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Home My WebLink About20949-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall S~uthold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21133 Date NOVEMBER 6, 199~. THIS CERTIFIES that the building REPAIR Location of Property 225 HORTONLANE House No. County Tax Map No. lO00 Section 63 Block 5 Subdivision Filed Map No. SOUTHOLD, NEW YORK Street Hamlet Lot 16 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 9~ 1992 pursuant to which Building Permit No. 20949-Z dated SEPTEMBER 10, 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 REPAIR EXISTING OPEN PORCH AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A MARGARET F. DOW (MURPHY) / ~/Bui~[ding Inspector Rev. 1/81 · 0~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? 20941Z Permission is hereby granted to_g;~ . /~ . - .... o~ ~.. . ................................. ..~ .............. .~ ....... ~ .......... ........................................ at premises located at ...~.q~.~.,....,~..,,.~'~n~,,,,(,,L,..c~'~ ...... ................. ...................... ~t ,~,-~ ,~-- I / County Tax Ntap No. 'I000 Section ..... .~).~g..~ ....... Block ..... ~ ............. Lot No....(...~. ............... pursuant to application dated ............... ..~. ............. , 19..~,..'~., and approved by the Building ~nspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT T0~N HALL 765-1802 ': APPLICATION FOR.CERTIFICATE OF OCCOPANCY i .... ~ : ...... 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: 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 f{om Board of Fire Underwriters. 4. SWOrn statement from plumber certifying that the solder ~sed in system centaina less than 2/10 of 1% 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-ex~stlng land uses: , 1. .A~curate survey'~f property showing all property lines, Streets, building and unusual natural or topographic features. 2. Aproperiy completed applicatio~ anS'~ 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 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.0Q~ 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 - $10.00 · ~. .Updated Certificate of Occupancy - $50.00 5. ~gmporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ate .. · :w Constraction~o. ......... Old Or Pre-existing Building..}~. ........... £Z~ " -' ~cation of Property~ ....................... ; ................. .~... .... House No. Street Hamlet wet or Owners of Property, , . . . unty Tax Map No I000, Sectzon ........... Block ............. Lot. · .... ~diviaion ~ ' ' " ' Filed Map Lot ~. ..... Dat~ Of Permit ........ Applicant. ~ith Dept, Approval.,~,~ ...................... Underwriters Approval mning Board Annrov~] uest for: Temporary Certificate ........... Final Certicate..~., ...... Submitted: $., 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ .~NAL REMARKS: ,INSPECTOR ./~/~ OU~DATIO~ (2nd) ~OUGH FRAblE & ·PLUMBING IIbA?E il'' iNSULATION PER N. STATE ENERGY CODE FILIAL ADDITIONA'L COMMENTS: FORM NO. 1 ,~ o TOWN OF SOUTHOLD ~;[.~p - 9 :A)~. BUILDING DEPARTMENT 'TOWN HALL .....,' ,,! , ,, , SOUTHOLD NY 11971 )isapproved a/c .... . ................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS SURVEY CIIECK CALL .. .~ ........... HAIL TO: a. This application must be completely filled in by Wpewrlter erin 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- ~tion. c~ The work covered by this applidation may no~ 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 tall be'kept on the premises available for inspection throughout the wr~rk. e. No building shall be occupied or. used in whole or in part for any purpose whatever until a Certificate of Occupancy .ail 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 ailding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ':gulations, for the construction of buildings, additions or alterations, or for rempval or demolition, as herein described. _'~e applicant agrees to comply with all applicable laws, ordinances, building cod~, housing code, and regulations, and to '.mit authorized inspectors on premises and in building for necessary inspections./~ .. · . .... ; .... ........ -- : (Signature of applicant, or name, if a corporation) ... (Mailing address of applicant) :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. amc of owner of premises ......... . . . ~ ..................... · c~ (as on the~tax~ro'll' ;r iit;~t ~applicant is a dorporation, signature of duly authorized officc~. - (Name and title of corporate officer) uilder'sUcense o Plumber's License No ......................... · '' ' ' 1% Electncmn s Lmense ....................... Other Trade's License No ...................... Location of land on which proposed work will be'done .......................... .N. llouse Number Street Hamlet County Tax Map No. I000 Section ............. Block ................. 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 occupanc . ?.0 r'C./~ t;trz.~X, /%0 0./~ .... b. Intended use and occupant e, ~ z p/~ ~ ,, . Nature of.w/ork (check which a~plicable): New Building .......... Addition .......... AJteration .......... Repair ~ ?. ....... ~... Removal/ .......... Demolition .. . /~'e~gta. W~-/ /~)-,0-r~-'/Og'r~ct'/'~' .. ......... Other Work ............... .'~..., o. o o.I. (Description) 4. Eat/mated Cost .... ~ ................ Fee ~ (to be paid on filing this application) 5. If dwelling, number 6f dwelling! units .. '~---~" [ ' ............. Number of dwelling units on each floor. · Ifgarage, number of cars ..-...j ..... '. ''~'~ ....... 6. If business, commercial or mixed occupancy, specify nature and extent of each t f use ....... . .... D~mens~ons ot emshng structures if any' Frnnt ,, ype o ......... 7.. ...... . -' .................. l~ear ...... ....~... Depth ............... nmgn[ ............... ~umber of Stories ....... e'4. ,~.. a..~ .... ~ .......... D~' ' vJith .... ' ........... tmensmns of same structur,, alterati°ns°radditi~''ffr~°n't'~i Rear..~ ........... ~epth ........ He oht · ' ' ' ;,; ~: ~ff~ L'~' '.' ....... t~ ....................... ~'mmuer of Stories ............ .~.v ...... 8. Dimensions of entire new const~ction: Front ............... Rear ............... Depth ............... He.oht .............. ,,.,Num her of Stones ............. 9. Size of lot: Front ... F.~;'.; ~,~, 7C .............................. ............. r .../.~ ................ Dept ....... I0. Date of Purchase /.~ $ g [ - ,, ,~ c~ P~t~ ~, ,../~, . .~....~... 11. Zone or use district in which pr~mises are situated ................. I2. Does proposed construction violate any zoning law, ordinance or regulation: ~4~.d. ....................... 13. ',gill lot beregraded . ,Crt) .... ,. ..... . N--~ -~ ~" ~ , ' ' . .... 3fl~'L' ;.2' ' ' ' '; '~' '~', .... ~ wm exce_ss nu oe renl.oveu ~rom premises: Yes 14. aan~ or,owner otprem~ses /r<¥.<.~.qre~ .<'.,,~.~.r~fa~ress ./,ff~. ~..~,~. ~.q ./~..ddF~/nh,,,,~ ~,~ 7~ · ' 'q~. ,2z '~.,~.. ......... Address ........ PhoneNo ., . Nam. e of Contractor . ~4~. ?.~, ~-~. ~I$C',/-Z~. ,. ~:~ ~c ,'7~; ' ' ';,' ' ':.-- ' '~, .... '-' '~' · '~' · 15. IS thzs property within 300 feet of a tidal wetlanh~/%qvl'~'' t% .... :'(~llon~ No. ~.. Y...y~.~.... · If yes, Southold [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 whetl~er interior or comer lot. STATE OF NEW~OR~ 77/ '~ S (Name of individual signi0g contract) :bore named. being duly sworn, deposes and says that he is the applicant 'leisthe 6onf'w~ed~°~t" i ' (Contractor agent corporate officer ete ) ' said owner or owners, and is dulyIauthorized to perform or have performed the said work hnd to make and file this :pplication; lhat all statements contained in this application are true to the best of his knowledge and belief; and that the ~'ork will be perfo~ed in the manner ~et forth in the application flied therewith. ;worn to before me t~s I . ........... ...... ..... / . , ' .' [.--.~.~ounty ,. / / ~bl~ State of N~ ' ' ...... .......... ~ · · .', · ~;. · .~ ........... ~ O~m~ ~,19~ ' J, L