The URL can be used to link to this page

Home My WebLink About20752-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20983 Date AUGUST 28, 1992 THIS CERTIFIES that the buildin~ DECK ADDITION Location of Property 2205 HOBART ROAD SOUTHOLD~ NY House No. Street Hamlet County Tax Map No. 1000 Section 64 Block 4 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 22, 1992 pursuant to which Building Permit No. 20752-Z dated JUNE 22, 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DRAGUTIN GOBIC & WF (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev.-i/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) H°-N? 2075~Z Permission is hereby granted to: ~/ ........ ~ ~-.'C~.~ ...L?~./..c.... ..~..~.~..~..~Z~.~ ........ ~.~.~....{~ ,o .....~~.....~.,..... ~.~.= ,m/.....~....~ ....... ~~ ............ co~,o~ ~.~ ,o. ~0o0 ~,~,o~ ....... ~ ........ ~ ....... ~¢ ..... ~o, ~o ......... ~ .... pu~u~nt to ~ppltc~tion d~t~ ................... Building Inspector. / B~ilding Inspector 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 less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residentes and similar buildings and installations, a certificate of Code Compliance ~i~ architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed sit~lan requirements. / For existing buildings (prior to April 9, 1957) ~n-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 $15.00, Commercial $15.00 Date ~..~.~. ~. /2 ' ~.g. New Construction ........... Old Or Pre-existing Building ................. Location of ......... ~ Property-~ .................................................. ~. House No. ~. ~~reet R~A Hamlet ~F~Z~. Onwer or Owners of Property ........... . ....................................................... County Tax Map No 1000, Section...~..J/ ....... Block....~. ........... Lot ...... .~.. ............. Subdivision ...................... . .............. Filed Map ............ Lot ............ Permit Xo~D.P~.~..~. .... Date Of Permit ................ Applicant ........................... . . Health Dept Approval . Underwriters Approval Planning Board Approval . Request for: Temporary Certificate ....... .,.. Final Certicate ......... .. Fee Submitted:'~ .5~.~_ $~-Y~': ............... ' ..... , ~./~. .... J"~'~~ .~T.~...~.~.~.~ ~ ' ................. FOUNDA'TION {1st) FOUNDATIO;~ I 2nd ) 2. ROUGH FRAME & INSULATION ·PLUMBING FERN. STATE ENERGY CODE FI;IAL ADDITIONA'L COMMENTS: 002' 0 0 m -¸I Examined ..... App 19~~.'~ roved ....... ( ., Permit No Disapproved a/c ...... . ............................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971' TEL.: 765-1802 (l~i~i~ Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTtl SURVEY '.l~.. . CHEEK/.. .................. SEPTIC FORH .............. t:OT I PY: MAIL TO: Date .................. , 19... · I INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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- eati6n. e. 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 w6rk. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall h~ave 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. rhe 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.r~/:a /__2__ ~ ' . .~...~ ....... ~~..-~.~.../5...--.-.-.-.-.-.-.-:~..... --(, (Si~,nature (~f applifdnt, or name, ifg(corporation) .~. 2g~. ~../d~e .75~..~..: Sdt/r4~. ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. wdt.,q .................. . .................................................. Name of owner of premises... P~..~r/~-- ~..~..~./~.~[ ..... 4~..1~/~.. .................... (as on the tax roll or lateSt deed) if applicant is a corporation, signature of duly auth. orized officer. · (Name and title of corporate officer) Builder's License No .......................... U ) . PI mber s License No ......................... Electric an's License No Oth T d s L' N er ra e cense o ...................... Location of land on which proposed work will be·done .................................................. ..... House Number Street Hamlet County Tax Map No. Snbdivision ..................................... Filed Map No ............... Lot .... (Name) State ex/sting use and occupancy of premises and intended Use anti occupancy of proposed construction: a. Existing use and occupancy ............ b. Intended use and occupancy ........ 9. 10. 11. 12. 13. 14. 15. Locate clearly and distinctly all buildings, property fines. Give street and block number or interior or corner lot. ~. ~}~.O..j~)0" (Description, Estimated Cost ....... . ................ Fee ...................................... (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor If garage number of cars ' ' ............... If busine'ss ..... ................................................................... commercial or mixed occupancy specify nature and extent of each type of use Dimension's of existing structure~ if any: FrOnt Rear ..................... Height Num '~er of Stories ............................. Depth ............... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... L. Height ....... Dimensions ofenAire new construction: Front w~- ~t ....... r' · · r · · · · .. ~/.~...0 ..... Rear ............... Depth .~.,.~.-~../ .. Height .. Sizeoflot Front · .; ......... Rear ................. iiii. D;p[t; i.i...i.i.iii ......... Date of Purchase ........... i ....~ ....' ......... Name of Former Owner ............................. Zone or use district in which pre,mises are situated ........................ ~ ............................ Does proposed construction violate any zoning law, ordinance or regulation' ~.~ ...................... Will lot be regraded ~,~t'~ ....... W ........ N .... ' ' ' ' ;,~'~'o~;,-x '~'z.i~:' · ill ex~ess filL1;)~ removed from premises: ~ Yes 'lq,, ,.rune o[ .uw.n.e.r or p,re,~n_ises ~. g~...~_~l.OI. :~D~I[ .*-Address .g'?...~.~../.~. ~r~ .~.,; Phone No....~.~. ~ .~]"..~.~..'~. ~ame or Architect . ¥{~t~C,{'. 'i' ~'"~ '1''~ ...... Address ~. ~,~... 8~J[~'~o...l~.~ .~ .~,~.~.. Name of Contractor . ......... , ............... Address .................. Phone No ................ Is this property within 300 feet of a tidal wetland? '*Yes ........ No ......... · If yes, Southold Tbwn Trustees Permit may be required. ... PLOT DIAGRAM' whether existing or proposed, and, indicate all set-back dimensions from description according to deed, and show street names and indicate whether OCCUP NCY OR USE ]$] UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED N~)~IFY BUILDING DEPABTM'ENT AT 76,6-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION o TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, ST,~rE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ~TATE OF NEW~ORK. . (NamO of individual sign[g; contract) ~bove named. le is the .......... ( : (Contractor agent corporate officer etc ) ......................... ,f said owner or owners, ~d is duly a,uthonzed to perform or have perfo~ed the said work and to m~e ~d file this Pplication; that all statements containdd ~ this application are true to'the best of his knowledge and belief; and that the forth in the application filed therewith. , ~ork w~l be perfomed in the manner spit .worn to before me this ~ ,' ................. dayof..~ ........... ,19 ,ota~ Pub c ~SS~O ~ - ,' . ~1~ ........... ~al~in No.au ~u~ i. ~ (Signat~e of applicant) i~ti JUN221992 ~! j TOWN OF SOUTHOL~ OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE !,'h · ,/