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Home My WebLink About20725-zFOI~M NO. 4 TOWN OF SOUTMOLD BUILDING DEPARTMENT office of the Building Inspector Town HaL1 Southold, N.Y. C~RTIFICATE OF OCCUPANCY No Z-23685 Date JUNE 6, 1995 THIS CERTIFIES that the building. Location of Property 340 RAMBLER ROAD Mouse No. County Tax Map No. 1000 Section 88 Subdivision ADDITION street Block 5 Filed Map No. SOUTHOLD NY Hamlet Lot 24 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 12, 1992 pursuant to which Building Permit No. 20725-Z dated JUNE 17, 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 .A DECK ADDITION TO A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HELEN RUSCH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF MEALTM APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N°. 20725Z ~ate ......... .~../,Z. .................... . ~.~.~. Permission is · * ................ ~...~../.......~:.~ ............. ,o ..... ~~.~.....~.....~ ........ ~~.:.....~ .....~/ // .,. ........... i ....... o, ............ ~"~iiiiii"~.......'~ii ........ ~"~"iiiiiiiiii"iiiiiiiiiiiiii'iiii ....... .......... '..."~' at prem ses loc ed at .................. ~ :~...-~.: ................. ................................................... ~~ ....... ~. ....................................................... County Tax Map No. 1000 Section ..... ...~,.~. ........... Block ........~..~...~... ..... Lot No ........ ...~-/ ....... pursuant to application dated .................. ~./../'...'~... ..................... , 19..2..~~, and approved by the Building Inspector. Fee $ .................... ~ 8uildm0 Inspector Re~. 6/30/80 Ferm No. 6 TOWN OF SOUTIIOLD BUILDING I)EP~RTHENT TOWN HALL 765-1802 JUN - 11995 APPLICATION POI( CERTIFICATE OF OCCUPANCY This application must be filled in hy typewriter OR ink and inspector with tim following: for new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, aed unusual natural or topogr;phic features. 2. Final Approval from HChith Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electricm~ installation from Board of Pire Underwriters. Sworn statement fromlplumber certifying that the solder used in system contairs less than 2/10 of i% lead. 5. Co~vrcial building, industrial building, multiple residencea and .... and lnstallatzons,~a certificate of Code Cum-~ - . . s~mzlar buzld~ngs responsible for tbe building· 6. Submit Planning Board Approval of completed site plan requirements· F~r existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-ex~sting land uses: 1. Accurate survey of property showing all property lines, streets, building aud enusual 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 appl. icant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alteratioss to dwelling $25.00, Swinging pool $25·00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. Certificate of Occupancy on Pre-existing guildint - $100.00 Copy of Certificate of Occupancy - $20.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00., Co~ercial $15.00' 3. 4. 5. Date ......... .~.~. .... New Construction. ~ .... Old Or re-existing Building...~. ............ .... p /~/ / ................ Location of Property ............. }louse No, Street Hamlet Onwer or Owners ,.,f Property .... . .................... ~7z~ .... County Tax Map No 1000, Section ~'~. --Black. oubdlviszon ................................... Filed Map .... 7.-7'. .... Lot ...................... ............ Date Of Permit. Dept Approval · ' ......................... Underwriters Approval ........... ?lanning Board Approval.. Temporary ~ .~. ~equest for: Certificate ........... Fiual Certicate .......... ~ee Submitted: $ . .. '4+ qqs O ................. ' Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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: I. 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 ~, Vpre-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. · · 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 - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ew Construction .......... 0~., n~ = ..... '/ .......... llouse No .... · .............. o~ree~ Hamlet or Owners of Property ..... )unty Tax Map No 1000, Section... ......... Block ................ Lot .................. ~bdivis~on. .................................. Filed Map ............ Lot ...................... ~rmit No '" ................ Date Of'Permit Applicant alth Dept Approval ' ' ' ........ Underwriters Approval anning Board Approval ........................ quest for: Temporary Certificate ........... Final Certicate .......... ~ Submitted: $ FOUNDA'TION FOUNDATION 2. ROUGH FRAME & (lst) _..( 2nd .) .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION¶ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ]INSULATION [ ] FINAL DATE /~///~,/'- INSPECTOR ~~ ~ Examined Approved ....... ~/.../~.. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19 .