The URL can be used to link to this page

Home My WebLink About19772-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20114 Date JULY 25, 1991 THIS CERTIFIES that the building~ Location of Propert~ i0 HICKORY ROAD House No. County Tax Map No. 1000 Section 54 Subdivision ADDITION SOUTHOLD~ N..Y. Street Hamlet Block 6 Lot I4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 9_z_,1991 ..pursuant to which Building Permit No. I9772-Z dated APRIL 12~ 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 GARAGE ADDITION TO EXIS~?INGONE FAMILY DWELLING ASAPPLIED FOR The c~rtificate is issued to ....... ~ SWEENE¥ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N-194573 - JULY 1~ 1991 N/A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHOP. IZED) N~_ 19772 Z Permission is hereby granted to: , ,, . ........... ~t premise~ Io~ated at ........ .~...~.......r~....~.5.~~:....~..~.~.~...X ................................................... ....... ~,5.~...~../....~ ............................................................... cou.~ Tax Mop No. moo S~ct~o. ~'~-'~ mo~k .......~.. ............. Lot Uo.....~ ~ . pursuant to application dated ......... ~.~...~ ................................ , 19.~.~.., and approved by the Building Inspector. Rev. 6130/80 TOWN OF SOUTHOLD BUILDING DEPART~IENT TOWN HALL SOUTHOLD, NEW YORK 765 - ~802 11971 TOWN OF APPLICATION FOR CERTIFICATE OF OCCUPANCY . ?/. CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDINC ...... VACANT LAND~ ....... HOUSE NO. STREET ' HAMLET Subdivision ....................... Filed Map ........ LoC .......... Plannimg board Approval ......... ~. . ~ Fee Submitted: r'ev. '10114/88 Co~Qolly De FOP~ NO. 6 TO~N OF SOU~IIOLD BUILDING DEPARTMENT TOWN I~LY. 765- 1802 APPLICATION FOg CEETIFICATE OF OCCUPANCY INSTRUCTIONS This application must b~e filed in typewriter OR ink and submitted to the Building Inspector with the foll,'owzng; for new buildings or new use: I. Final survey of proplerty with accurate location of all buildings, property lines, s~reets, and uuusual] natural or topographic features. 2. Final oppro~hl of Health Dept. o~ water supply and sd~erage-dlsposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement fro~ plumber certifying that solder used in system contains less' than 2/10 of IZ lead.. 5. Commercial buildings!, industrial buildings, multiple residences and similar.' buildings and instal!latioos, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning goarld Approval of completed site plan requirements. !(Prior to For existing buildings April 9, 1957] non-conforming uses, or buildings and "pre-existing" lan~ uses: ' I. Accurate survey of plroperty~ showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed appllcatiou, a conseut 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,Occupancy is denied, the Building Inspector shall state the reasons therefor in ~riting to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. For Vacant Lend'Certificate of Occupancy: ~. An application for ~acaut land Certificate of Occupancy shall-be submitted, and a certified abstract of title issued by a title company showiug single and separate ownership qf ,the entire lot prior to April 9, 1957 shall also accompany the application. I~ a Certificate of Occupancy ia denied, the Building Inspector shall state the reasons therefor in %r riling to the applicant. FEES: ~. CERTIFICATE OF ~CCUPANCY - New D~eltlng $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Fool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 -'Businesses $50.00. 2. Certificate of (tenDency on pre-existing dwelling - $100.00. 3. Copy of Certifi£ate of Occupancy - $5.00 - over 5 years - $I0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certifilate of Occupancy - $50.00 6. Temporary CertlJicate of Occupancy -$]5.00 Residential Commercial 10/14/88 FOUNDATIOM (1at) FOUNDATION (2nd) ROUGH FRAME & ~PLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION DATE , ,INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOU~ION 2ND [ ] INSULATION [//*]/FRAMING [ ] FINAL REMARKS: ~ ~ DATE INSPECTOR I__I FOFI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.; 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ....................,. SEPTIC FORM .. '' .......... Disapproved a/c ..................................... APPLICATION FO~ BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building I~spector, witl~ 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 Dyout of property must be drawn on the diagram which is part of this appli- ci~tion. ' o. The work covered by th.is application may not be commenced before issuance of Building Permit. d. Upon approval of tliis 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 La~vs, 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectom on premises and in building for necessary insnections. . ........... (~ignature ot,~t:~ca[ntl_or name, if a corporano, n) (Mailing address of applicant) State whether apphc~l~t is bwner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name fo~vner ofpremmes -% .., ~ : ;¢4 v: (as on the tax roll or latest deed) l£applicant is a corpor, a~,iorg~-~tgn~u/e ~3f duly:authorized officer. ,.,..;~...,~*'~'..,.......:.'",' : j..'