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Home My WebLink About20379-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hull Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20677 Date APRIL 27! 1992 THIS CERTIFIES that the building. ADDITION Location of Property 160 LAKEVIEW TERRACE House No. Street County Tax Map No. 1000 Section 31 Block 4 Subdivision Filed Map No. EAST MARION, N.Y. Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 9, 1992 pursuant to which Building Permit No. 20379-Z dated JANUARY 10~ 1992 was issued, and conforms to all of the requirements of the applicable provisions of the la~. The occupancy for which this certificate is issued is WOODEN DECK ADDITION OVER EXISTING PATIO AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A NORMAN WOODCOCK Rev. 1/81 // Building Inspector rOR.M ~;0. 0 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~ 20379 Z Permission is hereby granted to: .... ..T~.~....~a.~ ................................................ at promises located at ..... ..~....0......~.~..~,~._~ ~,.~..~d~,....~..-~....~.....~~ ......... County Tax Map No. 1000 Section ..... .(~...~../. ........ Block :~..~... Lot No ..... !-.7. .............. pursuant to application dated .... ..~...O~t~...~......~. ................. , 19.~''~, and approved by the Building Inspector. Fee $..~., .............. Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN I~LL 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 ail 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 bui%dings 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. ,F°r existing· . buildings,, (prior to April 9, 1957) non-conforming uses, or buildings and pre-exzst~ng land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A ~roperly 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 i. 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 . 7.7. . .... New Construction ...... ~ .... Old Or Pre-existing Building ................. Location of Property.. ~.~O..~K~Z.~7...~-.~d~e.~.~ ............ .~.'.~Z~..~. .............. House No. ' Street Hamlet Onwer or Owners of Property...~/~d~fT7~../~..~.~O~.~.q~ ................................... County Tax Map No 1000, Section .... .O.~ ..... Block...~ ......... Lot ..... 22 ............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No..~.~ ~7.~ .~ .... Date Of Permit..~77~/~/~f~Applicant..~.~../~. Health Dept. Approval .......................... Uuderwriters Approval ......................... Planning Board Approval ........................ Request for: Fee Submitted: $. ~, ~. ~.~ .~. ..... Temporary Certificate ........... Final Certicate....A- ....... ............... i APPLICANT FOUI~DATION (lst) FOUNDATIOI4 (2nd) 2. ROUGH FRAME & INSOLATION .PLUMBING PER N. Y. STATE ENERGY CODE FINAL ADD/TIO~IA'L COMMENTS: to Height ....~¢.' ........ Number of Stories ...~ ..... Dimensions of same structure with alterations or additions: Front ................. Rear ? .. . 8. DD;mP}hnsions o f enti;e ne~v c;~st~tg~..~rg~t' ................ ~.. Number of Stories ...................... ................ r~ear ............... Depth ............... Height ............... Num bet of Stories 9. Size of lot: Front .~? "~ .... '/; 7:-' '~ ..... : .......................... 10. DateofPurchase /..~.~'~.' .............. ~ear.L}l,~..~- .............. Depth ./~..~.:'. ...... ....................... t~ame of Former Owner . ~ q~./.~.~. ~¢ .rvJ. ........ 11. Zone or use district in which premises are situated } o o o.. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded ............................... ............. ; .............. Will ex,qess fill be removed from premises' Ye 14. NameofOwnerofpremisesfd..ol~l~l~14~..to,>o,O~o,~K.a,~,~,.,,~/boz_ftKc~O~ ~.- .. · s No Name of Architect . Address .~'m--~4,,qc, z~ ..... none mo.. 2 2.. q~.. ?.~/.. ................................ ~.-.~,~a,W... Phone No ................ Name of Contractor .......................... Address ................... Phone No .............. [5. Is this property within 300 feet of a tidal wetland? *Yes ........ ~ '' · If yes, Southold Town Trustees Permit may be required, ' ........ ... 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 tnterior or coruer lot. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ~( Repair ......... Removal .............. Demolition .............. Other Work .............. 4. Estimated Cost .~. ~ o o (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dweiling units on each floor ................ · If garage, number of cars ............................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... 7. Dimensions of existing structures, if any: Front...