~.g~. ., 19 ~.. Permit No.~./.).2z..-~.'~.--.. Disapproved a/c ...... . ............................... _ ., . (B~Ydifig Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTIt ......... /3 SETS OF PLANS .......... /.SURV£¥ ........ CALL ................... HAIL TO: · I 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 m'eas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ~. The work covered by this application may not be commenced before issuance of Building Permit. · 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 w6rk. e. No building shall be occupied or nsed 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to dmit autho ed inspeoto on premises and bulldog for necessa, inspeotion .......... : ............../4~,~,~ ~e:...~M~. .............. --' (Signature of applicant, or name, if a corporation) ( cz ........ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................ .' 7'"; ....... ;~-; ..... (as on the tax roll or latest dlqJ~FV 8UILOING DEPARTMENT"~A 7654802 ~ AM TO 4, PM FOR THE If applicant is a corporation, signature of duly authorized officer. FOLLOWING INSPECTIONS: 1. FOUND.AT(Ofo TWO REQUIRED FOR POUREU CONCRETE · (Name and title of corporate officer) 0CC[~PAt~C¥ ~)~ 2. ROUGH- FRAMING & PLUMBING Builder's License No. [JSE )S)JN[A%~JF~JL a..INSULATIOIX' , ' ....................... FINAL - CONSTRUCTION MUST ¥/{T~{O~T CEIRT~F~C~TE '~' SE COMPLETE ~':OR C.O. Plumber's LicenseNo ......................... OFOCCUPA~C¥ ALL CONSTRdCFION SHALL MEET I .... THE REQUIREMENTS OF THE N.Y. E ectrlc, lan s License No ....................... STATE CON:;?F~UCT!ON & ENERGY CODES. Ik,, RESPONSIBLE FOR Other Trade's License No ...................... DESIGN OR CONSTRUCTION ERRORS I. Location of land on which proposed work will be'done .... ' "~ .................... : ............................ ~..r?... House Nmnber Street Hamlet County Tax Map No. 1000 Section . ' ~ ~ ¢ Block Subdivision . , ............................. Filed Map No. Lot (Name) · Slate existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~' ~/¢~ ~0 b. Intended use and occupancy Cg'/ ~PT~ ~ ..... I0. 11. 12. 13. 14. 15. Nature of work (check which aplplicable): New Building .......... Addition .......... Alteration .......... Repair . .J~. .......... RemOval 0 Demolition .............. Other Work ............... 4~9/.~.,~ f '" (Description). Estimated Cost ........ 7.,~..?. ....................... Fee [ (to be paid on filing this application) If dwelling, number of dwetiing 0nits. . ."'~ Number of dwelling units on each ............ floor If garage number of cars i · If business, commercial or mixed occupancy, specify nature and extent of each type of use .. ~ ....... Dimensions of existing structure~, if any' Ft:ont /.~, '~'~'.. Rear / ~ ,~- - ' ........ H~;,~,+ -~ ,,~_,,r- ,, r.' .............. ~, .......... Depth ............... .~,e-, .. ~:~..,,r ./. ....... rqum.?er of Stories .................... , ................................ Dtmenmons of same structure wgh alterations or additions: Front .. Depth ' "~" · I. · Height ., .og ~.7 .............. Number of Stories.. ~ ......... ....... Dimensions of entire new construction: Front - Rear Depth -- Height Nmr )er of Stories Size of lot: Fr6nt .................... Rear ...................... Depth ...................... Date of Purchase . Zone or use districi .......................... Name of Former Owner ............................. in which pre~ nises are situated ..................................................... Does proposed construction viol~'te any zoning law, ordinance or regulation: ...4/.0.. Will lot be regraded [ .................. Will excess fill be removed from premises: Yes No Name of Owner of premises i Address Phone No Name of Architect ...... . ....! ................ Address ................... Phone No ................ Name of Contractor ~ Address .... Phone No. Is this property within 3~0 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold TOwn Trustees Permit may be required. PLOT DIAGRAM' ~ L . .... 1 ocate clearly and d~shnctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from, property tines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~TATE OF NEW..~ORI~ ~t2) :oum'v f s.s. ....... ...,..~.~.~ & ff ~' ~ ~ [e ~ being duly sworn, deposes and says that he is the applicant (Name of individual signin contract) bore named. is the ............................... ~. . . . . said owner or owners, ~d is duly ahtborized to perform or have performed the said work and to m~e ~d file this pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the 'ork w~l be perfo~ed in the manner s~t forth in the application filed therewith. worn to before me ~his ..................... 'ota~ Public, .~ .............. ~ .... ~.x~ County ~o. 487~0~ ; .......... · ...... ' OuMi~d In $ugolk Couo~ ~ 0 (Signature of applicant) ~ml~slon ~ires D~r