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Home My WebLink About19531-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19528 Date NOVEMBER 21, 1990 THIS CERTIFIES that the building Location of Property 225 SOUND AVENUE House No. County Tax Map No. 1000 Section 67 subdivision ADDITION Street Block 2 Lot 8 Filed Map No. Lot No. PECONIC~ N.Y. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 21, 1990 pursuant to which Building Permit No. 19531-Z dated NOVEMBER 21~ 1990 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 (AS BUILT} TO EXISTING ONE FAMILY DWELLING The certificate is issued to BARBARA BERGMANN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 IPOKB[ ~0. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ~-"~ / ~ ~ ~-~........~....~~ ....... ....~ / ~ ~¢ ~- ..~ ~-~ ....~........ ~..~.~ .... ...~. ............................... ~ ......... ~ .............. ............ at premiss I~at~ at -.~ ........ ~......~-.~.~.~ ...................... ~.. o~2 County Tax Map No. 1000 Section¥.....O....(R...~ ......... Block .......~.. ............ Lot No ......................... pursuant to application dated ...~...~,...~... '~! 19.~...O.., and approved by the Building Inspector. Fee $ ........................ Building Inspector Rev, 6/30/80 Form No. 6 TO~ZN 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 "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. ~. 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 ~ertificate 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 ... ........................... ~ew Construction ........... Old Or Pre-existin~ B~ding ........ [~~.~ ~ocation of Property .... .-~-....~.. .... ..~~...~: .................... House No. Street Hamlet ~nwer 000, .... ....... ....... ................ ~ubdivision ...................... Filed Map ........... ;~ot .... ~ ~ ............. ~ermit No../. ~.~.~. J..~. i. i~te'~'~ i .. ~!~. .~.~.l '?'~ .... Applicant..~.../././..~... !ealth Dept. Approval .......................... Underwriters Approval... ,. .................... . . 'lanning Board Approval 7 .equest for: Temporary Certificate.....-~.. .... Final Certicate...~... ~ee Submitted: $..~. ~.,. / CO "~ I~g~ APPLICANT FOUNDATION FOUNDATION (lst) (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADD IT]~O~I~ L COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHQLJ~,. L~¥. l~tClTL TEL.: 765-1802 BOARD or "EALT. 3 SETS PLa.s CllECK s PTic';; ............... NOTIPY ~ <ALL :g .................. MAIL : (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date a. Tiffs application must be completely filled in by typewriter or in ink and submitted to thc Building I~peCtor, with sets of plans, accurate plot plan to scale· Eec ~xccord'ing to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app. cation. ' c. The work Covered by this application may not be commenced before issuance of Building Permit· d. Upon approval of this application, the Building Inspector wi/l issued a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. c, No building shall be occupied or used in whole or in part for a.ny purpose whatever until a CertifiCate of Occupant 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances c Regulations, for the construction of buildings, additions or alterations, or for ~:emoval 'or demolition, as herein described The applicant agrees to comply With all"appticab"le laws, ordinances, building code, housing code, and regulations, and t~ · . (Signat~,e of applicant; ~r ~a'n~e', (Mailing address of applica, zt) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil~ler. rfp cruise ~ ......... ' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No ..... .x%~.~.~_ ................ Plumber's,License No, . .~ ............ Electrician s License No ...... Olher Trade'x License No ................ I. Location of land on which proposed work will be done: llouse Number ' Street ........ Ham]et ....................... C tyVax,\l N IO00S ti .(-.~.Z .2..7. oun ap o, ec on .............. Block ...... S bdl i i .......... ' .... C ..... · Lot u VSon. -....... .................................... Eilcd Map No. , (N:nne) ............ Lot fp -. State x s ~ng nsc and occupancy o remises and intended usc and oCCupancy of proposed construction: A. Existing use and occupancy , B. Intended use and occupancy ....... P,_epair... ............. Rpmoval .............. Demolition ......... .~]ll~]Sw~£ng P~,t..Ifil 'xennxs Court .... ~ .... i Accessory Building .......... Fence . ]~]..~e~o~.. 4. Estimated Cost ...... ~..'f:~. · '~' ....................... Fee ........ !...g.,~, If dwelling, nmnber of dwelling units ............... Number of dwelling units on each floor .......... Ifgaraee number of cars ' 6. If business, commercial or mixid occupancy, specify nature and extent of each type of use .............. 7. Dimensions of existing structures if any: Front ............... Rear . .: ............ Depth ........ Height ............... Number of Stories ............................... .... Dimensionso£samestmcture~.~thaterationsoradditions:Front .i;i ..... :::::.i: Rear i..-~:~:~i:~ .... Depth Irleight Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height Number of Stories · ' 9 Size of lot: F?ont Rear' Depth 10. Date of Purchase ............................. Name of Former Owner ................ 1 I. Zone or use district in xvhich piemises are situated .................................................. . . 12. Does proposed construction viglate any zoning law ordinance or regulation: 12, Will lot b d ' ' Will fill d f Y · e regra ed ........ ~ .................... excess be remove rom prerai~es: . c.~ .... 14 Name of Owner of premises Addre~x Phone No Name of Architect ' Address Phone No Name of Contractor Address Phone No lr-.l.~ t. hi~ property loclated within'~O0 feet of a tidal wetland.* ~YES .... NO .... mil yes, Southold Toon Trustees Permit may be required. ! PLOT DIAG ILAM Locate clearly and distinctly I buildings, whether existing or proposed, and. indicate all set-back dun e..~.o.., :': property lines. Give street and bloc number or description according to deed, and show stree{ names and indicate interior or comer lot. ~OT~FY gLULDING OFPAH'F~ENT 76~-1802 9~ AM TO 4 FM FOF~ TH~ FO~.LOWIN G~ tNSPL:C'HONS. 1, FOUNDATION two ~OR POLICED CONC~ilTTE 2. ROUGH ~:RAMiNG & PLUM~ING 3. INSULATION 4. FINAl. "~ CONSTRUCTION MUST BE COMPLETE FOR ALL CONSTRUCTION SHALL ME~T THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY COO~S, NOT RESPONSIBLE FOR DESIGN OR :ONSTRUCTION ERRORS STATE OF NEW YORK, I S.S COUNTY OF ................. · (Name ofmd;wduaI mgnmgcontract) above named. ' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CER1'IFICATE OF OCCUPANCY being duly sxvom, 3cposes and says that he is the applicar HELEN K. BE VOE NOTARY PUBLIC, S~e 9t New York No. 470787B, Suffofl', Couflt't~/ · Term Expires March ~, (Signature of applicar= He is the ~. ! . I (Contractor, agent, corporate officer, crc.) of said owner or owncrs, and is dluly authorized to pc,florin or have performed the said work and to make and file tl= application; that ail statcments coOtained in this application are true to the best of his knowledge and belief; and that work will be perforated in the manner scl forth in the applicatiou filed therewith. S~vom lo before me this NolaD, Public ............ County