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Home My WebLink About21691-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-22959 Date APRIL 20, 1994 THIS CERTIFIES that the building ADDITION Location of Property 2515 SOUNDVI~W AVENUE House No. Street County Tax Map No. 1000 Section 68 Block 1 Subdivision Filed Map No. PECONIC, NEW YORK Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 20, 1993 pursuant to which Building Permit No. 21691-Z dated OCTOBER 4, 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 SCREENED PORCH ADDITION TO EXISTING ONE F~-MILY DWELLING AS AEAPPLIED FOR. The certificate is issued to of the aforesaid building. LYNN McWHOOD (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N--297379 -- NOVEMBER 30, 1993 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N_0 BUILDING PERMIT (THIB PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date.....~ ................................................... 19 .. Permission Is hereby granted to: ,?~,:..~ .-:...... ~..~. ~.. ~: ................ .................... ......... CounlyTaxMapNo. 1000 Section ....... ~..~... ....... Block ........... ./,, ........... LotNo. O¢:t pursuant to application dated ........~ .................................. 19., .~.~.. ..... Building Inspector. and approved by the Rev. 6/30/80 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 6r new use: 1. Fifial survey of property with accurate location of all buildings, property linep, 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 leas than Z/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildiJgs 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, buiiding 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 Inspe~o~;~hall state the reasons therefor in writing to the applicant. ~. ,,,1. ,,Certificate of, Occupancy -New dwel],z~g~$25,0,D,, Addzt~e~ls ~o,dwe%ling $25~00,, ~ ~.,.~i;]~.i~~, ~ Al~eratigqs,, tp,~welli~g. $25,.00L Swirm~in~ ~0~1.~$~5'~00~ 'A~c'ess~ry ~uiidi~g '$25.b0," · 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 - $i0.00 4.. Updated Certificate of Occupancy - $50.00 5f Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....~/7..~./..~.~.. ......................... New Construction ........... 0~1~ Or Pre-existing Building .... i .~[~i .... ~,~ Location of Pro eft .. ~-/ ~ f p y ...... ................ ............ House No. Street Hamlet 0nwer or Owners of Property..~.y~.~. ......................................................... County Tax Map No 1000, Section...~.~. ...... Block .... / ........... Lot ..... Subdivision ............................. Permit,No...~/.~.~/..~%...Date Of Permit. Health Dept. Approval ................... Planning Board Approval ................. Request for: Temporary Certificate ..... - Fee Submitted: $ ................ ...... Filed Map ............ Lot ...................... ...... Underwriters A royal ~ F~UNDATION _ ( ~ s t_.Z.) _ FOUI{DATION 2. I2nd) ROUGH FRAME & .?LUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIO~A'L COM~ENTS: FORM NO. 1 /' i" ,~[:? 2 0 I~ ! TOWN OF SOUTHOLD 3J u BUILDING DEPARTMENT ......... ~x.,-f , TOWN HALL L__!'gwN o¢ sotm)o~.o ~ SOUTHOLD, 11971 TEL: 765-1802 Ex,mined . .'. ...... , 19~ ' Approved .... ~ ...... 19 ¢~Pemit No.. ~/~.~ ~ D's ppro ed a/c . . . ............................... ........ (Building Inspector) ~PP[IGATIO~ FOB BHIkDI~G PffB~IT INSTRUCTIONS BOAgD OF HEALTII ......... 3 SETS OF PLA~iS .......... SURVEY ................... ClI~CK .................... SEPTIC FORH .............. CALL . . - . . . HAIL TO: ; 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 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. 7,~' .fit 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 w6rk. 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. .., .~. ] .~.~...o~. ~ .e~. r...~_/~....x... { .~..c.., ........ -- (Signature of applicant, or name, if a corporation) .... '.¢. ~..~ .~.~.~....~..~...t. tq. 5 ~ ............ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....~...~....~%.. ~.~.. ..... . .c~..~ .~.-x%...~ .~:-c9...~.. .................................................... Name of owner of premises ..... ~..¥..~..~.. ........................................................... (as on the tax roll or latest deed) If ap ' i n signature of duly aut~ orized officer. (Name d title of corporate officer) Builder's License No... 5~ ~'/¢9 14 Plumber's License No ......................... Electric. ian's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be' done .................................................. House Number Street Hamlet c ty * ~ N l OOO .~,.~ B1 I ~' oun ax a o. Section .. ock Lot ............ Subdivision ..................................... .Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~. ...... f~. ................... b-Intended use and occupancy, .-~ J ~ .~.-..~t.~..( ~.~. ~'..~.~-t .C~.. ~. (,)?)~.. ~c.C.e..~.; : 3. Nature of work ( beck 7hich applicable): New Building .......... Addition ..; Alteration .......... Repair ............ RemCval .............. Demolition ........ ~. Other Work /~.orc.~q.... ~iO00' oo~} ' (Description) 4 Estimated Cost ' , / (to be paid on filing this application) 5. If dwelling, number of d~'ellingiunits ............... Number of dwelling units on each floor.. ~ ..... ., ...... Ifg . · stage, number of cars .... , ............ 6. If business, commercial or mixe occupancy specify nature and extent of each t e of use 7. Dlmenmons.otcxmtmgstructures, ffany: Front ...... Rear ... :.~... , De th Height [.C~[ ...... Nu..~ ...... t .... p ............ ....... moer ot ~tones ..... [ .......................... ..... Dimensions me structure w alterations or additions: Front ....... Rear 8. sJlmenslons oI entire new construction: Front ........ Rear ....... De ............ 'o ·. · ' ...... ,. . Nun{ber of Stones 1 I. aone or use district in which pr tuated, go~s., .cji 12. Does proposed construction violate any zoning law, ordinance or regulation: iQ. 9 ............................. 13. Will lot be regraded ; ... i ..... Will excess fill be removed from premises: Yes ."-'-"No Name of Architect : . Address /~' ..... 15. .ts this property within 300 feet of a tidal wetland? *Yes ........ No ......... ' ' · If yes, Southold Town Trustees Permit may be required. PLOT DIAG RAIVI Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, SiS ..... ~-'~' ' ;-''' ~-~ r;x'~ '~' wrv-~'~,~.v.A/ex, .......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contact) · . ~bove named, i Ile is the [ ~ent, corporate officer, etc.) . ff said owner or owners, and is duly ~autl3orized to ~perform or have performed the smd work.and to make and file this tpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner Set forth in the application filed therewith· ;worn to before me this ....................... aay ot · · LII~DAJ. COOPER [' . ~otsry Public, State of New YorJ~ ~ ~' <~' ..................... No, 4822563 Suffolk. CounttFC(~- · ~ ' (Signature of applicant) Term Expires December 31, 19.-~ -15LAND ' I Ld 0 0 ! !