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Home My WebLink About19930-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20070 Date JULY 12~ 1991 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 11425 PECONIC BAY BLVD. House No. Street County Tax Map No. 1000 Section 144__Block 3 Subdivision Filed Map No. ~ATTITUCK_~N.Y. Hamlet Lot 20 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE4_~ 1991 ... ~ursuant to which Building Permit No. 19930-Z dated JUNE 6~ 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 EXISTING DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ROBERT J. & DOROTHY ANN ENDEP~LE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL__. UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 I~OBZ~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN HALl. SOUTHOLD, N. Y. BUILDING PE~,MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.~ 1~30 Z Date ......~../.~.. ...................................... , 19..~./ Rev. 6/30/80 Owner or Owners of County Tax Map No. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NEW YORK 765 - lB02 FOR CERTIFICATE OF OCCUPANCY DATE ....... j ......... NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING.Z...VACANT LAND ........ Location of Property ........................ ~ HOUSE NO. STREET HAMLET Property ...... 1000 Section /~ Block ~ Lot' ~ Subdivision ....................... Filed Map ........ Lot .......... Permit No ........... Date of Permit . / -Applicant 0 ¢ ~ ~ ~C Health Dept. Approval .................. Uaderwrlters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ............. Fee Submitted: $ .................... , £ o 'Z 0o'?o rev. ]0/14/88 FORM NO. 6 TO~iN OF SOUI'HOLD "' ~"' ~/' I BUILDING DEPARTMENT [ TO~fl HALL .~. ~ I 765 - 1802 ZATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be[filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual datural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage-dlsposal(S-9 form). 3. Approval of eleetricai installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/10 of Il lead.I 5. Commercial buildings,!zndustr~al buildings, multiple residences and similar. buildings and nstallatmons, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning BoardlApprova1 of completed site plan requirements. For existing buildings (Prior to April 9, 1957~ non-conforming uses, or buildings and "pre-existing" land dses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or to~ograpblc features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. If a Certificate of Oclcupancy is denied, the Building Inspector shall state the reasons therefor in w-r, iting to the applicant. 3. Date of any housing co!de or safety inspection of buildings or premises, or other pertinent information !requxred to prepare a certificate. For Vacant Land Certiflcaite of Occupancy: I. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, ]957 shall also accompany the application. If ai Certificate of Occupancy is denied, the Building Inspector shall state the reason~ therefor in writing to the applicant. FEES: I. CERTIFICATE OF OCCIPANC¥ - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accesssry buildings, $25.00- Businesses $50.00. 2. C~rtificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificat. of Occupancy - $5.00 - over 5 years - $~0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certifieat~ of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial FOU~DATION (1st) FOUNDATION 2. ROUGH FRAME & .PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: GAFFN~¥ ?~coNIC BOO LEvARD .... SURVEY FOR ROBERT J. AT MATTITUCK TOWN OF SOUTHOLD sUFFOLK COUNTY~ N,Y, SCALE*' I"= 40' JAN. 9, 1970 JAN. 19~ 1970 JAN.£2, 1970 APR, 7~ 1970 REFERENCE DOROTHY ANN ENDERLE GUARANTEED TO' THE TITLE GUARANTEE CO. ROBERT d. 8 DOROTHY ANN ENDERLE LAND SURVEYOR N. YS, LIC, NO.£8?R5 RI VERHEADx N. Y, 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ~FINAL DATE INSPECTOR Examined . ~ .......... , 19~-/ _ Approved . .~/~ ........ ,19 ~Pemit No. Z~.~' Disapproved a/6 ..................................... APPL IGATION FO~ BUILDJN~ PEBMiT FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC FORH .............. ! ?.: '. '. '. '. · .~.~./~. 7 ....... '.. ' 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- 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, a~. 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 insllections. -- r ...... ~.:.o k,, jf.o:..~., .?. (;..~., ..&.: .......... - (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... C ;o... ./ ~.~ ~ ./?~ ........... .= ............................................................. Name of owner ofpremlses....~..o.b.e.',:./....~..... ?.. !:s~.6n. :,'~x'~o'q~t~t'fi:7'~'~''):?'~: ................. If applicant is a corpo[ation, signature of duly authorized officer. ... ....... .... (Name and title of corporate officer) Builder's License No ...... ./.0..'7 .C7. '.7....].~. Z. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ... ((.q. .~3: ............... ~. e.~:~.'. . . &.~.'/. . .~&d ........ ~. .~.:. Z .:. .~.~. !.<. ................. House Number Street Hamlet County Tax Map No. 1000 Section ................. ]~t~ Block ....-~ ............. Lot. .................. Z O 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 ..... ,~).'! .V.~.(-'~'. .... '~' ~/?' '~' ............... g~.I~ ,J.~tl~d~ .................. b. Intended use and occupancy ................................... ~t,o .'.) aml~, ~ ~ ~ ........... ' · · ' 3. Nature of work (check winch applicable): New Building .......... Addition... {.C ..... Alteration ...... Repair .............. RemQval .............. Demolition .............. O,[~,er ~Work ............... 4. Estimated Cost ..... ~.{7. .......... Fee ......................... (to be paid on filing this application) Ifd b fd lli finit N b fd Iii it hr 5. welling, hum er o we ng s ............... um er o we ng un s on eac oor ................ If garage number of cars" 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures,, if any: Front ............... Rear . ...... ....... Depth ............ ... Height ............... Number of Stories ........................................................ Dimensions of same structure wffh alterations or additions: Front Rear Depth ....................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new constr~ction: Front ............... Rear ............. i Depth ............... Height ............... Number of Stories ............................. i ....................... - 9. Size of lot: Front ........... i ........... Rear ...................... Depth ...................... 10 Date of Purchase ~ ' Name of Former Owner 1 1. Zone or use district in which premises are situated .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .1/? ......................... 13. Will lot be regraded ..... ~. o.. i._. ........ ....... ~. · Will excess fill be removed from premises: Yes. .N.o 14. Name of Owner of premises~.O.l': .v( .4. {~. 7,~../~-~i . ~..~.~:Address ................... Phone No .............. N f A i ,, Address ........ Phone No. amc o rchitect .......... , ......................................... Name of Contractor ... i.. Address Phone No 15. Is th±s property w±thin 3100 feet of a t±dal wetland? *Yes..~ ..... No...~ ...... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property Hnes. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. STATE OF NEW Y~RK~/~_/3 S.S COUNTY O,~I~ .,.. ~q¢,~.~[.~..,, / . . .~.o/~ ~,---/- /"~ KC ~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... . ................................................................ I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this ............. ..... ............................... _ ~II~KI ~ ~a~ ~ ~?....-~ (Signature of applicant)