The URL can be used to link to this page

Home My WebLink About19137-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Zi9377 Date SEPT. 21~ 1990 THIS CERTIFIES that the buildin~ Location of Property I90 PVT. ROAD #32 House No. Street County Tax Map No. 1000 Section 0.59 Block 09 Subdivision Filed Map No. ADDITION SOUTHOLD Hamlet Lot 10.02 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated IUNE 15, 1990 pursuant to which Building Permit No. 19137Z dated JUNE 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 EXPAND AN EXISTING DECK ADDITION AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED MICHAEL & KAT~LEEN WIDENER Rev. 1/81 TOWN OF SOUTHOL BUILDING DEPARTME TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PRE/ cOMPLETION OF THE WORK AUTHORIZED) NO- '~'~13'/ Z Permission is hereby granted to: ....... ,o~ ....... .~... .~ ~........~,~ ....... at premises located at ..I..°*.~.....(...~.U..~.....~.......~..~..).....~..~..~......~...~ Cau,t,,, Ta,, ~ap No. ~000 Section ..... ~..~,":...~ ........ B~oc~ .......~3 .......... Lot N/o?....O..~... .......... pursuant to application dated ..... ~..~J~.~....L.~.. ................... , 19.c~.~)., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN HALL 765-1802 i 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 suz~rey of property with accurate location of all buildings, property 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 Aiectricai installation from Board of Fire Underwriters. 4. Sworn tatement from plumber certifying that the solder used in system contains ~ less than 2/10 of 1% lead. 5. Commercial building, indus·trial building, multiple residences and similar bu~/dings and installations, a certificate of Code Compliance from'architect or engineer I responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 195_7) non-conforming uses, or build,rigs and "pre-existing" land uses: 1. Accurate survey of property showing ali property lines, streets, building and unusual natural or topographic features. · ,.o 2.~ A properly completed application and a consent"to inspect signed ~y the applicant. If a Certificate of Occupancy is denied, the ~uilding Inspector shall state the reasons therefor 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 Building - $100.00 3. Copy of ~ertificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated C~r~ificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15..90, Commercial $15.00 ew Construction .... ~/ ....... [ .... , o...f., uxu ur ~re-ex~st~ng Building ................. , HOuse No. Onwer or Owners of Property. ~ .-~ ...... ~ C~.< ....................... count Tax 1000. Seetion.. .g ..... ......... .... ~ubdi~ision ....... [ ..... : ........... . ........... Filed Map ............ not.~ ........... .: ....... //ealth Dept. Approval .......................... Underwriters _. Approval ......................... PI d App 1 ' Request for: .Temporary Certificate ........... Final Certicate ........... Submitted: $ .......... - FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ]/~DATION ZND [ ] INSULATION FRAMING [~' REMARKS: DATE INSPECTOR ,. · .,.. FORM NO. 1 TOWN OF SOUTHOLD ;- BUILDING DEPARTMENT TOWN HALL $OUTHOLD. N.Y. 11071 ............... (~uildin~ InspectOr) APPLICATION FOR BUILDING PERMIT BOARD OF HKALTN 3 SETS OF PLANs SURVEY ..................... CI{~CK CALL . -. . ......... HAIL TO: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submRted to the Building {J~'peetor, with 3 sets oF plans, aecu~tu plot plan to scale. Fee according to schedule. b. Plot plan showin~ location of lot and of buildings on premises, relationship to adjoinln~ prem~ or public or areas, ~nd ~ivin§ a detailed description of l.;,yout oF property must be drawn on the diagram which i~p-~ of' this appli- cation. o, The mvork covered by this application may not be commenced before issuance oi~ Buildin~ Perm d. Upon approval of this application, the Buildin,, r ............. Z ~, it. ' ' .