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Home My WebLink About21772-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, NoY. CERTIFICATE OF OCCUPANCY No Z-23336 Date NOVEMBER 10, 1994 THIS CERTIFIES that the building ADDITION Location of Property 225 F~ANKLINVILLE RD. House No. Street County Tax Map No. 1000 Section 125 Block 1 Subdivision Filed Map No. LAUREL, NEW YORK Hamlet Lot 3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated O~TOBER 29, 1993 ~ursuant to which Building Permit No. 21772-Z dated NOVEMBER 10, 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 EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH. APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ROBERT H. & KA'J'H,.REN K. GERDTS N/A N/A N/A FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ...././..~.../...O. ........................................... 19...~.,,~.... 21772 Z Permission is hereby granted to: .... .~:...~.../£~ .............................................. ...~~,...~,~....~..~.¢.....¢..~ .......... ~, at premises located at ................. ; ............ .................. CountyTax Map No. lO00 Section ........ /'~.~...... Block ...... Z ............... Lot No ....... .,~.,~.,.....,' ......... Building Inspector. and approved by the Bul~fng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 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 lihes, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposa%(S-9 form).~t~ 3. Approval of electrical installation from Board of Fire Underwriters.~ 4. Sworn statement from plumbe~ certifying that the solder used in system contains ~ess 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. .. B.. 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-existinK Buildin~ - $I00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial ~15.O0 Date ...... .~ ~.~-. ~..~. ......................... New Construction.....,~. ..... Old Or Pre-existing Building ................. Location of Property.~<~.~o~.~.~.. ~~ House No. ~ ~ Stree~ ~ ~ Hamlet ~ Onwer or Owners of Property.~a¢~.. ~... ~ ~"~e~ ~'. -~W~ .......... County Tax Zap No 1000; Section.i~ ........ ~ock ....... { ........ not ...... [~..~ ........... Subdivision ................................ Filed Map ............ Lot ................... ~e=~t Pe~it,..{t[{~[q~ .... Applicant.~Bi K~. ~ Health Dept. Approval .......... ~ ~ ........... Underwriters Approval ............... Planning Board Approval .................. ]Request for: Temporary Certificate .... Final Certicate .... ~ Fee Submitted: $ ~f~ FOUND~T!ON ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING e INSULATION FERN. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Exam~fi'/~d; .......... , 19 Disapproved a/c ..................................... (Buikfin,, In~ector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... SURVEY CI1ECK SEPTIC FORH ..... t:O?l FY; CALL ................... HA]IL TO: Date. INSTRUCTIONS a. This 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 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 of this application, the Building Inspector will i~sued a Building Permit to the applicant. Such permit shall b~ 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 authorized inspectors on premises and in building for necessary inspections. (Signatuf~ of applicant, or' name, if a Corpbration) (Mailing address of~pplicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. ........ ................. : .................... ' .............. . ........................... N me of owner of premises .... ................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... ~1 ................. Plumber's License No... ~x]! ~ ....... . .......... Electrician's License No...~ 1~ ................. Other Trade's License No p ed ' 1. Location of land on which ropos work will be done ....... ,.; ....: ................ :,~., Itouse Number ~ Cou'nty Tax MapN6. 1 OO0 ! a. Existing Use '3. Nature of work (check which applicable): Now Building ...... Addition ...~/,~ .... Alteration .......... Repair Removal Demolition Other Work 4 Estimated Cost . .~. ~.~..~.. ?...' " · ' .... I ........... Fee ................................ , · (to be paid on filing this application) 5. ~f _d~elhng,' nu.mber~o f dwelh'nfl] u~nits ..... ._. ........ . Number Of dwelling units on each floor ............... · ,~ garage, num oer oI cars... ./l;. ~.~... ~.~.~. I .-~.[0./~...-'U. ~... 1~){. 1~717. ~/~ .. ~. . (,.2.~..~. .. ~./~l..~ .~ 6. If business, commercial or m~xeld occupancy, specify nature and extent of.each type of use ..................... 7. Dimensionsgf_.exisOngstructur~s, ifany: Front ..... ~ ~.. . Rear ~ ' ' . . ~m.e. nsmns~hm~e~.~structure w~th alterations or additions Front ' ~}~.'.i~ '~r~ .... ~21~' ' ' ',~'~'~ k~'~-~ ..... P . ..O~ ........ He ~ ~ · . . ~t ....... ~ ............ '. * Num e . 8. D~menmons 9f enhre new const~ction. ~,~ ~ ~ ~ ~o~tones ........... ~ ....... H '" ~ ~ ~ .............. ~'.~ ..... ~ ~ear ... ~ ...... Depth .... ~ ....... .e~gnt ... :~ .... , .....~ber of Stories .......... ~ ...... - 9. S:zeoflot:Front ....... ,tql ....... ear.. .... '"' .... ;%]d ............ 10. Date of P-~"~ ~ ~ ' ........... ~ ............ ' ............ 1 l. ~ uistrlC[ 1~ W~ICB pr~mmes are mtuatea .............. ' .................................. . ..... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... 13. Will lot be regraded ....... ~ ~ ......................... ..... : ............ Will excess fill be/emov~,d from premises: Yes 14. Nme of Owner of pr~mises~m~ ~5 ~~Address ~K~. Cn~rhone No .~ 15.' I9 this property wSChin 300 feet of a t~dat wetland? ~Yes ........ No ......... ~If yes, Southold ~own Trustees Permit may be required. PLOT DIAG~ Locate clearly ~d distinctly ~1 [build~gs, Whether existing or proposed, ~d. ~ndieate M1 set-ba~k d~easions from prope~y Hnes. Give street ~d block number or description accord~g to deed, and show steer n~es and indicate whether ~tefior or corner lot. . . now or' ,' t°~merl~- Loartl $c~oo~ D~3tr/ct Ro. ii ~TATE OF NEW YORK, I ~ ~ .... ' 20U~y OF S,S (Name of individual signing contract) bovenamed· , ~i , ~ ," ~ · f said owner or owne~, ' ' .. ~ : ,ofpo~a~e office~,.ete.): ' - pplication; that 'ork will be perform worn i0before mp this , Of formerly ~cnO01 Dstdct ~' II now or formerly L6u~el School i~strict Ne.# 765-1~02 BUILDING DEPT. INSPECTION