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Home My WebLink About21362-z TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22292 Dute APRIL 28~ 1993 THIS CERTIFIES that the building ADDITION Location of Property 1480 LANDS END ROAD ORIENT, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 15 Block 9 Lot Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 22~ 1993 pursuant to which Building Permit No. 21362-Z dated APRIL 26~ 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 BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A BORES & GLORIA MOTOVICK /~/~ui]'dinq Inspector Rev. 1/81 ~O~e TOWN OF BUILDING D£PART~I:NT, TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°2~T? 2136RZ Permission is hereby granted to: / ,, , ............ ../,...~~ .......... ~ ........ ~:~...~_ ...~.~......~..~. .......... //, ,o..~..~~ ~./'."~i i.....~~.......~.....~...~.~.~. ...... at prem,ses located at ** .~** ,.~¢~.~***~**.....~.~...~** .~~ ....................................... County Tax Map No. 1000 Section ......... ./....~... ..... Block ............. .~.. ..... Lot No ....... ././.....~....~..... pursuant to application dated ....... .~/~.~.~.., .7,~:... ............................... , Building Inspector. Fee $ ......... .~./?~ and approved by the Rev. 6/30/80 Ao Form No. 6 TOWN OF SOU~HOLD 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 features. 2.. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 f6rm). 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-~onforming uses, or buildings and Vpre-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 ~inspeet signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwglling $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 - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ........... Location of Property.. J.~.~..°....~QL~.%b.%...~..~A.~...~.~...ii ........ .~..~i .... House No. Street Hamlet ?, County Tax Map No 1000, Section .... ~...~.~....Block .... ~,~..c~. ..... Lot ........ .~..O .......... Subdivision.~...C~..~J ~ ..~...~..~i.~..tT...Filed Xap. D .~.O..~..not...~.~ .... Permit No ................ Date Of Permit ................ Applicant.~.~.-.......~.~. . Health Dept. Approval ......................... · Underwriters Approval ...................... . . Planning Board Approval ' lequest for: Temporary Certificate ........... Final Certicate .... ~.. Fee Submitted: $ ............................ .... AP LI0 .......... '~U~ DA TIO~'~ ( 2nd ) ~UGH FRAME & .PLUMBING ~;SULATION PER N. STATE ENERGY CODE FI;;AL ADDITIO~A'L COMMENTS 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FORM NO. 1 TOWN OF SOUTHOLD i'? BUILDING DEPARTMENT ....... ~, t)L;'~, ~ SOUTHOLD, N.Y. 11971 ...... , ......... TEL,: 765-1802 Examined ............ , I9 f~-~ ' ' Approved../~.~. ........ 19/~.. Permit No a~ ./.~. Disapprov~B~ ~[~ ......... ~ .......... ] .... FOLLOWING ~NSPECTIONS: /. ~ ¢fxmo znspecror) 1. FOUNDATION TWO REQUIRED APPLICATION FOR BUILDINGPERMIT FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST INSTRUCTIONS OE COMPLE~/FOR C,O, BOARD OF HEALTH ''s% /SURVEY . i .... . . . SEPTIC FORH CALL . ,.~ ........ ' HAIL TO: Date ' . ........ 19... ~LLT~Ntt~l~iglllll~sH.O~kLc~tely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets'~fFpl~Qt~lat~t~tt/~l~t~FanTNEsc~', Fee according to schedule. ' ltl'Ai~lotCt~lNs'~tfgNo~tiB~tF~roTGt and of buildings on premises, relationship to adjoining premises or public sti'eets o:r 'ae~Z~/~Snd ~lglngl~tSEgill~dRt~cr~tbn of layout of property must be drawn on the diagram which is part of this appli- cati~lGN ' c. Th..e w~r~'[~[~egl~Yl~%pplication may not be commenced before issuance of Building Permit. d. ~c.. -~.~.~! o~l.~q~ ~vv .......... the Bmld~ng Inspector will ~ssued a Bui/dmg Permit to the applicant. Such permit shall l~E~ept on the prenlj~s available for inspection throughout the work. ' . e.N~l~u~lttlt[ll}lNOll~m°~Bl~Nt' c~Tused in whole or in part for any purpose whatever unti~ a Certificate of Occupancy shall I~1t1~t~802 I~aAMdTO~ 4hl~t~lilihi}'l~spect or. FO LLOW[NG INSPECTIONS: · .' AI~.P~a~qT3~S I:IE~[~I~iE'~]~I~o the Building Department for the issuance of a Building Permit pursuant to the Buildih~r.