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Home My WebLink About20728-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20865 Date JULY 16, 1992 THIS CERTIFIES that the building Location of PropertF 2375 HARBOR LANE House No. County Tax Map No, 1000 Section 13~ Subdivision ADDITION CUTCHOGUE~ N.Y. Street Hamlet Block 1 Filed Map No. Lot lB Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 12~ 1992 pursuant %o which Building Permit No. 20728-Z dated JUNE i8, 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 DWELLING AM APPLIED FOR The certificate is issued to KARL JOHNSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FO~ NO. ~ TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP-J~IT MUST BE KEPT ON THE PREMISEs UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? 20728Z 19..~..~..~ Date / ~o ..~~..~...~~_~.....~:.~ "' .................................. · // /.-J~s?~ ~ ot ~re~,,,es ~,ed £ ........................................ ~ ................... ~...~ ................ - /~. . Co..~ Tax Mop No. 7000 Sec.o...,./..~...&.. ......... B~o~k .,.,~/.. ........... Lot No...,/..' ................. pursuant ,o application doted ..................... ----~././....,~.. ..................... 19...~...~., and approved by the Building Inspector. Fee $ ......... ', .............. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 loss 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: 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 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 Date ........ New Construction ........... Old Or Pre-existing Building ................. Location of Property ............................................... House No. Street Hamlet Onwer or Owners of Property...~.~...d.Q.b~..~.~. ....................................... County Tax Map No 1000, Section .... 4! g ..... Block.. O f .... Lot ..... < .~. ..... Subdivision .................................... Filed Map ............ Lo t ...................... .. £ . ...:d Fer it of Permit..d ........ ./..2 pl cant. : ...... Health Dep~ Approval . Underwriters Approval . . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $.. q~. ~'~.. ~'%,, .................. .~..~, //~. ~ q q 3 .................................. FOUNDATION FOUNDATION (lst) (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI:IAL ADDITIONA'L COMMENTS: JUN I 2 1992 FORM NO. 1 TOWN OF SOU/I'HOLD BUILDING DEPA'RTM ENT TQWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .,,pro,.ed ...... .g/'O,e. ..... Perm,t No. · ed ale ' ~sapprov . (llu)d'ding Inspector) ' ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS CALL ~,^~ ;;;'~'Z .......... a. This application must be completely filled in by typewriter erin ink and submitted to the Building Inspector, with 3 s o'f 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 publ/c streets areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ion. c. The work covered by this application may not be c})mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector ~vi/l issued a Building Permit to the applicant. Such permit .11 be kept on the premises avaiJable 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 11 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 lding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or :ulations, for the construction of buqdings, additions or alterations, or for removal or demolition, as herein described. : applicant agree~, to comply with al/ applicable laws, ordinances, building code, housing code, and regnlations, and to dt authorized inspectors on premises and in building for necessary i~,~p/eC,~i~ns,tN __. . .... . .~.~.r/...~-..., ~..~).~-.c,,~ ......... ' (Signature, o£ appl~l~, ~/a~:e, if a :~rt~(}radon) :e whether applicant is oxvner, lessee, agent architect, enoineer ...... /~ )/j ~ ', s .... ,- ~.vntractor, ezectrmian, plumber or builder. · - ' "'- ............. -~' '- ............... '... ~gRO¥[D II$.NOl'£D .... ~p,cant ~s a corporation, signature of duly autborizcd officer. ,' · NOIIF~ BUILDING DE~-ART~EN? (Name and title of corporate officer) Builder'sLicense No.. I ~ ~ ~ O OCCUPANCY OR USE IS UNLAWFUl Pl.mber's License No ........... : ............. ~ITN01JT CERTIFICATE Electriciau's U~cnse No ....................... OF OCCUPANCY Other Trade's License No ...................... 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TVVO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL COnStRUCTION MUST BE COMPLETE OR C,O ALI. CONSTRUOT!ON SHALL: THE REOUIRES/~ENTS OF THE NY, ,-1ATE .ONSTRUCTION & ENERGY C ~'c)r':r':[:~ ,~J O'f RESPONSIBLE FOR and on which proposed work will be done ......... ' " ' ' .ocation oil [ ¢ ~':'"}'q uR CONSTRUCTION ERRORS zC ' ..................... ...... . , .... ouse Numbcr Street .... Ham'l~t ' '~ ....... l' ....... ~bdivisinn ' .......................... Filed Map No. (Name) .............. Lot ............... ate existing use and OCcupancy of premises anti intended use and occupancy of proposed construction: ~ ~ ~,,~,,,,~...-,,,..,,,,~,,,~,.~... Intended use and occupancy ......... ~:~r · "t~t · 3. Nature of work (check which ap!plicable). ' ~ ,,~.. , . New Building .......... Addition ,\lteratmn Repair ....... ~ .... RemOval ....... · ........ . ......... ............... Fee i (Description) 5 Ifd . ' n fi · tobc >aido ' , ' · welhno, number of dwellin,-, '[ni's "'-----' ( I hot. thru application) · If garage, number of car~ ............ Number of dwelhng un ts on c ch floor 6. If business, commercial ~)r -:-'" .......... ' : ................................ i J ............ .., ~. , . . mxxe%ocet panty specify laturc and exten o[ e' ch t m of use ~ ........ t. um~ensm~s..~,J exmt,ng structures, if any: Fro~ t ,. ~'O.t 2. t Yl .- , .. 8. D,mensmns of entire new const~&,-:~ ~. ' · . .......... Ntu ~ber al Storms.../.~ 9. ' ....... mo, er at ~tories ....... 1. Zone or usc district n W'~c' . om'i~,~ ,,' 'J,, , .~ ' ' -.a~,fo.~fFormer Owner ....... ' .............. 3. Will lot be regraded . -,,)f,7~.~..,? ,,ny zomng law, ord,nance or. regulation: .... ".~.~., ;; ............. 4. Name of Owner of t~remis~,i'~t'~ ~{"~l:~J.-'' ;l/,/d3,;i,Will excess fi[l be. ~emove. d from ,remis,.~. ' 'x~ ..... Name of Architect., ....... _ ' ' ' · Address ,~ p. · '&x yes, Southold Town Trustee~ o~- ? .... ann. *Yes ........ 'No..~.. .... ''''' ' ,,.. ! PLOT DIAGRAM , . ; Locate clearly and distinctly all bgfldmgs, whether existing or proposed, and, indicate all set-back dimensions from roperty lines. Give street and block nu ~terior or comer lot. nber or descriptioh :iccording to deed, and show street names and indicate whether ;NT¥ OF ( s,s · .4. (Name of imlividual signing co~ntract) .... being duly sworn, deposes and says that he is the applicant 'e named. , ' . the . ~ (Contractor agent ........................................ corporate officer etc) " ' ' ' id OWner or owners, and is duly aut :onzed to perform or have performed the said work and to make and file this aation; th t all statements contained ih this will be perforated in tim manner set fdrth in application are tree to the best of his knowledge and belief; amt that the a to before me this the applicalion filed therewith. 77 $. 07°~8'50"~." . /00. 00' HARt~OR I~NE ~,, ,~ /-oT'