HomeMy WebLinkAbout19844-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26659 Date: 09/03/99
THIS CERTIFIES that the building ADDITION
Location of Property: 870 OAK DRIVE SOUTHOLD
(HOUSE NO:) (STREET) (HAMLET)
County Tax Map No. 473889 Section 80 Block 2 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 3, 1991 pursuant to which
Building Permit No. 19844-Z dated MAY 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The cert if lcate is issued to JOHN MCCOPPEN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NIA
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Insp for
Rev. 1/81
A'OB.M NO. 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 AUTHORIZED)
N°- 19844 Z Date 19.1
Permission is hereby grante~,d, to~
..~~.1.....~.s...~!~..`.... 074 0
to
...~..1.~.... ~
at premises located t .....dt•.~..~~'~,~............~ o®~.~../~/.~~/..`~
............................................S4r:.~~
..:l~r.....................................................................................
County Tox Map No. 1000 Section .......~v.......... Biock Lot No......~9
pursuant to applicotion dpted 19.~~., and approved by the
Building Inspector, %Iv~-eG ~ j/3~~~
Fee 5...4 ..f.,X~,r..
~.~.rl..
Build Inspector
Rev. 6130/80
~ Form No. 6
1S ` 2 ~ ~~~R TOWN OF SOUTHOLD ~,~0 j - r~ b
r-l~•--- -~r--•- ~5-~ BUILDING DEPARTMENT
TOWN HALL
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4''.^?.i~}:i'! APPLICATION FOR CERTIFICATE OF OCCUPANCY
?F`! D _ _
A. 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 Gode Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. 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 tYierefor in writing to the applicant.
C. Fees
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 Buildine - $100.00
3. Copy of Certificate of Occupancy - •2~C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
New Construction..... Q Old Or Pre- xisting Building.....
Location of Property. V..?~... .'YC ~6 Cf ~l~d~i~~
. .
• ~ Hamlet
House No. AA,n~,, //~~AA ~reet r-~
Onwer or Owners of Property.. e~.~.~'~c..L:~ ~:~~~`r
County Tax M,a/,p~(No 1000, S{ection.~~....Block...lll.~. .Lot.. 1•I•t.~~.}.,L.~.
Subdivision .Y4~~~~~• S~j6~~`:5............Filed Map.... ..Lot .
Permit No... I ~•!•••..Date Of Permit..~j. ~.~....Applicant
..l /
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate..........•
Fee Submitted:c~ $
. .
C., 5le'L 7- . • • • • • ..APPLICANT . •
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765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION iST ( ]ROUGH PL G.
[ ]FOUNDATION 2ND [ ]INS TION
[ ] FRAMING [ NAL
[ ] FIREPLACE A CHI NEY
REMARKS: C~~7
DATE °Z INSPECTOR
r1ELD I;:SP~C:iUIJ ~~UATE ~ i;OaKMENTS \
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1 . \ ~
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FOUIJDATION (1st) l'~
FOUNDATIOIJ (2nd) _ -
2.
o °n
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ROUGH FRAME &
PLUMBING
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y .
3. ~
ca
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IIJSULATION PER N. Y. '
STATE ENERGY
CODE
x
a
7 . J-!
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4 .
FINAL
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ADDITIONAL COMMENTS: x
x
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1$T r-~. [ ] ROUGH P G.
[ ] FOUNDATION 2ND [ ]INS ATION
[ ]FRAMING INAL
FIREPLACE 8~ CHI NEY
REMARKS: ~ ~
DATE °2 INSPECTOR
_ ~B~OARD OF HEALTH
k`il ~~~arf~-y~C, v ee~r'~"'i'~j~i~ FORMN0.1 3 SETS OF•PL.127S-•...•..•.
TOWN OF SOUTHOLD SURVEY
! BUILDING DEPARTMENT _ CIICC}: . . . . . .
MAY - 3f99f ~ ~ ~ TOWN HALL st:rrlc roR:l
t'+..6,~,..,...N_,..~.....~,<.~,..as ~f°`Y SOUTHOLD. N.Y. 11971 . .
;,,_r~r;. wr. ? TEL.: 765-18U2 r:ar I PY ;
T6V'v(H C ~'!}IJTii(3k..f'k rl~~y~' CALL .
p % JoN~!sTatiL
approved 199/ Permit No..~~ ~ (7~` 4~ ~ 0~99,Z',O.P
Disapproved a/c S6r.T/fvtd,~. //97~ .
(B in^ n ector)
APPLICATION FOR BUILDING PERMIT ~-e~
Date U""'... 19~j
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
;t~ 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
r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
rtion.
c. The work coveted 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
call 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
call 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 Tov+n of Southold, Suffolk County, 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 all applicable laws, ordinanc building code, housing code, and regulations, and to
imit authorized inspectors on premises and in building for necessa i sp tions.
~,'J~'..p-.~..L:........
Signature of applicant, or nam ,>if a corporation)
(Mailing address of a plica t)
~O~T~f ~ ~ L d ceJ~L~ ,e1'~/ 0 7 006
tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......U Ct.J.~1.1. ~ .
"ameofownerofpremises ...~.~~i'.L....l~.~....!~.e(~?.~J.v`
(as on the tarX roll or latest deed)
applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ~.'3~ 7~ ~71-r
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
Location of land on which proposed work will be done . .
House Number Street Hamlet
u u
County Tax Map No. 1000 Section L7 Block
Lot. 1 .
