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Home My WebLink About21078-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z21t43 Date November 12~ 199~ . THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1200 Reydon Shores Drive Sout-hold . House No. Street H~nlet County Tax Map No. 1000 Section 80 Block 4 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 12, 1992 pursuant to which Building Permit No. 21078Z dated NOVEMBER i2~ 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 RAISED~CONCRETE PATIO ADDITION WITH AWNING The certificate is issued to JANE C. PEACE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A.. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 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,° 21078 Z Permission is hereby granted to: ~ ~../.~ ......... ~~..~.: .......... , ', at premises located at ......../..~...~...../~..~~....~.'.~?_~....'~..~..,~ ................. County Tax Map No. 1000 Section ........ 'Z ........... Block ...................... Lot No ......................... ;:~:::gt ,t~Osp::::::ation dated ...... ./...~......~.., ........................... , 19.~....~¢g-, and approved by the Fee $..~../. .......... Rev. 6130/80 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: ~. 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 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. $. 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 p'lan requirements.' I. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.pre-exzstzng land uses: 1. .Accurate survey'~f property showing all property lines, Streets, building and unusual natural or topographic features. 2. A properly completed applicatio~ 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 $50.00. 2. Cer.tificate of Occupancy on Pre-existing Building -$i00.00 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 R ' ' - esmdentzal $15.00, Commercial $15.00 w Construction.. ~ ~ ..... 7''~ ............................. .......... ~= ~ =re-exmst~ng Bu~ldin~ ..... .... House No. Street · ' Hamlet Owners of Property ~ ~ ./.g~ ~__ ' ~nty Tax Map No I000, Section .... ~. ....... Block .... ..~... mi ..... / ..... Date Of Permit ................ Applicant ......... · lth Dept. Approval ..... ' ' ..................... Underwriters Approval .. nalng Board Approval .... '''' ~est for: Temporary Certificate ........... Final Cer cate ........... Submitted: $~.: 3. Nature of work (check which applicable): New Building .......... Addition fY. . Alteration ! .... ~g Repair .............. Removal .............. Demolition .............. Other Work ............... . prr' ~. ~ ~ ' (Description) ~ 4. Estimated Cost . 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 .................. ~ ..................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories... i .................................................... 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 ............... Number of Stories .............................................. - .......... 9. Size of lot: Front ...................... Rear ..... : .......... Depth .... 10. Date of Purchase . ~-/~7..7 .......... . ........ ._Name of Former Owner .~_~..c'g~-'fi¢'xg4~2-..o~.... iiiiiiiii'" 11. Zone or use district in which premises are situated.. A~'7.~o...~?/.~..r7.4~4~ ~... ~.,~..~Tt'.oF~.,-.~.~.--K) ............... i ii 12. 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. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... 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 T. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. 765- 2. ~OUG~ BE COMp ALL CONs~ THE REOUll 8TA~ CON~ CODEs. NO DESIGN OR C STATE OF NEW..,YORK, . COUNTY OF .,S&/~:..~.~ .F~. S.S ..... -~..~/d~....~,rJc~-~ ........................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. -Ie is the ......................................................................................... (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this tpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ,york will be performed in the man~er set forth in the application filed therewith. ,worn to before me this J/ /'otary Pub~6,../~-,,.P~.~'~'.r4../-:~(~.,... ' ........ '.., .....'. County ~)~ /~ Notary Publio, ${a~:e of Now Yolk · · .// ............................ No. 487:~093, Co~,n~ of SugoI!L . / i~/gnature of ;p~licint) Term Expires September 22, 1~' // rm [ ~ ~ m ~ ,~ ~ I. SOUTHOLD, N.Y. 11971 .... I TEL.: 765-1803 Examined ....... , 19..~. Approved ...... ~ .... 19,,~eermit No. '~../~..7..¢~. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL ................... HAIL TO: . (Building I~lSector)~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 'Date ..... 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 scal~. 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 descripiion 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 applicatilon, 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 whatever until a Certificate of Occupancy shall have been granted by the Buildin~ Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tow~ 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 ail applicable laws, ordinances, building code, housing co{% and regg~ations, and to admit authorized inspectors on premisJs and in building for necessary inspections/Q /F.,~ -~' (Slgnatur~pf apElicant, or name, if a corporation~ (Maiffng address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contraftor, electrician, plumber or builder. Name of owner of premises . ..~ /~ C'°'. .~.~q..C.~-. .... (tis on the tax roll or latest deed) If applicant is a corporation, signature !of duIyi~auth~orized officer. (Name and title of corporatle officer) Builder's License No .......... i .............. Plumber's License No ......... i ................ Electri.cian's License No ....... [ ................ Other Trade's License No 1. Location ofland on which proposdd, work will be done .................................. .......... House Number ,t Street Hamlet County Ta× Uap No. 1000 Section: .... .......... Block .... ........... Lot../..7../. ........... Subdivision.. .,~....~/,~.o.r?.~. ................ Filed Map No..~. ?../. ........ Lot ~.~..P. ~..~.. ,~,-~..~. (Name) State existing use and occupancy o~ premises and intended use and occupancy of proposed coffstruct'ion. a. Existing use and occupancy...id..~.~.. b. Intendeduseandoccupancy ....~........~~ Gr2Ot/E