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Home My WebLink About21512-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southotd, N.Y. CERTIFICATE OF OCCUPANCY No Z-22482 Date JULY 29r 1993 THIS CERTIFIES that the buildin~ Location of Property 70 DEEP HOLE DRIVE House No. County Tax Map No. 1000 Section I15 Subdivision ADDITION MATTITUCKr N.Y. Street Hamlet Block 12 Lot 2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 23~ 1993 pursuant to which Building Permit No. 21512-Z dated JULY 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 & INST~T.T.~TION OF WINDOWS IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GRACE E. NELSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. ~'81 FORM NO.3 BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORJZED) Date ...................... ..~../,~... ........................... 21512 Z Perm ss on s hereby granted to:,~ ........ ........................ ........ ~...~Z/..~...~ .................... ........ ~~/....~:~...z..x.~ .V..'' .... to ....~~..c.~.....~..... ~_.....-~....--~,~. L.~.~..>.~' ........ ~..~...~ ..... .. ~ ~ ~. ~. ~ ~ ........... /~ ....... ~. . . ~,. .~ ~ . . . . . ~ . . . . .~ ?. '.~. .~ ...... . . . .Z~. ~ ~ ......... ~. . ~. . . . . . ~¥.,. .~. . . . ~ ............................................. ~ ......... Coun~yTax Map No. 1000 Seoflon ...... ../../....~... ........ Block .......~.....~... ........... Lot No....~ ................... pursuant to application dated ........... £/7.~..~...~.....~. ............................... 19.....~...'~...~ .... Building Insp~¢lor. ~ee ~...Z~.~ ....... and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT 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 electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contaims 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 "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 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-existin~ Bui~din~.?.?~. ...... Lo ation Property. .-- . ..... .................. .. House No. Street Hamlet Onwer or Owners of Property.~YT~.~-.~. .... ~..~..~..~ .............. County Tax Map No 1000, Section...fM~.~. ..... Block..f v_--- .Lot.. Subdivision ' Filed Map Lot Permit No..~.~.~..~ ~ .... Date Of Permit-.~/--~'' ....... mpplicant~¢-~---~'~'-'~i-/'~'~-~? .... tleulth Dept. mpprova~..~~ ........... Underwriters Approval ................. Planning Board Approval ............ .i. ....... .. Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ........ /f.~.... ~/ APPLICANT' " i ./ ~LJFFOLI~. SUi:q-~ CO.'F?,~ ~,~k~ DATA: I~.CgDO-I ID- ~" _ .... ~_~ 1~';~,, · o' : 0 · · ~'. :. i-ri 'OUNDATIO~! (2nd) ~OUGH FRAME & -PLUMBING ~I~SULATIO~; PER N. STATE ENERGY CODE FI;;AL ADDITIONA'L COMMENTS: 76S-J.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~I~AL~ DATE INSPECTOR Examined ....... ?/.,.~.... Approved . i ' ' '" ' Y'~'' ' ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19 .~.,~. Permit No. ~../,~/..~.~.. Disapproved. a/c ' . (~zqldin~ Inspector) APPLICATION FOR BUILDING' PERMIT B~ARD OF HEALTH ......... 3 SET~ OF PL~S ......... SURVEY ................... CHECK .................... SEPTIC FORH .............. Date .................. 19 INSTRUCTIONS a. Tiffs application must be completely filled inby typewriter or in ink and submitted to the Building Inspector, with 3 iets of pans, 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 st?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. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval 6f this application, th6 Building Insp6ctor 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' Inspe~.tor. 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, an~ regulations, and to admit authorized inspectors on premises and in building for necessary in ctions. - . -- . / (~tgnatur/ffof a!dplicant, or name,.