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Home My WebLink About21079-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22341 Date MAY 19~ 1993 THIS CERTIFIES that the building. ADDITION Location of Property 16740 MAIN STREET NEW SUFFOLK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 16.1 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 1992 pursuant to which Building Permit No. 21079-Z dated NOVEMBER 12~ 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 SCREENED PORCH ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOSEPH McKAY (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 ~~i/i~spec tor · OR~ 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) 2107JZ Date ..... ././..~ ............................... , ,9.~....~ granted to: , a remises located at .../'...~.. Z ...~.._.~.. ..7..~, Coun~ Tax Mop No. I000 Section .... Z2..Z .......... Bilk ......~ ............ Lot No .....~.,~ ....... pu~uant to application dat~ .......... /~ .............................. , 19..~and approv~ 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 This application must be filled in by ~ypewriter 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. Fiual 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-~onforming uses, or buildings and '.'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildimg 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 Building 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 t9 accessory building $25.00. Businesses $50.00. 2. Certificate 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 - Residential $15.00, Commercial $15.00 · New Construction ....... Old Or Pre-existing Building..~ ......... Location of Property. ~.~..~. ~.~..~.~O./£~ .......... ~2~. .... .~.../~.%~f.....~.~. ........... House No. Street Hamlet Onwer or Owners of Property....~.o.~?.~. ?.....F~...~.M~.~. .................... County Tax Map No i000, section..l/?. ........ Block,...~ ........... Lot../~.~7. ....... Subdivision .................................. · . Filed Map ............ Lot ................... . . . Permit No ~ ~) ....... Date . .... '~' ......... ~ealth Dept. Approval ............. Underwriters Approval ~lanning Board Approval ........................ ~equest for: Temporary Certificate ........ Final Certicate ........... 'ee Submitted' $ ............................ a:,qS 'ei ......... · 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;~ND [ ] INSULATION FRAMING [/.,]~AL DAT~ INSPECTOR~~/ 70 W TOUNDA~fON (1st) :OUNDATIO:4 ( 2nd ) ~OUGH FRAME & -PLUMBING [1;SULATION PER N. Y. STATE ENERGY CODE FI:;AL ADDITIO~A'L COMME~$TS: POS. PO' 8o. 0o° ,~ £ot2 IV.. 85".28 *00 'W. 80.00' t /0/.45' RSWS~ONS YOUNG & YOUNG A/~..~..~/985 400 OSTRA~DER AVENUE, RIVERHEAD, NEW YORK -~INoR SUBDIVISION FOR Approved..../¢..7~. ..... 19Z.~'. Permit No. ~. ,{~. ?..~.~ Disapproved a/c ..................................... _ . (BuildJ, r(g Ins~fifor) . APPLICATION FOR BUILDING PERMIT BOARD OF 1 2, SETS SOUTHOLD SURVEY 3EPARTMENT ClIECK N HALL SEPTIC LD, N.Y. 11971 :765-1803 INSTRUCTIONS HEALTH ......... OF PLANS .......... FORH .............. Date a. Tills 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 this application may not be commenced 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 wkole 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 £or,,re~oval or ~l<emolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building C0~te, housir~}iq~le, and regulations, ahd to admit authorized inspectors on premises and in building for necessary i~~a.'" --' (Signature of applicanf, or name, if a corporation) ... 2 c f . . . .f .4 0. e (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.. .WP. .S~.~....~...6./[~.e.y. ................................................... /(as on the tax roll or latest deed) If applicant is a corporation, signature of duly authprized officer. (Name and title of corporate officer) Builder's License No .... .-~¥.] ..... Humber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be'done....~/.~. ,~. ~ °?.(G.~.~ 1.67 qo/YAd House Number Street Hamlet County Tax Map No. 1000 Section .. J.l.~.. ........... Block . .c~ ............... 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 ....... ~., ./Y/ .... t ................................. b. Intended use and occupancy property lines. Give street and block number or description according interior or corner lot. 3. Nature of check whach applicable): New Building .......... Addition .......... Alteration ...... Repair .. t' ........... RemoTal .............. Demolition ............ Other Work ............... ~ (Description) 4. Estimated Cost ........................... Fee ......................... · i (to be paid on filing this application) 5. If dwelhng, number of dwelling units .... i/i ........ Number of dwelling units on each floor · If garage, number of cars ...... ...... ............ ' ' ' ' If business, co.mmercial or mixe occupancy, spec atu e and extent of each.typ.9 of use ............... 7. Dimensions of existing structures if anv' Front ~.0 3 ' ,,--- ~.0' '~ ' ~. .; ~q ' .... r -. ............. ~x~a, .............. tJeptn p · Height ............... Num er of Stories ...... ! ................. .. , ............. Dimensions o sa~et structure wit alterations or addition~' Front O '3 ~ .......................... pth ..................... ~. Height ............. Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Numl~er of Stories ............................................. : .......... 9. Size of lot: Front ............ .......... Rear ...................... Depth ...................... 10. Date of Purchase ............ i ........ ' ......... Name of Former Owner ............................. I I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~/..~C ~ .............. .,-xx ........ 13. ,W. ill lot be regraded ....... '--' 'i .... ,'. ..... ~ ....... Will excess ~11 be removed from premises: ~ No 14. ~ame of Owner of premises . ~p6~../~l~' ,'v~A/,,~' .Address ~'~;~' ,.. Name of Architect Addre N~ame.o.f Contractor . ./~..,X/~.. ~'/~.F~.-.'?,E'.,~.q. <~... Address . .2/.5...~,~.o~.f. Y+..4.... Phone.No..~/'2 2.- :~ ~ $.~- 15. ~s tnzs property within 300 feet of a tidal wetland? *Yes ........ No..~. ..... ''''. '' ' · If yes, Southold T~wn Trustees Permit may be required. -.. ! PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an&indicate all set-back dimensions from to deed, and show street names and indicate whether APP, ROV D AS!NOTED 765-1802 ~ A~ TO ~ p~R THE FOLLOWING IHSPECT~Ok S: FOH POUr~I~ . O qC~lE1 E. 2. ROUfH FRp,~/t~NG ~ PLUM[~ING 3, INS~N ANO~ ,' 4.. FINAL CONSTRUCTION BE COMPLETE FOB C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT~ OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. N~ RESPONSIBLE FO~ DESIGN OR CONSTR JCTION ERRORS /%' COUNTY OF. 5.u.~-P0l~ .... S'$ .. . ~ ..... .C.i.t.. ~.~..~.5. ~. ! .................. being duly sworn, deposes and says at he is the applicant (Name of individual signin~ contract) above named· ! He Js the . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly mthorized to perform or have performed the said work and to make and file this application; that all statements contain~ed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s~t forth in the application flied therewith. Sworn to before me this , ........ ~.~f: .......... day of..: .., 19 Notary Public, ' ~