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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20957 Date AUGUST 19, 1992
THIS CERTIFIES that the building ADDITION
Location of Property 700 LEETON DRIVE SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 59 Block 1. Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 8, 1992 pursuant to which
Building Permit No. 20628-Z dated MAY 15, 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 GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to ZAFAR FATIMA
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-245428 - AUGUST 4 1992
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
FORM NO. a
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)
I
N°-° 206282 Date ..s 19P..
Permission is hereby grant d to
."....r.. !
% /./,5p
to .
at premises located at 7~..~....... ,~:?7......~~...............................................................
......................................................c/`°'d • •
6 / 1
County Tax Map No. 1000 Section Block Lot No...... 6
pursuant to application dated 19.- and approved by the
Building Inspector.
Fee
I for
7gOn
Rev. 6/30/80
S
Form No. 6
Rls7
TOWN OF SOUTHOLD
BUILDING DEPARTMENT AUG 1081992
TOWN HALL fi l 1,..,.~
765-1802 ;'..a. C t"
Ii eY k'J~i a~jY4 „m,w.,
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:
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.
6. Submit Planning Board Approval of completed site plan requirements.
B. 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 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 o:, Pre-existi.ng Building - $100.00
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
Date, ~//Z/F z
New Construction........... Old Or Pre-existing Building
Location of Property... .~77 J.Qti ...................AFAr,14i Aflex Xoti77`oc0
House Street Hamlet
Orower or Owners of Property
.4~1...
County Tax Map No 1000, Section ...°.~.5 9 .....Block....../..........Lot.......'
Subdivision ....................................Filed Map............ Lot......................
Permit No....ty 77. Date Of Permit ...Y 7~+ Applicant. ..Ae. K°?HC~s 11-A
Health Dept. Approval ...........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary
~~jjCertificate Final Certicate...........
Fee Submitted: $.....P
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S~Ffu~~C TEL. 765-1802
moo: o~y TOWN OF SOUTHOLD
OFFICE OF BUILDIi]G INSPECTOR
P.O. BOX 728
~`n,.~ TOWN HALL
SOUTHOLD, N.y. 11971
C E R T I F I C A T I O N
Date
Building Permit No.
Owner
(please print~)/
Plumber
Cplease rint)
I certify that the solder used in the water supply system
contains less than 2/10 of to lead.
(plu er's •gnature)
Sworn to before me his
_1v_ day of
Notary Pub is
Notary Public, County BARBARASTEPNQWSKI
Notary Publi% State of Now York
No.4844752
Qualified in Suffolk County
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS:
DATE INSPECTOR
INSPECTORS
Victor Lessard 5UFF0(/(
Principal Building Inspector
Curtis Horton ur SCOTT L. HARRIS, Supervisor
Senior Building Inspector CD
Thomas Fisher Southold Town Hall
Building Inspector P.O. Box 1179, 53095 Main Road
Gary Fish Southold, New York 11971
Fax (516) 765-1823
Building Inspector Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
AUGUST 12, 1992
BOB KEHL'S HOME IMPROVEMENT, INC.
28545 MAIN ROAD
ORIENT, NY 11957
RE: ZAFAR FATIMI
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
ffi An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
aZx The check is txzxkdcbcdjnot on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file..
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 20628-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY
y
+I TOWN OF SOUTHOLD CHECK
~ 4 MAY + 81992 =I4 BUILDING DEPARTMENT SEPTIC FORM
L; TOWN HALL
COUTHOLD, N.Y. 11971 NOTIFY
TO, 0 TEL.: 765-1802 C ~C4
ALL
Examined 3 19 .9 M L T0:
Approved . ~/S 19/LPermit No.PO6. 2
Disapproved a/c
(B4[ilding- n ect r)
APPLICATION FOR BUILDING PERMIT
Date 19 .
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-
cation.
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 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 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 all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary iipnspections.
f~0.L~.1~•C/~,f ,/oHt /S ~iNPQa ?2ti9 R.vj
(Signature of applicant, or name, if a corporation)
5~/ S A~!'~ P~'..Q~r vT~ it/sr.//%S7
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
o67• <c,De2
Name of owner of premises ....~~v-.. Z:.. I
(as on the tax roll or latest deed)
If app, is a corporttjon, Fcorl ture of duly authorized officer.
/J Gl~ C ~S/ Ppv T~
I~(N (Name and title o o rate of5cer~'
Builder's License No.
Plumber's License No .
Electrician's License No .
Other Trade's License No .
