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Home My WebLink About21859-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22820 Date JANUARY 3~ 1994 THIS CERTIFIES that the building Location of Property 580 WIGGINS LANE House No. County Tax Map No. 1000 Section 34 Subdivision ADDITION GREENPORT, N.Y. Street Hamlet Block 4 Lot 28.30 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 20~ 1993 pursuant to which Building Permit No. 21859-Z dated DECEMBER 30~ 1993 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 ADDITIO~ TO EXISTING ONE FAMILY DI~JSLING "AS BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OP HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 SASVATORE & FRANCINE PRATO /~~i~ding Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED) Date ,.....?...~...l~ ...................................... 2:J. 859 Z / Permission Is hereby granted to: /-/,~...... ...~.....Z..... ..~...,..~.~.:..~...~ .................. ........... ~.~......~?-...,,...~:....../...~., , ,~.. .~ ........ ~ ......... h ~ ....... ~:.,. .: x~ ......... ~ . . . . . . . ~. . . . . . ~ ~. ~. . . . . ~ ,. . . . .: . . ..~././.~ ........ ~: ....... ~.:.,.'.~. ......... ~..~.:..: ........................................................... ............................................................ ~.,:?..~+:...-.....~:....../.~.x~.... ........................... CountyTax Map No. 1000 Section,....,~..~ .......... Block ......... ./...~?../,~... ...... Lot No. .,.~,,.,?,,~..~ .......... pursuant to application dated ........................................................ 19 ........ and approved by the Building Inspector, Fee ~.,.,.Z~ ...... ....... ...................... 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 ~urvey 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 I% 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. Fees i. Certificate of Occupancy - Ne~ 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 ..... V~.~. ...... ~ J? .................................... 2/ ..... House No. Street Hamlet Onwer or Owners of Property .... ~.~.~. ~ :.~....~..~_~...~/..~/.~:.....~.~. ~. ............ County Tax Map No i000, Section .... .~.~,'i .... Block ...... .~. ....... Lot .... .~.~. 7..~.~. ........ 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: $ ........................ .~~ ~ 337 '"' '[. · ............. N FORM NO~, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .... .... ,19.9 . Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... ClIEcK .................... SEPTIC FORH .............. NOTIFY CALL ................... ['IA I~L TO: Date ~ ~ ' gO ~ ~ .... '. ............. , 19... 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 cbmmenced 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, builCjfig code, housing co, d% and regulations, and to admit authorized inspectors on premises and in building for necessary insp~ti~.._.,___ J;;'~ Z;.'; ¥; ;; ............ -- . (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 ~ ~..o'.~..;/d~'- ~ t~-//d'/~/,/--/6~' .................. (;~ ~'n' t'~e' ;~' ;o'li ;; ilt;it' JJid')', ,, ,, _,~.'APP*n0VED'A$ ~{0EB.~ ...... applicant isa corporation, signature of duly authorized officer. } DAT~: ~B.R iV If 'FEE: ,,~'¢t¢O' BY: .............................................. NOTIFY BUILD~NG DEPARTMENT AT (Name and title of corporate officer) 765-1802 9 AM ~ 4 PM FOR THE VOL.LOWING INSPECTIONS: Builder's License No .......................... 1. FOUND~,3'IOr~ 'B/VO REQU{RED FOR P(.)UR,.:u CONCRETE Plumber's License No ......................... 2. ROUGH ~ FRAMING & 3. }NSULATK)N 4. F NAL C(~STRUCTiON MUST Electrician's License No ....................... 8E COMPLETE FOR C.O. Other Trade's License No ...................... ALL CONSTRUCTION SHALL MEET '{'HE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY ]. Location of land on which proposed work will be done ..................... (~OOEg;. 'NGT- 'REgPONSIBEE · FO~ hT. aT-, /d.C/ .l. { o. cons'muc ,o House Number Street Hamlet County Tax Map No. 1000 Section ~.fl .~. ............. Block .... ~ ........... Lot.. ~.~./.~..~. ...... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy j .... .~.(~.~ J ~. ~."t'J~t~.~-. ............................................... b. Intended use and occupancy Nature of work (check which applicable): New Building ......... Alteration Repair .............. Removal ........... Demolition .............. Other Work ............... .......... '~ ,.~-~Z9 ~ ' .~. 7~. , .~... (Description) 4. Estimated Cost ' ............. i .................. Fee .................................... Ii (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 .... i . " 6. If business, commercial or mixed occupancy, specify natu, re and extent of each type of use ..... .. 7. Dimensions of,~xisting structurei if any: Front ~--.~..'. · Rear ,0.~9 ~ De,,th ' '~ > .... Height ..... ~ ......... Num,ber of Stories .... ,7'Z'.~. ~. i i i i i i .... ". i ......... . ~' .............. Dimensions o~fsa~me structure wRh alterations or additions Front '~' ? ''i'i .... I{;-;"''~'zD'" ......... ueptn ~'. . Hei,,h, ~ ,. ~ ' ......... ,, ,.,. . · '. ....... :. · s, .......... : ............. number of Stones .............. . . . o. tamenslons of entire new construction Front ~'¥' / p,~, Z ¢/ r~,,,h /~ 't ..... Hei ..... ' ........................... ~v,,, .... · ........... gn* ............... Num,,er of Stories ................ - . 9 Size of lot: Front //~ ? Rear '~;/~ '~ ........ ;- T,' ..... ~,~"2 ............ " ' .............................. ~Jeprn ..... - ................. 10. Date of Purchase ~ ............................. Name of Former Owner ............................. 1 1. Zone or use district in which pretnises are situated .................. ', ................. 12. Does proposed construction viol ~te any zoning law, ordinance or regulahon: . ,,c, o. .. 13. Will lot be regraded ......... r .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises " Address ....................................... Phone No ................ Name of Architect Address .......... ' ................................... Phone No ................ Name of Contractor . i · Address .. ~' .............. 'd'?' ~ .... ,~,,... rnone No ................ 15. Is this property within 300 feet of a tidal wetlan .. ~ . .... · If yes, Southold Tpwn Trustees Permit may be req~rgd.' ........... .... PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ffumber or descriptioh according to deed, and show street names and indicate whether interior or coruer lot. 01 STATE OF NEW YOR~ ~c_ S ~ (Name of individual signin I contracO ' g . above named, i ' ...... being duly sworn, deposes and says that he is the hpplicant He is the · 0~o ,,~ ! (Contractor, agent, corporate officer, etc.) ofnnH ti .said ownerthatorallownerS,statementsand is duly,:~uthorized to perform or have performed the said work and to make and file this l~,-..ca,.on, commneu in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s~t forth in the application filed therewith. ~wom to before me this ........ ........ .... .. .:...... // , %tary Public ...... .~. '~ .~k~ ,.~...~ ~4 NOTARY PUB[IC, State of N:Y. · No. 4725089, Su~lk l~rm ~pi,a Ma~ 31, 19~ (Signature of applicant)