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Home My WebLink About21651-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22735 Date NOVEMBER 18~ 1993 THIS CERTIFIES that the building. ADDITION Location of Property 1210 TUTHILL ROAD EXT. SOUTHOLDr NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 6 Lot 15.49 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 25, 1993 pursuant to which Building Permit No. 21651-Z dated SEPTEMBER llr 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 DECKADDITION 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 STEVEN & MAUREEN DUNNE uilding Inspector Rev. 1/81 FORM NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENi' TOWN HALL SOUTHOLD, N.Y. 21651 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: o?~...~.~~. ....... ...~.~..~ .... ~./.~.....:~.,,~...~......~..~..... ................ ,~.., ..~~..~.....¢~.~.~........~~....;.~.~..~...~./~ ~ ~~...~..~ ....... ~ ......... .~.~.~..._.~ ............................................................ ....................................... '...' ............. CountyTax Mop No. 1000 Section ....... ~...,~... ..... Block ........... ~ ........... Lot No...../,.,,~...'....~...?. ....... pursuant to application dated .......... ~t~/,~ .......................................... 19...~..~... ...... and approved by the Building inspector, Fee $....,~,,~,,(,~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 feathres. 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 i% 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 feature~. 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 ........... Location of Property ........ House No. Street Hamlet Onwer Owners of County Tax Map No 1000, Section...~ .... Block ..... ~. ........ Lot ..... ~ ........ .... .... .... ............. Health Dept. Approval ......................... Underwriters Approval ....................... Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate...~/.. ..... Fee Submitted' $ ~,~, I/P/& ~ APPLICANT FOUNDATION {1st) FOUNDATION 2. f2nd) ROUGH FRAME & .FLUMBING INSULATION FER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. IN/~/.ATION [~INAL REMARKS .......... DATE OF OCCUPAI~C' ., . S,34'~::'40 E I00.00' "~ :, 2 STO~ F RAM[ :. ~ GARAGE o ~ ~ I I I I I tOO. bO, '" CI't ~ FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1197J TEL.: 765-1802 Approved .. . ......... , 19~'~.. Permit No:~../.~.~.Z/. Disapproved a/c ..................................... APPLICATIOtq FOR BUILDING'PERMIT ~3 SETS OF PLZ~t$ z/CIlECK .......... SEPTIC FOR:I TO; .. INSTRUCTIONS a. This applicati°n must be completely filled in by typew~ter or in ink and submitted to the Building inspector, with '~sets of plans, accurate plot plan to scale. Fe~ according to schedule. , b. Plot plan showing location of lot and of bdildings on premises, relationship to adjoining premises or public st~ee~ ~or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appl cation. ¢. 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 permi shall bo 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 Occupant, 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 th~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o 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 tc admit authorized inspectors on premises and in building for necessary i spections. . . (Signatur9 of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. ' · feve.o ¢. ' Name of oxvner of premises . .. · .... cee . ' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriied officer.' (Name and title of corporate officer) Builder's License No..../~.l.~. .................. PI tuber s L:cense No .......... · E .... lectncmn s Lmense No. Other Trade's License No...~. [..~. .............. Location of land on which proposed work will be 'done .~PLO. ..................... House Number Street Hamlet .............. County Tax Map No. 1000 Section ................. Block ............ ' Lot... ~.... ......... (Name) .......... 2: State existing use and occupancy of premises and iutended use and occupancy of proposed construction: Nature of work (cheek which applica ........ '; ' /'^ ,~\ . ~ otc): r~ew tiuiluing .......... Addition~, .fd~g~i~.~l. Alteration Repair .............. RemovaI .............. Demolition ..... ; ......... Other Work ..... 5¢, stimatedCost .'¢/,¢..0.0,?.? ..... ' "esc,ipfion 5 If d oiling mb fd I1¢ its ./Y;I~ N (to be paid on filing this application) · ifgW ,nu crc we ngun ..... umberofd~vellingunitsoneac ocr... · arage, number of cars .. *¢¥1 ~ .......... ' h fl ........... · i fy ' ' ' ' ' ness, ¢Ommerc a r m occu alley, spec na ute ' ' ' ' ° · ' 7 Di sic fe ' · !u if any: F e .ea' · men ns o XlStmgstmc res, font .... ' ............ I,..I 'gl F{ mb rorst ie ' ' ......... Rear .............. Det~th i i fsh e witt It tic ' ' ' " ' ad lift s: F ............................... u mens ons o me structur ~ a era ns or c on ront D pth ' ' · , .................. Rear ...... .... ;.. tuber of Stories .......... · mensions of tn re new col struction: Front ............. ; Rear ";. i¢ : Ny fst ' ,, ............Depth .... e it .............. tuber o cries ......................... . Date of Purchase ......... i~ .......... , ......... Name of Former Owner ....... 11. Z°ne°rusedistrictinwhicll~remisesaresituated.,~q.~}.{~.~/n...o.~... .............. · ...... !!!!iii!i .... 12. Does proposed Construction violate any zonin aw, ordina ce or regulation: . . 13. ~9 .......... ' ' Will lot be re.graded · .... - . ~ ' ' '.' ' ' '/~ ~, ....... .'. .....~.. ....Will excess fill be removed.from premises:' Yes ' ' .... ;'. .. · · .' ..... Address ........ ' ........... 'Phone No ............. Name of Contractor . ..~J .~. I ................... Address; ............ . ...... Phone No'. ...... .. ' 15.' I.s this property witht~ 300 feet of a tidal wetland? *Yes ........ No..¥~. .... ' ......... · If yes,'Southol4 Town Trustees Permit may be required. ' ... ' PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed, and. indicate all set-back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. .NOTIFY ffi31Et.,l'll~i DEPARTI~.ENT AT 765-,I.802 9 AM ~ 4 PM FOR THE t. FOilN[YA'RON - '1~0 REOUIRED ~0[~ POU~ED CONCRETE 2: ROUGH - FRAMinG ~ PLUMBING $. INSULATION 4. FINAL OO~8TRUCTION MUST afl COMPLET~ FO~ .A~.,L .CONSTRUCTION SHALL 'THE ~EQUIREMENTS OF THE N.Y. STATE CONSTRUCTION [ ENERGY CODES, NOT RESPONSIBLE' FOR DESIGN OR CONSTRUCTION ERRORS STATE O F N:~W YOTa~ ri, ; COUNW. X_pLbU 5s ..... (Name of individual signihg contract) above named. I .... being duly sworn, depose, s and says that he is the applicant /Contractor ................................................ , agent, corporate officer, etc.) said owner or owners, and ~s dulyl authorized to perform or have performed the said work and to make and file this pplication; that all statements contaiimd in this application are tree to the best of his knowledge and belier; and that the vork will be perfomed n the manner:set forth in the application filed therewith. ' ' .worn to before me ~hjs/ , . C~IRELGL~. Ouallfl~ln 8uff~kC~u~ ~/~ (Signature o[npp]}~t)