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Home My WebLink About21504-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, CERTIFICATE OF OCCUPANCY No Z-22499 Date AUGUST 6{ 1993 THIS CERTIFIES that the building ADDITION Location of Property 1120 BROADWATERS ROAD House No. Street County Tax Map No. 1000 Section 104 Block 9 Subdivision Filed Map No. CUTCHOGUE ~ N.Y. Hamlet Lot 2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 17~ 1993 pursuant to which Building Permit No. 21504-Z dated JUNE 29~ 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 ADDITION TO DECK ON PORCH OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PADRICH FURLONG (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 FO~MNO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAJ, I SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 21504 Z D,~tey ............ .,~.....~ .............. ~9..¢....~. Permission Is hereby granted to: ..... ..................... ....~.~.~.....~,..,z.~ .................................. , .~..~...~.~....~./....~.,z...~ .................... ........................................... ~..~,,.,~..,,~.~.../...L,~ ..................... Cou~tyTax Map No. 1000 Section ........... /~...~,....z,./. Bio'""- ' ck .......... ~ ........... LotNo ......~ ........... pursuant to application dated ..~ ............ /'"'7 ....... 19..¢:~'..,;,~, ..... and approved by the Building Inspector. Rev. 6/30/80 TO~N HALL 765-1802 APPLICATION'FOR CERTIFICATE OF OCCUPANCY me 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 aurvey of property with accurate lecatien ef all buildings, property lines, streets, and unusual natural er topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval ef electrical installation from Board ef Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/lO.el l%.lead. 5. Commercial building, industrial building, multiple residences and aimilar 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 (prier to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: I. Accurate survey of property shewing all property lines, streets, building and unusual natural or topographic features. 2.. A properly completed application and a consent te inspect· signed by the applicant. If a Certificate ef Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the appllcant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations te dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions te accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I00.00 3. Copy ef Certificate ef Occupancy - $5.00 ever 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00,. Commercial $15.O0 , .......... ....... New Construction ........... Old O Pre existzng Location of Property ..................... House No. Street . Hamlet ~ County Tax Map No 1000, Section..~...~.~. ..... Block .... f .......... Lot..2. ~ Subdivision ........... .. ..... ~ ................. Filed Map ........ ~...Lot ...... Fermit No,, ,,~,/,,, ,~,, ,~at~'-- Of Permit. ,~*JJ~v' ' ', ,~,~,~, .~Applicant.,, ,~,,,,-, ~,,,'~ ............ Health Dept. Approval .......................... Underwriters Approval. ............ ............ . Planning Bo rd Approval ' Request for: Temporary Certificate ........... Final Certicate .... Fee Submitted: $. ~-~f..~.. - INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Build/n~ Impector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P,O, Box 1179, 53095 Main Road Southold, New York 11971 Fax ( 516) 765-1823 Telephone (516) 765-1800 JULY 23, 1993 CHARLES g. TIIORP 863HAIN STP, gET GREENPORT, NY 11944 RE: PADRAIC FURLONG & WF To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the followin9 reasons: xxx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is fg~K~mw~/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 ~ 21504-Z Please contact our office on cooperation. CC: this matter. Thank you for SOUTHOLD TOWN BUILDING DEPT. PADRAIC FURLONG &WF FZ£LD % '"IIDATE FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING' (2ndl INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: -/ P 'o BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ~MING REMARKS: [ ] FINAL DATE ~ · t~ ~ TOWN OF SOUTHOLD T BUILDING DEPARTMENT [~t\\~, - ~!~J{ TOWN HALL IU ~' ~--.,:r',.~c ;;~pT.'~_~ ''" SOUTHOLD, N.Y. 11971 Ex~ncd ................ , ~9... Disapproved a/c ..................................... sETs SURVEY ... SEPTIC FORH CALL ................... HAIL TO: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ................ a. This ap~lication 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 6n premises, relationship to adjoining premises or public sti'eets 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. Thc work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will igsued 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 describbd. 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 inspec~gn/~ , . . --' (Si,,nature of applicant, or nam ,&'if a corporation) ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer ctrician, plumber or builder. Name of owner of premises dDt:a--~ ~' .~...6-.. ff.~ ' If applicant is a corporation, signature of duly authori2ed officer.' (Name and title of corporate officer) Plumber's License No ......................... ' Electncmn s L~cense No ....................... Other Trade's License No... .................... I. Location of land on which proposed work will be done .... ,/./. ,~,,.~. ..... ~.. ~... .......... · ..... ........ House Number Street - Cou'nty Tax Map No. 1000 Section ........... Block ..... .~.~'... Lot..."~....".~. ~ ......... Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) . 2~ State existiug use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ................ ~ ' ' ..... '?~;,,~ '~,;,,~ .................. , ~',. ~- c, b. Intended use and occupancy ........ ............... ~;. ......~.,. .... ,~,~,~,,,~ ........ 3. Nature of work (check which applicable): New Building .......... Addition .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost .................................. Fee .... ~...~ ~.q .... ..~?....: .............. (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... /. ........ Number of dwelling units on eaoh root ..... ~ ........... · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of.each type ofxuse ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ........... '... Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .... ' .................. Height ........... ' ........... Number of Stories ................ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of loc Front ...................... Rear ...................... Depth ...................... I0. Date of Purchase ............................. Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated ..................................................... 1 2. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... : ...... , .............. Will excess fill be removed from premises: Yes No Name of Architect ........................... Address ................... Phone No ....... Name of Contractor .......................... Address ................... Phone No ................ Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly a~l buildings, whether existing or proposed, and. indicate all set-back dimensions frm'h property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. 1.5. /4( "' '~f~'ff'~'f' '~'-'~::'" '~"''' (~' '& '~f' 'f~X" ......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..... . ............................. · .............. o}porate officer, etc.) of said owner or owners, and is duly authorized to ~erform 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 manner set forth in the application flied therewith. Sworn to before me this ............. ..... ' Ct.AIRE L GLEW '~ NO. 4879505 .,~ ~- ....................... Qualified in Suff~k County ~ (Signa/~re of applicant) q F- O 4