HomeMy WebLinkAbout21446-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22534 Date AUGUST 18~ 1993
THIS CERTIFIES that the building. ADDITION
Location of Property 50 SOUTH HARBOR ROAD
House No. Street
County Tax Map No. 1000 Section 69 Block 6
Subdivision Filed Map No.
SOUTHOLD~ N.Y.
Hamlet
Lot 10
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 24~ 1993 pursuant to which
Building Permit No. 21446-Z dated JUNE 2~ 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUN~ DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
~T.T.AN So & THERESA CONNELL
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, No Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~? 31~41i Z
Date
Permission is hereby granted to:
~....~...~~¢~/..,.. ......... .
....... ~._~........~~ .......... ~. .....................
..£~~....~:~ ........... ~ .........
,o ..~?~....~.....~, ~ ......... ~~.:....~.~....~~. ........
.. . .. ./. .. .~ ~. ,:/;...~¢:...~~~ ............................... ~ .....
at premises located~at ..... ~.....P.~....~***-.;~F. ..........................................
................................................. ~~~;~ ........................................................
County Tax Map No. lOOO Section ...... ~.~..~.. ......... Block ........ ~ ....... Lot No .......... ../....~.. .......
pursuant to application dat.e~ ..~./.../.~?/. ...... .; ............................ ~ ..... 19.~...-~..., and approved by the
Building Inspector. /
Rev. 6/30/80
Form No. 6
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL .
765-1802
. APPLICATION FOR CERTIFICATE OF OCCUPAN.
This application must be filled in by typewriter OR ink and
inspector with the following:
1.
for new building or new use:
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 B~ard 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 requirement.~..
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'.'pre-existing" land uses:
i i. 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 Inspect'or 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
Date
New. Construction .... ./.x. .... Old Or Pre-existing Building .................
..................................................... · "z" .....
House No. Street . .
Onwer or Owners of Property ..... ~ .....
County Tax Map No I000, Section...~..~..~ ..... Block...d~. ......... LOt ....... LQ ............
Subdivision ' Filed Map Lot
Permit No. Z~ ~ ~ _' Of Permit..~..--.~.~.?.~ .... A licant ~ ..~.~
Health Dept. Approval ...................... Underwriters Approval
Pi nni g ard Appr val ·
Request for: Tempo. rary Certificate ........... Final Certicate ...........
Fee Submitted: $ ..........................
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieezorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 6, 1993
SCOTT L. HARRIS, Supervistn
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Allan S. Connell & wife
50 S. Harbor Rd.
Southold, N.Y. 11971
To Whom This May Concern:
We are unable to complete your
because of the following reasons:
Certificate of Occupancy
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 21446-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
FOUNDATION
1st)
FOUNDATION
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL
COMMENTS'.
API~ROVED AS NOTED
NOTIFY 801LD1NG
765-1802 9 AM TO 4 PM FO;; [HE
FOLLOWING INSPECTIONS:
I, FOUNDATION ~OP'~
FOR POURED CONCRET~
2. ROUGH. FRAMING
3. INSU~TION
4. FINAL CONSTRLJCT~¢h ~
BE COMPL~E FOR
ALL CONSTRUCTION S:~..~.
THE 'REQUIREMENTS {~ ~-~E N.Y.
STATE CONS~UCTIO~. R, ENERGY
CODES, N~ RESPC':~St~LE FOR
DESIGN OR CONSTRUC ~'lON ERRORS
~1 II I~1 II Ibll'
II II II
~ ii II II II II 11 II II
LII II I~1 .... II
RECTANGULAR DECK PLAN
,Mo?'- 7~
TYPICAL RECTANGULAR DECK ELEVATION
DECK A]-I'ACHMENT TO THE HOME
Sl~ecial requirements may necessitate direct attachment of the deck to you~ home. Extreme s~ope$ a~d high deck
e~evations may require the use of a ledger to support the oists where the deck meets the house. In this instance
we recommend that you consult a professional contrac or due to he cr ica na ore of h s procedure For your
The ledger should be !he same size as the beams all beams in these plans are made Lip of two 2xg's a ached to
posts, so nai two 2x8 s together to make the ledger.
