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Home My WebLink About19179-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21190 Date DECEMBER 3, 1992 THIS CERTIFIES that the building ADDITION Location of Property 7092 NEW SUFFOLK ROAD NEW SUFFOLK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 flock 6 Lot 7.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application far Building Permit heretofore filed in this office dated ,7ULY 2, 1990 pursuant to which Building Permit No. 19179-Z dated JifLY 3 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 THOMAS C. SAMOELS & NANCY L. STEELMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A or~1l~ uildinq Inspector Rev. 1/81 FOSffi NO. A 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) Na + ~ Z Date 19.4.u. Permission is hereby granted to: ~".W...L-....~a..:~.:..... ~ ~.9.3~~:..... \ of premises located at ...1.~.9 ~:........~..4r::~.... .l~..~......N °5 County Tax Map No. 1000 Section .......J. ~ 7......... Block ~ Lot No.....7.:.~............ pursuant to application dated .............~...1:..................., 19.~.<?., and approved by the Building Inspector. Fee S. Building Inspector Rev. 6/30/80 Farm No. 6 . ,.r..„wi~ .,....r,~~~.,,~. , TOWN OF SOUTHOLA `1 1 ^ 4 { , ! BUILDIDIG DEPARTMENT TOWN HALL - uCti , ~~~Z 765-1802 uC APPLICATION FOR CERTII'ICATE 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 oz 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 17 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-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 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 - $10.00 4. Updated Certificate of Occupancy - $50.00 5.' Temporary Certificate of Occupancy - Residentianl $15.y0y~0, Commee~r~7cial $15.00 Date. 4r~~~.'~1~>~~. vf4r~.. . New Construction...........p Old Or Pre-existing~7~B~uilding...Y/ Location of Property...~di.Q ~Y:'Y.STJ~L~(7~,~.~~~7 .....i,V~f .~!UF,FA~LJ~ IIouse -Nyo~.~,~., Str-eet_! q/ Hamlet Onwer or Owners of Proper.ty.: ;rs~i.V~..L.~•.~L~.S..F~'../. Y~~i` t•~ • ~~~'•r • • • N ,t County Tax Map No 1000, Section..../l,/.......Block..... Q.(Y........Lot... Subdivision..~.y./.~/.q...../y.~ y...2..Fipled Map.........~~q.~.,,,Lot.....~.(*.r~2~m........... Permit No..~,?t~.l./......Date~,O//f Permit..L~i~/1~....Applicants'+~"~//lU~s•~•Y!ygY~,Y~~:jj~:'f~~~ health Dept. Approval........CT~p .............Underwriters Approval.........,,,Y.RL Planning Board Approval........~/1 A~ Request for: Temporary Certificate........... Final Certicate..!.,•..... Fee Submitted: $.~5 ~.y rJ~~S,.) .APPLICANT • . • . • • . c n I1 Q'D l~f~l`~~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ FINAL REMARKS: _ rr DATE l~ INSPECTOR -~f'~--- =1ELD Ii:Sl'~C7?U2! ~~Un:E ~ COMMLNT~ ' 1 . _ a. ~ J y ..O FOUtJDATION (1st) :(N - °~b FOUNDATIOtJ (2nd) 2. 0 !Ls v~ P,OUGH FRAME & ~ • W Ni PLUMBING N H 3. ~ p,~, c~ IIJSULATIOP! PER N. Y. STATE ENERGY CODE x ~ a 4 . y ~ FI;JAL ~ o z ADDITIOPlAL COMMENTS: x .f x ro~ H ~ • (W 9 y H O Z O ~ S m A • r ` H C ' x o m 1J ^o H B0.1RD OF HEALTH FOR6n N0.1 3 SETS O~PL.INS SURVEY TOWN OFSOUTHOLD CHGCR .?'fI; ,e2,f7~ QUlLDING OFPARTMENT SEPTIC FORP1 TOWN HALL $OUTIiOLD. N.Y. 11~J71 NOTIFY TEL.: 7G5.1II02 CALL ..73 ~2~(SJ~,, , , , , , , P1AIL T0: Exaruincd 199.Q . Approved . 199 PcrmitNo.~.l,)7,~ DisaPProved ale R w... D Ji _ ,~l ~ ~ z~ (Building Inspector) BLOG.DEPT APPLICATION FOR BIJILDINGPERNtt'f TOWN OFSOUTliOLD Date ..:...I~2_......., ]5q~ INSTRUCTIONS a. This application must be completely filled in by typetivriter or in ink and submitted to the Buildin;iiupector, 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 premises or public streets ar areas, and giving a detailed description of layout of property must be drawn on the diagram which ispart of this appli- cation. ~ e. 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 applic~t. Such permit shall be kept on the premises available for inspection throu~ttout the work. e. No building shall be occupied or used in whole of in part for any purpose whatever until a Certifiate 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Rc_ulatiorts, for the construction of buildings, additions or alterations, of for removal or demolition, as herein described. The applicant agrees to camply with all applicable laws, ordinances; bull ing code, h using code, and rcoulations, and to admit authorized inspectors on premises and in building for necessary ctions. i~gjn~a~tjur~ t'appllyi~canyyyt~~~,orname,ifacorporarwn)~ - (Mailing address of applicant ~J'cl State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . G T7._tt .k :'cti.?. ~.r. ~J :1 V~~ ! V ./"tJ~l,-.