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Home My WebLink About19157-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19236 Date JULY 24~ 1990 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 715 DEEP HOLE DRIVE MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 13 Lot 07 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 4, 1990 pursuant to which Building Permit No. 19157Z dated JUNE 25, 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 PORCH ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED EDWARD C. TABORSKY N/~ Bu ~'~ding Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 191 57 Z Dote o~ ~' 19..~...o. Permission is hereby granted to: ...~.,.~.....~... ~.:..~......~.~..~.:. .............. ,o ..... ~~.~.~.,....~...~,~~., ........................ ,..........; ....................... at premises ,~atd at ..~...~.....~...~ ~ ......... ~.~~ ...................... County Tax Map No. I000 Sectio~.~_~.... ~.~.. .......................... , 19.~...~..., and approved by the pursuant to application dated ........ Building Inspector. Fee $,..~..~...:..~... Rev. 6/30/80 BLDG, DEPT. TOWN or sou q.Lp Form No. 6 TOWN 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 fnrm). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn state,out 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. g. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: · i. Accurate survey of property showing ali 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 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. Businesse~ $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 Location o~ Property House No. Street ttamJ, e t or O.ners of Pro ertv ' County Tax Map No 1000, Section. ](~ .Block. ET .... - - SubdiVision - .................................... Filed Map ............ Lot ...................... flealth Dept Approval Underwriters Approval Planning Board Approval ........................ Request for: .Temp°rary Certificate ........... Final Certicate. FOUNDATION (1st) FOONDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD Examined '~ 19 .?.O. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BO^RD OF HEALTH ............ 3 SETS OF PLANS .. CHECK ~ ...... SEPTIC FORH ................ NOTIFY ~ c ^ L ,.. ....... blAIL TO: x pp a/e---.-.-.-.-.-.-.-.~... -;, . . ~.~ ~...---r-~-_: ;~... ......... 'i.i ....... ..... . ............ (Building Inspector) ' ' ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. · b. Plot p!;~,, showing location of lot and of buildings on premises, relationshi to ad' ' ' - ' · or .areas, and ,,lying a detailed description of layout of nmnertv m,,o* '- ~ P . ,!omm= pre. m~s. es or public streets canon. - ~--~---~ ...-~t t,e urawn on the magram whmh m pan of this appli- , ~. 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 fo~ inspection throughout the work. ¢. 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 ~e Building Inspector. ' APPLICATION IS HEREBY MADE to ~iae= Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal 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 inspectors on premises and in building for necessa~-/in~Im:ictions. -l-'---- . '... - . (Si=nature o~ applicant, or name', if'a c'o;'po'ra~fi') ' ' (Mailing address of applicant) State whetiiei'"applican~"~.ner,~ee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ e raise .... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. nuilder's Ucc.se No ..... .O.?.?. ~ ............ Plumber's Licensb. No ......................... Electrician's License No ....................... O/her Trade's License No ...................... 1. Location of land on which proposed work will be done; .7..J,5. " tlouie Number .... · ............... Street Hamlet ..... C tyraxM N ~I000S ti [l~ ' I~ Oun ap o ec on ............ Black ....... /' ........ Lot... ~ ........ . . S bdi ii '"''' ' · ............ Eiled Map No. . (Name) ................ Lot .... :. State existing n~ and occupancy of premises and intended use and occupancy o roposed construction: ' -- .~B~U.C~ ~ · ........ , m~nded u~ ~ occupancy ....... . .... .~ ~, ,- ~epair ............ t<~mo~a, ........... ucmo ition ......... . sw~,~aee,-l~ pocttl[~ ........ ~ m~ ~.uu~ ......... aiccessory Buzldzng .......... Fence ....... Other Work ............ 4 Estimated Cost / ~ J Fee ''~'''~ ' - ~] (to be paid on filing this application) $ If dwelling number of d~vclling u~its ' Number of d~velling units on each floor Ir'garage number of cars ' 6. Ii'business. commercial or mixed bccupancy specify tqatu[e extent of each type ~£ usc . .' ...... ~ 7. Dimensidnsofexist,ngstructurcsiifany= Front.....~.' .tn.d... Rear ...... ~--.--L.~ ..... Depth ':. [[]:3 Hcl=ht .... .~3:~-~ ....... Nunl b,cr o f Stones ..... ~.... " Dimensions of sa~e structure with alterations or additions: Front ....~--{~; .~I~X' .... Rear..'.~ ~.. ~ } Depth ..... .~. ............ '. He'ght ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front Rear Depth Hci~2ht ............... Numb'er of Stories ...... , .............. s _c~'r'~ ~'W~t~6r~ 9. Siz of lot: Front .......... Rear ............ Depth ...*,-~.",.<..L~-~..t.. 10 Date of Purchase I Name of Former Owner 11. Zone or use district in which premises are situated ...... '. ............................................ 12. Does proposed Construction violaie any zoning law, ordinance or regulation: .... ~ ...................... 13. Will lot be regraded ........ .._[N/t~ ............... will excess fill be removed from premises: Ye~ ..... No. l,l. Name of Owner of premises . ~...~...~ressl~. ~~ .... '. Phone No..2~: ~..t?.~.O.. · N~e'of Architect ~ Address Phone No N~e of Contractor . . ' ..... Address ................... Phon No ...... ~ ..... 15.Is this proper locatJed ~i~'~ tO0 feet of a txdal wetland? YES...~... · If yes, Southold Town iTrustees Permit may be required. ~ PLOT DIAG~M Locate ele~ly ~d dist~ctly MI bu~dMgs, whether existing or proposed, =d, indicat~ ~I set-back d~ensions fro~ propemy Hnes. Giw street ~d block nhmber or description aocordMg to d~d, ~d show street n~es and Mdi~at~ whether imefior or coruer lot. STATE OF NEW YOR_K. ~.. ' .............................. .... ,Z ......................., . (Name of individual s'~n'in;gi ................... contract) being duly s%vorn, deposes and says that he is the applicant above named. ' Pre is lite - , . i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly iauthorized to pe,rform or have performed the said work and to make and file this application; that all statements contained in this application are tree to the best of his knowledge and belief; and that the Work will be performed in the manner ct forth in the application filed therewith. .......... {Signature of applica~.t) ~