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Home My WebLink About20662-zFORM NO. 4 TOWN OF SOUTHOID BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20793 Date JUNE 16~ 1992 THIS CERTIFIES that the building Location of Property 2190 HENRYS LANE House No. County T~x Map No. 1000 Section 74 ADDITION PECONIC, N.Y. Street Hamlet Block 1 Lot 44.10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 22, 1992 pursuant to which Building Permit No. 20662-Z dated MAY 28~ 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 TO EXISTING ONE FAMILY DWEY~JNGAS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A GREGORY & BARBARA RUNKEL Rev. 1/81 ilding Inspector · OB~ NO. O TOWN OF SOUYHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NoNe. 20662Z Permission is hereby granted to:/~ ~ ~,~-c.,~ /. ................ ....... .... ~..~ ............... :../.? ............................., at premises located at .,..,.~],,,/,.?,,.~. ........... ~.,/,~,,.....~ .................................................. County Tax Map No. 1000 Section ...~...~.~.. ......... Block ...... ..17./,, ......... Lot No......~....~,. ,~..'...,/,.,~. pur~uont to opplicotion dot~:l ............. ~ ........................... , 19...~A ond opprovc~l blt th~ Buildtn~ Inspector. / J~ilding In.q:~ctor Rev. 6/30/80 Form No. 6 TOWN OF SOUTtlOLD TOWN HALL 765-1802 ~.'~ APPLICAT20N FO~ CERTIFZCATE 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-co~forming 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 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. Certificate of Occupancy on Pre-existing 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 ding .~ .... · · .......... Old Or Pre-existing Bui~ ........... .ouse No. r~e~ ....... ~amlet )nwer or Owners o f Proper ty..~f~?~-', f .~..../.. ~/~ . .~..~.~..~.~..~% ~ounty Tax Map No 1000, Section...~..~. ....... Block ..... ~P.K ........ Lot.. ~.~ .......... ....................................... .... ..... ........ ealth Dept. Approval ...... .................... Underwriters Approval ........................ lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate ...... ~e Submitted: $... ........................ ~, Wo ~ ~ ............... ~OUNDA'TION ~OUNDATION (1st) {2nd) ~OUGH FRAME -PLUMBING iNSULATION PER N. STATE ENERGY CODE FI;;AL ADDITIO~L COMMENTS: -~- FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . Approved..i ~/.'.~.'~ii :.,19~fi,<eermitNo..~..d'.Fe'..~:'..~.~. Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PL,;'.[',IS .......... SURVE. Y ................... CIIECK .................... SEPTIC FORN .............. / ~,~'..~ / ,.7~1 _. ~ /// ~ ~..~.~., . . .~ ~x ............... '~L TO: 9Bui~'din g Inspector) ,r APPLICATION FOR BUILDING PERMIT Date ...~/. ~.o. ........... 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. r 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 wGrk. e. No building shall be occupied or used in whole or in part for any purpose whatever untiLa 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 c. odeTcnd regulations, and to admit authorized inspectors on premises and in building for necessary~tions. (~d:-'~/~ ~/.~e --' (Sig~im~/of applicant, or name, if a corporation) . : . ::.c. . . , . . . ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . C.~.,~f-~.:~..x.>5....,/:..x.472 ............ /'..x,c--r~-j.x.~. .... '. · l · ·,: · · .. · · :;;7. ........ / (as on the tax roll or late~4~d~._/~d~:-~.E ~ If applicant isa corporation~ signature of duly authorized officer. F~E ~:.~..8Y: NOTIFY BU~L.D~N(3 DEPA~T~dEN~ AT 76~4802 9 AM ~O 4 PM FOR THE (Name and title of co~orate officer) FOLLOW}NG ~NSPECTIONS: ~. mUNt~AT~C,~ - ~0 aEau~aa) Builder's License No. '~z~4C~ ~Cgg~A~tC~ O~ SO~ POUa~D COUC~Er~ ~. ,~.A~ COaSmUCT,O~ ~UST Electrician's License No ...................... 