The URL can be used to link to this page

Home My WebLink About21195-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22119 Date JANUARY 22~ 1993 THIS CERTIFIES that the building. Location of Propert~ 930 PARKWAY House No. County Tax M~p No. 1000 Section 70 Subdivision ADDITION SOUTHOLD, N.Y. Street Block 10 Lot Filed Map No. Lot No. Hamlet 42 conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 20, 1993 pursuant to which Building Permit No. 21195-Z dated JANUARY 21, 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. N/A PLUMBERS CERTIFICATION DATED N/A JAMES B. & JOAN B. DRUMM Rev. 1/81 /~ui~ding Inspector FOII,~ NO. J TOWN OP $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, No Y. BUILDING PERA41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~T°.' 21195 Z Permission is hereby granted to: .... ~.~....~.~...~ .~ ...................... ..... ~:..~.....~../...7.. ...................................... ..... ~~,..../..:.:ff....J./.. ...... z. ............ . ~-....~..c. ........ ~) ......... ~./~ ......... .~.~.~/.~.~......~r~..~m...~.....~....~..4.~.. '~ z~,~ ~;~ ~ ~./~ .. ~:. .. .....~.,:.f ............... ~ ....................... .~ ...................... , ......... ~ .......................................... atp 's ocated at ............... ;. ................. · ..~..~ ....... ~ ............... : ............................................. ............................................ ~..~. .......... ...~...:_~ ................................................................. / Counfy Tax Mop No. 1000 Section .... .~.~. .............. Block ...... ./~. .......... Lot No ...... · .~...~. ............ pursuant to application dated ...................../~. ....................... , 19..~..-~..., and approved by the Building Inspector. //B~ilding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 2/10 of 1% lead. 5. Conunercial 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. B. 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 - $i0.00 4..~Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .~.~. ~...~- ?. /~ ~ 4ew Construction ........... Old Or Pre-existing Building ................. Location of Property...~.~.. ~.~ ~ )nwer or Owners of Pro r · ~ · · L ' .......................... ~ ]ounty Tax Map No 1000, Section.~.. .Block ............ Lot.: ......... ;ubdivision .................................... Filed Map ............ Lot ...................... 'ermit No .~ iI ~.~..~. Date Of Permit ..................· .... Applicant ....................... [ealth Dept. Approval .......................... Underwriters Approval ......................... 'lanning Board Approval equest fo~: Temporary Certificate .......... f Final Certicate ........... -~ ee Submitted: $.~.~ ~.~..~. ........ ~ .. C~ ~ ~oO~)) q ~// APPLICANT '. .. JAN 2 019 FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..... ¢ .~t./. ...... 19 .?~ Disapproved a/c ~ _ , (B./filding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTII CIIECK CALL . 0J? ............ aO'.. a. This 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, relatior~"ship to adjoining premises or public streets or areas, and giving a detailed description df layout of property must be. drawn on the diagram which is part of this appLi- cation. c. The work covered by tkis 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 work. c. No building shaI1 be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy ;hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buff'ding 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 applicrlble laws, ordinances, building code, housing code, and regulations, and to ldmit authorized inspectors on premises and in building for necessary ins~e~)~ns. (Si~,fi/ture of applicant, or name, if a corporation) .. . . G =% , - ' (Mailing addr~s~ of applicant) State whether applicant is.(own'w'w'w'w'w'w'w'~er, lessee, agent, architect, engineer, general contraftor, electrician, plumber or builder. =eofownerofpremises ,-. ................. (as on the tax roll or latest deed) f applicant is a corporation, signature of duly auth~orized officer. (Name and title of corporate officer) B~ der's License No-0~. ~Fev. Plumber's License No ...................... ... Electr',cian's hcense No Other Trade's License No ...................... Location of land on which proposed work will be'don~. ltouse Number Street Hamlet County Tax Map No. 1000 Section .~..6.-.~qT. Block ........ · .. ' /.67' ..... Lot ....... Subdivision Mhp No Lot ' ..................................... Filed ..................... (Name) .... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy v'~ ' -'. ' , b. Intended use and . occupancy . 3. Nature of work (check which ~pp icable~. New Bu"" . Repair .............. Removal ~' umng~, .... .~ 5 .... Add~tmn ....... rm~,~,Alter~i, on . . .., ...... }1 ~OOt ~ ! ~ (Description) 4. Estimated Cost .. I .......................... Fee ............................. $ If d Iii b f d elli ~ it (to be paid on filing this application) · we ng, num ero w n un s ......... N mb If ga ag numb of ~ ...... u erofdwelling units on each floor 7 Di i of itl ~ ifa F t type f ' · us ness, Commerca or m x ccupancy, specify nature and extent of eact o use .......... · H mens ohs ex s ngstmctu es, ny: font ............... Rear ........ e e ...... Nnmber of Stories ......... pth ............... ight ......... . ..... D D~ ' ns of stm e ~vith,alt arid dditi ......'' ' i .................. i...'ei t .................. Nnmberof tores ......... ,, .... · mens OhS of entire new constlruction: Front i ...... ; ..... Hight N i~lbe fSto ' ' .............. Rear ............. Depth 9 Si ofl t:Fr ' · ze o ont .... .... Rea ................... : .................. 10 D fP h ............ r ... D pth ......... · atto nrc ase ..... [ ............... ' e .................. 11 Z distictin l~i'~"?'i ....... ' ......... Name of Former Owner .......... · one or use r w c pr m scs are situated ....... ' .................. I2. Does proposed construct on violate any zoning law, ordinance or re-ulahon ..... 13. Willlot be regraded ....... = ' ' ........ Name of Owner of premises ~ ' ill e ss ll.be removed ~rom premis ........................ Address . --x. ..... · ........... ~ .................. rnone r~o .............. Name of Contractor ......... : ................. Address ......... . .......... Phone No .... ' ...... 15. Is this property within 300 feet of a tidal wetland? *Yes.' ....... No.ff/..~. .... ' ..... · If yes, Southold ~own Trustees Permit ma~ be required· ' "'- i PLOT DIAGRAM Locate clearly and distinctly all[buildings, 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 comer lot. ;TATE OF NEW YORK, ' S (Name of individual signingicontract) ..... being duly sworn, deposes and says that he is the applicant bore named· ~e is the ' (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork w/Il be performed in the manner se~ forth iii the application filed therewith. ' ,yam to before me this 0