~~...L.. , .J.~4~~-~.~~ . (as on the tax roll or latest deed) - !fapplicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ' Builder's License No . . . Plumber's Liecnsc No. Electrician's License No . . Other Trade's License No . . . 1. Location of land on which proposed work will be done: .~~9.~ I~..~. 5c.~ff~1~..1........... 1~1~~..~~?-~~I.k,. House Number ~ f Street. ,may/-- Hamlet r County Tax ,,\tap No. 1000 Section Block , , . , , ,4 :4~, , , , , , , , Lot ~s.l... , . ~ . Subdivision Filed t•fap No. Lot ..~Nmnc) ~ • State cxistin~ use and occupancy of premises and intended use and occupancy of proposed construction: ` - ~ , o.Existin~ P Y ..~1N~~.:.~~M!!-Y..~2~Ja~_.t~yC.~; . use and occu anc " " b. Intended use and ~ ~ occupancy 3. Nature of wor}. (check which app X t~a5 cUteraGon l#cable): Ncw DuildinS • • • • • • • • • • Addition . Repair jtFmov~l Demolition ..........Swi:anin ; pool........... . Tennis Court Accessory Building..,.......Fence .......Othec[dork............ Y , 4. Estimated Cost Fee . (to be paid on Cling this application) 5. If dwelling, number of dwelling units , t Nttmbcr of dwelling units on each floor Ifgaracc.numbcroCcars 6, If business, commercial or mixed ¢ccupancy, specify natttrc and oxtcnt of each type of use 7, Dimensions of existing structures,~~iC any; Front . ~ ~•.r0~.~..... Rear ~rJfr:....... Depth srJ~1..... . . Height ..2RF.'T.-....... Number of Stories ..I~........... . . Digcsnsions of same stnrc urP~tt4 alterations or additions: Front Rear .:`l'JrFf.......... . . D~~p'r i'. ~~FJ: (/-?~,~~~;`y s . } Iicight ....$AM~ ............Number of S[orics ...nJ~d2~~.:. . S. Diir#~`s~sions of entire new coti~~ tGtion: Front ....24.>:'C...... Rear ....~d i'.t..... Depth ,1.[?F.r , , . He ~ Nye} bi:r of Stories ....toa• . 9. Si ~f'lot~Fin't D Pth . . l . Rear . 1~~t l0. Da e of~~Purchase • Name of Former Owner . ~~C»Y: • K;•lL~......... . . 11. Zo a og°Cis`e°iiiSttict in wl~i~lr pr ' ices are situated . . ,~,pySt'~i~Ssed constructitYfiV ale any zoning law, ordinance or regulation: • • • • • • • • • • • • - 13. 1Vill lot be regraded . ; .Y74 . . . Nil excess fill be removed from premises: , Ycs No~C 14. Name of Owner of premises~lbM~aAM4.2EL9~A)Af.~(.51i~1!~d"~`'res~`) •2.b2~M91bL~1»Cvlch~y~-Phone No. (.~1~).7~`~:: (:`~45.•. Name of Architect .~/A17~.. • ~ .........Address ...................Phone No................ . Name of Contractor •I . ......:........Address . .Phone No.....;'... lS.Is this property located within 1 00 feet of a tidal •vetland? ^YES....KO~.. *If yes, Southold TowniTrustees Permit may be required. PLOT DIAGRAMS Locate clearly and distinctly all uildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block n~rmbcr or description according to deed, and show street names and indicate whether' interior or corner lot. i , _ . p ' STATE OP NElV YORK, $ S COUNTY F ......./.~.-r.''.....'.I,~/ . , , • , ,~,~l~~r~. , x.,11 N: ,l~ , ° • being duly sworn, degoscs and, says that he is the applicant (Nam of individual siSni~rg contract) above named. is the ...~e~~r.:.,/.>~r~h~:~ . i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty autltorizcd to perform or have pcrfotirtcd the said work and to make and Gle this application; that all statements conta4ned in this application arc true to the best of ltis knowledge and belief; and that the work will be pcrfarnted in the manncr',sct forth in tlto application filed therewith. Swom to~~bcforc me this Notary Public, ,flv,~. A..u~: ~~v~~~• • . County ~ DIANE DaFl~t7JQ Namay Pudb, State aI Nab Meth • • • • . • • • . • . P12.4GJ57~6 ~ (Si;nature of applicant) QuafiBod i,i 3ufio?k t5y~y Commfoatoat sn r3ro~ i9~~ . a "€F ~ ~ ~ s. F _ y k ~'3 '1'~ _ ~ _ _ pvnn y { ~ x 5,~ - ~ a ~ i~ - ~ n x 1. ~ ~ ~ ~ ~ ~ ~ ('tr. ~ , G. p t t. k c. ~ i ~ ~ ~ ~ ~ t ~ ~ ~ :rn . , ~ ~ sa - . ~ ~ ° ~ D. ~ ~ ~ ~s ~ ~ s k . ~ ~ ~ ~ ~ ~i ~ y ~ ~ ~ ok ~ ~ o ~ ~ ~ ~ ~~a ~ ~i~ ~t ~ ~ ~ 1 ~ i~ { ~ r, ~ ~ . ~ mgr ao~w. C. w; WGY1..1 {c G?6. ~.t s;~ a~ ~ ~ ~ x C1 ~~r, ~a , ~ ~ ~ a a i_: a ~4~ ~ a ~ ~ ~ ~ k ~ Q S ~ ~ ~ ~ ' ~ r * s c ~ 1 (r y~ +y t~ ~ is (A+tt4 ~ Sl ~~~r s~ ~ i , N ~f> ^ i ~ ~1,~ ~ "e tr t ( ^ ~ r. x ~ ...,,~.....~,.,._.A..._.....«-,,,.~. _...._.w.a "'`mo"""w - , ~ ~ ~ q. c ~ tk. t.. ~ , z 7c -.-~va sav..L ~,e, .v ~ r~h5n hh~' l i i 1'ln ulu~i~