0F 0COY FANCY BE COMPLETE .O~ ALL OONSTBUOTION 8HALL Other Trade's License No ...................... THfi ~EOUIREMENT$ OF THE STATE CONSTRUCTION fl ENERGY ]. Location of land on which proposed work will be'done .......... CODES. NOT RESPONSIBLE FOR .................................................. ~(( D ...... : ............. tlouse Nmnber / Street. Hamlet ,000 ......... ...4: ........... ....... Snbdivision. [.~.~/~...~ ........... Filed Map No..~(.Q.~ ..... Lot... ~ ........ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: .... ...................... . b. Intended use and occupancy ......... Remgval ............. Demohtlon ..... i '(5ih'er Work ~.~.'C.'~ 4 Estimated Cost ~t/~,.~,,~, (Description) .............. ~ ....................... Fee ...................................... ! (to be paid on filing ti/is application) 5. If dwelling, number of dwelling ~nits ............. Number of dwelling units on each floor ................ · If garage, number of cars ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~ if any' Front 7'~,',5~. . Rear ~o. ~ Depth ..~.~. :.~... Height ............. Num,ber of Stories D~nenmo,n~of ~m.e structure wilth alterations or additions: Front ~..~. i ~.. Rear ~..~.; .37. Depth ~..: ~. ] Height ........... ~.' ' '~ ....... ...................................... Number of Stories ...... 8. Dimensions of entire new construction: Front 2. ~. ~. ~,~-, , , ............... Rear ..../~.~ ........ Depth .,/~.., Height ................ Number of Stories.../. ................ ' ': ...... Size of lot: Front ../..7')~ ~.~.i ........... Rear ../~ff..~.. ............... ~. . i .................................. Depth ...~..2r.,~...~,~.. Date of Purchase ' " Name of Former Owner Zone or use district in which pre[nises are situated ..................................................... Does proposed constructiqn violgte any zoning law, ordinance or regulation' z~.~.. ........... Will lot be regraded ~4,/.~. · ,-~-'-'-~. Will excA-- ~" ~-~ ' ' ' ~; ........ -"' ' ....... , '~, .... ~..~ ..... ~;5;~ Ihl O~ranu~v, ea ~rom premises: Yes Nal~ne of Architect .......... ~ ................ Address ................... Phone No ................ Name of Contractor .......................... Address .................. Phone/N~ ................ I$ this property with'In 3100 feet of a tidal wetland? '~Yes ........ No, M/ ...... · If yes, Southold Tiown 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 gumber or description according to deed, and show street names and indicate whether interior or corner lot. --10. --11. 12. 13. 14. 15. STATe OF ¥OR , COUNTry OF ............... .~'iS (Na(ne of i~dividual signing contract) above named. ...... bein sworn, deposes and says that he is the applicant He is the ! i (Contractor, agent, corporate officer, etc.) f smd. .°wner or owners, and m. duly authorized, . to perform or have performed the said work and to make and file this apphcat on; that all statements contamled m this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application flied therewith. Sworn to before me this ........ .0~./. ........... day of..i...cZ~Q.c4-*~ ....... , 19 ~,t:~ NOtary Public ........ ~ .... ?. .... County /,// ............ Notary Public, State of New York .-~ ~/ (Signature of applicant) No. 4822563, Suffolk County C~7 // Term Expires December 3~, 19.~..~ ~ .TA FOR APPROVAL TO CONSTRUCT SURVEY FOR GREGORY RUNKEL ~ BARBARA RUNKFL LOT 9, "MAP OF PECONIC KNOLLS" AT PECONIC TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK NUi,~UTHORIZgD ALTERATION OR AOOITION 10 11'i15 SURVEY I~ A VIO~.ATION O~ SECTION 7209 OF THE JUN. 4,1990 DATE:: MAY 8, 1981 SCALE: I" = 40" NO. 81 ' 241 GUARANTEED TO: I CHICA~NCE :OMPANY I GR~/~t~'~kNKE~' I~]J~ARA RUNKE/