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Home My WebLink About21617-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22583 Date SEPTEMBER 10, 1993 THIS CERTIFIES that the building Location of Property 295 BIGHT ROAD House No. Street County Tax Map No. 1000 Section 14 Block 2 Subdivision Filed Map No. ADDITION ORIENT~ N.Y. Hamlet Lot 17.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 11, 1993 pursuant to which Building Permit No. 21617-Z dated AUGUST 20, 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 APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JAMES D. & CHRISTINE FRANKE Rev. 1/81 /~ding~ Inspector TOWN OF $OUTHOLD BUILDING DEP~TMENT TOWN ~ SOUTHOLD, N.Y. No ~1617 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: .... ~..~.~: ..... '~. ~~ .................... ....... ~......~:~ ....... ~ ........................ .... ~.~ ........ ~..:¢....; ....... ~.~...:...z ............. to ........ ~...-Z..~,.:.. .................. .~,,.~,..: ........ ~...~.~..~, ................. /.. ................................. ..~.~ ........ ..:..-..~..,..~y ........ ~.~.~..:..~ .......... ~ ........... ~~.. --':-.r '/~-. ...~ .......... ~ .......... ~.,....~ ................................................................................................... at premises located at ........... ..~:...~...~ ............................................................................................ ............ ~ .:.... ...... 1:.,~. .:.......~.. .............. ~:~ ......... ~ y... .......... /../~.. CountyTax Map No. 1000 Section....Z.,~.... ........... Block ....... ~.'~. ......... L/arNo ....... L,Z....~... ....... pursuant to app,,caflon dated ............... .~../l/. ........................... , ~,...~....~.. ..... and approved bythe / Building Inspector. Fee $.......?...~..~,...c~.. ...... Building Inspector Rev. 6/30/80 '¥OWN O~ ' ' ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by gypewriter 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 f~rm). 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 requirements. Bi For existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and '-'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildimg 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 t9 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 ~-~AP,, I I.i..I.O.~.. : v' ' ...... ,yew Construction...Z~, ....... Old Or Pre-exi~t,ing Buildin~f. .... ' House No. Street Hamlet Onwer or Owners of Property.J~..b~..~.~. County Tax Map No 1000, Section ..... J..~...'...Block....~. .......... Lot...l.?' ''~' Subdivision.. .................................. Filed Map ............ Lot ..................... 'ermit No Dat Of P reit t.d~.-.~, k ~.~.~.~. ................ e e ....... Appli {ealth Dept. Approval ......................... Underwriters Approval ...................... ~lanning Board Approval ~equest for: Temporary Certificate .......... Final Certicate ........ ee Submitted: $ ....................... · rco APPLICANT BOUGH FRAME & -PLUMBING ~SULATIO~ PER N. STATE ENERGY CODE FI;~AL ADDITIO~IA'L CO~.ME~/TS: ~ ~t~ ~ ~--~I' ~ ) TOWN OF SOUTHOLD ;'.1 !!'~ ............. BUILDING DEPARTMENT 1 ~J /~1 ~ I Qn~ TOWN HALL . ~/ \\, ,,Lib I I 1~0 SOUTHOLD, N.Y. 11971 ~[-I~ ~ ~ TEL 765-1803 Disapproved. a/c ' . ( B ufldi(lg' In S'p ect o r ) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS SURVEY ClIECK SEPTIC FORH NOTIFY ~ CALL ................... HAIL TO: Date ................... 19... INSTRUCTIONS a. Ttds 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 deta/led description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tlfis 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 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 appl~cant 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. ..... .................. . .... -- (~ ~'ature of applicant, o~ name, if a corporation) ...... !!55'7... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nameofownerofpremises ~ei - &~ vi6' ,~¢ (a~ ~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title o,f corporate officer) B dder s L~cense No ......................... Plumber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location ofland on which proposed work will be done.' .~..~..~...~).5~..:~.~.'t~ ........ DY.{.~.~?.~t~ , ........ d House Number Street Hamlet County Tax Map No. 1000 Section........]~ ......... Block ..Qr. .......... :... Lot...I.q.:..~. ........ Subdivision ........ . ............................ '. Filed Map No .... ........... Lot ............... (Name) State existiug use and occupancy of premises and intended use and qcgupancy of proposed construction: a. Existing use and occupancy .~.6.~ b. Intended use and occupancy ~ ~ ~ - '3. Nature of work (check which applicable): NeW Building . ~ ....... Addition ....... Alteration .......... Repair .......... Remloval ............. '. Demolition.. ........ .... : ......... Other Work ........ 4. Estimated Cost..,/....:.... .......................... Fee . ..... ~, ............ 5 lf'l]~velling llinglunits (to be paid on filing this application) · ,numberofdwe ..... Numbe fdwelli nits each floor Ifgaage mb oft · ......... . ro ngu on · r , nu er ars .... i ........... ............... 6 Ifbusines i I ' 'd ..... ' ....... .............................. '' pecify nd tent f ach type fuse ' · s, commerca or mlxe' occupancy, s nature a ex o .e o .................... 7 Dim nsio of exiti gst ct' +s if Fro · e ns s n ru ur , any: nt .......... ..... Rear ........ Depth ...... Hight N mb rofStori ' ' '' ' ...... '" Dimensions of shine tructur with alterafio additions: Fro ............................... s e ns or nt ................. Rear .................. Depth .............. nelgnr ................. .. · Number of Stories ' · lmenmons of entlre new construction: Front ........... : Rear . .............. Depth Height ............... Number of Stories... 10. Date of Purchase ' .. , . ~ ................. Name of Former Owner ............... ~, . 11. Lone or use district in which prpmises are situated .............. .12. Does proposed constru on rio ate any zonin aw, ordinance or regulation.. 13. Will lot be regraded . .l?. 9 .... : ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ............ . ........ Address .............. ~Phone No ..... i. · · Name of Architect .......... i ............ Address ................... Phone No ............. Name of Contractor ......... ~ .............. Address ............. . ...... Phone No ......... '. 15.' I,s this property within 300 feet ~'f' a tidal wetland? ~Yes ........ No.~(~ ...... ' ...... · If yes, Southold To,wn Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly all lbuildings, Whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block mmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWrYORIG...--- COUN'rY OF...x . . ........ ~ 'k~w--)"" ' ' ~, ' ' I" ~ 'v~" ~' · "?'~' being duly sworn, deposes and says that he is the applicant (Name of individual sifniag contract) ' ' ' above named. HeJs the ~ ~.~ ' ' (Contractor, agent, cor'porate officer, etc.) of said owner or owners, ~d is duly~ · ' ' lauthonzed 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 perfomed in the manner get forth in ~e application filed therewith· Sworn to before me this ......... x. o,,. ' ' ~otarv'buhlie, ~~[~. . , . ' . / } ' (Sig ature of applic~t) . //' APPROVED AS NOTED N~' BUILDING DEPARTMENT AT 765-1802 9 AM ~ ~ PM FOR ~E FOLLOWING INSPE~ION~: 1. FOUNDATION * ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. ih~ULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALI CONSTRUC~O~ SHALL ~EET · H~ R~aUm~ENTS OF ~HE S~ATE ~ONST~UCT~O~ ~ E~ER~Y CC~?I ~m RESPONS~L~ FOR O~I(,NJOR CONSTRUCTION ERRORS OCCUPANCY OR USE ~S UNLAWFUL I;~ffHOUT CERI'IFlCATE OF OCC[IPANCY f OO2: oz>