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HomeMy WebLinkAbout20869-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20924 Date AUGUST 7, 1992 THIS CERTIFIES that the building. Location of Property 1210 COX NECK ROAD House No. County Tax Map No. 1000 Section 113 ADDITION TO ACCESSORY MATTITUCK~ N.Y. Street Hamlet Block 14 Lot 05 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 31, 1992 pursuant to which Building Permit No. 20869-Z dated AUGUST 3, 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 AROUND ACCESSORY INGROUND SWIMMING POOL AS BUILT. 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 Rev. 1/81 HENRY & CLAIRE PESCE FORM NO. ~ TOWN OP $O~TNOLD 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? 2086JZ Permission is hereby granted to: .~....~ ~ Cd,;~ ,~-c,_ ..........~./,~. ........ ..G~....~..~.....~,~, ~ .................. ...... ~.~~ ........... ~......z/f~+ ~..~ ........ a....~.~z~ .... ~.~..i~L~.~ ......... ~....~..e ....... ~.~ ...... ~.~ b.~ ..~f~,~.a. ~ ~ ~;~ . ~, ~,~,,~ ,~,.a ~, ............................ z~.g. .......... ~ ....... ~:~.....~.~.~ ..................... ................................... ~, ...................................... ~(..E%.~z% ............ ~..~ ......................... .................................. .C...~e~. ,....~&?~ ........ ~.~ 'jr Building Inspector. / Building i'~; ................. 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 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. 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 applicJtion and a consent to inspect signed by the applicant. Ifa Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. CJ Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming poe% $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 .......... Old Or Pre-existing Building ....... .~ ......... Location of Property~.] ~10 ~0~ fO~ ~ ~ 'IL)6~, AJ~"~ /.[.~.~..~. "House No. Street Hamlet · Onwer or Owners of Property ........................................................ . County Tax Map No 1000, Section .... ././.._5, ..... Block ....... /..~. ...... Lot ..... .~l . . . Subdivision . ' Filed Map . . Lot . Permit No ................ Date Of Permit ............... .... Applicant .......................... tiealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ..................... ... Request for: Temporary Certificate ........... Final Certicate ........... co _o?0 ~'0~ ' JUL31 ~ TEL.: 765-1809~ Examined ._~./~.. .... , 19 Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 APPLICATION FOR BUILDING PERMIT BOAgD OF HEALTtl ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL .~'~% ~ ........ HAIL TO: Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in 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 appli- :ation. 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 ;hall be'kept on the premises available for inspection throughout the w(~rk. ' 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 3uilding 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. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code and regulations, azld to ~dmit authorized inspectors on premises and in building for necessave'rfi'~oetions, f~ ~. : --'. . /Sighatur~pplicant, or name, if a corporation) · ~.z~... ~'..x ..... ~/~Z..~.o~.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. "lame of owner of premises . .~j., ..... ~ ...~.[~jA,~- .&- (as on the tax roll or latest deed) if applicant is a corporation, signature of duly authorized officer, oA'rl~: ~B.P, # ...................................... 0[~ NOT,~¥ BUI[O,N* O~PART~NT AT ( ame and title o corporate AM ~)%~ 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE P,u ber's License ,o .............. ' 'C/RTtFICATE ,'"°UG"'FRAM'"" & Electrician's License No. !J~*~ I ~:'IOUT 21. INSULATION ..... CONST~UCT,O. UUST' ...... "': ~ ~,:~ ,~ g~ ~ BE: COMPLETE FOR C.O. .-~the~-W.de~ L, eense No ......... :.~,.< . i"L.?; ?3qP F¢5~L~I A[[ CO~STRUCT~O. S.ALL MEET :3,,~ .... TNE REQUIREMENTS OF THE N.Y. g:~L¢ca*ior~0flandonwhichproposedworkwillbe'done ' . STATE CONSTRUCTION & ENERGY ~' Ilous~ Nmnber Street Hamlet County *ax Map No. 1000 Section ..... IZ24 ......... Block ........ ././. ...... Lot...-~.--7. ............ Subdivision · '-":~' ......... ~ ........................... Filed Map No ............... Lot ............... ' ' (Nmne) · State existing t~'~'~'a~d occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~¢,4~ ..... ~./~.~. d(,d,/.~.. , .~..OP/. b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Budding .......... Addition v// Alteration i R pal R I D oliti ' e r .............. emova .............. em on .............. Other Work ..... ~ ....... ~.~..O O. (De~scripti°n) 4. Estimated Cost ............. F ' : (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ' If garage number of cars ...... * ......... 6 If b i I d ify ' · us ness, commercia or mixe occupancy, spec nature and extent of each type of use ....... 7 D ..... if · ~menmons of emst~ngstructures, any Front ........ Rear ......... Depth ............ H ight N f St ............... ' e ............... umber o ories '.. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth Height ' Number of Stories 8. Dinmnsions of entire new construction: Front Rear .............................. Depth ............... Height Number of Stories 9. Size of lot: Front ~ Rear ...................... Depth ............. 10. Date of Purchase ............................ Name of Former Owner ............... ....... 1 I. Zone or use district in which premises are situated ................................................ 12. D°es pr°posed construction violate ~ny zoning law, ordinance or regulation: ...................... z4(O.... ' .... 13. Will lot be regraded ........ ~p/p ...... ........ ,/0. · · Will excess fill be removed from premises: Yes 14. Name of Owner of premises ,~-/~7~.~. ?,L<.?/~.~/7.~...-7~'.r--~kddress/.~.,q. ~..~.~.4Jtr,~-./:~r,f. .... Phone No..~.~.F..~./. ~.~... . Name of Architect .......... C~. ............... Address ................... Phone No ....... : ........ Name of Contractor .......................... Address ................. .~one No... 15. Is th±s property w±thin 300 feet of a tidal wetland? '~¥es ........ ~ ......... '"''' · If yes, Southold Tbwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back d/mensions from property lines. Give street and block number or description according to deed, and show street names and indicfite whether interior or corner lot. ;TATE OF NEW YORK, . ~ o 7OUNTY OF ............ o.o , . "'~-' ..... (q. being duly sworn, deposes and says that he is,the applicant (Name of individual signing contract) .bore named. [e is the .... ~~. : (Contractor agent corporate officer etc ) ...................... f said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work 'and to m~e and file this pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the .'ork will be perfomed in the manner se{ forth in the application filed therewith. worn to before me this CA~ERINEA.~RI~ ' ~[ Not~ P~l~, Sl~e of ~ y~, .......... w"~'} .... ....dayof....~ % ........... ,19..<< ' .maw Public . % ....... x .......County ~ . ' .