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Home My WebLink About20486-zFORI~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20581 Date MARCH 10~ 1992 THIS CERTIFIES that the buildin~ Location of Property 1955 HENRYS LANE House No. County Tax Map No. 1000 Section 74 Subdivision ADDITION Street Block 1 Filed Map No. PEC0NIC~ N.Y. Hamlet Lot 6 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 5, 1992 pursuant to which Building Permit No. 20486-Z dated MARCH 10~ 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 D~ELLING AS APPLIED FQR. 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 RAYMOND & KATHLEEN LEONE Rev. 1/81 · uilding Inspector TOWN OF SOUTi'tOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N? 20t86Z 3_J./.o !~..~....~' Date / Permission is hereby granted to: ........... r?~:.~.......~ ............. ...... · /..~....,.....~/..'. ............................. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ........................ /.~ ........ ~,~7~ ..... ~, ............................................... County Tax Map No. lO00 Section ..... ?..~,.. ........... Block ......... ./. .......... Lot No ......... ~ ............ pursuant to application dated ........... ~../....~ ............................. , 19..~....~., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TO~fN HALL 7/0/5-1802 A~PLICATION FO~CERTIFICATE OF O'CCUPANCY 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 Plauning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-exis.ting" 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 New Construction...R.. .... . . Old Or Pre-existing Building ................. Location of Property.....1955. .....HENRYS...LANE. PECONIC, N.Y. House No. Street Hamlet RAYMOND & KATRLEEN LEONE 0nwer or Owners of Property ....................................... . . . . .... ....... . .. ....... . . ty ' B1 ~. Coun Tax Map No 1000, Section.. ock ...... · ..... · 7. ............. ot.. ................ Filed Map ............ Lot ..................... Subdivision .................... . Permit No ............... . Date Of Permit ............ . ...Applicant... ................ .. . ..... .. Health Dept. Approval ...................... --- · Uuderwriters Approval ........................ . Planning Board Approval ...................... .. Request for: Temporary Certificate ........... Final Certicate Fee Submitted: $ 25.00 - ..~....... £0 03 Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTII 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL ................... HAIL TO: .... .rr:.. :. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 3',5~- 7'g- 19. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts 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 appli- ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit roll 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 roll 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 uilding 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, housing code, and regulations, and to ~mit auth°rized inspect°rs °n premises and in building f°r necessary in~;.°..-~.. ~O.~..~. (Signature of applicant, or name, if a corporation) ;/? . '1. (Mailing address of applicant) tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, el~fiCr~/~npi~na~r builder. .............................................. rmE: 'ameofownerofpremises ./:/q~/~0/l) ct- /~/:CD4LcC-~d L-~c)/(, ~EE ~,--4~2,$~O . ' ....................................... NGrIF~ .BU~LDtN(~. ID~PARTIk*~BN$ ;Al;. (as on the t.a~x roll o? latesPA{~4~102 ~ AM TO 4 PM FOIl 'applicant is a corporation, signature of duly authorized officer. FOLLOWING INSPECTIONS: · I. FOUNDATION TWO REQUIRED ............................................. FOR POUREDCONCRETE . (Name and title of corporate officer) ,,,~ Z ROUGH ~ FRAMING & PLUMBING 3. INSULATION B alder s L cense No .......................... 