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Home My WebLink About21186-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22288 Date APRIL 28~ 1993 THIS CERTIFIES that the building. ADDITION TO ACCESSORY Location of Property 5600 INDIAN NECK LANE PECONIC, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 98 Block 5 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 11, 1993 pursuant to which Building Permit No. 21186-Z dated JANUARY 14, 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 ADDITION TO EXISTING ACCESSORY GARAGE AS APPLIED FOR The certificate is issued to PATRICIA WOOD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 1~0R'I~ NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N9 211~8 Z Permission is hereby granted to:_ ..~.~~ ........ z,......~ .................. ...~~ ...,&.~.,.~ ................................ ,~.~~~...~~...~~~....~..~~.....~ ..... ~/~"~"~ ............ ~7 ~:'""F:~"v'"'"~ .......................................... at premises I~ate~ at ..... ~, ..~.a...~~...~Y/~...~ .................................. County Tax Map No. 1000 Section ........................ Block ~ Lot No. pursuant to application dated .................................................... , 19.~...'~..., and approved by the Building Inspector. ~.. ,.~..?../.~.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPJRITMENT TOWN HALL 765-i802 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 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 2½10 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. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming 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.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. ~'ees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, ' Alterations to dwelling $25.00, Swintming 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, Co~nercial $15.00 Date ...... ,~.f. ...................... ! New Construction ........... Old Or Pre-existing Building ................. Location of Property.. b~O ~.~7%~..~. /V~ 7..~z~'-- i~6~-~zV/~ House No. Street Hamlet Onwer or Owners of Property ................................................................ .. County Tax Map No 1000, Section ......... ~...Block ..... J'~ Lot · Filed Map Lot .... Subdivision ................................................................. Permit Xo....~.!~ f~.~ .... Date Of Permit .... I~)+/gD .Applicant. Health Dept. Approval .......................... Underwriters Approval ........................ . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... /595 ....... " .. ...... '. ....... ".:/ ' OUNDATIO:~ (lst)'- .OUGH FRA~-IE & .PLUMBING .NSULATION PER N. STATE EHERGY CODE FINAL Ye ADDITIO~A'L COMHENTS: 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ] I.N/.~JLATION FRAMING [//j FINAL REMARKS: ~~ ~:~- ~ DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ./:'.~.. TEL.: 76 · . ........ 19 ....~'-~ ' ' Examined Approved.../.~..~. ........ 19 .~w~.. Permit Disapproved a/c ............................... BO,\,qD OF HEALTII ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .......... . . ...... · , .... '"'"".. TO: k ~ector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ............ 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, relation'ship to adjoining premises or public streets or area's, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation.' 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 avaQable for inspection throughout the wt3rk. 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 3uilding 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. rhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for ~~_ ne ssa ' 'ons...~F"~-.....~.~ ~..~.~.(.~,_~-~--- ~h~o f applicant, or name, if a corporation) (Mailin= address of applicant) - State whether applicant is owner, lessee, agent, architegt, engineer, general contractor, electrician, plumber or builder. Xtame of owner of premises . .~~-v~.-... . .................................... .. (as on the tax roll or latest deed) :f applicant is a corporation, signature of duly auth~orized officer. (Name and titleof~rporate~,_ a~ officer) Builder s License No.. . .............. Plumber's License No ......................... Electric. ian's License No "- Other Trade's License No ...................... Location of land on which proposed work will b~'don,e .............. .. ' . ......... · ........ ........ ....... House Nmn ber Street Hamlet County Tax Map'~i',lo. 1000 Section c/738'°~? 'fK --5'-/'~. ~ ot "/''~ .................. Block ............. L ................... Subdivision .... '~, ................................ Filed Mhp No ............... Lot ...' ............ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: . a. Existing use and occupancy ........ b. Intende~d use and occupancy . 3. Nature of work (check which ~pplicable): New Building .......... Addition .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............. -. ' , ,~,~ ~ (Description) 4. Estimated Cost ,-- ,-- ,-- ' ~ Fee 5 Ifd Ill b old llin~u it (to be pad on filing this application) · we ng, num er we n s ....... Numb fd Ifc b of cars ~ ........ er o welling units on each floor 6 Ifbusi rci I x~d ......................................................... ify d f h ..... · ness, comme a or mi ' occupancy, spec nature an extent o eec type of use ................. · /menslons ct existing stmctur ;l' ............... Rear .... H 'ght rp[~D~St~b~i~,' ..... .. . Dqpth .~ . . el ............... Nn .................. Dim f with ................................................ ensions o same structure alterations or additions; Front ................. Rear ............ Dep th ........... ~ ........ :... Height ...................... Number of Stories .............. ,).; ...... 8. Dimensions of entire new const~ction: Front ............. Rear ............... Depth .............. Height Number of Stories 9 Size of lot: Front ' '" ' i Rear ~ Depth 10 Date of Purchase ~ ................... · ' ......... ~ ....... ' ......... Name of Former Owner .................... Zone or use district in which ra i~ag .~,. 12, Does proposed construction vic !ate any zonin aw, ordinance or regulation: .......... .......... ·... 13. Will lot be regraded ................. Will excess fill be removed from premises: Yes No 14. Name o£Owner of premises ...~ ................. Address ................... Phone No ............... Name of Architect ...~.~L.. '~e~? ............. Address ................... Phone No ............ Name of Contractor ....... .-Z, ................. Address .... ' ' ' ' ..... ' .......... Phone No ............... 15. ]'s t:h±s propert:y w±t:h:f.n ~'0' £eel: of a l:±da], wet:land? *¥os.' ....... No ......... ' .1£ yes, $ouehoZd ;own Trustees Per)nJ.e )nay be requ±red. PLOT DIAG IL, kJV[ Locate clearly and distinctly I omtdmgs, whether existing or proposed, and, indicate all set-back dimensions Trom all .... property tines. Give street and block number or description according to deed, and show street names and indicate wh6ther interior or comer lot. AP, PRO)/ED AS NOTED · .4 ~- ~(~'~ ...... ~ EE: _ _ NOTIFY 8tflLDIN~ OEPAR~NT Al' 765-1802 9 AM TO 4 PM FOR THE FOLL.OWING INSPECTIONS: 1 FC)IfNDAFtf)N 'TV~IO REQUIRED FOR F~OU~,%:D CO~,ICRETE 2. I~OUGH ~ FRAMING & PLUMBING 3. INSHL ATIC)N 4. FINAl, CONSTRUCT!ON MUST 8E COMPLETE FOB C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS !TATE OF NEW YO-R~',-t-- ._ , I , ,' .... ( .... g;in~o: cont;ac'~_--3') .... being duly sworn, deposes and says that he is the applicant acre named· . ; . "' ( '6~agent is the , " ' ' , corporate officer, etc.) said owner or owners, and is duly a~thofized to perform or have performed the said work and to make and file this ~plication; that all statements containe'd in this application are true to the best of his knowledge and belief; and that the ork will be performed in thc manner sci forth in the application filed therewith· ' "Omtobeforemethis//~ ' i ' ' ........ .~ .~..'~.. :~ny(6'~..0 ..... .~, .A'.~. ?.c .~...~Q9 .~.~. ' ...... // (s of hcanO