1. Location of land on which proposed work will be done . .
House Number Street Hamlet
County Tax Map No. 1000 Section !R5.7 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 iS_,'e A/C'f` mIji'F},JH91Ai3
.......................sk3"Rf'blfssi'•'.•tY''te peA'.eb~~+°t?fM11'a~'4jari
b. Intended use and occupancy
I /17/Atcffrv
3. Nature of work (check which applicable): New Building Addition Alteration
Repair • • • • erpoval Demolition , .....Other Work
's •R(1)escription)
4. Estimated Cost /f)O Fee , .
5 If dwellig, number number of of dwellinl (to be paid filing this application)
g. g units . . . Number of dwelling units on each floor .
garage, cars --w 0
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . .
7. Dimensions of existing structu' es, if any: Front . ' . ' ' ' ' • ' .
Rear ...`>Y.z........ Depth 3?..........
Height ...(6........... NumberofStories Q,-y,AP,,,,,,,,,,,,,••..
Dimensions of same structure with alterations or additions: Front . , ! a. Y. o • _ • . .
Depth 6.y...... 6 Rear
( , .height E' . Number of Stories ..4k: .
S Dimensions entire new construction: Front ...:p: Rear,... a,Y, . • , , , .Depth ,Y,q ; ,
Height
mberofStories . ..QN&
9. Size of lot: Front . .1, 7 S Rear 1..76' ~ Depth . ~!0.,. . /.85!
10. Date of Purchase • • • ? , " " "
•••••••••.......,NameofFormerOwner
11. Zone or use district in which premises are situated , , , ~rrSraKw, rie4c , , , , , , • . . ;
12. Does proposed construction violate any zoning law, ordinance or regulation: !VQ............. 13. Will lot be regraded / "
• • • • • • • . , Will excess fill be removed from premises: Yes No
14. Name of Owner of premises Aff, •294ce9A, -)5M4! 1 , , . Address Phone No..
Name of Architect
. Address . .Phone No. .
Name of Contractor Ad - .!t~ti/f4fka c Ts! Address .~~d`ys,4+9 to a?grr • Phone No. 3AY. -?M
15.Is this property located within 300 feet of a tidal wetland? *YES NO....~
yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. a all set-back dimensions from
property lines. Give street and block number or description according to dee how st eet names and indicate whether
interior or corner lot. ! SCAN) I~b.gwNIR
wN «
I .
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-f 0 Al f9le /
STATE OF NE 11
COUNTY OF S.S
' being dul sworn de oses and says
1 ' ' Y P that he is the applicant
(Name of i dividual signiing contract)
above named.
He is the
(Contractor agent, orporate officer, etc.)
of said owner or owners, and is dul authorized to perform or have performed the said work and to make and file this
application; that all stateme contained in this application are true to the best of his knowledge and belief; and that the
work will be performed in tltmannef set forth in the application filed therewith.
Sworn to before me this
(.:..day ofd. 19
f
Notary Public . ~'yy , 1
~ County
Noniy PuubiK state o~ NewYait . . . . C. n
No.4079601
Ouelified in Suffdk Cou"ty QQ~
Commission Expires Deee~mber%0.6. (Signature of applicant)
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ AL
REMARKS:
- e
G7
Ole
DATE INSPECT
~
r r
NG 2
BUILDING DEPT.
SPECTION
[ ] FOUNDATION 1ST [ 7 ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
f~ [ ] FRAMING [ 7 FINAL
~,6d
REMARKS:
~w•`
DATE INSPECTOR
FIELD: ~CP*lLNT~
FOUNDATION (1st)
c
FOUNDATION (2nd)
2. Z o
z
0 0
ROUGH FRAME &
-PLUMBING r
Al-
3. v
o m
INSULATION PER N. Y. '
STATE ENERGY -7r
CODE I T~
4'
FINAL I IK
ADDITIONAL COMMENTS: m
X \
. ro
H ~
H
H
O
. H
v
H
765-1802
BUILDING DEPT.
INSPECTION
[ , FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: e &
DATE INSPECTO
i
• J~
§ 46-14 FLOOD DAMAGE PREVENTION § 46-14
(1) The lowest floor, including basement or cellar, elevated to
or above the base flood elevation.
r FArdttrw closed argas below, the slowest- floor that are~~
s ol~O i 7 1 i -to automatically, equalize
bfofpes on exterior walls l)y allowing for
the e
pt y and exit of floodwafe s De na for meeting
thissgt~vtrexlxent ~ b ~ither be certified by a licensed
R~ss gog Ong atec~to e t or exc the ,
(*)A tnmimam hof two (2pmes having u total'°net
2.,, k
ar a of not less than -one (T~gbare ihli for every,
square foot of enclo d area subgegt to flao it g
(b) Thjo.bottom of all such oliehifi shall be no:higl,er
than one (1) foot above the lowest adjacent finished
grade.
(c) 0 ~mn ~m#y beeq`u~ipped with louvers valves
e~ot tl@Axployldedythat
perrp t ~aulomatic'entry and 1, -;4f
floddwaters.
