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Home My WebLink About19279-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20520 Date FEBRUARY 6~ 1992 THIS CERTIFIES that the buildin~ ADDITION Location of Property 2350 JACKSON STREET, NEW SUFFOLK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 10 Lot 20.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 23, 1990 pursuant to which Building Permit No. 19279-Z dated JULY 30, 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTIigNT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED THOMAS & JAYNE MARTIN N/A Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .... ....... ....... ....... .... ~..o.....~. ~..~..g ......... , ................................ .................. ~.~ .......... .~ ......... .~. .... ', ......... '~"' ............. ~'~"~"~'& ................ = ........ : .......................... ~'~'"'~"="n .... Otp remises ~t0coted at .....~..~..~.........,'~-~..°..~'..,..,e%,~.,, .,.?/..~.~.Z;.~......~ ....... .~.,. ~.... I~...)~J~ .... County Tax Map No. 1000 Section ....... I.L.'7. .......... mock ...... /....q .......... Lot No...c~...D..:.....~.. ..... pursuant to application dated ..... ...~.,R~......~...~'~ .................... ,, 9.~..~., and approved by the Building Inspector. Fee a...'~. ................... Rev. 6/30/80 7G5-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. / FOUNDATION ZND [ ] INSULATION FRAMING [ ,-]~AL RECMARKS: //~/?' Ic~ INSPECTOR APPRCIVED AS NOTED FEE: ~'~"~ .... , BY: ~' ~' L. FOLLOWING INSPECTIONS. 1. FOUNDATION ~0 REQUIRED FOR PO~J"ED CONCRETE 4 nN~,~. CO~ST~UCT~O~ ~UST ALL CONST"UC~ION SHALL MEET ~TATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE FOR Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN UALL 765-i802 J, 13 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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% icad. 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. g. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pfc-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 l. 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 - $I0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ........ ~ Construc~io-~.~ ....... Old Or ~r~- ', ' · · '--. ~- .-~ · ~ex~st~ng Building ................ l.ocation of Property ..~2..~.~.?.... .~J..~*-~ ~^~ ................. ~.~..~.~.. ~ .......... .'¢.,~.. House No. Street Hamlet ..... On,er or Owners of Proper .~ ........ t County Tax Map No 1000, Section..7.~.~ ....... Block..· /O ...Lot ~:~O~ ~.~ Subdivision ........... i'i'JJJ'JJ'~'~ilj ........ Filed Nap ............ Lot ............ .~. ...... · ~ . ~.~.... ~lealtb Dept Approval ~' Underwriters Approval " ' I-nning Board Approval {equcst for: Temporary Certificate ...... ee Submitted: $ ................... ~ .... APPLICANT FOUNDATION (1st) FOUNDATION ( 2nd ROUGH FRAME & PLUMBING 3. II~SULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS BLDG. DEPT. .... TOWN FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~.O., 199.°. Permit No. J Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS ............ SURVEY ........ ; ............ CHECK NOTIFY~ CALL MAIL TOA._~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Ihspector, with sets of plans, accurate plot plan t~'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 lhyout of property must be drawn on the diagram which is part of tiffs appLi- cation. c. The work covered y 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 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 Bttilding Permit pursuant to the Building Zone Ordinance of the Town of S(mthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~;emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit author/zed inspectom on premises and in building for necessary inspections~ - - / gnntu eot applicant or name, . ,., if a c'o~-l~dr~tlo'n')' ' ' State whether applicant i essee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as or/the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· ........ .................... title o~ ~o~r'a~/;fficer) Builder's License No. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... · Location of land on which proposed work will be done; ', ...... .~,.~.. Ilouse Number Street, Hamlet ............ County Tax Map No. 1000 Section .......... ock ........ Lot. ° " Subdivision ' " ' ' Eiled Map No (Name) ........... State existing use and occupancy o£ premises and intended use and OCcupancy of proposed construction: A. Existing use and occupancy .... .'q. , B. Intended use and occupancy ......... .---.... 3. Nature'of work (check which applicfible): New Buildiffg ......... Addition .......... A/teration t.~ ilJ ....... Repmr .............. Removali .............. Demolmon .............. Sw~a;z pgC~P c~J~c :.h,h~/~ ...... Te~is Court · Accessor B~' ' ' -' ~'/~' ....... ' y zldlng .......... Fence ....... Other W 4. Estimated Cost q. 00~ ...;.. Fee ................ : (to be paid on filing' this appl;cati~n) 5 If dwelling numberofdwellingunit~ ~ Nnmber of dwelling units on each floor If garaee number of cars 6 If business commercial or mixed oc6upancy specify nature and extent of each type of use 7. Dimensions of existing structures, if~any: Front .......... 2. .... Rear ............... Depth ......... Heieht_ ............... Number;of Stories ................................................... . Dimensions of same structure with alterations or additions: Front ................. Rear ......... Dupth ..................... Hm~t ............ Number of Stories ....... .... , . .-;~ ..... ~.~;., .... 8. D~mensmns of entire new constmctron: Front . .~Q.. Rear ............... Depth ~' Nmb jfstfi si,, or~ot: v,o,~~i¢" ............; ; ...~o~.:7.~.: ;~; ;" ............... ~ o ...... o ,, ............... ~= ..]P.W ............ ~ ............ _~,p,~-;4.a~, ...... ¢; ';"~. '; .." 9. 1. Zone or use district in which premises are situated .................................................... 2. Does proposed eonstructiqn violate ~ny zoning law, ordinance or regulation: . Mo .............. 3. WUl lot be regraded ..~.~. % ...... ~ ....../ .......... . . Will excess fill be r~o~d f~rt~ises:' ' '~i ~. ~.'. 4. N~ of Owner or premises., .~ ~ ~,.~. ..... Addr~s~.~2.. eW~No..7.~:~.. N~e of Architect ' Address Phone No N~e of Contractor ........... 2.. ' . Address ................... Phone No .......... ' j~ feet of a tidal wetland~ *YES...~ :~' ~I~ yes~ Southold Town T~rustees Permit may be required. PLOT DIAG~M Locate clearly and distinctly,all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. ~ ;TATE OF NEW,.~YOI~K.,, , S.S "' deposes and says that he is tile applicant .............................· · i .................. being duly sworn, (Name of individual signin: contract) ~bove nam'ed. (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly athorized to pe,rform or have performed the said work and to make and file this ~pplicafion: that all statements containOd in this application are ~rue to the best of his knowledge and belief; and that the .york will be performed in the manner set fort ~ in the application filed therewith. ~Wom to before me this tiOT~IW PUBLIC, ~ ~ ~N~w Y~fl~ (Signatur~ o~ applicant) No, 470787S, Suffolk Couldy o '~ Expires .'.J I oo0 - / / 7 --' Io - ;.'.'.q o, ,...q