HomeMy WebLinkAbout19927-zFORM MO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z220240
Date SEPTEMBER 25~ 1991
THIS CERTIFIES that the building. ADDITION
Location of Property 2605 NORTH BAYVIEW ROAD EXT.
House No. Street
County Tax Map No. 1000 Section 79 Block 2
Subdivision Filed Map No.
SOUTHOLD~ N.Y.
Hamlet
Lot 10
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 3~ 1991 pursuant to which
Building Permit No. 19927-Z dated JUNE 5, 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 REPLACE ~-×/~TING DECK ADDITION AS APPLIED FORt
The certificate is issued to
ROBERT J. & MONA McCARTHY
(owners)
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
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
Ne_ 1992? Z
Date ............ ~...~ .................. , i 9..c)...l
Permission is hereby granted to: , ~ ,~ . ,~
.~.~.~....~.~~..~.L~ ....
...~.&~.~....~.~.~ ................................................
.~.~&._.....~:~.,.....t.z..v..~. ../. ......... ,
,o ...... ....
~ .............................. ~'~'~:'"~'"'"~ ............ '~'""~':' ............ ~c"'"'"~ ...... '~'"'~"~
at premises located at ...c~... ....................... :.....J...'~....~ .................... :.~.........~...[.:........~~ .~
Coun~ Tax Mop No. 1000 Section ......C~....")...~. ........ Block ...... ..C~....~.. ..... Lot No...J....O.. ................
pursuant to application dated ......... ....~..~......~.. ................ , 19,.~,,[,, and approved by the
/
Building Inspector.
Building Inspector
Rev. 6/30/80
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FRAMING
REMARKS:
FOUNDATION 2ND [ ]/INSULATION
/
~/~ FINAL
DATE ~ !/~//~ INSPECTOR ~ ,~~j/~
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUP~
BLDG. DEPT.
TOWN OF SOU!!~pLm
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 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 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
Ye /
W Construction ............. Oldx~Or Pre-existing.~ildin~..~ ........... D / '.~
n ~Y .......... (~ ...... ~. ~...~TX~ ........... ~/~.~ ....
House No~ Stree~ . ~ Hamlet
o~ o~ ow~r~ o, ~rop~ty.. ~ ~s~ .'w .~..~ ~ ~.. ~/~ 4~&/~ ¢ .........
co~ ~ ~ ~o ~000, ~o~..~ ....... ~o~..~..g ..... ..:~o~..~...~... .........
Subd~v~sfon .................................... FSled Hap ............ Lot ......................
Pormi~ ~o..~.~.,..Da~ O~ P~rm~r ..........................
..... ApplScant ..............
Health Depg, Approval .......................... UnderwrS~ers Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
.... ................. : .
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
.?LUMBING
3.
INSULATION PER N.
STATE ENERGY
COMMgNT~
CODE
FINAL
ADDITIONA'L COMMENTS:
'L
~ITNO[Fr CErTiFICATE
OF OCCUPANCY
NOTI~ BUILDING OERART~ENT AT
765-1802 9 A~A TO ~ F'M FO~! THE
FOLLOWING
1. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. RO[JGH ~ FRAMING 8~
3.
4, FINAL CONSTRUC*fff}N
~E COMPLETE FOR C O
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N Y
STATE CONSTRUCTION ~ E~EF(GY
CODES. ~ RESPONSI~LE
DESIGN OR CONSTRUCTIO~
Z
0
FORM NO. 1
JtlN .. 3199l TOWN OF SOUTIiOLD
t~,~',. BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.; 765-1802
xamined .... l.~.~.., 19~.{.
pproved ''~..~., 19~}/. Perm t No./Jc/a7..'~.
isapproved a/~ .... . .............................. f~
(I~mTding Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF' HE,,'kL~-II .........
3 SETS ?F P ' . .
t.,lds .....
SURVEY ........ . ..... .' ''
CI1£c~
SEPTIC FOR:I
z/ I'IA I L 'FO:
INSTRUCTIONS
Date ........ 19
a. This application must be completely filled in by typewriter or in iuk and submitted to the Building Inspector, with 3
s 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
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appI~-
ion.
c. The work covered by this application may not be c'bmmenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
11 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
11 have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buildina P '
lding Zone Ordinance of the Town of Southold, Suffolk Count*, Ne,,, v..~t- ..,~ ,.th ,. ~,, e.rm~t pu..rsuant to the
~, ..... ., ........er appucame Laws, urdinances or
:ulations, for the construction of buqdings, additions' or alterations, or for removal or demolition, as herein described.
: applicant agrees, to comply with aH applicable laws, ordinances, building code, housing cod , and ' frs, and to
dt authorized inspectors on premises and/n building for necessary insv~
--' (Signature of aplMicant, or name, if a corporation)
(Mailing address of applicant)
te whether appl,icant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. -
.... ./., ....... ......... : ................. . ...... .....................
ne of owner of premises. ~.~~.~ ¢- ~!/'¢.]/E~ ~ s't.~c'~ .' .~.~.'~¢
(as on the t~t roll or late )
:>plicant is a corporation, signature of duly author zed officer.
