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Home My WebLink About20885-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21029 Date SEPTEMBER 18~ 1992 THIS CERTIFIES that the building ADDITION Location of Property 1060 MOORES LANE NORTH GREENPORTr N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 33 Block 2 Lot 43 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 7~ 1992 pursuant to which Building Permit No. 20885-Z dated AUGUST 10r 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 WITH ROOF ABOVE TO EXISTING ONE FAMILY DWELLING The certificate is issued to CARL & RUTH NELSON (owners) 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 FORM NO. ~ TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALt. $OUTHOLD, N. Y. BUILDING PERMIT n',~,s ,~,~,T ~UST ,~ K~T oN 'rH~ ;:~,s~ u,~T,, ~u~ C~PL~ION OF ~E WORK AUTHORIZED) N~N9 30885Z D.,~ ............... ~ ......................... , ~..~ Permission is hereby granted to: .... ../..~../......~.....-...~.~c..~.~, ~, ....... £.~:.....~. ...... ~..~. ........................... ...... ~~_~.... ~;.~,......//~ tO ............................. ~. .................. ~ ..~ .................. ~ ................... ~.....~ .............................. .~. ......... ~ ..................................... . ,~ p~, ~,t~a ~ ............................... Z~a ........ ~z...~.....~ .............. ...... ~e~ ~ , ....................................... ~....~ .................. & ......................... ~ .................................... ......................................... ............................ ..................................... Co,,~ To. ~op No. ~000 Se~,on .... ~J ............. m~ ......... ~Z ...... ~ No ...... ~J ........... pu~u~nt to ~ppli~tion d~t~ ..................................................... , 19 ..... =nd oppr~ b~ ~ Buildln~ In~p~tot. Fee $,.,~,;~ ....... ~"~iidlng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTtlOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter 0H 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 lsss 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 Vpre-existing" land uses: .Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 3. 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. 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-existing Building ................. ~ Location of Property~ /.~Y~? ..... ~o~ ~ ' ,., House No. Street Hamlet )nwer or Owners of Property ............. , .......................... ;ounty Tax Map No i000, Section .... ~ .-~..Block ..... .~ ...... Lot ...... .~¢.~. ;ubdivision Filed Map Lot 'ermit No ................ Date Of Permit ................ cant ..... ~ ............... {ealth Dept. Approval .......... '.~... .......... Underwriters Approval ..................... . .. . 'fanning Board Approval .. '.equest for: Temporary Certificate ......... .. Final Certicate....~...o.. 'ce Bubmit , ................... .... ................... ", ~. 69 '02 '!0 "~. FOU~IDA~ION ( ls t) . FOU~DATIO~ (2nd) ROUGH FRAME & -PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL COMME~ITS .' ~ - T 19cj2 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N.Y. 11971 ' - ' ' TEL.: 765-18013 E.,~m~ned ..... ~./.7 ....... l~.~ Approved ........ 19 Permit No. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF' HEALTH ........ 3 SETS OF PL,%NS ........ SURVEY CIIECK SEPTIC P 0 R,~I ............. NO?iPY: CALL .................. MAIL TO: a, This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. '¢. The work covered by this application may not be commenced before issuance 0f Building Permit. lid. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ~al[ 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 :mli have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildhag Department for the issuance of a Building Permit pursuant to the .uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buLldings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to Jmit authorized inspectors on premises and in building for necessary j~spections., __ / .v . ....~.£.&..&:::', ~,.~..~w.r,..~..'~!~...z..,vr. -- (Signature of applicant, or name, if a corporation) Z~. o. ~ ~- ~,/4~,.~...~j, xx Y//~ (Mailing address of applicant) tare whether applicant is owner, ],',;see, agent, architect, engineer, general contractor, ...................................................... :'- ......... ¢~: :amc of owner of premises .... C~ ~L..~. !~¢ ~ ..... ~!~... ~}~~r;~ r~?::...}~ applicant i~corporation, ut~orizcd officer. 1. FOUNDAIION IWO (N~~r m~mt~ . 3. ,NSU~*,ON ' ' .~ co.s~.~c~,o, s.~ Plumber's License No ......................... Elecmcmn s Lmense No ....................... Other Trade's License No ...................... THE REQUIREMENTS OF, 3'FIE N.Y, STATE CONSTRUCTION ,'& ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Location of land on which proposed work will be done .................................................. ..../.c~..o. .............. p..4. ~ .~.,:. ~.~...z.~.¢..,,.x..'~..~.. ~ ........ ~,:~ ~.ff..~..~c.. ........... llouse Number Street Hamlet County Tax Map No. 1000 Section ...... .~.~.. ....... Block ...... ~ ......... Lot ..... ~Z,_~ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of l~roposed colamruction: ' .,,?.....;'"'¢ · ' :"" " ~. Intended use and occupancy ........... ......... ~ .~,~ ,~ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . ~. Repadr ............ ?/,Removal .............. Demolition .............. Other Work ............ ~/ ,~o ' ~ (Description~ .. U 4. Estimated Cost ...... ~/. .... : ......................... ret ......... ~-e .... ' ..................... (to be paid on filing this application) $. 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 ..................................................... 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 ............... : ....- ......... Name of Former Owner ........................... l I. Zone or use district in which premises are situated ................................................... 1 2. Does proposed construction violate ~ny zoning law, ordinance or regulation: ·. · 13. Will lot be regraded ...... ~, ..... ~. ,. ~ ...... ; ...... Will excess fill be removed fro~rrt premtses: Yes i 14. Name of Owner of premises ~'.'~!e.L.~'l~]2~..]?~g:x.. Address .4~.~...O. ~/.a't.a~../.~.APf.d~. Phone No...~/.7.7:./.~q~.~... Name of Architect .. :934 . · ..:. 7."- .............. Address ... Phone No. Name of Contractor ~f,~.//5~,.,.].~¢:~ ............ Address );Z'2,2'i½d 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 DI AG PoMM Locate clearly and distinctly ~I buildings, whether existing or proposed, and. indicate all set-back dimensions fro~ property lines. Give street and block number or description according to deed, and show street names and indicate whet.h, interior or coruer lot. : / st, PrE oF s.s · ' . cou )q OF i' ..... (,~i~.~..(.~.....(~{i .~..J.t--...~,., ......... being duly sworn, deposes and says that he is the applican "(NaDde of individual signing contract) ~bove named. [fe is the ....................... ~ ................. ~ ................. ..-- .......... gent, corporate office , etc.) >f said owner r owners, and is duly authori~~to perform or have performed the said work and tomake and file thi tpplication; that all statements conta£ned in this application are trne to the best of his knowledge and belief; and that th. york wi/l be performed in the manner set forth in the application filed therewith. ;worn to before me th~_{~ . . ... . 't