......... (Name and title bf:¢orpom~:~ officer) Builder's License No ....... ..... Plumber's License No ' Electrician's License No..- ..................... Other_Trade's License No .................... . . 1. Location of land on which proposed work will be done;' . ' / o ' tlousc Number Street, Hamlet " .... '... County Tax Map No. 10O0Section ..' i. ' ... Block ..... ............ Lot ..... Subdivision Filed Map No' (Name) /-' ' ' ' · State emStmg use and occupancy of premises and Intended use and occnpans,y or proposed constrnction: . .. ..... e [ · ~ . , F/ ..... .~;~J~.~ ~C~ .......... -au occupancy ,.; ;..'. · ·, ~ .~-. .... ~' ' ' ~ ~ ~ ~~8)g~.~t . ,, ' tion 3 Nat of k (the k hich ppli~ bi ): bi B ildi Additi.. ..... · · · · .......... · ure wor c w a a e ew u ng .......... on era Repair .............. R~raova! .............. Demolition .............. Swimmlngll[~~ .............. Tennis Court ......... Accessory Building .......... Fence ....... Otherll~.~.~ ...... I _ 4. Estimated Cost...~. t~. · ·~. :.-.[ ....................... Fee ..................................... ' ' J (to be paid on filing this application} 5. If dwelling, nmnber of dwelling unltS ............... Nnmber of dwelling units on each floor ................. If garaee,, number of cars ...~...~.4t~. ...................................... : ..................... 6. If business, commercial or mixed o~cupancy, specify nature and extent of each type of use ...................... 7. Di2ensions of existing structures,!fany: Vront .,., ............ Rear ............... Depth............... Height .............. Numbe:r of Sro es ............................................ Dimensions of same structure withl alterations or additions: Front ................. Rear .................. ; De~,h .................. i Height .................. '. Number of Stories ....................... 8. Dimensions ~fentire new constmcl:tion: Front .. ,/.,~. .......... Rear X' ./,a~.. ......... .D. epth...'.27-...~. .......... Height . , ~.o~,. .......... ,Nu~btff of Stories .... /. ?..7~j~..~i~ .................... ,:_...,_. ~, . .... .,, ... 9, Size of lot: Front ~.='~ ..... ~ ......... Rear... ~ ~. .... ' .....,.~.. Depth ~/~'7/.1~. i .X..:/. ~.~..~ . . 10· Date of Purchase ............ 4 ................ Name of F/~.. r ,,~t.~/',~ ............. ........ 1 I. Zone or use dmtnct xn winch premmes are s~tuated ......................... ,>4~cj~ ................. .,' · · 12. Does proposed construction>'j,91at~ any zoning law. ordinance or regulation[ ................... Will lot be regraded ..... /.~. ,a..L ................. Will excess fill be rem?%kfro_.~emis~s: , Yes., N ' ... .i.. ' .... ame of C=traetor ........ ^ddress :Z: ..........e × .... 15.Is this property ~oca~ted within 100 feet of a tidal wetland? ~¥ES...~.- · ~f yes, Southold Town ITrustees Permit may he required. PLOT DIAGRAM Locate clearly and distinctly all ~uildings, whether existing or proposed, and. indicate all set-back..din)..en~mn.s f,r.om property llnesi: Gilte street and block n~mber or description according to deed, and show street names aha tnmcate wnemer, interior or comer lot..". API~0VI~D AS*N0~D ? / DATE: ~s... #,.,,/¢ FEE' ,.-~ZZ-'~"'~ N ¥~" u, ' /' '- 0 IF*/ ,~.UILD~NG DEPARTMF,~ 765-i802 9 AM TO'4 PM FO'~ THE FOLLOWING INSPECTIONS: 1, FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMRING 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. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S.S COUNT~ OF'.,,~//. ..... r'h. · r"¥2 I -- I//rZ/~.~_. "¢ ..... /,a.h-. ~.x; ...... '/...7".' 2a-Z' ~.' '.' ................... being drily sworn, deposes and says that he is the applicant · .. (Name of i~[vid~m'l signing contract) above named. . , . He is the .' · ' ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly author/zed to perform or have performed the said work and to make and file this application; that all statements contbined in this application are trne to the best of his knowledge and belief; and that the Work will be performed in the manner set forth in the application filed therewith. ' / Sworn to before me this ] ......... .d. r~x~~ ~\ }. ', ~day°[ .... / ~ ,~//'~"'v~" . ..~~, ": ~/'~-~, ~'~ ' ' .~...' · . County , ~ M. WlIXII~ ,i · . ........ ~ll,~aff~l~Ye~ Signature ot' applicant)