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HomeMy WebLinkAbout19034-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Zi9358 Date SEPT. 13~ 1990 THIS CERTIFIES that the building ADDITION Location of Property I35 CASE RD. & 410 BAY RD. House No. Street County Tax Map No. 1000 Section It6 Block 02 Subdivision Filed Map No. CUTCHOGUE Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15, 1990 . pursuant to which Building Permit No. I9034Z dated MAY 21~ i990 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 OVER EXISTING PATIO. The certificate is issued to SF2~4US LYNCH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED v/// Bhilding Inspector /y Rev. 1/81 lJ~R~ NO. lJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~U'I'i,~L~. H~ Y_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N! 9034 Z Permission is hereby granted to;~ , ~... ~ .... :/..~-,~ ¥,/rO/ ......................... : ........................... .-,-, ,,,.~,,~ .,,,,, .. ..................... .,..:.~%.~.....~.. .................... .,~.....~~..., ~e~,'r'4', ~,, ,.,t p,.,,,.,~sos ioc,:,ted at ........ ./.a~..~.....~/..,....~...~./..O.....~...~....~.~.... ........................ County TOx Mop No. 1000 Section ...... ./../..~.. ........ Block ........ ~ ........ Lot No....,../.../-~.. ........... pursuant 'to application dated ......... .~../../.~..'~'[ ............................. , 19.~..~., and approved by the Building Inspector. Rev. 6/30/80 Fo~m Moo 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-t802 · APPLICATION FOR CERTIFICATE OF OCCUPANCY .!' This application'must be filled in by t'ypewriter 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 form). ' 3. Approval of %lectrical 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 bu~/dings and installations, a certificate of Code Compliance from~architact or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 19~3) 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 Oceupancy on Pre-existing Building - $100.00 3. Copy of ~ertificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated C~rEificate of Occupancy - $50.00 Temporary Certificate of O:cupancy ~Reszdentmal $15..~0,~Co~merciai $15.00 i:ew Construction .... ~ ...... O_~id Or Pre exi'stz D~1 ...... ~/~ .................... - 'ru~ ' ding ................ ~treet Hamlet . Onwer or O aers of Property .... Co nty Tax Map No I0n~ ~ Ill . ~ ' Subdivision ............. ~ ........... . ........... Filed Map ............ Lot.] ....... .. ~ea~th Dept. Approval ........ ~./~. ............. Underwr~t Approval ...... anning BOard Approval .... ' ' .,,. equest for: .Temporary Certificate ........... Final Certicate ...... FOUNDATION (1st) FOU:~D~TIOX ( 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE EllERGY CODE Fi;:AL ADDITIONAL COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined · ./~. ........ , 19 .~. Approved..../~. ..... 19 ?.~. ee rmit No./.~70..~..~...~ Disappro ed a/c ............................ BOARD OF HEALTH ............ 3 SETS OF PLANS ....... SURVEY .... · ................. CHECK .... ' .............. SEPTIC FORM ..... ~ ~ ~°n ~ple~C~:::::::n ,ak and subm,tted to the Building l~spector, with, 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 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. 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. s't e. No building shall be occupied or used in whole orin part for any purpose whatever until a Certificate of Occupancy l~all 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/inspe, o~i-ens. ' (./ (Signature o£applicant, or na'r~e', · ""!. L;Y ~,iO,l- ~P~bOl,~lN~ ~0~ ' -t.: ......,.'.-.4,.;'. ~. :'r=7::..':./.'....' ' '.q .r.. ........ ": ~: r (;OVi~;~qfWi. i~O~ · ~16r~l~lL'& (Mailing address of applicant) State whethe o , ~e. ~t~ axchitect, engineer general contractor, electrician, plumber or builder. Name of owne' " r of pre ,m, lses~ ~ ................................. (as on the tax roll or latest deed) I£ applicant is a eorporatio~ signature i~i~f~'~Ql~horized officer. (Name and t'itl~ ~o'f~eor~/?.qt~,~)~> 730 Builder's ~icense No ..... ',.~.q, .~. 7:' .-'...T~Z'. ...... Plumber's License No.; .'~ ~"."~ ~ ?'j{{,iy,?. ............ Electrician's License No ....................... Other %ade's License No ...................... 1. Location of land on which proposed work will be done~ J 5 · ........................ House Number Street OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF ocou 'AN,c¥ , Hamlet Subdivision Kiled Map No (Name) ........ Stateex~st:ng" ' use and occupancy of premises and intended use and occupancy of proposed construction: A. Exist:lng use and occupancy ....................... ~.- .~ .~..tM~..D..da~%q3O ............... - 3. Nature of work (check which applichbte): New Building .......... Addition .......... Alteration ........... Repair ............. Rpmova[ i .............. Demolition ............... Swimming pool .............. Tennis Court ' . ... Acc~essory Building .......... Fehce ....... Other Work ............ 4 Estimated Cost /,. '''' '" '"''"' (to be paid on filing this application) '''' .?.~ (t. Number of dwelling units on each floor 5 If dwelling nmnber of dwelling uniis · · If garage number of cars ' · ............ 6. If business, commercial or mixed odcupancy, specify nature and extent of each type of use .................... if any: Front ' Rear ' Depth 7. Dimensions of existing structures, . · ........................................... D~_m_enmons of same structure w~th ~lteratlons or addttlons: Front .~.Ca.. ~ Re ........ Dopth ...................... .'Height ...................... Number of Stories .... ~ i . .. 8. Dimensions of entire new construcQon: Front ............... Rear ............... Depth ............ Height Number of Stories ' 9 Size of lot: Front :., Rear Depth 10 Date of Purchase . , Name of Former Owner 11. Zone or use d~str~ct m which premises are situated ................................................... Does proposed Construction violat~ any zoning law, ordinance or regulation: ............................... 1 2. 13. Will lot be regraded ........... .~. ............... Wiil excess fill be removqd from ~ises: .Yes . .. 14 .... Name of Owner ofpremises ~..~5 .~...,~. Address .C~.¢-.~-~4 .'fv.~ rune No, .~.":.~..~- ..... Name of Architect ............ ~ ............... Address ................... Phone No. :....._. · ._ ....i · ·· · Name of Contractor ~.-~/~.&q'z~2'~ ........ Address ~...~/~. ~fl/J..~. ........ Phone No. ~.~'.~ · · '. 15.Is this property located within lO0 feet o~ a tidal wetland? *YES .... NO.~ · If yes, Southold Town ~rustees Permit may be required. i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. ,/ , g' lBNO lggU LON '$a003 ~/tZa'-) ~--~'~~ ~<:" being duly sworn, deposes and says that he is the applicant (Name of indi,~idual sig~ lng contract) above named. ~ is the .~~ ' ~ntra~agent, corporate officer, etc,) of'said owner or owners, ~d is dui authorized to perform or have perfomed the said work and to m~c and file this application; that all statements con(ained in this application are true to the best of his knowledge and belief; and that thc work wQl be peri~rmed in the m~n~r set. fprth in the application filed therewith. / S. wom to before me this ' j ' .......... ~.~: .da~~ ....... ~. .