~59f~d~.~lNg~[:}tt Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulitiffig~,(~w.tgl~tGu&tif~tj~l~Ni~lings, additions or alterations, or for removal or demolition, as herein described. The a$~;~i,o$§[A~l~s to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit~.ultJN~tjJed, in~t;91~f~grROOlI1Oq~qnd in building for necessary insgections. ~ . I$E COMPLETE FOR C.O, Au ' .ONSTRUCT,ON SHALL ..... ............ THE REQUIREMENTS OF THE N.Y. . (~natu~e of applicant, or name, if a corporation) STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR . . DESIGN OR CONSTRUCTION ERRORS ' .(Mailino address bf applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, elect~cian, plumber or builder. ................ .O...~.o....wh. % .w~. ..................................... . ........................... Nme of owner of premises .. 1.~..o.."~..o.'(.~..~......~...~..O..Q .ow.~.. }~. ..... O~t:3..~....~. ~ .................. (as on the tax roil or latest deed) OCCUPANCY USE !S UNlgt i?UL WITHOUT OCCUPANCY If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ; Builder's License No .... ~).t~)...~N.IE.~ ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................. i ..... .... 1 ...... : ......... <~x. -~. ~ .. p.~,.,~ ..... ' ...... .Q.ff\,~, ............................ Itouse Number Street Hamlet County Tax Map No. 1000 Section ...: ~.. ~ ~ ....... Block ...~ ~.~. ' Lot ..... L*. ~'5 .~ ........ Subdivision ¢~.~. ~..~. ~ ' Filed Map No. .~. ~. Lot ~ (Name) . 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: · . a. Ex~stmg use and occupancy .. ~ ~ ~ ~ b. lntended use and occupancy ' .~'*%;~ .~[.~ ~ ~ i>: ?' ~' ' · 3. Nature of work (check which fiPplicable): N?w Building . ~ ........ Ad lition . .'..~..... Alteration Repair Removal ~ Demolition Other Work eser on 4. Estimated Cost .......... : .... ................. Fee .. ', - (to bepald on illin th' ' ' (~.I · . . . . g Isapphcat:on) ~ Ifdwelhng, number of dwelhn units { .... Numb~-A~ .......... ut ut UW lin units on e .. "-. If garage number of cars .i ....... ~k. ..... .... g ach/loot .............. 6. If business, commercial or mixed ~o ............ .~ - - ' ..................................... ' .... 7. - .-.- .... Fu,,,~y, ~l-,~cliy nature ann extent of each type of use .... .--w ............ Dimensions,o~e~is3i~g structures, if any, Front ~ o ' _Dimensions .o,f?am, e structure With alterations or additions: Front .... 8. ~imensions of entire new construction. Front . ~ .t q ¢~ '~d~ height ...~,~.., ......... Nun~ber of Stories ~ .... IO. Date of Purchase ~P/._D~ ..... . .. ~.~,' ..... 11. Zone or use district in which pr~mises are situated..17~..~, l.( .~.e. vLr~ ~.~ 12. Does proposed construction violate any zoning law, ordinance or regulatio 13. Will 10t be regraded ~; O ~vame or Arcnltect ..... .~.L~ ~. ...... ' Aa4~ Name of Contractor ......... ' ................. Address ..., ..... 15.' 19 th±s property within ~00 feet of a tidal wetland. *Ye · If yes, Southold ~own Trustees Perrait may be requ:[~ ... ~ PLOT DIAGRAM Locate clearly and distinctly alli buildings, Whether existing or proposed, and, indi~at~ all g~et,back d~ensions fronl property lines. Give street and block ~umber or description according to deed, ~ nd show street names and indicate whether interior or corner lot. STATE OF I~W YOP~,-. , . , (Name of individual signing contract) lbove named. . ~ ........ being duly sworn, removed from premises: Yes ~ No Phone No u Phony~o ' ........ No...~ .... etc.) ' '" ............ :he said work and to make and file this ff his knowledge and belief; and that the (Signature of applicant) . Ie is the . ..2~ .............. I i (Contractor, agent, corporate officer, ~ owner or-m-:::;:s, and is duly ~uthorized tO perform or have performed pplication; that all statements contained in this'application are true to the best ~ ~ork will be performed in the manner set forth in the application flied therewith. worn to before me this .......... '. .day of.. ~. . .,, otary Public, .... ' ' · .......... County_ . · No. 4942668, Suffolk Coup.../ , ' Term Expires Ootober 3, i 9 ' deposes and says that he is the applicant