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Home My WebLink About20221-zFORM NO · 4 TOWN OF SOUTHOI~ BUILDING DEPARTMENT office of the Building Inspector Town Hall Southeld, N.Y. CERTIFICATE OF OCCUPANCY No Z-20777 Date JUNE 9, 1992 THIS CERTIFIES that the building. Location of Property 80 WEST DRIVE House No. County Tax Map No. 1000 Section 58 Block 2 Subdivision Filed Map No. ALTERATION SOUTHOLD, N.Y. Street Hamlet Lot 16 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 16, 1991 pursuant to which Building Permit No. 20221-Z dated OCTOBER 21~ 1991 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 REPAIR TO EXTERIOR STAIRS & INSTALL A SKYLIGHT IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ERNEST SCHROEDER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERAAIT (THIS PERMIT MUST BE.KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 20221 Z Permission is hereby granted to: ~e..~=....~....~....~. ......... ............. o, premises Iocoted at ..... ~C?...~...~.....~..~j~E:¢~....~'..'~...~...: ................................................................... County Tax Map No. I000 Section ........... '~?. .........Block .....~ .......... Lot No ......... Z.~.. ....... .... ../~ ./...o. ..... pursuant to application dated .. ./../. ................................ , 19.?,./..., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTI[OLD 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 i 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 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 Occupaucy - $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 . .~..~..~ .~..~ ................... .,ew Construction ........... Old Or Pre-existing Building ................. I.ocation of Property ...... ~ ......................................... House No. ' ....... Street Hamlet Onwer or Owners of Property ...... Comity Tax Map No 1000, Section .............. Block ............. Lot .................... S~bdivision .................................... F~led Map ............ Lot ...................... Fermit No.~.0..~.~J.~...Date Of Permit..~.~.~/~.~ .... Applicant~J~!~..~..~.~._.~.'.~.~.~..~... ......................... un~erwrzners Approval.~.)~. ................... :'lanning Board Approval. ,~.~,1~ . 3eqoest for: Temporary Certificate ......... /. FinalZrticate ........... Fee Submitted: $...~.~..~.. ................ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FI;;AL ADDITIONA'L COMMENTS ~alniued '. ' FOI1M NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL,: 705-1B02 sapproved a/c ' / (Bu~'ng lnspecto~t) APPLICATION FOR BUILDING PffRMIT. INSTRUCTIONS ~UARi) 0i,; ili~AL'ftl 3 SETS OF PLANS SURVEY .............. CtlECK ............. SEPTIC FORbi ...... NOTIFY CALL ....... HAIL TO: a. Tiffs application must. be completely filled in by typewriter or in ink and submitted to the Building inspector,'wlth'3 s of plans, accurate plot plan to scale. F~ ~ccord ng to schedule. ' b, Plot plan showing location of lot aud of buildings on premises, relationship to adjoinin~ premise~ ,?cas, and givh~g a det~led description of l~yout of property must I,e drawn on the diagram which is p,a~of d.'. Upon a~rovaI or fins apphcaUon, the Buildi.g Inspector wUl issued a BulldOg P.