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HomeMy WebLinkAbout19194-z TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19391 Date SEPT. 27~ 199Q THIS CERTIFIES that the buildin~ Location of Propert~ 805 House No, County Tax Map No. 1000 Section MAP OF ADDITION BAY HAVEN LANE SOUTHOLD Street Hamlet 88 Block 04 Lot 33 Subdivision BAY HAVEN Filed Map No. 2910 Lot No. 4_4 conforms substantially ~o the Application for Building Permit heretofore filed in this office dated JULY 5, 1990 pursuant to which Building Permit No. 19194Z dated JULY 16~ 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. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 NORMAN WYNNE~ JR. & WF. N/A N/A TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER.MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~91~4 Z Permission is hereby granted to: County Tox Map No. I000 Section ....... ~.,~,,, ...... Block ......... , ,,~,.,,.... Lot No ..... ~ ......... pursuant to application dated ...... ~../...~ .................................. , 19.~and approved by the Building Inspector. Fee $..~.....~ 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 su ~itted 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 limes, 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, indus, trial building, multiple residences and similar buddings 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 bulldogs and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building ~d 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. 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 A ~. Updag=d Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....... ::ew Construction .... ~. .... Old Or Pre-existing Building ........ House No. Street ' Hamlet Subdi0ision.. ~. ~ ~,.. J~ ............ Filed Ma Permit No..L~L.~. ~..~..Date Of Permit.-~//~l~ .d~...Applicant...~.~...~A~..... ....... [{ealth Dept. Approval ....... './/~.~. ............ Underwriters A nroval ,, Planning Board Approval ................. ,'~' Request for: Temporary Certificate ........ Final Certicate ........... Fee Submitted: . APPLIC~d~T FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI;;AL ADDITIONA'L COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ?~OUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined ........ , 19.~.~. ...... Disapproved a/c - I~,/I .... i:1 II APPLICATION FOR BUILDING PERMIT BLDG, DEPT, TOWN OF SOUTHOL,~..,.,.,.~ D.,,~..~ INSTRUCTIONS Received ........... ,19.. · Date .................. , 19... a. Tkis application must be completely filled in by typewri.ter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedide. 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 layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit· a 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 throughout 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 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 authorized inspectors on premises and in building for necessary inspections. ~ (Signature of applicant, or name, if a corporation) ' .. :.,..~..s..~..os... ~..~. ~.~.~. ~ (Mailing address of applicant) (' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ ~[.~ .............................................................. Name of owner of premises . ~0Z_.,k.~.....~. ~Z..[~.A..V', .... .t~...x~ ~4~k) .~.... ~-/k,. ............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. l .~.]..Cb..~[ .FJ..-/~. .......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · .~..o. 5. ........... ¢.~.¥. ~.~,,.. ~,..om~... ................. ~.o ~..¢~.,,~ ................. House Number Street Hamlet County Tax Map No. 1000 Section ..... ~.~... ....... Block·..'C.[ ............. Lot...~. :.~.. ........... Subdivisi°n'X~''"~a~¢)~.t ..., ................ Filed Map No. . ¢,~.~, /. ~. ..... Lot ..... .""J.'~{. ..... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... b. Intended use and occupancy ........ ~.~%.[c.'I .................................. i ................. s~q; out o~ojoq o, ~o~ ~q~ o[~ p~ o~ o~ pug ~xo~ p!us oq~ po~o3:od oagq ~o ~aoJ~od o~ pozuoq;n~ AInp s~ p~ '~ou~o ~o ~ou~o pt~s 3~ ................ ON ouoq,:I ...................., sso:tppV .......................... :tolo~:quoD to oureN ~ ............... 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