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Home My WebLink About19797-zFORN NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19864 Date APRIL 24, 1991 THIS CERTIFIES that the building ADDITION Location of Property 895 DEEP HOLE DRIVE House No. Street County Tax Map No. 1000 Section i15 Block 13 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 21, 1991 pursuant to which Building Permit No. 19797-Z dated APRIL 22r 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 REAR DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS BUILT. The certificate is issued to LEON H. STANDLEY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ' ~uil~i6g lZnspe'ctor ' Rev. 1/81 TOWN OF $0UTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 19797 Z Permission is hereby granted to- , . .~ ~...~..~../.......~..~..~ ~... , .. ......... ~..~,~..~...~.~..~..~..~ ,t premise~>c'ated ~at ...~....,~ ~..~ ..................... ~ ................................................................ ............................ ~..~...~..~..~....~..¥~....~..~ .............................................. pursuant to application dated ................. ~...~,.~.., ,9.~.../, ond approved by the Building Inspector. Fee $.....(..~..~....~(....~'. Re~ 6/30/80 Form No. 6 TOWN OF SOUTIIOLD 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 Cempliance 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. 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 - $I00.00 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 April 23, 199.1 New Construction ........... Old Or Pre-existing Building .............. DEEP HOLE DRIVE fiATTITUCK~ .N..Y: Location of Property ...... .8.9.5. ................................................... . . . ... . .. House No. Street Hamlet LEON STANOLEY ~nwer or Owners of Property ................................................... iounty Tax Map No ;ubdivision .................................... Filed Map ......... .. . Lot ...................... 'ermit No..]~%~ ....... Date Of Permit. 4/22/9~ .... Applicant..~P~ H. STANDLEY Iealth Dept. Approval .................... .... .. Underwriters Approval ......................... 'lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate ........... ee Submitted: $ 25.00 CO~.,}~O~ APPLICANT (lst) ?OU~;DATIO:! FOU~;DATIO:4 FRAME & -PLUMBING (2nd) EOUGH iNSULATION PER N. STATE ENERGY CODE FI~AL Ye ADDITIO~L COMME~;TS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................. 19... Disapproved a/c ..................................... BOARD OF HEAL'I'll ......... 3 SETS OF 'PLo%NS .......... SURVEY .... (;flEcK . . . SEPTIC .............. CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 .'ts 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 publ/c streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- etlon. 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 ~ail 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 rail 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 uilding Zone Ordinance of the Town of Southold, Suffolk Cohnty, 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. he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectom on premises and in building for neces~,,,,,,,,,,,,,,,,,~inspect~. ~.~ ~ ~ ...... / (Mailin~ adOfi'~s or applicanf)// tate whether applicant is lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. lame of owner of premises .......... (as on the t .~ .roll or IatesJd~'~r~d) ' applicant is a corporation, signature of duly authorized officer. ,' (Name and title of corp_orate off'ruer) Builder's License No....~.~ // Electrician's License No - - Ot er Trade s License No ....................... Location of land on whictl proposed, work will be done. > ................................................ ............ ...... 0 -'-'-- ............ -- ...... House Number Hamlet County Tax Map No. 1000 Section .. 'l' /' ~'~' · ...... Block ...... /.y ........ Lot .... 7 ............ Snbdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and oc~ctwancy of proposed constructi~on: b. Intended use and occupancy ~ ...... ~''' ~ .... V..~....~~ 3. Nature of work (check which applicable): New Building .......... Addition . teration Repair .............. Removal .............. Demolition .............. Other Work ..... ' ......... i (Description) 4. Estimated Cos ....................... Fee ... (to be paid on filing this application) 5. If dwelling, number of dwelling flnits ............. Number of dwelling units on each floor ....... · If garage, number of cars ..... i .......... · ........ dl ify ......... 6. If business, commercial or mixe occupancy, spec nature and extent of each type of use ............. ;.. .... 7. Dimensions of existing structure , if any: Front ..~. ~ .......... Rear .... Depth ....... . Height ............... Number of Stories .................. ' ...... Dimensions of same structure w alterations or additions: Front Depth I Height ................. Rear .................. 8 ............................................ Number of Stories ............... Dimensions of entire new construction: Front Rear Height Num her of Stories .............................. Depth ............... 9 Size of lot: Front I . ' ................................................. · - ...................... Rear ..... 10 Date of Purchase i ................. Depth ...................... · ' ........... ........ ......... Name of Former Owner 11 Zone or use district in which premises are situated ............................. 12 Does proposed construction violate any zoning law' ' '' ' ' ..................................... 13.. Will lot be regraded ~ , ordinance or regulation: ................................ .......... i .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .... i ............. Address ................... Phone No ............ Name of Architect .... i. ' ' ' ' ...................... Address ... Phone No. .. ~ .... Name of Contractor .......... i ................ Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Tdwn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 10raidings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block m mber or descriptioh according to deed, and show street names and indicate whether interior or comer lot. ,TATE OF N 'OUNT¥ .S! (Name of individual's]~[n~'c'ontract being duly sworn, deposes and says that he is the applicant )eve named. , e is the ~/-~ I i (Contractor agent corporate officer etc ) .............. · said owner or owners, and is duly auithorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in ttle manner set !forth in the application filed therewith. yom to before me this i ........... .~.~..~- · . . .day/of. ~P~... ........... 197/ )tary Public,...~..~~/. ~~' .x. j... '' N~ary Publi~, State of Fiew York ' ~ ' "' S ................. Commission Expires, .July 3~, 1~/~--'~''' ~gnature of applicant)