The URL can be used to link to this page

Home My WebLink About19318-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTI~ENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19316 Date AUGUST 23~ 1990 THIS CERTIFIES that the building Location of Property 320 SOUND ROAD House No. County Tax Map No. 1000 Section 35 Subdivision ALTERATION Street Block 1 Filed Map No. GREENPORT, N.Y. Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1990 pursuant to which Building Permit No. Z-19318 dated AUGUST 10, 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 ALTERATION TO INSTALL SECOND FLOOR BATHROOM~ APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A MOLLY R. HARROWER /~uilding Inspector Rev. 1/81 FO~M NO. ~ TOWN 0~: $OUT~OLD B~JILDING DEI'AP~T/~,[NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PER/WIT MUST BE KEPT ON THE PREk41SES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is here.by granted to:// // ...~~..~.~ .................... ..~_.... ......... ..... ~~,~X....,.~.~....~.~.~.~.~ ,o ..~~~~..~.....~~~.....~~~ .~ ....... ~~.~..~ ...................................................................................... ~, ~,~,,,,,~,,~ ~, ....... .~..~;~~~.....~..~. ......................................... pu~uent to opplication dat~ ........... ~ ............................., lg..~ end opprov~ by the Building Inspector. Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 i APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This applicarion'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 l~nes, 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 ~ 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses or buildings and pre~exzst~ng 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 o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. f. 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 - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~:~w Construction .... i ...... Old Or Pre-existing Bui~ ........... ~. ..... Location of Property...~ ....... ~...~ ......... 2. t~-~5~_.~k House No. . ........ ~-~...~...,..v.~..% ..... Street Hamlet ooo. ...... ....... ........ ..... ........... Subd £~ision ' ' .................................... Filed Map ............ Lot ............. % ........ ?ermit No ....... ' - ........ Date Of Permit ................ Applicant ............................. [;ealth Dept Approval ' ' ......................... Underwriters Approval Planning .... . Board Approval ............... Request for: .%emporary Certificate ........... Final Certicate ........... Fee Submitted: $.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y, 11971 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ........ ~ ............ C~ECK ...................... SEPTIC FORM ................ NOTIFY~ CALL '''r ......... MAIL TO: Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted t0 the Building Ihspector, with 3 ,sets of plans, accurate plot plan tO~cale. 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 l~yout of property must be drawn on the diagram which is parr of th/s appli- cation. ¢. The work covered 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 shall be kept on the premises available for inspection throuodaout 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 Sduthold, Suffolk County, New York, and other applicable Laws. Ordinances or Regulati0~se~,i~,r~t.,l~c~ftatruction of buildings, ad~ditions or alterations, or fo.r..'~oval or. demolition as herein des ' . ~J~,ap_P.??_nJ_g~r..ees to. co,m_~plg,,,W.i[.h all applicable laws, ordinances, buildjzfg ¢Zode. M.f6-v~ng code an~t re,.ulati~,.= %nndbetdd ....... auumr~z~m-'mspecto.,rs, ,on premises and in building for necessary ins[~ti~ -~¢~" ~' " ' · ': - ?] ' , .~-~ghat~ofmp~.licant, or name, if a corporanon) ' "~ ~ (Mailing address of applicant) St'ate wllethe~ applicat~[,is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name o[,own,,e,r of, premis~;,' . . ' ' '.. '. : .' ',, ,, ~O.: (as on the tax roll or latest deed) If apphcant m ;l'Corp~oration~ignature of duly authorized officer. ........ ;iff ti'tl/;f ~;rpgr'ate officer') 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: House Number Street, Hamlet ....... County Tax Map No. 1000 Section ................ Block ....... Lot ..... " Subdivision ..................................... Eiled Map No ............................ (Name) Lot . . · State existing use and occupancy ot premises and intended use ~Occupancy ot proposed construction: B. Intended use and occupancy .... 3. Nature'ofwork (check whzch apphgable): New Building .......... Add,t~on .......... Alteration ....... ~ . 4 Estimated Cost (to be paid on filing this $ If dwelling number of dwelling un is Number of dwelling units on each floor If garner, number of cars ....... ~ ........................................................ 6 If b ~ 'fy f h typ · usiness, commercial or mixed o cupancy, specl nature and extent oeac e of use ..................... 7. Dimensions of existing structures, it'any: Front ................ Rear ................ Depth ............. . . Height .......... NumberofStories ................................................. . . . Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth.... ............... . .. Height ................... i..NumberofStories ................ .... 8. Dimensions of entire new constn~ct.ion: Front ............... Rear ............... Depth .. . Height Numbei of Stories · 9. Size of lot: Front ............. , ........ Rear ...................... Depth .................... 0 Date of Purchase ' Name of Former Owner I Zone or use district in which premises are situated 2 ' ' ' ordinance or regulation: · Does proposed constructxon vmlatelany zoning law, . ......................... . .... . 3. Will lot be regraded ........... i ................ Wi[l excess fill be removed from premises: . Yes ,.. No. 4. Name of Owner of premises ..... ~ .............. Address ................... Phone No .... Name of Architect ~ Address Phone No Name of Contractor ~ ' Address Phone No ' 15.I~ this property loe41t:e~d ~irhln 300 feet: of a tl. da! wet:land? ~¥ES .... NO .... · I~ yes, Soul:hold Town ~rust:ees Permit: may be raqu£red. , PLOT DIAGRAM Locate clearly and distinctly~all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and bloLk number or description according to deed, and show street names and indicate whether nterior'or comer lot. ,~CL. -- /f / ~,3r"X_. ' AP,,eRQ /£D AS frO*rED . . . NOTIFY B lLm ?fi5-1802 9 AM TO 4 PNJ-~OR THE FOLLOWING iNSPECTIONS: 1, FOUNDATION . TWO REQUIRED FOR POUREDCONCRETE 2. ROUGH. FI~AMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST SE COMPJ~TE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQIJJREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ;,T~ATE OF NEWc-YOPcI~ . , ._ .-, (Name of individual signinglcontract) ibovc na~ed, ~ is the ................. ' . r r~ agent, corporate officer, etc.) )f said owner or owners, ~d is duly ahthorized to pegform or have performed tho said work and to m~e and ilia this ppi cat on that all state nents conta ~od ~n thru app lear:on are true to the best of his knoxvledga and belief; and that the .york w~l be perforated in the m~ner se~t forth in tho application filed therewith. ;wom to before me this ' j ' ·