~6:... Rear /~ ' 'Depth.. g$" ...... &TE OF NEW YOR~,~,t, , . u rr¥ OF ..... S.S (Name of individual signing contract) ye named. being duly sworn, deposes ~d says that he is the applicant 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~NAL REMARKS: INSPECTOR J~N - 9~ · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 _d Examined ...-xj~,~ j.q., 19~/.~r. Approved.~.~. J.O.., 19~.~. Pemfit No..~.O. ~.'~.~ ..~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CllECK ..................... SEPTIC FORH .............. :..'. .... /'-HA I L) TO: ,,,2 ,% ~. /' · .......... '.. Date ././?. ........... a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s~ts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan slxowing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~r areas, 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 cbmmencefl 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 availabl? for inspection throughout the work. e. No building shall bO 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit author/zed inspectors on premises and in building for necessar,,,j inspections:,/4/ · ...................... --' (Signature of applicant, or name, if a corporation) /L ~, ~ ~.~ .~. 4 ~. . . z~ , .mn ~ / ¢ ~. ~ /¢ : )( . /Z f?..f ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... .0. re./9. 6-70~. ...................................................... : ........................ Name of owndr of premises ~..~.fl~/~A)...//,. ~ .~4.~... g-:..(4¢.0.o, fl..o¢.cr K ................................ ~ . (as on the ts¢ roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..(1 ¢..~.~ ................. PlumbeFs License No ......................... Electrmmn s L~cense No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done. 1~o. .... ~.~ 7.//z.-'¢/..-r.~.-R~P~. e~ .... , .~.r:z-.. ~/~,~/.~; ~ House NumberStreet Hamlet County Tax Map No. I000 Section ... 19.. ~. f. ......... Block ..... ~ ............ Lot... [. '? ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 'T~ O..'7 / b. Intended use and occupancy ~ ~ O ,~'~ ~'~.~ g~ .~ TM,. '"~, ......................... · ~ ~.. ~ ~,~ ............................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . ~' ........ Repair .............. Removal ............ Demolition .............. Other Work.' ...... ........ : ' (Description) 4. Estimated Cost . .~.~.,.o. ............................. Fee ...................................... (to be paid on filing this application) 5.If dwelling, number of dwelling units ............... Number of dwelling units on each floor ........ ........ If garage number of cars . 6.If business, commercial or mixed Occupancy, specify nature and extent of each type of use ............. . ........ sting structures, ' ' .' .gp.', . 7. Dimensions of exi if any Front ...~.6... ' I ~ , . · ..... ... Rear ........ ' ..... Depth ....... Height ..... ~ ......... Number of Stories ...~ ................... ' ' Dimensions of same structure with alterations or additions: Front Rear Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories .... . 9. Size of lot: Front . .~?.'. ' ........ "' ' ................................ ·. Name of Former Owner . ~q/~./.~,5. q A). ............. 11. Zone or use district in which premises are situated 1. o o 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. ?.ill lot ~b~regradefi ...... :; ....!.. · ;.:, ............ Will e~s. filLob~removed from premises: Yes No ............. Address ...... ~'.-.~/~a.~... Phone No ................ Name of Contractor ' Address Phone No 15. Is this property within 300 feet of a tidal wetland? *Yes ........ ~ ......... · If yes, Southold Town Trustees Permit may be required· PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block ndmber or descriptioh according to deed, and show street names and indicate whether interior or coruer lot. ' OCC JPA C¥ OF OCCMP C ~TATE OF NEW YO~,~ , . OU~y OF ...... ~.. S.S ........ ...... (Name of individual signing contract) tbove named. ~ APPROVED AS NOTED FEE: ..~____[3Y: V. ~',/._, , NOTIFY BUILDING DEPARTMENT 76~-1802 9 AM TO 4. PM FOR ~HE FOLIDWING iNSPECTiONS; 1. FOUND~[~ON ~O REQUIRED ~OR POURE-D CONCRETE 2, ROUGH ~ FRAMING & PLUMBING 3. lNG[J[ ATION 4. FINAL CONSTRUCTION MUST 8E COMPLETE FOR ALL CONSTRUCTION SHALL MEET STATE CONSTRUCTION &' CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ER~IOBE~ is the..¢.cY..N.Gcl/~. .............................................................................. (Contractor, agent, corporate officer, crc.) said owner or owners, ~d is duly authorized to perfo~ or have perfo~ed the said work and to m~e ~d file this pplication; that all statements contained h this application are true to the best of his knowledge and belief; and that the york will be perfomed in the m~ner set forth in the application filed therewith. ;worn to before me this .............. /~ or, .~..T~g~>]~ ..... 193~ ~[~ · ..... ~ ~, ~ ............... ~'~ g~ (Signature of applicant)