4. FINAL CONSTRUCTION MUST gE COMPLETE FO~ Plumber's License No ....................... ALL CONSTRUCTION SHALL t~JIEET THE REQUIREMENTS OF THE an,'s Electrici License No .............. ,.L~tE CONSIRIJCTION & ENERGY COo~S. NOT RESPONS~ELE FOP, thor Trade s Lzcense No ...................... Location of land on which proposed work ,,,,,ill be done ............... · 5 Ilouse Number Street Hamlet County Tax Map No. 1000 Section '7 q Block [ Snbdivision . /9~'c°"CC //* ~,:: "~ :< ~ Filed Map No. j.~..q.%77 Lot '-~ (Name) ...................... State existing use and occupancy of premises and intended use and occupancy of proposed construct/on: a. Existing use and occupancy · b I d d /qb0:q'$o,-) ~::'" " ;:~'~;" · nten e use and occupancy ...... ", ';., : Nature of work (check which ~ applicable): New Building Addition ~)~(1~1~'~ .... Repair .............. RemivaI .............. Demolition .............. Other Workx. -: ,', (Descnptipn) Estimated Cost.. ' /: ' : ..................... Fee .... (to be paid on filing this applka/ic~n) 5i If dwelling, number of dwelling Onits .............. Number of dwelling units on each floor ...... · If garage, number of cars ..... i ..... . 6 If business, commercial or mixe otc.panty, specify nature and extent of each type of use .................... 7 Dimensions of existing structures, if any: Front ............... Rear .............. Depth .... ', ......... Height ............... Num her of Stories ...... . ...... "vz " .... D~ensions of same structure w ~ alterations or additions: Front Rear .. pth ................. . .... De ................. ~. Height .. '.'~'~ · · ~.,,~ ........ Number of Stories .......... ~ 8.[ Dimensionsofent re new constmction: Front .~q ~ [~ Oeg~ Rear De ............ ] Height ........ ~umber of Stories ..... 2l ' i '.1(0, /~' ' ..... , Depth .~..~'J'' ~ .......... Size of lot: Front ..~ f0~ ~.~.~ ........ Rear .................... ~ ~'...~ ........ 10 DateofPurchase ..,~ ........... .. · ...., ........ ' ......... drm r 1 I.[ Zone or use district in which prmpises are situated, . ' ............................ 12. Does proposed construction viola're any znn~n~ l .... ' .......................................... · . ........ ~ ..-, ordinance or regulation: ...... ~ ......................... 13.1 W~I lot be reoraded ~ ~ ' ~ ' , ,~ · ..... ~Vfll excess fill be removed fro rem~ses: , 14.[NmeofOwnerofpremises ~O{y¢odO a~m~ .~. .~./ ........ ~.. ~rP _~. Yes ~ M .... ~ ~ ~.. . · .... · .......... aaaress ~.(J. ~.tt~'~/L~ ~ /e~n~ ~ ~ ~ .~. I ' ' ..... Address ................... Phone No ............... Nme of Contractor .......... ................ Address ................... PhoncNo ................ [5. Is this property within 300 feet of a tidal wetland? *Yes ........ No.~ ...... · I~ yes, 8outhold TSwn Trustees Permit may be required. ... ~ PLOT DIAG~ ocate clearly and dmtinctly ~1 buildings, whether existing or proposed, and, indicate ~1 set-back prope~y Hnes. Give street ~d block nOmber or deschptioh accord~g to deed, and show stmet nines and d~ensions from integer or comer lot. ~dicate whether rATE OF NEW YO;R~K~ . SSi /Z~ o 4. ouNTy OF . .4 . out< · ,, t~ 5~o 6 · 'i ..... (~aRe otindi,,id~,al sign,ng'/o~'t~:ac'O ....... ore pained. , being duly s~vorn, deposes rind says that he is the applicant ! (Contractor, agent, corporate officer, etc.) saidI owner or owners, ,'md is duly authorized to perform or have .erfonned Ire s ' - . )bcatlon, that all statements contained in this an,,li,'-,~ ..... * .... : ..... to,. a!d xvo,rk, and to make and file this ~,- ....... ,~.,~ .uu to rue vest o~ ms Knowleage and belief; and that tire k ~ll be perform.ed rn the manner setfforth in the application filed therewith. om to before me this ....... ........d,,of.. , ,4_'...'..'¢.'..~..~,--.'.a.t'..az~...'rT..x,27-ZC...F_.4~ County CLAffiE L. GLEW i : Notary Public, State of NoW York ....................... . .... No. 4879505 , Qualified in Suffolk Couhty /---) ~..---'" (Signature of applicant) Commission Expires December 8, 19