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Home My WebLink About19871-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19924 Date MAY 21~ 1991 THIS CERTIFIES that the building Location of Property 4095 VANSTON ROAD House No. County Tax Map No. 1000 Section 111 Block 14 Subdivision Filed Map No. ADDITION CUTCHOGUE~ N.Y. Street Hamlet Lot 39 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16~ 1991 pursuant to which Building Permit No. 19871-Z dated MAY 16~ 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 EXISTING ONE FAMILY DWELLING AB APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 HARRY A. & MARIE BEIAKE TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No ¥. NO_ BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) t 9871 Z C<,e ..... : ..................................... , ... County Tax Map No. 1000 Section ........ //~. ......... Block ...... .~...~,.: ....... Lot No ........~...~.. ......... pursuant to application dated ~... .~./.. ..................... :..., 19 ........ , and approved by the Building Inspector. u ~j~g Inspector \~. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archiuect or engineer responsible for the building. Submi~ 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. :. 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 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 .... i ......... k -- ew Construction.~. ........ Old Or Pre-existing ~uilding .......... ~,..~.. ocation of Pro ert~ ~O .~.J~. ~x~ ~ ~ ~ ~ ~ ~ V , , . ...... House No. Street Hamlet nwer or Owners of Property...~.~.~.~5.~]~.~A .~~~--.~..~..,~.~ ounty Tax Map No 1000, Section...~.~ ....... Block .... ]~ ......... Lot..~. ............... ~bdivision .................................... Filed Map ............ Lot ...................... mrmit No ................ Bate 0f Permit ................ Applicant ............................. ~alth Dept. Approval .......................... Underwriters Approval ......................... ~ques~ ~or: Temporary CerrSf~cate .........final Cer~ .. ~~ , . ........... ................................ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~- ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,'~NAL DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 . (Buqldin,~nspcctor) APPLICATION FOB BUILDING PERMIT BO,kF~D OF HEAL. TII ......... 3 SETS OF PLAN~; .......... SURVEY ................... CIIECK SEPTIC EOR:I .............. CALL . · . HAIL ? Date ............ louse Number Street Hamlet " ounty Tax Map No. 1000 Section ................. Block .... . ........ Lot ............ .... .42,[ .~ .kt,~ o .... :,bdivision ' ~ ~ · · )~. ......... Filed Map No. (Namc) .. · ..... Lot ............... alo ~zi~lin~ us~ a~d occupancy o~ ~rcmJscs and intended usc and occupancy et proposod construction; Exi~lin~ usc and occupancy Intended usc und occupancy (Name and title of co~oratJ Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... OCCUPANCY OR USE IS UNLAWFUL WF[HOUT CERTIFICATE OF OCCUPANCY INSTRUCTIONS a. Ttds application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ion. c. Th work covered by this apphcanon 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' dl 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 il have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issua f a B ' ' ,, . ' 'lding Zone Ordinance of the mown of Souff^'-' ........... ~a..¢c.~ mldm~ Permzt pursuant to the ; .~ppl~,can.t a~r. ees. to comply with all applicable laws, ordi~h~'~s, b~t'~.~'~e~;u°s:na;cmn°~'°~n_'~as he,re~ described. ~ m~s ........ ~--~mg mr necessary msp.,ct-tpn~..//~ ~ /r:) / ~ ..... (S~gnaflre of qtpplicant, or ~':ll}n,e,.if a cm'rp, ora~rion) ..... .v..~...9..~P,...~. ,,'-r.~.k.~. ~,..~, .... (Mading address of applicant) (~ te whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pinmber or builder. ....................... -.~ .N.~,'Tx..-:.-~ o,,,~ .............. ; ........................ (as on the t,ayt roll or latest deed) pplicant is a corporation, signature of duly authorized officer. ,' Repair ... -I --,.e,..,e ......... ~, .......... Addition ....... ........ Removal ........ Demolition .............. Other VVork ............... 4. Estimated Cost /'.~?' ~"~ ~ ~ (Description/ ............................ (to be paid on filing this application) 5. If dwelling, number of dwelli'hg ufiits .. Number of dwelling units on each floor ............... · If garage, number of cars i ............. Ifb ...... ...... · ....................... 6. usiness, commercial or m~xe~ p n ..................... 7. ~ nens~o ts o! emsnng structures,iif any: Front Rear ... ' ............. D' . . ~ y, specify nature and extent of each type of use ........ ~ ~t ....... · .......... Depth ...... .. .............. Numb r of Stories ........................................ · ........ ~mens~ons of same structure w alterations or additions: Front ................. Rear .......... Depth · · .' Height ......... Number el Stories ..... ........ construeJ ...... . ....... 8. Dimensions of entire new tion: Front ............... Rear ......... Depth Height ............... Num b~r of Stories ..................... 9. Size of lot: Front .. Rear... Deptt ............ 0. Date of Purchase ................... · ............... ~ ..................... ............. , ....... ' ......... Nanm of Former Owner 1. Zone or use district in which premises are situated ............................. 2. Does proposed construction viola,a ...... :_ . ' ...................... regolation: 3. Will lot be regraded ........... I ................ Will excess 'ill be removed from premises: No ~-.Name of Owner of premises . ' 'i ............. i. Address .... I. Yes .- Name of Architect ..... · ............. Phone No ................ ....... ~ ............... Address Phone No. Name of Contractor ...........: .......... · ................................. · f ... .... Address ................. Phone No ................ ,. Is this property within 300~ feet o ~ tidal wetland? *Yes .. ' · No ......... If y ..... · es, Southold To n Trustee Permit may be required · .-. I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from · operty Lines. Give street and block nun bar or description according to deed, and show street names and indicate whether. terior or coruer lot. .TE OF NEW Y.O~g, -- ' ....... '. (Name of individual signing cra}tract) .... named. ..... cCTIONs: L FOUN5A~iO~ . . FOR POO ~0 REQuI 2. RED CONCRETE RED ROUGH. FRAMING 3. INSULATioN & PLUMBING 4. FINAL . CO~S~RUc ~TATE CONSTR,.~.~F THE g.~ CODEs N~'Uu"ON & EN~ " ~uNSTRUCTION being duly s~vorn, deposes and says that lie is thc'applicant (Contractor, agent, corporate officer, etc.) id owner or owners, and is duly autb0rized to perform or have performed the said work and to make and file this :orion; that all statements contained i~i this application are true to the best of his knowledge and belief; and will be perfo~ed in the manner set fo}th in the application filed therewith, that the ~ to before me this . .......... .......... ' ' ~mmi~lo L --no~ uou , , of apphcant)