application dated .../.!~~~G.... .......`.........................1 19., , and approved by the
Building Inspector.
Fee
.
uild goector
Rev. 6/30/80
Form No, fi ~GRV
TOWN OF SOUTHOLD
BUILDING DEPORTMENT
_ TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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 electricaa 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, ta certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. 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 Buildine - $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
New Construction.... Old Or Pre-exi
/~ting Building Location of Property.] i',3~. • tom. 70, -j 2~ l p • . • ~EG
House No. Street F t Hamlet
Onwer or Owners wf Property.....
County Tax Map No 1000, Section 1.••.Block... .
20 ..........Lot
Subdivision.. ~ •
.................................Filed Map............ Lot......................
Permit No.. 171 ,Date Of Permit..
..............Applicant................
Health Dept. Approval........
•••-••••••••••....Underwriters Approval
Planning Board Approval
Request for: Temporary Certificate........
Final Ccrticate..
=ee Submitted: $-K
JIL
O~~gOFFO(,~eo tI Ip III 1 7 Gym
;
C2
H
Town Hall, 53095 Main Road Vp + Fax (516) 765-1823
P. 0. Box 91971 Telephone (516) 765-1802
Southold, NewYork 1
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 9, 1998
Anthony D. Hughes
61 Irving Place
New York, New York 10003-3324
To Whom This may concern:
We are unable to complete your Certificate of occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22054-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
hlu I~ COMMENTS ~'V~~'=-_
FOUNDATION (1st) - y
FOUiJDATIO ti y
(2nd)
- - - and
2.'
ROUGH FRAME 4, 0
-PLUMBING
3. ti
I H
~
INSULATION PER N. Y, m
I c~
H ^
STATE ENERGY I
CODE
4. FINAL I P R
` O
ADDITIONAL COMMENTS: cn~
x~
x ~
H
77
• O I
. ~ a\
0
m
ANTHONY HUGHES
~gpFFO(,~C , • . _
Gov °o £4 APR 3
dA
Town Hall, 53095 Main Road °y Z rax (5161)-766-1 R2-;:. .
P. O. Box 1179 ~r0 n~ Telehonet$<t~s;.q
Southold, New York 11971 ,y • '&........a~.a-^`'~""""
~O1 ~ Sao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 5, 1998
Anthony D. Hughes 4 p, ,ES I: (lj S 4 °e:
L_
61 Irving Place
New York, New York 10003-3324
x.11A FEB 13+t,=;
****SECOND NOTICE**** t'r
k.,,,,, TOWN OF,
To Whom This May Concern:
we are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (outdated&ret)$25.00
No Health Department Approval on file.
No final insoecti.on has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT #22054-Z screened porch
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
****A BUILDING PERMIT IS REQUIRED FOR YOUR.SHED BEFORE A
CERTIFICATE OF OCCUPANCY CAN BE ISSUED FOR THE SCR ENED PORCH.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: , tv
. a
107
DATE Ae. INSPECTOR
r
O
4
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST -T---l- It6lUd-H'PL8--G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS:'
f
DATE INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ) FOUNDATION 2ND [ ) INSULATION
[ ] FRAMING FINAL
REMARKS:
t
1
DATE 4,*, INSPECTO
~~o~oSUFFO~K~oG~
Town Hall, 53095 Main Road ti Z Fax (516) 765-1823
R O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 14, 1995
Mr. Anthony Hughes
1250 Salt Marsh Lane
Peconic, NY 11958
Re: Premises: 1330 Salt Marsh Lane, Peconic NY
Suff. Co. Tax Map #1000-68-3-3
Dear Mr. Hughes:
It has been brought to the attention of the Building
Department that a shed has been erected without first obtaining
a Building Permit.
According to the Code of the Town of Southold a Building
Permit is required before any construction can be undertaken.
Please contact this office as soon as possible so this
matter can be resolved.
I thank you for your anticipated cooperation.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
z6c7ABuilding Inspector
GJF:cmt
(Cert. Mail)
3. Nature of work (check which applicable): New Building Addition . fem....... Alteration
• • Removal Demolition . OthgX.,,ctrk..
