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Home My WebLink About21560-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22575 Date SEPTEMBER 8~ 1993 THIS CERTIFIES that the building ADDITION Location of Property 2305 LITTLE NECK RD. & 60 EMORY RD. CUTCHOGUE~ NY House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 4 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13, 1993 pursuant to which Building Permit No. 21560-Z dated JULY 27~ 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 GARAGE ADDITION TO EXISTING ONE FAMILY DW~¥.LING AS APPLIED FOR The certificate isissued to WILLIAM J. JACOBS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-288346 - SEPT. it 1993 Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALl. $OUTHOLD, N.Y. No BUILDING PERMIT ITHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED1 Rte ...................... ~/..ZZ .......................... ~ 9...~.. 21560 Z Permission Is hereby granted to: ...... ~i/../,~.~.~....~.~..~ .................................. .... ~.o;...o.. ...... ~,~.r.....~ .................................... .~.,-~,~.~,.,...,~ ......... ~.....y.~ .......................... : ......... to ...... .C~.~.~..r.~......~, ......... ~..~ ........ ~',-~,z...'/:rzo:~ .............. ./..'-~... ........... .... ~ ........ ~'~.~ ............. ../....~.,?.y.. .......... ~~. .......... ~...-c. ....................... ..... ~..~::~ ........ ....~...~.: ................... C.. .................................................................................. Counfy Tax Map No. 1000 Section.....,/.~?_~. ........... Block .......... ..~.....~... ..... Lot No ...... ...'-~.../.. ............... pursuant to application dated ............ . .~...//..~..../ ............................ 19.....~....--~.. ..... and approved bythe Building Inspector. ~, s....~ .... Rev. 6/30/80 mo Form No. 6 ~,,';i :-'~'P '" " TOWN OF SOUTHOLD ~ ~ ' BUILDING DEPARTMENT ~.. TOWN HALL ~'~.i ¢'- ' - 2 !~,,, 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 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 i'n 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 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 featares. 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 ....~..~... ]. {.,. J. ~ ~.~ ............... New Construction ........... Old Or Pre-existing Building ................. g a. Location of Property... Street /Hamlet House No ~o~ Onwer or O~ers of Properey... ~ l~ .................................... Subdivision Filed Map Lot ..... Permit No.D~.~..~?...~....Date Of Permit..~/..7/.~. ..... Applicant .~.. ~.~.~ ~ : .. ~---~ ....... Health Dept. Approval .......................... Underwriters Approval ........... Planning Board Approval ........................ ./ Request for: Temporary Certificate ........... Final Certicate ........... ..................... ..... ~OU~IDATION ( 1st)' ~UND^TIO~.I (2nd) ~UGH FRAME & -PLUMBING .T~SU LATION PER STATE ENERGY CODE FI~AL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT, INSPECTION ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL [ ] FRAMING 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ F~MING [ ) FINAL 765-1~02 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~NFINAL DATE ~/////~.~ INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS ~, ~ L185077 BUREAU OF ELECTRICITY -- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only t~ electrical ~uipmen~ ~ ~scrib~ be~w a~ intr~uc~ by t~ ap~icant ~m~ on the a~ve appl~ation number in the prem~es of wasexa,n~nedo. AI;GU~ ~' 3~,1993 and found to be ln compliance with the National Electrical Code. Lot FIXTURE OUTLETS DRYERS IECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS R V I C NO OF CC. COND. A,W.G. PER ~ OF CC. CON~. NO. OF HI,LEG, A,W.G. OF HI-tEG NO OF NEUTRALS OTHER APPARATUS: CL~C}{O~I;~], NY, :L1935 OENr~AL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPy FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUSi: NOT BE ALTERED N ANY MANNER. ....................... 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