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HomeMy WebLinkAbout21401-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22379 Date June 8, 1993 THIS CERTIFIES that the building. Location of Propert~ 500 YOUNGS ROAD House No. County Tax Map No. 1000 Section 18 Subdivision ADDITION Street Block 2 Filed Map No. ORIENT, N.Y. Hamlet Lot 18 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 5~ 1993 pursuant to which Building Permit No. 21401-Z dated MAY 11, 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 & INSTALLATION OF PATIO DOORS IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH &ANNE MARIE SOITO (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A '~ // ~ilding Inspector Rev. 1/81 · 0~ NO. It TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No-N°. ~1401Z Permission is hereby granted to: 4 ~ / ~ ~/~ //~/ ,o ~, ~r.~g., ~*ted*,..~ ...................... ~ ~ ....................................................... Co.nW Tax Mop ,o. ~000 Sec,o. ...... ~.~. ....... e,~k .~ ............... Lo, ~o. /~ pursuant to application da,ted ...... . .~.~...~. .................................... , 19.~., and approv~ by the Fee / ~ding inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~his applicat±en must be filled in by typewriter OH ink and submitted te the bn±lding inspeeto~ with the follow£ng~ for ~e~ building or new nse~ 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 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 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. 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-existing Building - $I00.00 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 ..... /Z .~/~..~. ........ Location of Pro ert . ..~..~ ..... ~'~vq~'~'''' ...... ::~,~;;~iiiii i ii New Construction .......... ; Old Or Pre-existin Building... House No. Street Hamlet Onwer or Owners of Property....~.~.~.~..~.~/..///~2~.. ~..~/~Z~...~.~./.~?. ~. .... .............. . .. County Tax Map No 1000, Section..'/~............Block .... ~. ..... .... Lot.../,~.'. ............ . ... Subdivision ................................... · Filed Map ............ Lot ................. . .. .. z Permit No.. .Date Of Permit .......... Applicant. ~/?) ~ ~'~ Health Dept. Approval....~./.~ ................... Underwriters Approval ..... /.~..~. ............... Planning Board Approval..~.~ .................. Request for: Temporary Certificate ........... Final Certicate...~. ....... Fee Subm±tted: $ .......................... · ......... ............ APPLICANT 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: [ ] ROUGH PLBG. 2ND [ ] INSULATION DATE INSPECTOR ~ELD /,~ ~. ~DUNDA~ION ( lstl ~OUNDATION (2nd) ~UGH FRAME & -PLUMBING ~SULATION PER N. Y. STATE ENERGY CODE FI;IAL ADDITIONA'L COMMENTS · / '~ .......................... TEL.: 765-1802 Examined .......... , 19 ~. ' , i Approved ............. 1977. Permit No..~ .... '.~ Disapproved a/c ..................................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 (~ildi~Fnspector) APPLICATION FOIl BUILDING PEIIMIT BOARD OF HEALTH ....... 3 SETS OF PLANS ....... SURVEY ................ CIICCK Date . d.P.7.~'./.Z-.. ?..~. ...... 19~.J. INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter erin 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 sti'eets or areas, and giving a detailed description of layout of property muJt be drawn on the diagram which is part of this appli- cations, ¢. ~The'work covered by ttfis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Bu//ding 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 IvlADE 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 admit authorized ~spectors on premises and ~n building for necessary inspect~s._2 . . ....... ~.~...~... (Signature of applicant, or name, if a corporation) O (Mailing address of applicant) 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. Plumber s L~cense No. . ....... Electrician's License No. Other Trade's License No ...................... Location of land on which proposed work will be done ................................. ~ ....... ' ' 0 ' ' ......... House Number . Street Hamlet Con'nty Tax Map No. I000 Section :]['~'. .... Block ~ '" · ................. Lot .............. ' ..... Subdivision ........ . ............................ '. Filed Map No. (Nanm) ........... -... Lot ............... State existing use and occupancy of premises and intended. Use and occupancy of proposed construction: a. Existing use and occupancy ...................................... ~... .......................... b. lntendeduseandoccupancy r,4~te 7 '3. Nature ofwor check whic cable): New Building ..... ~ · · · tion Alteration w~'''" Re r .............. Removal .............. Demolition ..... : ......... Other Work ............... 4. Estimated Cost .f i,t t, aD . i : ...... ' .... i. ' (Description) ......... t ........ ,... Fee ...... ............................... 5. If dwelling, number of dwellin~ units I (to be Paid on filing this application) ICg j ............... Number ofdwelling nnits on each floor. · arage, number of cars ................ · .............. 7' a rmtx occupan ,spec nature an extent o eacl e o use. · g tm if Fr &~......Re .d..~ ....... '...- · ..c ..... , ..... · tufas, any: ont ...... ar . H 'gl /..~. N tnb fSt i /.. - ..... D pth el It ..... . ...... n ero ores . e Dimension~hme structure with hlterations or additions: Front .¥P..c&.q .'2.,,t.q~ ..... Rear . .~p.c. tlq o.b.e..or ..... Depth · · ~ He oh, . ~ ot~'~,( ...... .'. · Number of Stories .~.~ct~a,~.~.4~ ' 8. Dimensions of entire new construction: Front .... ~..~. .... :Rear . Depth . .~.~. ...... · Height ... ~..~..e~...,Fyff?.. Number of Stories.. ' ~ ~ cfi a ,~ ~-e,/ ........... , 9. $izeoflot' Fro'~t I . · ,. . 10. Date of Purchase ., ;.Z' ........ Depth ........... 1 1. /-,one or use aistrict in ' ' · rm ............................ winch premises are s tuated . · · · · 12. Does . · ' . .............................. . proposed construchon wo;late any zoning law, ordinance or regulation' .~Xt o 13. Wtil lot be regraded ~to . . ...... · ......................... 14. k~___~,-, ~ '''."'~.l'...''2''.: ............ wm excess fill be removed from remises Ye ~,un~ muwner olpremmes .o.i .~. ~.qtto AA,~ .... -.,' Name of Archit0ct . "i)' ........ 'c ............. Address ............ NameofContractor 4~tfft. F't~ ~,. b'"j..Phone . 15.' Is this property within ¢00 feet of a tidal wetland? *Yes ........ No..~. · If yes, Southold ~own Trustees Permit may be required· ' ..... PLOT DIAGRAM ]Locate clearly and distinctly ~llJ buildings, whether existing or proposed, and. indicate all set-back dimensions from property tines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. , · i (Name of individual signin, contract) bove named. . ~BPJL"(W~D AS NOTED . -~ N~:I~' BUILDING DEPARTMENT AT 7654802'9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, f:OUNDATION TWO REQUIRED FQR POURED CONCRETE ,2. ROUGH - FRA~ING & PLUMBING '3. INSULATION 4.. FINAL CON,qT~UCTION MUST SE COMPLETE EOR C.O. .. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSISLE FOR DESIGN OR CONSTRUCTION ERRORS being duly sworn, deposes and says that he i; the applicant is the . ... t, or~¢'rtt z/~ ,/ " (C or, ag offic ) ......................... : Ontract ent, cor'porate er, etc. said owner or Owners, ~d is duly ~uthorized to perfo~ or have parroted the said work and to m~e and file this *plication; that all statements contain6d ~ this application are true to the best of his knowledge and belief; and that the rk will be perfo~ed m the manner s0t forth in tlm application filed therewith. ' ,yom to before me this .......... /.~. ~ ....... day of ..... , .