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HomeMy WebLinkAbout21015-zFOR~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22303 Date MAY 6~ 1993 THIS CERTIFIES that the buildin~ Location of Propert~ 16740 MAIN STREET House No. County Tax Map No. 1000 Section 117 Subdivision ADDITION NEW SUFFOLK, N.Y. Street Block 9 Filed Map No. Hamlet Lot 16.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 9~ 1992 pursuant to which Building Permit No. 21015-Z dated OCTOBER t3~ 1992 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 FOUNDATION UNDER EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to JOSEPH McKAY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A //Building Inspector Rev. 1/81 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) No-No. ~IOISZ Date J/~X ~'.~ ........... ~,.., ~,.... ................................. ,1 Permission is hereby granted to: ....?..../.~.. ~¢..~ ...cT- ........ ~.~.,¢~..... ~'..~...." ...... /../.¢,,¢.,,~. .... ..C~..~..~.~..~.~ .~... ......................................................................................................................... · ~..~,~. ....... ~.~<......../..~.;.~ ....... ~.~.~~ ........ ~.........~...~.. at premises located at ........................ ~..~...~'.~. ............ ,~'~/~,/~...~"~..~..'. ......................................... ........................................ ~ ..................... ...~...~. ...... ~.~..¢~. ............................................. ................ ..................................... · // ~ Co, nW Ta× Mop No. ~000 Seot,on ............ Z. ........ ~o~k ........... ~ ...... Lot No ........ /..~. .......... ,,,uan, ,o opp',,o,,on date ........... .¢...~.....~ ....................... . ,*.~..~... a,d appro,~ by Building Inspector. //Buirding Ins~ctor Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 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. 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. ~or existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and "pre-existing" land uses: i. 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. Fees 1. Certificate of Occupancy - New dwgiling $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 - $10.00 '4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ............................. .. . '~ .~.. New Construction ........... Old Or Pre-existing Building ............. Location of Property...~.~ .~,~. ~./~ ...... Z~ 7~..../?~.'~...$..~. ............................. House No. Street Hamlet 3awer or Owners of Property %~.~.~. ./~..%~./f.~. ........................ ]ounty Tax Map No 1000, Section...f!2 ....... Block .... .~ .......... not .... /~,.~ ............. ;ubdivision ............................. . . . ... . Filed Map ......... . .. Lot......,.. ........... . . 2/~(~..~-~ /l~.':~/'~..2 A lzcant /~. ~'~/~.. ~ . .F~O,% .'"2~ ."~.~ .......... 'ermit No ........... Date Of Permit ............ pp ' . [ealth Dept Approval ............ Underwriters Approval . .. . .. 'lanning Board Approval lequest for: Temporary Certificate ........... Final Certicate .... ../.. .... :ce Submitted: $ 2~00 cc 't 2oq_50 OU~DA'TION (1st) OUNDATIO:$ (2nd) OUGH FRAME & .PLUMBING NSULATIO}~ PER N. Y. STATE ENERGY CODE FI;;AL ADDITIO};A'L COMME~TS: //q76S-'f802 ILDING DEPT. INSPECTION FOUNDATION 1ST ~ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ .~] FRAMING ~ ] FINAL' DATE/~//~,~/~//I NSPECTO OR USE ~S UNLAWFUL WlT~©UT CERWIC^TE OF OOOUP^NOY dc-- -./ £861 '£1 'NVP ::~.,.vo ,OZ = ,, I ::twos 'A'N "'OO )t'lO'l.lAS O"IOH J. nOS .,o .,~o,,. ............ )1-10-t-I rig. lA3 N I~?O~NV$ N3~V~ , Gi~'IO I .00'0~ ~'1o7 o' ' ,00'0~ , Og'gO$ I BLDG. DEPT. Tow. o; FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ......... SURVEY ............ CIIECK ............ SEPTIC FORH .............. CALL ._ . .._.. ......... MAIL TO: Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 set~ 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 streets or 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 commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspeclor will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughoat 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 MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordhmnce 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 demolilion, as herein described. The applicant agrees to comply with ail applicable laws, ordiuances, building code, houCng code, and regulations, and to admit authorized inspectors on premises and in building for necessaw~p~yns.~//~ /-''~ (Signature b~ applicant, or'name, if a corporation) · ?.<.( .......................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, ele~ric~nv~u~n~b~ builder. Nam n ' e of ow er of premises ............. /~.~ ..................................................... ~as on the tax rolm or mtest,~e~.c~)~ ~ ~M '10 4 PM FOR 'file If applicant is a corporation, signature of duly authorized officer. FOLLOWING INSPECTIONS: 1. FOUNDATION - 'I1NO IIEQOIIIED FOIl PO01{ED CONORETE (Name and title of corporate officer) 2. ROUGH - FPOM~ING & PLUMBING 3. INSULATION 8E COMPLETE FOR ~.O. Plumber's License No ......................... ALL CONST, RUO~ION $1~La~I,L MEET THE nmOmL~£ms OF ~ N.Y. Electrician's License No ....................... StAT~ CONSWiOcn0N &,~ ~GY ' COOE$. NOT RESPON~ffiLE FOR Other Trade's License No ...................... DESIGN OR CONSTRUgTION ERRORS I. Location of land on which proposed work will be' done .................. .L .............................. House Number Street Ramlet County Tax Map No. 000 Section ././..7. ........... look .... ............. ......... Subdivision ..................................... .Eiled Map No ............... Lot ................ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... .q.000 0o ' 4 Estimated Cost ' ' Fee ; (to<l¢~ p~id:on.~filin.g~t~is application) 5. If dwelling, number of dwelling iunits..../. .......... Number of dwelling' units on each floor ................ · If garage, number of cars ..... ] ................................................................... 6. I business, commercial or mixe~l occupancy, specify na, tute and extent of each type of use 7. Dimensions of existing structures if anv' Front ~o ~.'~ p,,~ go' "o" ' .................... Height ............... Number of Stories .... ] ................................................... Dimensions of same structure with alterations or additions: Front s,~,z Rear .x.~.'7.~... Depth 5~..~:ff. I Height Numb r of Stories 8. Dimansionsofentirenewconstruction: Front ............... Rear .......... · .....Depth ............... Height Number of Stories 9. Size of lot: Front ........... i. Rear Depth 10 Date of Purchase ' Name of Former Owner 11. Zone or use distric.~ in which pr~mises are situated .................................................... 12 ' ~ ordin ncc or regulation: · Does proposed con~tructmn viol3te any zoning law, ~ .............. 13. Will lot be regraded . ./~.~ ..... i ................. Will excess, fill be removed from premises: Yes 14. Name of Owner of premises .'~'o. ~ ../q¢[~,/t..~. ..... Address . (_.eft.)( ............. Phone No..~]~...~f.. Name of Architect .......... i. : .............. Address .................... Phone No ................ 15. Is this property wtth±n }00 feet of a tidal wetland? eYes ........ No...t(. ..... · If yes, Southold ~own 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 ~umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, SIS above named. being duly sworn, deposes and says that he is the applicant He is the ....................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner Set forth in the application filed therewith· Sworn to before me this ............. · ~.;.--~ ....... day of. ~ ...... , 19c~,~. ota. P?lic: ......... r .... · .................. Term F..xplre~ June '12, '1~,~ (Signature of applicant)