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Home My WebLink About21076-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22141 Dale FEBRUARY 16~ 1993 THIS CERTIFIES that the building ALTERATION Location of Property 3175 WEST CRKF. K AVENUE House No. Street County Tax Hap No. 100O Sectio~ 110 Block 5 subdivision Filed Map No. CUTCHOGUE~ NY Hamlet Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 29, 1992 pursuant to which Building Permit No. 21076-Z dated NOVEMBER 10~ 1192 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 CLOSE IN AN EXISTING (UN-HEATED) PORCH AS APPLIED FOR. The certificate is issued to MARY ANNE HUNTINGTON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N 265680 PLUMBERS CERTIFICATION DATED FEBRUARY 5~ 1993 Building Inspector Rmv. 1/81 FO~TM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N°. 21071~ Z / / Rev. 6/30/80 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. 76. 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 B~ilding 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 - $i0.00 4...Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . '~ew Construction.~.. ....... Old Or Pre-existin ............... g Building . . Location of Property.. f/Z5~ f,,,q)..~..'~ .~.~< .~.~.~.~ Rouse No. Street Ha~ nwer or Owsers of Property.. ..... ...... ...... No-7/J.Blo~' ' '' ' ;ubdivision .................................... Filed Map ............ Lot ...................... ~ ~'~.~./~ .Applicant. J ~ ~J. ................ ~ermit No. .~ .~ ..... Date Of Permit. '~ Dept. Approval ....... ~..' ............. Underwriters Approval ......................... [ealth 'lanning Board Approval Temporar ~ ~equest for: y Certificate .......... f Final Certicate ...... 'ee Submitted: ,~ .. ,._, . .... ~'~ '~. ~-~-~ZAPPLICANT ...................... fOUNDAtION (1st) :OUNDATION (2nd) ~OUGH FRAME & -PLUMBING .'NSULATION PER N. STATE ENERGY CODE FI;IAL ADDIT~ONA'L COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~: ~ 1,1,[~qi)'] ~ BUREAU OF ELECTRICITY ~- 88 JOHN STREET, NEW YORK, NEW YORK 10038 Date J~][~l~¥ (~ri~ q~ ~pplieationNo. onfil~ '/~43729~/92 ~ 26%f~ THIS CERTIFIES THAT only the electrical equipment ~ ~scribed below and introduced by the applicant ~med on ghe a~ve application number in the prorates of in thefollowing lacatlon~ ~ B~sement ~ Ist FI. ~ 2~d ~. Section BIlk Lot u~sexaminedou J~{~[[~ 2q~~ andfoundtobeincotnplianceu'iththerequirententsQfthisBoard. FIXTURE OUTtETS SWITCHES 4 FIXTURES RANGES :OOKINGDECKS OVENS DISH WASHERS EXHAUST FANS NCANDE$CENT FLUORESCENT OTHER DRYERS FEEDERS SYSTEMS E OTHER APPARATUS: E R V I PO,BO× 164 GENEllAL MANAGEI~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ]~INSU~TION [ ] FRAMING FINAL REMARKS: INSPECI'OR..~//~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]* ROUGH PLBG. FOUNDATION ZND [ ] .INS.~. TION FRAMING *RE:MARKS, DATE INSPECTOR 765-18~2 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION ZND [ ] INSULATION [~MING [ ]FINAL REMARKS, DATE~INSPECTOR.../~/~~ ~ . ~ . ,.~ , , . .... . .... .~. / ~ -..~. .MAP ,.~E Pf~QPE~Z~Y ~""'~"~' ............ , ...... . ' ................................ / NOV - 4 :MAP DATA* I0~,' Il0.5'9, ' .... ' ¢' ' FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTH .......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH ,, ,. ',, SOUTHOLD, N.Y. 11971 i ~',::~,[ ', , , ,~: ! ' TEL.: 765-1802 Examined . ././~ ../.0. ........ 19~.~e- Approved ....../d.?O. .... 19~.~. Permit No. ~2~. ~..~..~.,~d' Disapproved a/c ..................................... , (Bufading ~pectorj APPLICATION FOR BUILDING PERMIT c^,.,.. .............. HAIL TO: . az ....... Date O~- J~e ., 19.'P·.~ INSTRUCTIONS 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 is part of this appli- catibn. c. The work covered by this 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 bg 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 ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ' t w' --~ --' (Signature 6,0applicant, or name, if a corporation) fo. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... ge~.7.. ~.~.~. ..... '~'~ '~'/'~' '/:):,X ~'~' '~' ..................................... (as on th~Ctax roll Or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... [.'3'..0~...e4''. .~..'~. ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ....................... 1. Location of land on which proposed work will be done .................................................. fl?5" a, atr ,qu - IIouse 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 intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~..'~.'..~.)?. ~.~....~',~,~.i....~..A~....~Itff,"~:.,. e~F .................... b Intended and occupancy ~ ,,4ff. r'~.'~. use .... , .................. ~ ', 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ....... Repair ........ ..~ .....Removal ......... Demolition . . ~... Other Work ............... ,~Tfi~, ~'~ 1[ · (Description) 4. Estimated Cost , . ~ (to be paid on filing this application) 5. If dwelling, number of dwellingI units ............... Number of dwelling units on each floor ................ If garage number of cars ' ~ 6. If business, commercial or mixe!d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions ct emstmg stmctur?s, ffany: Front ............... Rear .............. Depth ............... Height ............... Num. ber of Stories .................................. 1{ ..................... Dimensions of same structure with alterations or additions: Front ................. ear ................ Depth ................... i · · Height .................. ' ....Number of Stories .............. ~ ........ 8 Dimensions of entire new consq*uction: Front Rear Depth ' Height ............... Number of Stories ......................... 9 Size oflot: Front ~ Rear Depth 10. Date of Purchase .......... ~ ....~: Name of Former Owner 1 I. Zone or use district in which prbmises are situated ..................................................... 12. Does proposed construction vioiate,~iny zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ~ ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises i ' Address Phone No Name of Architect ......... ' i''""'''"......Address ....... ............ Phone No ................ Name of Contractor ' Address Phone No 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. ~ PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate all set-back dimensions fro~ property lines. Give street and block 3umber or description according to deed, and show street names and indicate whether interior or comer lot. ~ T STATE OF NEW yo,P, Ir~r~, COUNTY oF .... .S (Name of individual signing contract) above named. ~ API~ftOVfD AS NOTED 765-1802 9 AM ~ 4 P~FOR THE FOLLOWING INSPECTIONS. 1. FOUNDatION -, ~qO PiO~ FOR POURED 2. ROUGH ~ FRAMING g PLtJP '2, 3. INSULATION 4. FINAL CONSTRUCTION MU 8E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT8 OF THE STATE CONSTRUCTION ~ ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR OONSTRUCTION ERRORS being duly sworn, deposes and says that he is the applicant He is the ' ' ~ (Contractor, agent, corporate officer, etc.) f smd owner or owners, and ~s dulyi authorized 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 manneriset forth in the application filed therewith. Sworn to before me this ~ [ / / t~, /' / -' ----,-,-- ,19... ................. or.!. NotaryPublc:.. 7~~,~//~- ' .... ''~''""~' ......................... (Signature of applicant)