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Home My WebLink About19165-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19186 Date JULY 6r 1990 THIS CERTIFIES that the building. Location of Property 755 TUTHILL ROAD House No. Street County Tax Map No. 1000 Section 55 Block 4 Subdivision Filed Map No. ADDITION SOUTHOLD, N.Y. Lot 2 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 25, 1990 pursuant to which Building Permit No. 19165-Z dated JUNE 27~ 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 WILLIAM CONROY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A /~Bui ding Inspector Rev. 1/81 ~vOB~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PEP, J~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 19165 Z _o.7 Date ...........~ ......................... , $ 9..~'..~ Permission is hereby granted to: ...~,a..~.....L~.~..!. ........................................... ........ ,o at premises located at ....~..~...~.......~...~.--~.....~....L..... ................... the Building Inspector. Fee $..~....~...:~ Building Inspector Rev. 6/30/80 Form' No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 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 ail 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,ant from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, indust'rial 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. .,3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. 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 e£ 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. 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. .~.~a Certificate of Occupancy $50.00 5. Temporary Certificate of Occupancy - Residential $15..~0, Conunarcial $15.00 ' ... · ,ew uonstructzon ..... .;~ ..... Old Or Pre-existing Building ................. Location of Property....~p.~-..~. ............. .~..f~.T/~//~!/~- /2> ~u~= ~u. Street Hamlet Oawer or Owners of Property....~z~/../.~-./f2 ~/./~.../~ ..... J~d¥ {% c>~/ ' ' .... iiZiiii ........ County Tax Map No I000, Section,.~.P ....... Block ....................... Subdivision...~. ~.' ......... F~led Map ............ Lot.] ........... % ........ ermit ..... Of ..... [{eal~h Dept. Approval .......................... Underwriters Approval ........................ Pi d App 1 ' ' '" arming Boar rova ........................ Request for: .Temporary Certificate ........... Final Certicate ........... ~. 2qqJ/ .... · ................. c o a ~/s~(, ~PP~C.~.// '. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS~ATION FRAMING REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION AND [ ] INSULATION [ ] FRAMING [~FINAL ~ DATE ~/~ -/7' INSPECTOR FObNDATION ( 1st FOONDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE COMM£NTS FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF gOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTIIOLD, N.Y. 11971 BOARD OF HEALTIt ............ 3 SETS OF' PLA,'qS ............ SURVEY ..................... CHECK SEPTIC ..................... TEL.: 705.1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ;~ . a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Buildin~//mPector, with 3 sets of plans, accurate plot plan to scale· Fee according to schedule· b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premise~ or public streets cation, otvmo a dote/led description of l~yout of property must be drawn on the diagram whichi~part of this appli- 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 will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throuv~hout the work. e. No building shall be occupied or used in whole or ~n part for any purpose whatever until a Certificate of Ocoupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to' the Building Department for the issuance of a Building Permit 9umuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lawm, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hc~in described. The applicant agrees to comply with all applicable laws. ordinances, building code, housing code, and r~tions, and to a~mitauthorizedinspectomonpremiscsandinbuildingfornecessary~~~ . (Signature · ' (Maili;g ~ddre'ss of State whe'ther applicant ~essee, agent, architect, engineer, general contractor, electrician, plumber or builder· , e rp s ... df ..... , .... 7 .... ./&.~... ,~.,?.c.~... ~.~ ~1 *.a ;~.,~:.. ~'~;~ (~ o. thc ta~ ~oli ;~;t'=s[jJdd) ........ '" Ir app,cant !!.~:y_?a,__?rRtho~. y!g.2y.t~f? r.~ authorized officer. Builder's License'.Nd*" ~' - :;'-,)~·)~';,: Plumber's License, Nol: > ": ' ~!'.-', ', ~ > ~ ~ ~ -~ Electrician's LiCense No, :~ .... ' ' Oil r Tj'ade s Li 'se NbJ ~ ' ~" ' I. Location oflan~loti wJfi~h ' ': "' ~' ' proposed work'will bc done, House Nuhiber'~ '~'' .............. · - · · Street; ..... Hamlet ..... ........... bdi ....... Su vision . . · ........ Eilcd Map No. · · · · Lot ...... : i · .... .... , ' b. Int...,.-, }'~-- ~- -,/x/x/ ' ' - ' ~ ' '"' e ' '. ' '(' ' .................... ..... =~ u,e and o~- ...... /~')'<~ ,dl .~/.,3///. ~ /~ ' . ' · ' ' 3, Naturcot work (¢hcckwhich applicable) New Build ng ......... Add tGn ' ,, .~,~..,alm~'d~iPn :J[.,~', ....... ~ep=r .~ ............ ~.~o~ .............. ~o ~.o. ........ :,~.s~,~.., :~.~ ....... ~ · ~ y ~u~za~ng .......... Fence · ~ · · ~Ch,~7~ork~ .-4 . ~ ...... Estimated Cost .~..~... ! ...................... F-- ~ ~ ,-:,~z ~ ~ . . , (to bc p~O on Hhn~ th~s appl~catmn) 5, ]fdwcHing number o[dweiHng ufiits ' Nnmbcr of dwelling units on e~eh floor l/g=r~cc numbero/c~rs ' ' feb d 6. usincss, commercial or mixc ccupancy, spec nature ~nd extent of each typc of nsc .................... 7 Dimensions ofcxistmgst~cturcs 'if any: Front ' ' Rcar Depth Hcieht Num bbr o f Stohes Dimensions of same structure with alterations addit or Depth ~:Height Dimensions of entire new constrn6tion: Front ...... Hciuht ............. Nu nb~r of Stories ...... Size of lot: Front ' Rear ............ Number of Stones ............ Rear . Depth ....... I I. Zone or use district zn whzch premzses are situated 12. Docs proposed COnstruction violaia any zoning law, ordinance or regulation: ............... 13. Will lot be regraded .; ........ ! .................. Will excess fill be removed ['[O'm'pr'-~n'i~e's: .... ~'el ~.. No.. I 1 Name of Owner of premises i ' Address Phone No ' Name'of Architect ' No ............................ Address .............. .. .. . Phone ................. Name of Contractor ' No .......... ~'. .............. Address ....... ............ Phone 15.Is this property locatied within lO0 feet of a-tidal wetland? *YES .... '1£ yes, Southold Town ITruntees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street ~md b!ock nbmber or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY OR WITHOUT CERTIFICATE APPROVED AS NOTED DATE: ~:EE: S'~.-- SY: %/. ~".L-. NOTIFY BUlL.DING DERARTMENT AT 76B-1802 S AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~. FOUnO^TIO.. ~ORmU,REO oCCUPANCY mR POU.E~ CONCRm OF STATE OF NEW YORK, COUNTY OF .. S!'S 2. ROUGH - FRAMING & PLUMBING ................ 3. INSULATION ............. ,-'.: ......... bain u swo es cant · f tndw~dual s~,mll; contract above named. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, t'~is tile ............................... . . STATE CONSTRUCTION,. & ENERGY (C · oratc~ "" Cl~E~ OR CONSTRUCTION'ERRORS , ontraetor, agent, corp of said owner or owners, and is duly authorized to ps,florin or have peril'on'ned the said work and to make and file this aPpbcatmn: that all statc,ncnts cents,ged ,n this apphcatmn are true to thc best of his knowledge and belief;and that thc Work will be perforator in the manner set forth in the application filed thc~'ewith. ../ Sworn to before mc tiffs mm ~xpim ~h SO. 19..,,~ ' //(~ignamre of applic:m.t} C ~ 1"' n 0 ,-r Z ",r 0