~it to the appUc~t/'SUc~ dl be kept on the premises,avaUabh for ~spection throu~out the work. Y,' · . No bulldog shall be ~ecupied or used in wholo or in part for any purO~s~ whatever until a Ce~lfiaat~ of dl hava been granted by ~10 Build~g Inspector. ' ' . , APPLICATION IS HEREBY MADE to the Buildin '~ , · . . . g Dep~tment for thp ~bsuance of a Braiding Pe~tt pursuant to the ildmg Zone Ordinance of the Town of Southold, Suffolk County, New Y~k, ~d other applicable Laws, Ordm~cea gulations, for. the construction of bufld~gs, additions et ~,lterations, or f9~ removal or demolition, as here~ deathbed, ~. appllcan~ agrees to comply with all applicable laws, ordinances, buUdin~code, housin~ cod~ ~nd r~g~lation~, and to nit authon~spectom on premises and ~ bulldog for necessa~ inspcct~s. (Signature ot apphcant, or name, It a corporation} (~ili~ .d~ el .~ll~ut) ' .m~ of owner Ofpmmise~ ~ %~ ~G~ ¢o~ ~ ( · ..~" ' .' (asonthe tax roll or latest deed) ipplicant is a corporatiorL signature ofdgly authorized officer. ..: . (Nam~ and ~itl~ c.7 co.orate officer) ".~ Plumber s Li No ' ' ' '' ' ' No Electncmn s License ....................... :;[.0iher Trade's License No ...................... ~/~E~ ¢~ . :' ', ~tio. or~,na on which i, iopo~U work,via b~ do.~ ....... ~9,. ~'~ ~ ~c~ · '.. ' "'"' ................ '"""'"",', ; b, tb .~.IH ,~' ," ~ · ,. / Hamlet , '" ,. , .., l,,..,s,.. Lot,....,,,,i,,..~ .... F~ed Map No Lot Subdivision ...................... , .............. . ............ , Stat~ 9.dsting u~e and occup;mcy of premises and intended use and ~:ct~pancg of proposed constmctiom " . I ~,. -- :. ;a, Existing use and occupanc,t . ~t&.. ~ttH ~([{~ . ' .' .... ~ ~ ~ ,~ .,. , ...... ~ ..... ,..,,,,,,,,,,,,, . . 3. Nature of work (check'wbicb applicable): New Buildiug ....... Addition . ' ' ~. ' · · ' · ........ Alteration ,, ,';',,.,. Repair ............ Removal ..~ ........... Demolition ... Other Work,,..,,,,.,,,,. 4 'Eatimat~dC ~ ~00 ~ ~ ~} (Des flption) ' Oat ............ [ ,~ C , ,J [~ (lo be paid on ~ling/bis application) 5., If dwelling, number of dwelling uaits ...... ~ ........ Number of dweUing units on each floor,, ' . +If.garage, number of cars ...... ; . l ............................ , . 6,' If business, commercial or mixe ccupancy, speclr nature aaa extent of each t e o ~u~iqting structures ifany . Yp use ..... ,Y Dimensions of santo structure ,,,;m ~. .... , ......... ~"'" '"""'.,, ...... , .... ,. lhM~t ., .., ........... ........ , , "....,,..,, 4,'?N~o of Owner of premi;es . ~ ¢~'14' ' ~&~;;~2' wm excess fill.be rcmov?d from promises: ' '"~[Oeato clo~ly'~d dJst~ctJy ~l [u[d~[s, whether existing or proposed, ~d, indicato ~l s~t-ba~k, ~*.sto.l flora roperty lines. Give street and block n~mber or [terio~ or comer lot. ':~/.9~;' ' i" . : . · (Name ~ £indivtdual slgmltg flamed.· ;.S contrmt) description according to deed, and show street names ami indicate whether · 7~J5'~802 9 AM lB ~ PM FOB TH~ FOLLOwI~G INSPECTIONs: 1, FOUNDATION . '~0 REQUIR~n , " FOR POURED C~c~ 2, ROUGH . ~aan,~,,- 3, INSULATIOn' .......~ ~ ~LUMBIN~ 4. FINAL ' CONSTRUcTioN MUST ~E COMPLETE FOR C.O. .I. ~ :1.. ~i ' ALL CONSTRUCTION SHALL MEET THE _REQUIREMENTS OF THE N.Y. ' STATe CONSTRUCTioN & ENER~¥,,.~ .q CODE~. N~ RESPONsivE FOR. OR CONSTflUC~o ,';,';h ......... being y sxvorn, deposes ~d says that s, e, performed in the manner sci ,11 , bao e me'. a ',,,. ,.. .............. dayof Cern Oua!lfl~ in' Suffolk Coun~ mission expires May 22, 1~ 7-"5 )wrier or'owners, and is duly,auti'ro1~ed~ perform or have nemmn,,a atlonl that all statements contained in Ilia application are trna io'-' ' tim best of his knowlgdg