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Home My WebLink About20470-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20577 Date MARCH 9~ 1992 THIS CERTIFIES that the buildinq I~cation of Property 1335 HOBART ROAD House No. County Tax Map No. 1000 Section 64 Subdivision ADDITION SOUTROLD, N.Y. Street Hamlet Block 2 Filed Map No. Lot 10 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 3, 1992 pursuant to which Building Permit No. 20470-Z dated MARCH 9~ 1992 was issued, and conforms to all of the requirements of the applicable prouisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owuers) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A PAUL A. & SHIRLEY CAMINI~I Rev. 1/81 ~~j' Bu~ld~tnqInspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT CFHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 20470 Z Date .... .~.,/.~... .......................................... ,19.~...~ Permission is hereby granted to: ~.<.~..~,~: '~.....~ ./:.,. ........... . ..~,....~.:...~..~...~ .'2.. .......................................... ,o ....... ~.~..~~. ....... ~. ....... ~:/~.~ .......................................................... ~,. .................... at prem,ses located at .../...c~....-~......~.... -.~..~~...~. ............................................................... County Tax Map No. 1000 Section .......... ~....~...... Block......................~'~- Lot No ....... ./..~.. .......... pursuant to application dated ...... ...~./.~... ...................................... , 19..~....~., and approved by the Building Inspector. Fee $...'-,~. ~..~./~.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~ A~PLICATION 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 less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar ~buildings and installations, a certificate of Code Complianca 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 "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 Occnpancy - $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 ...... ~'~..~[~. f ~ .................... New Construction...¥~...... Old Or Pre-exis~ng Building~.~ ....... ~UIMO'~:~ Location of Property ...... i / .~-- /~~ ~ .......... House No.' ~ Street H~mlet Onwer or ~wners of Property ....... ./.~.//~/.~.....~.. 2...~.../~....~ .~.( .~. .... <~...~ ~ .......... C~unty Tax Map No ~0, Section ..... ~..~.~..Block ..... ~. ..... w..Lot ...... ~.~ ........... Subdivision ........ .'..~~... -.~...~..? ...... Filed Map....~?. ~ ~..Lot. ~/.~....~...~ )..-~... Permit No.~.~.~O.~....Date Of Permit ................ Applicant ............................. Health Dept. Approval ................... ... .. .. Underwriters Approval ........................ . Planning Board Approval .......... Request for: Temporary Certificate ........ Final Certicat~ ......... Fee Submitted: $....d?{~...~ ........... CO OS 7 '7 / A F ICA T Examined NAR - 4 1992 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 7654802 Disapproved a/c ..................................... ' ~;~t~i~t{~-h, p~,~t~r) "' APPLICATION FOR BUILDING PERMIT BOARD OF HEALTII ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. INS'FRUCTIONS .. a. This application must be completely filled in by typewriter or in ink and submitted to tire Building Inspector, with 3 :ets of plans, accnrate 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 ~iving a detailed description of layout of property must be drawn on the diagram which is part of this appll- :ation. c. The work covered by this application may not be cblnmenced before issuance of Building 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 iu whole or ill 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 hfilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and )ther applicable Laws, Ordinances or ~egulations, for tbs. construction of buildings, additions or alterations, or for r~.p~/ or~demo..DJ. Lt~, as herein described. 7he applicaut agrees to comply with all applicable laws, ordinances, buildingj~Sd94',~ fisin.~g~eo31ff~/arj, aWregulations, and to dmit authorized inspectors on premises and in building for necessary~ ~~ or,,ame, ifa'c ''5 (M~iliug address of applicant) ;tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. /as on the tax roll or latest deed) f applicant is a corporafiolL signature of duly authorized officer. (Name and title of corporate officer) Bu'ldcr s L'cense No .......................... Plmnber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of laud on whicl} }~roposed wor~wi~ll be done .................................................. ........ .................... ....................... Ilouse Number Street / Hamlet (54 Bloc,. L~-~ ;,; 15' ............ '"' ..................................... Comity Tax Map No. 1000 Section .{ t/ Snbdivision .... ~ ~C~au ~[; FiledMapI'lo...O~.?...~. ...... Lot. · State existing us'e an'd occupancy of premises and inte~J use and occuvancy of proposed construction: a. Existing use and occnpancy ......... ~..~.~.,..'~-..~..I.( F+' '~'~' '~' '~''''-~'¢.' .~/(~-.1/.#t.. ~..(/.~[.. -~...~ b. Intended use and occupancy .......... ~..~.~.. ................................................. 3. Nature of work (check which appli cable): New Building .......... Addition ..... Alterati__on . I~' ...... Repair .... - .......... Remove .............. Demolition .............. Other Work .g~.~'¢.~. .... ~ (Description) 4. Estimated Cost ...~00 ............... F (to be paid on filing this application) 5. If dwelling, number of dwelling un{ts ............. Number of dwelling units on each floor ................ · If garage, number of cars ....... l ................................................................. 6. If business, commercial or mixed o~cupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, ff any: Front ........... i ~.. Rear .............. Depth ............... Height ............... Numbei of Stories ........................................................ Dimensions of same structure with ]alterations or additions: Front ................. Rear .................. Depth ...................... iHeight ...................... Number of Stories ...................... 8. Dimensions of entire new construciiou: Front ............... Rear ............... Depth ....... ........ Height ............... N mbei' of Stories ........................................................ 9. Size of lot: Front .... / ..... Rear .................. Depth .................... 10. Date of Purchase ............. ] ............... Name of Former Owner ............................. [ I. Zoue or use district in which premises are situated ..................................................... 12. Does proposed construction violatelany zoning law, ordinance or regulation: ................................ [3. Will lot be regraded ........................... Will excess fill be removed from premises: Yes No [4. Name of Owner of premises ..... ~ .............. Address ................... Phone No ................ Name of Architect ............ i .............. Address ................... Phone No ................ Name of Contractor ........... ! ............ Address ................... Phone No ................ 5. Is this property within 3001 feet of a 't'idal wetland? *Yes ........ No..~. ..... *If yes, Southold TowD Trustees Permit may be required. PLOT DIAGRAM L ate clearly and distinctly all btuld~ngs whether extstmg or proposed, and. indicate a I set-back dimensions from roperty lines. Give street and block number or descnpt~o I according to deed, and show street names and indicate whether nterior or corner lot. "7__ ~. "'-- ~' FEE: ~ BY: _.__ NOTIFY ItUf. k~- DEPA~ 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 3. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2, ROUGH, FRAMING & PLUMBfNG 3, iNSULATION 4, FINAl. CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ['ATE OF NEW ~Y'O'~K,f'~.' F [ c, ~ / ·. / ................ ~C.-..~. '.. ,'~.'~[~ ...... being duly sworn, deposes and says that he is the applicant (Name of individual signing c~ntract) Dye named. ! ~ is the - (Contractor, agent, corporate officer, etc.) md owner or owners, and m duly authorized to perform or have performed the said work and to m~e and file this plication; that all statemcuts containe{ in ihis application are true to the best of bis knowledge and belief; and that the >rk will be performed in the rammer ~et forth in the application filed therewith. om to before me tins t ~ ................. ......... NOTARY PUBLIC, ~tate of New York ' ' * ' No. 524618265 t)' - ' Quellfied In Suffolk Coun~ Commission Exp~r~ April 30, I~ ~ '1 (IV REVI$/ON$ YOUNG S YOUNG 400 OSTR~NDER AVENUE~ ~LDgN ~ YOUNG HOWARD ~ YOUNG ~OFE$$~ON~L EN~IN~gR ~ND LAND SURV~YOR SURVEY ~OR PAUL ~. CAMINI~] a SHIRLEY CAMIN]Ti HALF O~ LOt ~ a LOTi~,"FOUNDERS~$rA rES" ~r SOUTHOLD sourwoto ~vt~$ OF SouTHo~ rlrL~ ~ . NOV ~0,