The URL can be used to link to this page

Home My WebLink About19713-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Bouthold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19799 Date MARCH 15~ 199.1 THIS CERTIFIES that the building. ADDITION Location of Property 3065 COUNTY ROAD #48 House No. Street County Tax Map No. 1000 Section 141 Block 2 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 14.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 15~ 1991 pursuant to which Building Permit No. 19713-Z dated MARCH 15~ 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 EXISTING DECK ADDITION TO ONE FAMILY DWELLING AS APPLIED FQR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED RAYMOND & LAUREL FEERICK ~Bll~lding Inspector Rev. l/B1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PEWIT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~- 1971B Z Permission Is hereby granted to: ...... .... .?.~.~........~ ......... Kg ................................ ...~.~&....~....y.......L~..r..~. . / .... ~ .~.~._.....~....~Lc~......LY~_~~.n.......~.....~~{.......~...~ ~~..~.~.,...~.....~2~.i....&~, ............. ~ ....... C~.....~: ....... .~. ..... at premises located at .~'~ .I..~..~.~.......l~...v.~ ............. /...q. ................. /../../..V~d:'..-~....~....W~- · ...................... ~OG$ / County Tax Map No. 1000 Section ..... t..~..t. .......... Block ...... (~ ............. -~ Lot No. .../.....~d .......... pursuant to application dated ....)~..(~...~~ ....... /....~,-~.. ............... , 19.~...I..., and approved by the 1 Building Inspector. Fee $.,~.~....:....~ Building Inspector 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 Vpre-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 Date March 15, ~9~! ......... N Constr ction xx 01d Or Pre existing Building p 3o6s COUNTY A T TUC , Location of roperty ....................................................... ' ........ House No. Street Hamlet RAYMOND & LAUREL FEERICK 0nwer or Owners of Property ................................................................ . County Tax Map No i000 Section ]4! Block 2 Lot ]4.] Subdivision Filed Map Lot . ~Z!~ p/.].~.]. - RAYMOND & LAUREL FEERICK Permit No ......... Date Of Permit ...... Applicant ............................. Health Dept. Approval ......................... Underwriters Approval ........................ . Planning Board Approval ....................... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ......... 25.00 ' CO-?_:/qTf? :.~- :, . , ,~,, . ~ . ~.~,, , ...,.....~ ~.~-.~,~,~,~:~.~.~~~7 .~ FIELD .L,,S ..... uJ FOUNDATION FOUNDATION 2. ROUGH FRAME & (lst) (2nd) FLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BLDG. DEPT. ~ OF SOUlHOL~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 119TI TEL.: 7654802 Examined. '~/) ~.c~./..~*..-, 19 .~.J. Approved . .~. ~.~3. J..~'..., 19 .~{. Permit No../..c:).?]..~...-~. Disapproved a/c ................................... f~/ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: Date .................. , 19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 9f 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 thls 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, as herein described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary~la~pections. ~ (Sigr~ature o~ applicant, or name, if a corporanon) (Mailing address of applicant) State whether applicant is owner, les, see, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest d~ed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... )(~ .................. Other Trade s License No ................ ~,.~. · ' Location of land on which proposed work will be'gone. ' ...................... ....... .... ............................... House Number Street Hamlet County Tax Map No. I000 Section ./..~./ ............ Block.· d ............. Lot.../.3'.~ .[ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises.and intended ~j~e and occupancy of proposed construction: Existing b. Intended use and occupancy ........................................ : ............. ~: ............. 3. Nature of work (check which a ~pticable): New Building .......... Additiofi ,.: ........ Alteration .......... · · Repair .............. Removal .............. Demoht~on ........ t' *":' 4~,~ .... ese ption) 4. Estimatdd Cos ......... Fee ....... ~ ...... :*'~"~;'": ~r~ ' ' L .... ~ ....... Ifd ' ' 5. welling, number of dwelhngl umts ............... Number of dwelling units on each floor ............... If garage, number of cars .... [ ..................................................... 6. Ifbus~ness' ,commercml' orm~xe'd' ' occupancy, specify' nature and extentofeachtypeofuse ....... ............. ............. 7 Dimensions of existing structures if any: Front Rear Height Nun}.ber of Stones' ............. Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ................... ;.. Height ...................... Number of Stories. . · ~ .......... Rear .............. ' '-'Depth . 2-','F'ef. ........ "8. Dimensions of entire new construction: Front . o '~ ..... ' ....... Height ............... Nun~ber of Stories .............................................. .......... 9. Size of lot: Front .......... ~ ........... Rear ...................... Depth ........... 10. DateofPurchase ~ ' ' ......... .......... i .................. Name of Former Owner .......................... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ 2. ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises ~ Address Phone No ' Nmne of Architect .......... , ................. Address ................... Phone No ................ Name of Contractor ......... : ................. Address ................... Phone No ................ 15.Is this property loealted *rithin 300 feet of a tidal wetland? *¥E$ .... NO .... *If yes, Southold Tow~ Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bock :number or descnphon accordmg to deed, and show street names and indicate whether interior or coruer lot. APPROyED FOLCOWING INSPEgTIONS. 1, ~OUNDATION TWO REQUIRED FOR POURED cQNCRETE 2. ROUGH - FRAM,lNG & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES. N~ RESPONSIBLE FOR STATE OF NEW y~)F~,, N OR CONS1 RUCTION ERRORS COUNTY OF ........ ;,S (Name of individual signi ~g contract) above named. Itc is the ...................... of said owner or owners, and is dull application; that all statements cents work will be perf6rmed in the manneriset forth in the application filed therewith. Sworn to before me this ] ............ /.'~ ........ day of .! .......... 19 .~.~ Notary Public, .~..~-~--(-W~..~...~..,..d/.l~..... ~County flEtEN K. BE VOE NOTARY PUBLIC, State of New. Yed( NQ. 4707878, Su~lk Ceunty..:. o Term Expires Mar,ch ~lO, l~~ being duly sworn, deposes and says that he is the applicant (Contractor, agent, corporate officer, etc.) authorized to perform or have performed the said work and to make and file this ned in this application are true to the best of his knowledge and belief; and that the (Signature of applicant)