~h)~,_c2~poration) ~1~/0_ (Mailing addr~s 9~f,applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. (as on ,the tax roll or late~Oltll~ 8UILDINI3 DEI~ffi'ME[~I' 765-1802 ~ AM 10 4 PM FOR THE If applicant is a corporation, signature of duly authorized officer. FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO:BEQUIR~D FOR POURED CONCREt~ (Name and title of co~ooratc o£ficer) 2. ROUGH - FRAMING & PLUMBING Builder's License No ....... ~7. 4. FINAL - CONS~UCTION MU8?. 8E COMPLETE FOR C,O. Plumber's License No ............... . .......... ALL CONSTRUClION SNALIL MEET · THE REQUIREMEN'rS. OF THE Nfl, Electrician's License No ....................... STATE CON$1RUCTION & ENERGY r ' ' CODES. NOI RE$,~3N$1$1.E roll Other T ade s hcense No ...................... DESIGN OR CONSlRUCIION ERR¢!R$ i. Locat,on o land on which proposed work will be done., i . House Number Street Hamlet ! Subdivision ........ . ....................... ' Filed Map No ............... Lot ...... :. g, .. (Name) . 2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction} a. Existing use and occupancy ...~. d~.e. ((.../tV..~. .............. ~ ........... b. Intended use and occupancy .. ]~...'~4-g .... 4 ./~.-.~. ' ......... 2. . } .3. Nature ofwor (check which a~pplicable): New Building . 2 ........ Addition .......... Alteration .~.~u... ~.. Repair ............. Remc~val .............. Demolition ..... ; ......... Other Work I~).~'c.L ,f(~'. .. .~. ~ ' ~ . ' . (Description) 4. Estimated Cost ....................... Fee . ..... (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 ~ ' 6. If business, commercial or mix6d occupancy specify nature and extent of each type of use D~menstons of exmt~ng structures, if any: Front.. ' .................... 7. · ~-~ Rear . . z_/<' ' ~, ..... .-, ~ .;,.,-r-~ ......... r ........... Depth ~-~ ............ t~elgnt .z: :~ ....~F~ :w. ....Nmhber of Stories .. ~ .................................. Dimensions of shine structure with alterations or additions: Front ................. Rear .................. Depth ' Height ' Number of Stories .,~{~llg:.~ (~/ff ~ 8. Dimensions of entire new construct/on: Front ~ d r ' Rear .. ~%o. '.'.4 ~.w.. Depth ~7.'. Height Number of Stories glze of lot: Front../I~. t~'. ~.1~!..~'. ...... :.. R.ear.../.~.~,Z ~ ......... . Deplh :22..O.~..,.q.~'.: .......... Date of Purchase ......... i. .......... . ...... Name of Former Owner .......................... Zone or use district in which prbmises are situated ' ' Does proposed construction violate any zoning law, ordinance or regulation: . .~ ............................. Will 16t be regraded ..... ./f/:.~¢ ....... ; ........... Will excess fill be~re.~_moved from premises: Yes Name of Owner of premises . G~/-/l_r{.,~t~/./~.. ~,.~/£~'. . Address . z~/Z4..~..~/o.. {Z.Z'.4... Phone No ............ Name of Architect ...... Name of Contractor. ~. ¢ ~ .~v~<~' ~//~. ~. ~. ~ .... .... AddressAddress '. ~o~'~~z'/'~'~t ................... ~z..~-.. PhonePh°ne No.N° ...... ~/2~.'-~ ~ ~O.'~-F, ........ 15.' I.s this property within ~00 feet of a tidal wetland? *Yes{...~--~77... No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ali buildings, Whether existing or proposed, and. indicate all set-back dimensions from property li_ne, cs~d~street and blockinumber or description according to deed, and show street names and indicate Whether interior o~ i 10. 11. 12. 13. ' ' ~n.,~i~'idual signi;~'~(~)traot} ' being duly sworn, deposes ~d says that he is the applicant Hets the ..... ": ' ~ ontractor, agent, cot orate officer, etc. (C p ) ........... of said owner or owners, ~d is dul~ authored to perfom or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief and that the work will be perfo~ed in the mannerlset forth ~ the application filed therewith. Swom to before me this ~ ~ .............. ~ ..... y .;..~xx:.~ .... ' ...... 19 , ilo. 4. 52246 Suffo~kCou~% , ' / ./ / ' t~gnature of app--) , TermExpirasJune~2,19=" ' ,~ ~ ,