5
(Description)
4. Estimated Cost Fee , .
(to be p id onifiliq#41, is application)
5. If dwellineg
, number of dwelling = units Number of dwelling units on each floor / .
If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each t . .
YPe of us~~ . •
7. Dimensions of existing structures, if any: Front ....4 0
Hei ht .........Rear .....3.......... Depth
g ht Number of Stories , .
Dimensions of same structure with alterations or additions: Front • • • .
Rear...'............. .
Depth Height . Number of Stories .
Dimensions of entire new construction: Front . Rear . . . . . . . . . . . . . . . Depth
Height
Number of Stories .
...."p" • • • •
9. Size of lot: Front Rear............
10. Date of Purchase • • • • Depth
.
.............................Name of Former Owner .
11. Zone or use district in which premises are situated . . .
12. Does proposed construct'oQn violate any zoning law, ordinance or regulation:
13. Will lot be regraded ..9; "e is""'
• • • • . Will excess fill be removed from premises: Yes 144 ~0
14. Name of Owner of premises Address Phone No............... .
Name of Architect AA A . . . . Address Phone No.
Name of Contractor Fl.fERlA/fi , , , , , , . Address .R y gam, , 3G
15. Is this property within 300 feet of a tidal wetland? * X " '•Phone
*If yes, Southold Town Trustees Permit may be required. No.d
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.
~u7
STATE OF NEW YOF
COUNTY OF cij , S.S
U ~c ~c? y ~s 1 yc~. • , • , , being duly sworn, deposes and says that he is the applicant
(Name of individul-signing contract)
above named.
He is the ! ~Xc .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in the njarrper set forth in the application filed therewith.
Sworn to before me this
d a
day v~.I .
Notary Public, l
, County
ROBERT I.SCOTT . .of. .
NOTARY PUBLIC, Sta of N. Y. (Signature applicant)
No. 4725089, Suffolk Coun 7
Term Expires May 31,19
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OFSOUTHOLD SURVEY
Q _3 BUILDING DEPARTMENT CHECK . .
TOWN HALL SEPTIC FORM
APR 2 5 1 94 SOU EOLD65- 8021971 ttOT i Y y
Examined , .
TOWN OR' UT.., M TO:
Approved ermit No..?:~SZ .
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19.. .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
seas 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 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 witl all applicable laws, ordinances, build' ode, ho g code, and regulations, and to
admit authorized inspectors on premises and in building for necessary i ions.
(Signature of applicar~or name, if a corporation)
/y;-° .1'6 L ~ Ma2sv 62,V Jr PEAa V, c
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
a. r~Al +E' . .
Name of owner of premises ~Ho ~J y CaH S fu S A n/ k1CJ J_ ,E'
(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. . /.~.Q .
Plumber's License No. (~i . .
Electrician's License No. . dl.
Other Trade's License No. ../Ltic r7 ~ .
I
1. Location of land on which proposed work will be done . . .
~.c7J.J7.0 Jh47.-. Ax ,t'. fl ...........-.7a-,re, . set.
House Number' , , .II' c . . .
Street H Hanilet ~ C o A/ / t N,`!
County Tax Map No. 1000 Sectioln Block 3........... Lot , , , , , , , , , , ,
Subdivision .................I...... Filed Map No. Lot
(Nam.e)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy SvH~t6ti... /`~S!D~N
I.........
b. Intended use and occupancy .~J~4
j ~xls-7r L~G.DG.
I
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
DATE S•, BAJ3
ME:.1~ c9c~ 8*-
NOTIFY 13UILDING DEPARTMENT AT
788-1802 8 AM TO 4 PM FOR THE ±
FOLLOWING INSPECTIONS: - - - -
1. FOUNDATION - TWO REQUIRED IpMWITERSCERTIFIME
FOR POURED CONCRETE REQUIRED
2. ROUGH - FRAMING & PLUMBING
3. INSULASION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FORCA.
ALL CONSTRUCTION $HALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTIM & WWMY
N OR :IR ~s - - - g
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J, ~.f x 4 GGA!
I _ ~GUNC FrGS.
APR 25 1994
E BLDG.DEPT.
TOWN OF SOUTHOLD ___j
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