(Name and title of co orate o cer)
Bu'lder s License No ..........................
Plumber's License No .........................
Electrician's License No ,'
Other Trade's L cense No . "
oe .................... )~'~ ~ '
· ationoflandonwhichprop, osed,vorkwillbedone ..... .~..:~..~....~...,..~...O...~.~../.J3 ....
,rouse Number Street ..................................
Hamlet
ountyTax,"apNo.,0OOSe~t,on .... '."(.q .......... B,ock .... ~.. ~ot ¢?. .....
.thdivision ..... Filxq,d Map No.
(Name) ........... '... Lot ...............
'ate existing use and occupancy of premises and intended use and occupancy of proposed constrtiction:
Existing use and occupancy .~.~/?././/~)~. ' .. ,¢..v~,, ~.~ r.,t.~ .L,:I
'n'endeduseandoccupa,cy .~.~..¢.,.".:~.o....I .'%..:.,.k - '~,'"~ '..,,.
3. Nature ofwork (check which app cabe),New Buld lg Adc
e air . · .......... 't'on ,\
.......... emov · . ' ......... ltcrat~Orl .......
al . . Dcm ion , ~ ' ' '
· . ................. ................
5. If · ,, , /. (to be paid on filing this application)
dwelhn,, hum bet of dwelfin ....
. Ifgarage, number of cars ..... i ................ Number of dwelling umts on each ~oor... ............
6. If bnsiness, commercial or mixed ~CCUpancy, speedy nature and ex~cnt of each type of use .~...
7. Dimensions of existing St~C~UrCs, if any: Front j ..2 ............
He g It .... ' ........... Re'ar ........... Depth
'alterations or additiYns: ................ ' ........
D~ens~ons of same structure with~ Front .....................
.......... ' ............ Rear ....... .
Depth .......... ,Height ................... Nnmber of Stohcs ..................
8. Dimensions of entire new constn c~ion Front . · . '
He ght . . . xt ' ~ · ' ....... · ...... Donth
..... ' ......... t*Umoer ol Stones .,, ' ........... " ...... 't ...........
9. DlZeollOr: Front .. ~m~, '' · ~ .... ~.~ .....................
0. D~t~ofPu~ 'Jr~'~F"W~'' ...... Re~..~.%.N(:. ..... ~th I~D'/7V25J~~'''
........... , ........ .... . ........
2. ~oes proposed COnstruction V~la~[ ..... :.,, ' ', .................. '~'/,~ ...................
3. W~I lot be re~raded ~ ~ .~-~ ..om.g mw, Ormnance or regt lat on, m'~'~ ' ' ....
4. Nme of Owner of p r.~ xc~s~l~)~ r~o~m premises:
Nmne of Architect · ,.-~mur~s /F.. ~ ~g.t~.~.~ p one No
N=,~ oeco~c~o~ ~~ '~3;~ ....... adar~ .:~,.~ ........... P,o~ No ~ . . '
· '"',' · .~. ~,~t.~ ...... Addres ' ' ....... :~' ' '
... ~ PLOT DIAGR~
Locat~ clearIy ~d distinctly ~1 buiid~gs, whether existing or ro osed '
rope~y Hnes. Give street ~d block nu-[~ ........ ' P P , and, indicate ~1 set-back d~ensions from
tenor or comer lot. mo=~ ur auscnpnon according to deed, and show street n~es and indicate ~hether
,TE OF NEW YORK,~ /'/~///., -
J'NTY OF ....... ~..
........ .77~.4~' ~,,~ ec~ MA
(Name or individual signing contrac*t~ '~ · ·. being duly sworn, deposes and says that he is the applicant
e named,
: m .......................... iJC .................................................
k ontractor, agent, corporate officer, etc.) ' '
id owner or OWners, and is duly autho~zed to perform o
Ca,on that al statements contn r o,~ :-* Ut .'. .. . r I ave performed thc smd work and to mat-- --~ ~, -~-
will be ~crr .... , , ., - ........~ m]m~s'~ppucatmn are true to the best of his kaowled
~ to bef[re~,"'~g m me manner set form m t e applicatio ~ filed therewith. , ~ .... ~ ue,m; and that the
....... 3.: ...... .....
. ~ ~m~ ...... ,.~. ~. Y. TT~
~. ~ ! ~ ' ' 7 ~ ..........:~ 7 -- J .............
' I
ST,~TE CONSTRUCTION & ENERGY
.................... /~' O.e_. CODES. NOT RESPONSIBLE FOR
...................................................... DES,GN oR CONSTBUC~,ON ERBORS
APPRpVED AS ~OTED
NOTIFY BUILDING DEPARTMENT AT
765-1802 S AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - ~O REQUIRED
FOR POURED CONCRETE
2. ROUGH ~ FRAMIN~ & PLUMBING
3. INSULAtiON
4. FINAl. CONSTRUCTION ~UST
~ COMPLETE FOR C.O
ALL CONSTRUCTION SHALL M~ET
THE REQUiREMeNTS OF THE N.Y,