B. Nonresidential construction.
(1) New construction and substantial improvements of any
commercial, industrial or other nonresidential structure,
together with attendant utility and sanitary facilities,
shall either have the lowest floor, including basement or
cellar, elevated to or above the base flood elevation or be
floodproofed so that the structure is watertight below the
base flood level, with walls substantially impermeable to
the passage of water. All structural components located
below the base flood level must be capable of resisting
hydrostatic and hydrodynamic loads and the effects of
buoyancy.
(a) If the structure is to be elevated, fully enclosed areas
below the base flood elevation shall be designed to
automatically (without human intervention) allow for
the entry and exit of floodwaters for the purpose of
equalizing hydrostatic flood forces on exterior walls.
Designs for meeting this requirement must either be
4617 s-2a-A7
--entering or accumulating within the components during
-rconditionslbf,fluoding When designed for location below
the base flood .,elevation,. & professional engineer's or
archite 't'acertification is required.
(2) All new and replacement water supply systems shall be
designed to minimize or eliminate the infiltration of
floodwaters into the system.
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TRUSTEES O~pSUFFOLk049 SUPERVISOR
John M. Bredemeyer, III, President o~ y` SCOTT L. HARRIS
Albert J. Krupski, Jr., Vice President
Henry R Smith • Town Hall
John B. Tuthill 53095 Main Road
William G. Albertson P.O. Box 1179
Telephone (516) 765-1892 Southold, New York 11971
Fax (516) 765-1823 BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
NON-JURISDICTION
May 8, 1992
Mr. Bob Kehls
28545 Main Road
Orient NY 11957
RE: Dr. Zafar Fatimi
SCTM #59-1-6
Dear Mr. Kehls:
After an on site inspection the Southold Trustees found that the
proposed activity is non-jurisdictional, as per map submitted
dated May 6, 1992.
If you have any questions please call our office at 765-1892.
S' cerely,
John M. Bredemeyer, III
President, Board of Trustees
JMB/djh ~5 ~ MAY g t9~?
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§ 46-13 FLOOD DAMAGE PREVENTION § 46-13
§ 46-13. General standards.
In all areas of special flood hazard, the following standards are
required:
A. Anchoring.
-
,s shall
tl) All n c and substnt al en S
c gteral
Ica
.g ~ y I s
2) mariufa tnrod hozess}llbe tiistalle`,d using methods r
ati~es Whid `thmimize hood damage. Manufae-
ure om_s, must be elevated and anchored to resist
otation 11 p~aa or lateral movement. Methods of
fl, co
anchoring may include, but are not to be limited to, the
use of over-the-top or frame ties to ground anchors. This
requirement is in addition to applicable state and local
anchoring requirements for resisting wind forces.
b. Cou'Aroctiou i iate"rialsahd-methods.
Y~ (I)" ;-All new construbtion,alii'd,sgbstant>al improvements shall
be constructed with materials and utility equipment
resistant to flood damage.
(2); ;All ngw,cortstruction atld•substantialimprovements shall
be constructed using methods and practices that mini-
mize flood damage.
(1)` tlectricaI,&heating,, yent(lation, plumbing and_ air-
conditionin equipment and ot)ier service facilities, sliall~
Abe designed and/or located so as to present waterfrorn
entering or accumulating within the components during
a conditions'of floading.;Wherr designed for location, below,
the base flood elevation a ".professional engineer's or
arch~tets`i~ortification is~required.
(2) All new and replacement water supply systems shall be
designed to minimize or eliminate the infiltration of
floodwaters into the system.
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AP ROV q AS NOTED
DATO`j ZBP. lY
?17 BY:
4 _ MO~'IFY 8 .";!NG DEPART N AT
765 1802 9 AM TO 4 PM FOR THE
n 6v Ls y'~. - FOLLOWING INSPECTIONS:
eloll /J 1. FOUNDATION TWO REQUIRED. FOR POURED CONCRETE -
2. ROUGH - FRAMING a PLUMBING
.3. INSULATION
d. FINAL CONSTRUCTION MUST CUPANCY OR OC
41 E COMPLE FOR C.O.
IS ALL CONSTRUCTION SHALL MEET USE we UN9AINFUL THE REQUIREMENTS' OF THE N.Y.
E.RY,~{~EP~Clf IT PFF<TIFICATE SnAncc CONSTRUCTION RESPONSIBLE EFOR'
' DESIGN OR CONSTRUCTION ERRORS
OF OAjrr%' 'P,,,
81992
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SGIE' APPIIOVEO ry' p
SALE 2 SEO
BOB KEHLB HOME IMPROV. INC.
G ` P. O. POX 520 Ci SOCT,HJLD, Wy 17871
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