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Home My WebLink About21519-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22451 Date JULY 12, 1993 THIS CERTIFIES that the building ADDITION Location of Property 55 EASTWOOD DR.EXT.&400 MIDWOOD RD. CUTCUOGUE,~.~.:.. House No. Street Hamlet County Tax Map No. 1000 Section 110 ' Block 2 Lot 21 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 1, I993 pursuant to which Building Permit No. 21519-Z dated JULY 6, 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 BUILT" The certificate is issued to JOHN & FLORENCE REALE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A . UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A /~uil/d£nq Inspector Rev. 1/81 FORM NO.3 TOWN OF SOU';HOLD BUILDING DEPARTMENt' TOWN ~ $OUTHOLD, N.Y. BU;LDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ..... ~,..,...~~...~: ................. ..~.,~...~...~...~,~ ....... ~.,...: ................................. .... ~,¢..'~ .......... ~_¢ ................. ,......: ..... /......~...~ .......... ~ ...... ~.~. .......... ~.../..~ ........ ...,¢..~.~.~;~ ......... ~ .................... .................................. ~.~. ...................... ~ .......... ¢ ........... ¢ ................................... Cou~/TaxMap~e. ~000 sect~on,.../..L~ ......... ~. ~oo~ ...... ~ ........... ~o~ ~o ....... .~ ............. pursuant to application dated ................................................... ;, 19 ..........and approved by t~ Building Inspector, Fee $,,, .~.,.. ,5~;...¢~,.. ......... / ¢' Building Inspector Rev, 6/30/80 Form No. 6 TOWN OF SOUTI~LD BUILDING DEPARTMENT TOWN HALL 765-1802 . APPLICATION FOR CERTIFICATE OF OCCUPANCY A. ~his 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 contains 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 requirement,~. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '~pre-existing" land uses: 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 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 ~. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New'Construction..~.~.~ Old 0% Pre-existing Building ................. ......... ............... ..... House No. Street Hamlet ~ ' ' Onwer or Owners of Property .......... /~7~..~ .................. county Tax Map~o 1000, Seetion....\.h~ ..... Block .... ~ ...... t q~ ~ .... .................................... F21~d Ma~ ............. Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... ?lanning ~oard Approval ............. ; .......... Request for: Temporary Certificate ........... Final Certicate. e S~bm~tted: $....%....~...~. ................ · ?.. 0 0 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ...... 7/.~. ...... 19f4 Approved ...... ...... 1gl/. Permit No. Disapl~roved a/c ..................................... (B~il~efig Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY ......... , CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: a. Ttfis 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 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~ld~g Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, andp~fher applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for rem~al or de~l~olition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building coj~6,~l~ousin.~ode, acd regulations, and to admit authorized inspectors on premises and in building for necessary inspection~.~/~t~. ~ . .... ..... (Signature of ~pplicant, or name, if a corporation) ~Mailing, address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plu' r~ber or builder Name ct' owner (as on the tax roll or 1lhe.~t h~_: :~ of premises .....~..z2 .~.ND,..'~f...'x~....~ ..Q...{~L,f~...~..LJ~.~~j~.#~2~- ..... If applicant is a corporation, signature of duly authorized officer. NOIllY BUILDING DEPARTMENT AT 765-t802 9 AM TO 4 PM FOR THE .............................................. FOLLOWING INSPECTIONS: (Name and title of corporate officer) · 1. FOUNDATION - TWO REQUIRED ALL CONTRACTOR'S I~IUST BE SUFFOLK COUNTY LICENSED FOR POURED CONCRETE Builder's License No .......................... 2. ROUGH - FRAMING t% PLUMBING 3. INSULATION Plmnber's License No ......................... 4. FINAL CONSTRUCTION MUST 8E COMPLETE FOR C.O. Electrician's License No ....................... ALL CONSTRUCTION SHALL MEET THE REQUlREMENT~ OF THE Other Trade's License No ...................... STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR 1. Location of land on which proposed work will be done~ DESIGN OR CONSTRUCTION ERRORS . h i;6;r ........................ treet 1;t' ....................... County Tax Map No. 1000 Section . . .~.....~ ......... Block ............ Lot ........ Subdivision ~{- ~v O0~ ~..~..~..tq Filed Map No. ~q-,'O ' Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy....."'~.~-~..~.L>. Lg..~.~,?~,,'~.. ,~,,~:0a~ ~q~_._, ...... · ' ' ,;":;.; '-' ' ~ ~ ........ 2.~/:~:b'~' '.,~a?v'-' b. Intended use and occupancy .............. ,-. _ ~ ...... 6~"t'~:,a~ ~"'"""' ........... 3. Nature of work (check which applicable):" Building .......... Addition ....... Alteration .... ..,..,... Repair .............. Removal ......... Demolition .............. Other Work ............... ',~.~..~. ~ (Description) 4. Estimated Cost ........ ; .................... Fee ...................................... ~ ' (to be paid on filing this application) ' 5. If dwelling, number of dwelling ulnits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... i .............................. ; ................................... 6. If business, commercial or mixedloccupancy, specify nature and extent of each type of use .................... 7 .... ' if any' Front Rear · D~mensmns of ex~stmg structures .............................. Depth .............. _. Height Number of Stories ..................... Dimensions'of same structure wi~h alterations or additions: Front ................. Rear ................. Depth .................... i · Height ...................... Number of Stories ..................... '- 8 Dimensions of entire new constrUction: Front ' Rear Depth Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...........i .......... Rear ...................... Depth ...................... I0. Date of Purchase ........... i ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... i .................. Will excess fill be removed from premises: yes No 14. Name of Owner of premises ... i ................ Address ................... Phone No Name of Architect ' Address Phone No Name of Contractor ......... [ ................ Address .... : .............. Phone No ................ 15. Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town TruCtees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly~all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block flumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YDR~ xX. '' ............. .... b ing duly sworn, deposes and says that he is the applicant ~ ; ,~ (Name of individual sign~ ag contract) (Contractor, agent, corporate officer, etc.) of smd owner or owners, ~d ~s dul', authorized to perform or have perfo~ed the smd work and to m~e and file th~s application; that ail statements cont~ ined ~ this application are true to the best of his k~dge and belief; and that the work will be performed in the m~ne: set forth in the application filed therewith· f Sworn to before me this i ~ / Notaw mubli~~~~. County ~ -~ '~~ ~ / (Signature of anplicant)