Subdivision .~'~,~~,o~, ~S.?~f.D..~P.~: S....... Filed Map No. Lot .
(Name)
Slate existing use and occupancy~'olf premises and inten/de/d use a..n~d occupanc/y of proposed construction:
a. Existing use and occupancy 4l. C:~. ~ ~ ~~~t!.~~`/'tL.(./. ,7;~ d ~ ~;;.;..gr;:: . , , , ; .j,,, , , .
b. Intended use and occupancy d ~.~:-S/. ~ 4~ ...~~f:.4`.~! [~,,IJQ~
3. Napure of work check whiRemoPlicable): New Building , Addition Alteration
Re air (
• • • • • • • • • val Demolition Other SVork .
(Description)
4. Estimated Cost ~ ~ .
.
(to c paid,on filing this application)
5. If dwelling, number of dwelling nits . Number of dwelling units on each floor .
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 , , ~ • • • • • ~ ~ • • ' ' ' ' ' ' ' "
Hei ht Rear Depth
g • • • • • Num[?er of Stories .
p h alterations or additions: Front . Rear .
unensrons of same structure wit Height . Number of Stories . , , ,
8. D'' ~ensions of enure new c Nom
action: Front Rear , De th
Her ht P
....oriel
.......,....ero
9. Size of lot: Front i , Rear Depth , , ,
10. Data of Purchase i
p m • , .....Name of Former Owner , .
1 1. Zone or use district in which rc
12. Does proposegd construction viola ises are situated , , , , , , , • , , , , • , ,
to any zoning law, ordinance or regulation: .
' p • • • • • • v•~Q• • • • • • ......Will excess fill be remove from premises: Yes hIo
of be re raded • • ~Ci• • ®~ddressa~.~fl!r'i~ •Y~ ul~'•~a~"` Y9
S.Q,uQV 1. P, Phone No.~/1-d?~(p, , ,
Name of Architect N AL Dwt?GC, l~ J
ame of Owner of r~ses ~ ~i9zN~la~ Address . .............Phone No.
Name of Contractor .
15. Is thr.~ property within 3l~ ~ ~ • • " • • • Address . . . Phony o.
0 feet of a tidal wetland? ~ " " " " " " "
Yes........ No..~....
If yes, Southold Town 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 block number or description according to deed, and show street names and indicate whether
interior or corner lot. I
i
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.
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STATE OF NEW K,
'OUNTY S.Si
' ' ' ' ' ' ' ' `~THn o~l~eing duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
hove named.
"e is the......... ~~Td~~
I (Contractor, agent, corporate officer, etc.) ~ • ~ ~ ~ ' ' • ' ' '
f said owner or owners, and is duly authorized to perform or have perfomed tltc 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 the manner set forth in the application filed therewith.
,vorn to before me Phis '
'Mary Publicr~~: ~b~-~;x~
~Q~Count
WELENE D. HDf1NH ~I
Notary PuMlc, State of New 1'ptlC _ - - -
No.4961384 _
Qualified in Suffolk County (S afore of a • • • • • . •
Commission Expirea Moy 22,19 ~ ppIicant)
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SURVEY FoR
?ONN McCOPPE-,V
LOT NO,S. ;9, 20 Ei 21, BLOCK D , MAP OFREYDON SHORES
AT BAYVIEW DATE ~ APR. 9, /9B3
' NOTE + SCALE ~ / = 30
SUBO/V/5/ON MAP f/LED /N TNEOff/CE Of ENE CLERK TOWN OF SOUTNOLD
OFSUffOLKCOUNTYONJULY /93/ AS MAP NO. 63/ 5uFFOLK CC7UNTY, NEW YORK NO. 93- 22/
M UNAUtNORIZEO ALTERATION OR AODI TION TO TNId GUARANTEED TQ,~,,
SURVEY id A VIOLATION Of SECTION 7EOd OR THE CH/CAGO~~7„'~ It}/~S((~ANEf CO.
NEw YORK STATE EDUCATION LAw yip
Sp 1F COPIES OF THIS SURVEY NOT BEARING THE LAND SOUTN4CQ~S~ ~~G,S B•4NK
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL ;!I ~ j',a,'t~
/,r ifOUARANTUfE3 111RDICATED HEREON SHALL PUN ONLY TO ~T¢ f~
~
y(J THE PERSON FOR wHOM THE SURVEY IS PREPARED, l '`P fy 9
jam'" ANO ON NIS BEHALF TO THE TITLE COM PANY. GUVE RN- %~'z ~a'~
/ MENTAL AGENCY AND LENDING INSTITUTION LISTED L;; p. ~i
y0 HEREON,ANO TO THE ASSIGNEES OF THE LENDING ~ Y• ~s.i ?L}, q-~,
INSTITUTION. GUARANTEES ARE NOY TRAM SFERAlLE ~4 a ~ ~x~
TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT ,a '
OWNERS. ? Y~
' kO45TANCE8^ SHOWN HEREON FROM PROPERTY LINES ka iq:~~','
TO ExISTIN6 STRUCTURES ARE fOR A SPECIFIC fBY,
MOPERtt UNEd OR ORTTME ERECTION Of FENCES. ®pAt
" YOUNG ~ YOU'NG RIVERHEAO,NEW YORK E
ALDEN W. YOUNG,PROfESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S.UCENSENQI28i3
HOWARD W. YOUNG, LAND SURVEYOR t
w,~ ' . ~ ~t~~~. ~u ` , `~~n` r".. _ ~,NY3. LICENSE N0.43r343 =:77 } . r {