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Home My WebLink About21060-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22115 Date JANUARY 19, 1993 THIS CERTIFIES that the buildin~ Location of Property i980 LEETON DRIVE House No. County Tax Map No. 1000 Section 58 Subdivision ALTERATION SOUTHOLD ~ N.Y. Street Block 2 Lot Filed Map No. Lot No. Hamlet 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 30~ 1992 pursuant to which Building Permit No. 21060-Z dated NOVEMBER 5, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy forwhich this certificate is issued is INTERIOR ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. JEAN C. LEONARD (owRer) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - JAN. 12, 1993 PLUMBERS CERTIFICATION DATED N/A uild~ng Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEI)ARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_~? 21060Z Permission is hereby granted to: / / / / ~~....~~_~....~..~~ · ...................... ,o ....... ~..~.....~..~~ ~~ ......... ~.....~~~_~ ~ ...... ............................................... ~ ~... ~ ~,.~,~ ~ ..... z~.~~_~ ............................................... ...................................................... ¢..~~ .................................................................... co~ ,o~ ~ so. ~00o s~,o~ ....... ~ ..... ~.~.~ .............. [o~ uo....2~ .......... pursuant to appJicatlon dated ...... ~..~/,..~. ................................. , Building Inspector. /~_ Fee $... ~..~.....~.~... 19..~..~, and approved by the Rev. 6/30/80 C~JL~J L~ ~rJ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 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. 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 B6ilding 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 - $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 ,~, ).~1 ~ ............................ New Construction .......... Old Or Pre-existing Bg~lding .... House No. Street Hamlet 9nwer or Owners of Pro eft ... ~.~: .. County Tax Map No 1000, Section ..... .~. ~.. .Block.. ~ ....... Lot.. SubdivisiOnpermit No....~. ~ .................................... .~.~ Filed, Map ............ · .~L°t .... .... Date Of Permit...t.~.~ .~ .~icant. ~ealth Dept. Approval .......................... Underwriters Approval ......................... ~lanning Board Approval ........................ '~eqsest for: Temporary Certificate .......... ~ Final Certicate ..... ~ ..... ' ,ee Submitted: $ ...... "~.,~ ................... . , L, ... CO~&2'~ S ~ APPLICANT ' '. YOU~ D A'TIO.~ ( 1 s t ) :OUNDATIO|~ (_2nd) ~OUGH FRAME & ·PLUMBING ]IISULATIO}; PER N. STATE E~IERGY CODE Y® FI;;AL ADDITIOn;AL COMME~;TS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY V 85 JOHN STREET, NEW yORK, NEW YORK 10038 Dat~ ~ ~ ~[~.~ ~ 9 ~ ,[~ ~pplicationNo, onfile ~93/93 H THIS CERTIFIES THAT only the electrical equipment ~ ~scribed below and int~duced by the applicant ~med on the a~ve applicat~n number in the prem~es of in the following loca~' u~s examined on and found to be in contpliance with the requirements Qf this Board. AMI, AMT. K. W, O1[ H.p. OAS H. p ANat. NO A, W. G, 3-AM'r' A~p, AMI, AMps TRANS. ~ ' ' i ~H ~RVI~ DI~ONNECT NO, OF S J R V I C OTHER APPARATUS: .ILO.BOX 158 ]his certificate must not be uttered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IN ANY ~NNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765- Examined , 19 .~ .~ Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC PORtl .............. :O: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date Ol ~..~ 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, 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 ],s part of this appli- cation· ' · c. The work covered by this application may not be commenced before issuance of Building Permifi ~ d. Upon approval of this application, the Building Inspector will issued a Building Permit to the apphcant. Such permit shail 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 fq~ci~hovai or dekaofifion, as/herein described. The applicant agrees to comply with ail applicable laws, ordinances, bu_g~in~/~5.dde, housing/cgtde, ad ~tegulations, and to admit authorized inspectors on premises and in building for necessa..~M'fispec~h~t ~ / ~ --' ( (tSig'!aat3.t[e of.42~plicant, or name, if a corporation) ' .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ C. &.~."~..'./k..k .~r-~...~. : :; . . , (as on the tax roll or latest deed) If applicant is a corporation signatuYe Of duly auihorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ..... ................. ................................... }louse Number Street Hamlet County Tax Map No. 1000 Section .................. Block ~ Lot. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intend~ use and occupancy of proposed construction: a. Existing use and occupancy ...... .~..I.~..~..~.....~...t.c:~. .... ~"~ ~...k_.l..K,! .C,T,.. ,,. ,. .................. b. Intended use and occupancy ......... t_~ .... ~ · . 7/ L' '.5'~ ....... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . /.. Repair ........ ~fi .... Removal .............. Demolition .............. Other Work ~. ....... '-~ f Q) ov~,~ ' ' (Description) 4. Estimated Cost ......... y ""i ............... 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 ..... I ................................................................... 6. If business, commercial or mixed.oc~c~panqy specify nature and extent of each type of use ................ 7 ..... '~,:!:'~ ~hy~F ' ,r~. Rea 3..'~.-:'~.. ..... · D~mensmnsof ex~stmgstructur a : runt ........... r ...... 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 Num:ber of Stories 9. Size of lot: Front ........... i ........... Rear ...................... Depth .. 10. Date of Purchase i . ' .................. ........... I ......... ' ......... Name of Former Owner ................. 1 I. Zone or use district in which premises are situated .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... 1 ...... ............. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...' ................. Address ......... Phone No Name of Architect .......... ! ................. Addres~s ................... Phone No ................ Name of Contractor ......... ~ ................. Address ................... Phone No ................ Is this property within 3!00 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold Town Trustees Permit may be required. ". i PLOT DIAGRAM Locate clearly and distinctly all Ibuildings, whether existing or proposed, and. indicate all set-back dimensions from~ property lines. Give street and block r umber or description according to deed, and show street names and indicate whethei interior or corner lot. AP~O,,V~D AS NOTED B..# -- NOTIFY ed~ffO~ DEPARTME~ 765,-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION T'~,NO REOUIRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUMBING 3. INSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUC'nON & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 15. STATE OF NEWe..-YOR,~:,C-,- / I,-" S COUNTY O.F . .~'~. ~ ?.... 'L (Name o.f_ihdividuai signing contract) above named. He is the ........................ ....................... (~;n tract'o'~;rpora't; ........................ , officer, etc.) of said owner or owners, and is duly huthorized 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 flied therewith. Sworn to before me this NoteW Publlo,State of New York] v.v ......... ........... .,. No. 4879506 i - - / ' ' (Signature of applicant) uuallfled in Suffolk County Commission Expires December 8, 19 being duly sworn, deposes and says that he is the applicant