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Home My WebLink About21059-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21145 Date NOVEMBER 16, 1992 THIS CERTIFIES that the building ADDITION Location of Property 2300 PINE NECK ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 9 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 27, 1992 pursuant to which Building Permit No. 21059-Z dated NOVEMBER 4, 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 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 GEORGE L. & GERALDINE SCHWAB Building Inspector Rev. 1/81 FOU~e NO. 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) N~N.° 2105JZ Permission is hereby granted to: ..~...~.........~.~.....u...~..........~.~.. ............... .~....~..~' . ....... ,,.....'~, ...... ~ t ........... ,o__~_ ,0 ~ ~., _._n.:, ..~......~....a~.~.......o~..~,.....C..~..~....~.....~ ............. et premises located at ...~.~.....~J...)~.....~..~,~...../~.~., ...... ~...~ ........ County Tox Map No. 1000 Section ....... .~..']..~ ....... Block .~... lot No ..... ..~....-J. ............ pursuant to application dated .... I~L.~..~........-~....'J. .............. , 19.~...~.., and approved by the Building Inspector. Fee $..~..~....~ ..~ .... Building Inspector Rev. 6/30/80 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS: 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 ne~ use: I. 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 f~om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder Dsed in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial b~ilding, multiple residences an~ 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 r~quirements. ' ~.~ For existing buildings (prior to ~pril 9, 1957) non-conforming uses, or buildings and "pre-existing land uses: 1. .Accurate survey'~f property showing ail property lines, streets, building and ~ unusual natural or topographic features. 2. A properly completed application an~'~ 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. Fees I. Certificate of Occupancy - Mew 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. Cer.tificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate,of Occupancy - $5.00 over 5 years - $10.00 · 6. Updated Certificate of Occupancy - $50.00 5. T~mporary certificate of Occupancy - Residential $15r00' Commercial $15.00 '' " ,'" .... . .· : notrsetxon..,..o~ ..... Old Or Pre-~cistine Build~n~ //C-- f~i)~'r~ ,/=,~Z '~ ' ~ca · ' ' '~ ' '~ ....... t~o~ of prope=ty ....... ~J.~.~. .... .¥:.~.~.~..L7~..-~74~ ~(;~,7, 7-- .... House No. ..... ~t:~ ......... "/" :=:~ ...... : .......... ~er or Owners of Property .~. ~. . ............ ~ ...... . unty Tax Map No 1000, Section .............. Block ................ Lot ...................... 5division ~ ' " ' Piled Map Lot ~mit No Dat~ Of Permit ................ · ............... Applicant ............................. ~lth Dept. Approval .......................... Underwriters Approval ........................ inning Board Approval ..................... . uest for: Temporary Certificate.' .......... Final Certicate... Submitted: $ ..... . ........................ . <~ks¢-, q ~ ~ ~ ..... .. c.o ~2)~q.5 ,/ . APPLICOn'". ..................... INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Bt~ilding l~pector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Math Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOVgN OF SOUTHOLD NOV]~2qBER 6, 1992 GEORGE & GERALDINE SCHWAB 2300 PINE NECK ROAD SOUTHOLD, NY 1197 1 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~x~XR/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~. 21059-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. ~....°?n~-~....~...~.., 19 .~..a_ Approved ./Q...o~J.~....~....~-..., 19 .~.:h. Permit No..~t...~.Q...~..~. Disapproved a/c ..................................... (Buildin~ Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK ..................... SEPTIC FORH .............. NOTI PY: CALL ................... HAlL TO: INSTRUCTIONS a. Tkis 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, 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 covere'd by tkis application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will is?ued a Building Permit to the applicant. Such permit shall be 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 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 authorized inspectors on premises and in building for necessary inspe ions. ~ .... ....... ...... (~g~a~.reofap;piicant, ornam/~ifa~orpor /on) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises..~./F~&. ~. £~ .... ~..~. ~~ ................. ~' ~' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer, · ' ~pp~!l)~[~ ,~,~ ~0~'E~ (Name and title of corporate officer) Builder's License No ............. ....... PI ber s Lmense No .................. Electrician's License No Other Trade's License No ....................... FOR POURED ~.,.ONC,,~'~E .~, BE COiV~BL,ETE FOR C,O. 1. Location of land on which proposed work will be' done .................. At [ · CONS°SRtIt'[iON. .SIegLL. ~[E. Ef..., ........................ . House Number Street / C~IetNOT RESPONSIBLE FOR ome co smuc o County Tax MapNo. lOOOSection ...~.~: .......... ~lock ..~ .............. 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 ... f .......................................... b. Intended use and occupancy ...................................................... .' ............. 3. Nature of work (check which applicable): New Building ........ ~ ~ddition . .. Alteration Repair .............. Removal .............. Demolition .............. Other Work...~,(/_f-f-~-~- ...... (Description) 4. Estimated Cost.. ].~ ............................ Fee . ~.~.~ i.~. .............. (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixeg occupancy, specify nature and extent of each type of use ..................... 7 Di ensions of existing tract ' 'fany: F R Depth Height ............... Number of Sto~es ...................................... D~ensions of same structure with alterations or additions: Front .................. , ................. Rear .................. Depth ~ HeiSt Number of Stories 8. Dimensions of entire new const~ction:. Front ............ ... Rear ....... ........ Depth . .......... .. .. Height Number of Stories 9 Size of lot: Front ~ Rear Depth 10. Date of Purchase ........... ] ......... . ......... Name of Fomer Owner ......................... hp~ ''' 1 1. Zone or use district in whic r mists are situated ..................... ' I2. Does proposed construction violate any zoning law, ordinance or regulation: ~'~ ........................ 13. Will lot be regraded ......... ~ ................... Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises ...]. Add ................ tess ................... Phone No ................ Nme of Architect .......... l ................. Address ................... Phone No ................ N~e of Contractor ......... 1 ............... Address .................. ~ne No ................ 15. Is this property within 30~' feet of a tidal wetland? *Yes ....... ~No.) ....... *If yes, Southold Town Trustees Permit may be required. ~.. ~ PLOT DIAG~ Locate clearly and distinctly ~l~build~gs, whether existing or proposed, ~d. indicate M1 set-back d~ensions from~ prope~y Hnes. Give street ~d block ~umber or descdption accord~g to deed, and show street nines and indicate whether ~te~or or corner lot. ?osr STATE OF NEWbOrn I~ ' (Name of individual signin'g contract) .......... above named. (Cohtractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly tutho~zed to perform or have perfomed the said work and to m~e ~d file this application; that all statements contaified ~ this application are true to the best of his knowledge and belief; and that the wor~wHl be perfo~ed in the m~ner ~et forth in the application filed therewith. Sworn to before me this ............... dayof.q. ......... ,19~ ~ ...... , ....... ~ o~'m~W'y~ ..... Coun y