The URL can be used to link to this page

Home My WebLink About20736-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20817 Date JUNE 19~ 1992 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 1735 WESTPHALIA ROAD House No. Street County Tax Map No. 1000 Section 141 Block 1 Subdivision Filed Map No. ~4ATTITUCK~ N.Y. Hamlet Lot 5 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 17, 1992 pursuant to which Building Permit No. 20736-Z dated JUNE 19~ 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 ACCESSORY DECK BY SWIMMING POOL AS 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 ROBERT & KATHLEEN REYER Building Inspector Rev. 1/81 l~Ol~,~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PER~IT (THIS PEI;b~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N.o 207~8Z Dote Permission is hereby granted to: ~...~...+....~.~:......~..~.~ ....... ~.~..~.....~.~.~....~ .............. ...~ ~J~...~.:..~:.....!.L.~.~.~. ...... ,o ....~...~...~.~....~.~~.....~.....~.~..~ .~.....~.~..~ ........................................... : .............................................. , ......... .~ .......... ~,~r,m,,e:,--ed' ~,...~.~.~.~..=....~.~~....~.,. ...... .~.~ ....... Count,/ Tax Mop No. lO00 Section .... J...~...(. .......... Block ...... ..C~....I ......... Lot No.....(~..~.~.. ......... to application dated ......~.....~...~. ...................... , 19..~..~,, and approved by the pursuant / Building Inspector. .\6/30/80 Form No. 6 OF BUILDING DEPARTHENT 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: 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 I% 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. 3. 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. Fees 1. CertificJte 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 llouse No./,~ Street ~ ~ Hamlet wet Or Owners of Property... ]...~...~.. ~. ....... unty Tax Map No 1000, Section ............ Block ................ Lot ...................... odzvzsxon ............................... Filed Map ............ Lot ...................... rmit No , .-' ................ Date Of Permit ................ Applicant ............................. alth Dept Approval ' · ' ......................... Underwriters Approval ...... mning Board Approval ........................ ~uest for: Temporary Certificate ........... Final Certicate../.... '~OUND ATIO~'; ¢ 2nd ) ~,OUGH FRAME & -PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI;;AL ADDITIONA'L COMME~TS: oo FORM NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENrr TOWN HA'L£ SOUTHOLD, N.Y. 11971 TEL,: 765-180;~ (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTII ......... /~--. 3 SETS OF PLA~/S .......... ~---'"'SURV£Y ................... :CIIECK,. ................... SEPTIC FOR:I .............. C A L L .............. ~ · . . HAIL TO: Date .......... ,19 · ~ INSTRUCTIONS , a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 .ets 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 appl/- :ation. ¢. The work covered by this application may not be commenced before issuance of BuLIding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall 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 hall 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 ,uild~no Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· 'he applicant agrees to comply with all applicable laws, ordinances, building code~J~using code, and regulations, and to dmit authorized inspectors on premises and in building for necchi., i_~n .~r~. ~ (Sign,at,ure of a~ll~icant, or na~e, ifa (Mailing address of applicant) 7 ' ? ..... :rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) -applicant is a corporation, signature of duly auth. orized officer· (Name and title of corporate officer) Bu lder s License No ......................... Plumber's License No..O/iq. ................... Electri.cian's License No. ~J//:) .................... Othez Trade's License No. A//~q ........ Location of land on whicli proposed work will be·done House Number .~ Street ~ ..................................... ~ Hamlet ConntyTa× ap o.,000 e o ....... Bo k. I - - ...... · ................LO[ ..... ~ .......... · · Snbdivision ............................. ~ ....... Filed/',lap No ............... Lot ......... '....~ (Name) State existing use and occupancy of premises and intended Use ann occupancy of proposed construction: .............................. ~t ~,/lq..~ ~3.~o~ / ~ .... ' I .. · · .-~, ? · · b. Intended use and occupancy ..... ~ ............ 3. Nature of work (check which a~plicable): New Building .......... Addition . .I .(~.. .... Alteration Repair ......... ; .... Remgval .............. Demolition ..... Other Work (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... / ........ If garage number of cars ~ Number of dwelling units on each floor 6 If business commercial or mixed occupancy ......................................................... · ' specify nature and extent of each type of use 7 Dimensions ot exm't]ng structure~ if any: Front Rear · Depth Height Number ............................. ' of Stories ........ * ...... ' Dimensions of same structure wiith alterations or additions: Depth ' Front ................. Rear .................... i. Height Number of Stories ......... 8 Dimensions of entire new construction: Front ' ': .............. Rear ............... Depth ................ Hight N n! of St ri 9. Size oflot. Front ...... , · Re ''" ............. J ....... ' ............... 10 Dar fP ch ................ ar... D pth · e o ur ese I ............ 'v: .... e ....... · Name of Former Owner 11. Zone or use district in which premises are situated .......... .wu-.-. .......................... 12 Does proposed construction violate any zoning law' ;r(~in'an~; or regulation':', i Will lot be regraded ......... i ........ Will fr' i Yes ' N 14 N tofO fp i 4 i ......... excess fill be removed om prom sos: o · am wner o rein sos .... -~- Add N fA hit .............. ross ................... Phone No ................ ame o re oct .......... ~ ................. Address ................... Phone No ................ Name of Contractor . .'.... · · · Address ..., ............ ;... Phone 15/o ......... 15. Is this property w~'thin bbb 'f'eh't' ~>'f' 'a' 'tidal wetland. ~Yes.. - '~ ....... · If yes, Southold T6wn Trustees Permit may be required~ ..... ~o ......... ..., { PLOT DIAGRAM' Locate clearly and distinctly all buildings, whether existing or proposed, end, indicate all set-back dimensions from property lines. Give street and block n~mber or description according to deed, and show street names and indicate whether interior or corner lot. rATE OF NEW ¥,OKlr~ . UNr¥ S.S ......... '... ~ k~.~ ..... A .... ~ ~ .......... being duly sworn, 'deposes and says that he is the applicant . (Name of individual signing co~tract) ore named. - ~he i. , . ~ (Contractor agent corporate officer otc )' said owner or owners and is duly ~)~t mfized to perform or have'p~rformed the said work and to m~e and file this ')rl~Cafion; that all state~nents containe~ ~ this application are true to the best of his knowledge and belief; and that the will be performed in the manner set{ forth in the application filed therewith. om to before me this ~ ......... ........ .bli , . .. cou.,y r ·