DFCKING
SUB__FLOOR
LEDGER , , , · , o,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [ ] IN,..SIJLATION
[ ] FRAMING [/J/FINAL
REMARKS
DATE ,,~~
INSPECTOR
t
Grol ton
Gerord
formerly
O[
MONOMENr ~ -' SLAKE
r~SKCV oe~ BL De PARCEL
SURVEY FOR
8 I'HERESA A. CONNELL'
AT SOUTHOLO
TOWN OF SOUFHOLD
SUFFOLK:.COUNTY, NEW YORK
#UNAUTHORIZEO ALTERATION ON ADOITION TO THIS
NeUARANTEE$
T,E ~NSON FO~ wHoN THE $~NVEY I~ PREPARED
AND ON
fNSTITUTION. OUAI!ANT[ES A~[ NOT TRAN~F[~AiL{
TO ADDITIONAk
DEC,
DATE : ocr, I0,
SCALE ~ / "= 4¢
NO. ~ 83 ' 8g
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-1803
_ . . ./~rm ildm~mspector)
APPLICATION FOR BUILDING'PERMIT
B0anD or .E^Lra .........
3 SETS or vLaus ..........
SURVEY .
SEPTIC FORH ..............
INSTRUCTIONS
a. Tkis application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3
~ets 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 stfeets
'or areas, and giving a detailed description of layout of pr. operty 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 autkorize~spectors on premises and~ building for nec_es~?.i~g~..j~.~ d~. F.~: ~. .... ..
-- (Signature of applicant, or name, if a corporation)
. (Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder.
Name of owner orpremises ..... $, ..,4:'.,
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authori2ed officer.
(Name and title of corporate officer)
Builder's License No....O..~.%. e4L.. ...............
Plumber's License No ...............
Electrician's License No .......................
. Other Trade's License No ......................
Location of land on which proposed work will be done ..................................................
..... .q ......... o. ?. . . /,(,r. . . . . . .' . ... .So. .,,. . . . .,y,. . .. .Z,:.e. 7. /. . . . ., ....
House Number Street Hamlet
County Tax Map No. 1000 Section ...:...~.i ......... Block O~ ' Lot...~. O
6.9. ................................
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 ........ .~.~ ./.~.~.~..,. [~.~.. ~./~..'..~.~...C~... ............................
b. Intended use and occupancy .................. r~* ".'..,., - ·," 2'2x.
· 3. Nature of work (check which ~pPlicable): New Building ......... Addition Alteration '
Repair Rerno al ~ D lition .......... '" '; .....
.............. v .............. cmo .... ; ....... Other Work ~9.~..~OOg...~..O~.
4 Estimated Cost ..~'.(~.(~. ~) . (Description)
' ' ...... ~ Fee
· , , - (to be paid on filing this application)
5. If dwelling, number of dwellin~ units ..... .~/~,, ...... Nurhber of dwelling units on each floor ....... .......
· If garage, number of cars '"i ............. /~///~'" ................................................
6. If business, co,m~nercial or mixied occupancy, specify nature arid extent of.each type o[use ..... /[~//~ ...........
7. Dimensions o[ existing structuies if any:Front ...YJ,.I ~..~, Rear .'7.1.,.t.'F..~... Depth .... ,~.~..,.~.~.~.
Height ...... ~ ...... Number of Stories ... I ~ '
. ?unensmns of s~a~m_e st,ru.c.tur~e,,wjth alterations or additions: Front ~'/. I 4~C p,,~ ~ ,':'-~ ~) '/~,,
,g,,, .... r Fc~ ....... Plumber of Stories ............ .../~_//_/(~ ........................ ~ ......
1 1. Zone or use district in which premises are situated ............................. · .... '
12. Does proposed construction vi41ate any zoning law, ordinance or regulation' d[~/~ ......
Will 16t be regraded · ! · ' ...................
Name of Architect ........ ,~A~/) ............. Address ........ Phone No ............
Name of Contractor ....... I /]J///~ ............ Address ..... iiiiii i } i i i . .~e No ............ '. 2..;
15.' Is this property within 130~J' feet of a tidal wetland? *Yes ...... .ff ~o~.~ ...... .
] *If yes, Southold ~own Trustees Permit may be requirgd. ' ~--~' ' ~ '
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dknensions from
property lines. Give street and block
interior or corner lot.
number or description according to deed, and show street names and indicate whether
STATE OF NEW YORK,
coum'v .... S:.S
.... .~...e~.~.~. .~.. ~d~...~..m..,3~q-..L.C.I ......... . ......... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract) '
above named.
i (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly iauthorized to perform or have performed the said work and to make and file this
application; that all statements contai~ted in this application are ~rue to the best of his knowledge and belief and that the
work will be performed in the manner ~et forth in the application filed therewith.
Sworn to before me this /,~ i
........ .... ./da
NOTARY PUBtlC,~State of N~ ' ' '
N~ 4725089tSuff01k C0iint¥ .. ' (Signature