-,, m~pc~or wet tssucc~ a L~uiioing Permit to the applicant. Such permit shall be kept on the premises available for inspection throug.hout the work. ¢. No building shall be occupied or used in whole aria part for any purpose whatever until a Certificate of Occupancy shall have been grunted by the Building Inspector. ' APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ord/nance of the Town of SouthoId, Suffolk County, New Yol-k, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~:cmoval or demolition, as her-in described. The applicant agrees to comply with all applicabJe laws, ordinances, building code, housina code, and rcgu~fions, and to admit authorized inspector~ on premises and in building for necessary insuections. . , · . (S~=nature ot apphcant, or name, if a corpom~;~on) .... · ? ........ : ...... , .............................. (as o~thc tax roll or latest deed) Ir applicant ~ a cO~ora/ion, signature of duly authorized officer. Builder's License No. . Plumber's License No ......................... Electrician's L/cerise No ....................... OtherTradc License No ' ' ocation o£1andon yd,ich(~r~p~s~,,3d, work will bc done; llouse Number Slrcct, .. Hamlet ............... County Tax Map No lO00 Section ............... · Blbck .... · . ...... , .... Lo t/.~.~ e~,..' ......... .,.:. Subdivision. · .................. ' Eilcd Map No ';* (Name) ' Lot ' i . .b).~,.e.((~o.~ ...........,~,'~,;,,., ~;~ ~" .) . · ccupancy ............. , .... ./~. .3. Nature of work (check which appl.icable): Ne,v Building .......... Addition i~"' '~'~'~!" ~i'd:t~'r:ltmsl' · .......... R~r .............. ~o~ .............. m~o~,io. ......... ~ .s~i~i;;~' ~oi ............. ~. .......... ~ ....................... ~e~ ........ 1 .................. ~-.~ ..... ' Ir garage, number of car~ 6. If business, commcrc'al or mixed' OCCUpancy, specify' nature and extent of each type of usc ........ 7 D'mensions of ex ~tmg structures 'iff any: Front Rear Depth Height. ............... Nu nbcr of Stories ...................................... Dimensions of same structure with alterations or add lions: Front Rear Depth ~ HeiSt Number of Stones ....... 8. Dimensions of entire new construction: Front ' Rear · Depth ....... Hci=ht ~umbpr of Stories ' 9 Size of lot: Front : ' . ............. .......... Rear ..................... Depth ........ 10. DateofPurchase ............ ~ ................. Name of Fomcr Owner ...................... . ... .. . l 1. Zone or use district in which Premises situated [2. Does proposed COnstruction violate any zoning law, ordinance or regulation' . ........................ .: ....... , · ' · .~ .................. Wdl excess fill be removed from premises: Yes l,.{ N~e of Owner of premises ' ' Address Phone No ' N~e'of Architect Address Phone No N~e of Contractor ; ' Phone No F. · ' .......... ............... Address ................................. 15.Is this property lo et'ed within I OO feet of a ~tidal · If yes, Southold To~n Irusgees Permit may be required. PLOT DIAG~M Locate cle~ly =d distMctly ~1 bu~dMgs, whether existing or proposed, ~d. indicate ~I set-back d~nsions from prope~y fines. Give street ~d block n~mber or description ac~ordMg to deed, ~d show street nines and ~dimte whether interior or comer lot. STATE OF NEW YORK, COUNTY OF $i'S (Name of individual signi;ig contract) above named. being dnly sxvom, deposes and says that he i~ the applicant i (Contractor, agent, corporate officcr, etc.) of said o~vncr or mvncrs, and is dulylauthorizcd to pe,rform or have performed the said ~vork and to make and file this application: that all statcments contaiimd in this application are true to the best of his knoxvlcdge and belief; and that the Work will be perforated in the manner ~ct forth in the application filed therewith. ¢' S~Vom to before mc tilts ~ . ) , , ............. ,., ........... VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 June 21, 1990 Hr. Michael Widener 19100 Main Road Mattituck, N.Y. 11952 Re: Premises: 190 Private Rd. #32, $outhold, N.Y. Suff. go. Tax Map #1000-59-9-2 B.P. #19137-Z Dear Mr. Widener: Please be advised that your building permit to expand your deck addition is ready. The fee for the permit is $28.80. Kindly bring in your check for that amount and we will give you the permit. Very truly yours, SOUTROLD TOWN BUILDING DEPT. Georgia Rudder, Secretary