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Home My WebLink About21149-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22072 Date DECEMBER 30, 1992 THIS CERTIFIES that the building ADDITION 6515 NEW SUFFOLK RD. 6 Location of Property 6635 NEW SUFFOLK RD. NEW SUFFOLK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 5 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 8, 1992 pursuant to which Building Permit No. 21149-Z dated DECEMBER 16, 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 AS BUILT The certificate is issued to MICHAEL J. WITHERS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO. a TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN HALL - SOUTHOLD, N. Y. BUILDING PENT NTIL~F~ILL WORK AUTHORIZED) z WNI 21149Z Date 1 , 19 .2- Permission is hereby granted to, to [f cPaL , h s ~I C~YI.... .4-q....... ~u+s . f . at premises located at 5!.0..Sir .....>~.O~G~ 1d6/ . County Tax Map No. 1000 Section ...../ZZ....... Block a.7~.. Lot No......... pursuant to application dated ............1. ,Y 19..1..2,-and approved by the Building Inspector. Fee mod . B ' Ing Inspector Rev. 6/30!$0 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: 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 Planning Board Approval of completed site plan requirements. B. 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 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..000, Commercial $15.00 Date New Construction....... Old Or Pre-existing Building . Location of Property M-F-.C?.:. 7.Qf.pgLIG...RoA.a . dl(r.CLJ.. Uj:~OL 1~ House No. Street Hamlet Onwer or Owners of Property.Vik.~Cttlkf T,.W(.l (4F-. iQg County Tax Map No 1000, Section... 11.7 Block....99 Lot.... ~.1 Subdivision.. .................................../Filed Map............ Lot...................... Permit No.°1/y.. ......Date Of Permit. Applicant Health Dept. Approval....... JYJA ...............Underwriters Approval..... 4/ A Planning Board Approval..... 114 Request for: Temporary Certificate........... Final Certicate.... Fee Submitted: $ 1'* C 0 4- 0 APPL CANT ~:(i•itNTS m ~ ro OUNDATION (1st) c 'OUNDATIO,J (2nd) r LOUGH FRAME & I .PLUMBING I \ H C7 y :i1SULATION PER N. Y. - STATE ENERGY CODE O \9\\\ F141AL ADDITIONAL COMMENTS: x M ' H } H H BOARD OF HEALTH FORM NO.1 -.`-•P'3 SETS OF PLANS TOWN OF SOUTHOLD =7 SURVEY BUILDING DEPARTMENT CIIECK TO"l s~ sov7tl~~f~- ~~p TOWN HALL SErTIC FORM p_t LJ L.t? 8 C0 SOUTHOLD, N.Y. 11971 IJJ~ TEL.: 765-1802 NO TIFY: ~ Examined ~]q CALL ...p.~,•,K~./'~I,''!~1"t~NOLD MAIL TO: Approved 6/.`~~1! 1917! Permit No..`r~/, J `t Disapproved a/c _ . uild- 41nspectorf~ APPLICATION FOR BUILDING PERMIT Date 9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 seas 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. 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 work. e. No building shall be occupied or used 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature pplicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Q !f / / I Z . Name of owner of premises IT~J~.~..../h/.~~~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) _ - • w;<-Y_.--_, Builder's License No. Plumber's License No . Electrician's License No . Other Trade's License No . 1. Location of land on which proposed work will be done . 4.:P.5 /YF(~/ 4/f~44.! .V tiftr!~ House Number Street Hamlet County Tax Map No. 1000 Section /l7.......... Block ~.5 Lot ....a.y............ Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ! /.~U.S.G . . b. Intended use and occupancy D>zGK,•, , , , , , . • , , . a.......... 3. Nature Repair of work check which applicable): New Building Addition . Alteration • • • • • oval' . . . Demolition , Other Work . , . (Description) 4. Estimated Cost ....A4,5 : vP Fee .$r(g............................... (to be paid on filing this application) 5. If If dwelling, number number r of cars dweltingl units Number of dwelling units on each floor garage, 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . 7. Dimensions of existing structures, if any: Front ..26.', Rear , Depth .3Z, , , , , , , , , , , . Height :4,o Number of Stories ..2, . Dimensions of same structure with alterations or additions: Front Rear Depth . . . . . . . . . . . . Height . . . . Number of Stories , . , , , . , . 8. Dimensions of entire new construction: Height .2, (J, , _Number Front . S~.T4?.Sf!>'.... Rear . ~`P..'.......... Depth 3`l!, He *P'' of Stories ..Z , ' Size of lot; Front ~R , / Rear . Date of • . . 1 ~ • • • • ..............Name of Former Owner . E'/l.~VA........ . 10. Zone or uurch district in3whi h r • • • Depth p mtses are situated . r-;' . . 12. Does proposed construction vio ate any zoning law, ordinance or regulation: . 13. Will lot be regraded ..Al.O, i Will excess fill be removed from premises: Yes No 14. Name of Owner ofpremises.!?///Y4&4. 1411711 F9.5. , Address(jox6f~f SjOlibl~.. Phone 4o~/6~5 S.6~E Name of Architect . iYO/v . •II • • • • , , , , , , , , , , , , , Address ~ Phone o. g.' dOa Name of Contractor . 5 4 F. , . Address . 1? . Phone No. . 15. Is thi* Pryes, PetY within 3 00 feet of a tidal wetland? *yes,A ,~,~,~,~,~No "'•""j If Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. I APP OV AS ROTED ~S~2C ~Gwv DATE: B.R # FEE: NOTIFYNG DEPART AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTiONS: 1. FOUNfJATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL . CONSTRUCTION MUST BF 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 Ills STATE OF NEWjR S II'S COUNTY OF ox• , , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ~>G........... . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the Nork will be performed in the manners t forth in the application filed therewith: Sworn to before me this day//of.a?n„ 19 Votary Public . N. , , , County STEVEN J. CORM, SR. ~ Notary Public, Stara, of New ew York.........{. . 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