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Home My WebLink About21065-zFORM NO. 4 TOWN OF SOUTROLD BUILDING DEPAR%R~ENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21137 Date NOVEMBER 6, 1992 THIS CERTIFIES that the building Location of Property 225 MARION LANE House No. County Tax Map No. 1000 Section 31 Subdivision ADDITION & ALTERATION EAST MARION, Street Block 8 Lot Filed Map No. Lot No. Hamlet 12.4 conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 5~ 1992 pursuant to which Building Permit No. 21065-Z dated NOVEMBER 6, 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 & COMPLETION OF 2ND FLOOR BATHROOM IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUSAN E. LONG (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FO~ NO. O 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°N? 21065 Z Permission is hereby granted to: ........ ..................... ....... ........ _.~ ........... ~ ........ ~.~ ....... .~:...::L...~.q. ... ,o..~....~...%~.........,~. ~....':'.~.....~.~..~ ...... ~ ........... at premises located at ............ ~ '"'..~..........')~D.J~.,e~'~....(~at~d~. ....... ~.9~.~L~'.....~.l'~..q~/~-~ ........... County Tax Map No. 1000 Section ..... ~,.~1 ......... Block ....... ..C)..~. ....... Lot No...79...,/.~. ......... pursuant to application dated ..... ,~.~.~.......,~ ................. , 19.~...3~.., and approved by the Building 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: X. Final survey of property w%th accurate location of all buildings, property lines, streets, and unusual natural or topographic features. Z. 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 ~sed in system contains less than 2/10 of I% 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 requirements.' For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: I..Accurate survey'of 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 - 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. Cer.tificate of Occupancy on Pre-existing Building -$100.00 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 - Residen~i~ $15.00, Commercial $15.00 ' :w Construction.~ ........ Old Or Pre-exist~ng Building ................. ~cation of Property~ ~ -- ..~~b ~-m~ ~ .... House No. Street ......... Hamlet wet or Owners of Property ..... ~..~. ~. Ack,k) ~ . · e Map ............ Lot ...................... {lth Dept Approval Underwrite~ Approval · nning Board Approval ...... ~ ................. ues't for: Temporary Certificate ........... Final Certicate..~ ...... OU?__,;DA_?IO..._N ---. _~(1 ~t~) 3UNDATIOTI (2nd) OUGH FRAME & -FLUMBING IISULATION PER N. STATE ENERGY CODE Fi;;AL ADDITIONA'L COMMENTS: BU~L~ING OEPARTMENT AT 9 A~ ~ A PM FO~ THE FO~ ~,IDA~ON '~NO REQUIRED FOI~ POURED CONCRETE ROUGH - FRAMING & PLUMBING ,NSTRUCTION MUST FOR C,O. SHALL MEET FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~ .L~...(0., 19 Approved . lk)...0DP~a~...~....~o., 19c~ .~. Permit No...~.l..O.0.~7..~ BOARD OF HEALTII ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL ................... FLAIL TO: Disapproved a/c .... .'" .............. ' ........ '"'--4 (Building Inspector) APPLICATION FOB BUILDII'dG PERMIT ll/,Y. · Date ........... INSTRUCTIONS ! a. This application mU'~;be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 gets 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 ~iving 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 cbmmenced 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. . ' , e. No building shall be occupied or'used in whole or in part for any purpose whate-~er'until'aCertificate of Occupancy shall have been granted by the Building lnsp~ector. : ' / · 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, ol 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 inspections. C (') · ........ _ _ (Signature of applicant, or nhlrne, if a corp ' ) · (Mailing address of app icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Name of owner of premises ....~ .0. ~.~ ~.~.....~.,...J~ .~. ~.~o ............................................. (as on the tL~x roll or latest deed) If applicant is a qorporation, signature of duly authorized 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 ............... ~ .................................. ·. ....... tlouse Number Street Hamlet County Tax Map No. 1000 Section .............. Block ................ Lo .......... (Name) Slate existiug use and occupancy of pr~mises and intended use and occupancy of propose,d ¢.gnst~ucQ.0n: a. Existing use and occupancy . · ......................... : -"' ....( ........... , ..... b. Intended use and occupancy · ~'~""' '~*~ ..... ~ ...........~5~;:;~9~&kO~;. ' ............. 3. Nature of work (check which app icable): New Building .......... Addition .......... Alteration .. .......... Repair .............. Remov,ai ............ Demolition .............. et ~er Work .~A]~ ' (D ipti ) 4. Estimated Cost .......... g .................. Fee ...................................... ~ (to be paid on filing this application) 5. g '~ .. I/eft ....... Number of dwelhng un,ts on eac~ floor M.//~' ......... If dwelling, number of dwe lin un'ts . .4) . · If garage number of cars &!]~' '. . " ' 6. If business, commercial or mixed 9ccupancy, specify nature and extent of each type of use ... O./~ ........ 7. Dimensions of exi{ting structures,lif any: Front ..... ~/.A. ...... Rear ~/.&. ....... Depth . Height ...... M,/~4' Nu nbbr of Stories /~J/~ ' ......... Dnnens,ons of same structure witl3 alterations or additions: Front ..... ~l~. ....... Rear ..../,//~4:. ........... ~D.epth .. ....... .~. [~. ........ i Height ....... .N.I .d~7 .......... Nmnber of Stories...fl)J..~. .............. 8. ~mj,enstons of~eqtt~re new constmqtion: Front ..... ~41.~. ..... Rear ..... ~,/eq ...... Depth . .M./~ ......... ~.mgnt ..... Nl./.e ...... Nulnber of Stories to~,;F... ' 9. S,zeoflot' From b/~r~c Rear ~tdc' ............ ~,' ':.'": '/'f ................ 10. Date of Purch.ase . :...~.:'. ?o°.. ! ............... ..~Name of F. onqgr Owner .Lk~ ~ .~;;~ ..... 11. Zone or use dmnct ,n Much premiises are situated...l~~ .................................... 12. Does proposed construction violat~ any zoning law, ordinance or regulation: ...ri. O. ......................... 13. Will lot be regraded ........ ,tD.I.-O. ...... r~ ........ Will excess fill b.e remove~d from premises: Yes No 14. Name of Owner of premises ~. ~..~'.~.. Address ~,0a.,~-..f..~ .... Phone No..C/."/..7. Name of Contractor DJ ~4c. . Aa&o~ ~,~.~ 15. Is this property within 300 feet of a tidal wetland? *Yes ...... No . ~.. · If yes, Southold To~n Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly'all bpildings, whether existing or proposed, and. indicate all set-back dimensmns from property lines. Give street and block number or description according to deed, and showstreet names and md~cate' ' whether interior or corner lot. TATE OF NEW YORK OUNI'Y OF..5.o. e'.~. 0.L. [<, .... S.S .......... ~.0.~. ,I~ NJ...~.....~..P.~.. ~:> ............. being duly sworu, deposes and says that he is tile applicant (Name of individual signing ~ontract) )eve named, l ..i (Contractor, agent, corporate officer, etc.) ' said owner or owners, and is duly au(h~rized to perform or bare 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 will be performed in tile manner setI forth in the application filed therewith. yom to before me this ..................... aye0