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Home My WebLink About19071-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19382 Date SEPTEMBER 25, 1990 THIS CERTIFIES that the buildinq ADDITION Location of Property 2000 NASSAU POINT ROAD CUTCHOGUE~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section IO4 Block i0 Lot Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 1990 pursuant to which Building Permit No. 19071-Z dated JUNE 4, 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 DECKADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED RICHARD A. WALL III Rev. 1/81 TOWN OF $OUTHOLD I~UILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 19071 Z Permission is hereby granted to: ~,~,.~..t...~.....~..~ ...................... ..~.~.~ .....'7.....9..~'T. ............................................... .............. ........ ..... ,o,~. ~ ~.m.-'"~*~T~'""~'""~"""C~~"'~'""~*'"~T'"~ ....... at premises located'~ ~u ~1:~ 'at .~-.. .............. ~...~....~d~.. .......... .,...~.,.~..,~ ............ ~~ ..dr~.........¢. .............. County Tax Map No. I000 Section ...... ./..,,o,.,~, ........ Block ...... /.,,O,, ......... Lot No...~,,,.J./, ...... pursuant to application dated ........ J/~.~....~....~. ....................... , 19.c~...~.., end approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD !It]I~'~L~~\~-/ ::i TOWN HALL 765-1802 8LOG OEPT · ~- This apglicaCion'must be filled in by typewriter OR ink and submitted ~o the inspector with the followin8: for new buildinE or new use: J. Final su~ey of proger~y with accurate location of all buildin8s, property streets, and u~usual natural or topographic features. ~. Final Approval from Health Dept.' of water supply and sewera8e-disposal(S_~ fo~) 3. Approval of %lectrical installa~ion from Board of Fire Underwriters. 4. Sworn statement from plumber certifyin8 that ~he solder used in system ~ less than 2/10 of iZ lead. 5. Co~ercial buildinE, industrial buildinE, multiple residences and s~ilar b.~dinEs and insCalla~ions, a certificate of ~ode gompliance from'architect or enEineer responsible for the buildin8. 6. Sub~c PlanninE Board Approval of completed site plan requirements. B. For exiscinS buildings (p~for ~o April g, 19~3) non-conformin~ uses, or b-ild~s "pre-existin8" land uses: l. Accurate survey of property showin8 all property lines, streets, buildin8 ~d unusual natural or topoEraphic feacures. 2. A properly completed application and a consent" ~o inspect si8ned by che applicant. If a Certificate o~ Occupancy is denied, the BuildinE Inspector shall state the · reasons therefor in writing to the applicant. ~ 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swiping pool $25.00, Accessory building $25.00, Additions to accessory ~uiiding $25.00. Businesses $50.00. 2. Certi~ic. Ate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated C~rcificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.~0, Co~ercial $15.00 ' Date .. :'~''~ /~-~' ~ ::ew Construction ........... Old Or Pre-existing $ ildln ..~ ...... ' House No. ~treet Ha~et Onwer or Owners of Property .... . .. co~ T~ ~,.,o ~00o, s~o. .... /F:.~.. ~.~ /'o- . ~ ~ ...... ../~._ ~. J ~ ..~oc./.: .................. ........ - ........ r~ea ~ap ............ LoC ..... CF. ~ · · ..: .... _ [leal~h Dept. Approval ..... ................ Under~ri~ers Approval .... /u/~ Planning Board APproval ..... .. .: .. ' /"' ~equest for: .Temporary Certificate.. - ..... Ffnal Certicate ........... Fee Submitted ~ $ . . D~ ~ /~ ~z',~ vo:: .....' CO~ 1~3~ ' -' t FOUNDATION (1st) COMMENTS FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Examined ..... ~ ..... , 19 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 TEL.: 765-1802 Disapproved a/c ........................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH SURVEY .... ~0 ........... SEPTIC FORH ................ OTIFY, .... CALL r.9..5.% .... HAIL TO: it~~ TOWN OF 8OUYNOi.O Date ' a. Tiffs application must be completely filled in by typewriter erin ink and submitted to the Buildinglnspector, 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 Or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. o. 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 app§cant. 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 aoy purpose whatever until a Certificate of Occupancy silall 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 inspectio~ · (Signature b~ ilpplicant, or name, ]f'a do; 'o'r~i~n' ' ' ' · p ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. o~ r of premises . . ( d) ......... as on the tax roll or latest dee If applicant is a corporation, signature of duly authorized officer. Budders L,ce.se Plumber's License No ......................... Electrician's License No .................... Other Trade's License No 1. Location of land on which proposed work will be done: ' ;n','d .......... [louse Numbcr Street Ha ...... ' .4¢. County Tax Map No 000 S~ction ......... /. ........ Bl~ck ............... Lot..~ /"" Subdivision... · .... Eilud Map No. (Name) .............. Lot ../.~ ....... State e" · x sting use and occupancy of premises and in tended use and occnpancy of proposed constructinm . ' .... ~ ~Y~,, o~,.,~ ,a~,l~ ~ ............. occupancy .. .~ , - · .,. 3. Nature of~ork (check which appiicable): New Building .......... Addition . ~).~-~,~. ,Ulcratmn ........... Repair ............... Rpmov;al .............. Demolmon . .. ............ Swtmmng pool ; Tennis Court ........ Aycessory Bu~Zd~ng .......... Fence ....... O~her IqorA ............ 4. Estimated Cost .......... · ~ .................... Fee .... ~ ....................... .... . · · ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... ; .... Number of dwelling units on each floor..; ............. If garage, number of cars ...... : .................................................... ; 6. If business, commercial or mixed bccupancy, specify nature and extent o f each type of use ....... ~ ............. 7. Dimensions of existing stmctures~ if any: Front.. ~ .......... . .' Rear ............... Depth ............... Height ............... Number of Stories ...................................................... Dimensions of same structure wit~ alterations or additions: Front ................. Rear .............. Depth ..................... :. HeiSt ...................... Number of Stones .................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth Height ............... ~Umber of Stories .............. ;... ~ ................................... 9. Size of lot: Front ............ ; ....... .'.. Rear ...................... Depth .................... 10. Date o~urchase .............................. Name of Fo~er Owner ........................... 11. Zone or use district in which premises are situated .................. . ..~........... ..... l:. Does proposed Construction v~olate any zoning law, ordi a fie : ................ i;;i ' ' ................... ................ N~eof Architect ........................... Address ................... Phone No ................. N~e of Contractor .......... ....... ; ........ Address ................... Phone No ..... · If yes, Southold Town,Trustees Permlc may be required. PLOT DIAG~M Locate cle~ly ~d dist~ctly ~1 ~u~d~s, wEcthcr existing or proposed, ~d, indicatc ~1 set-back d~e~sions from prop¢~y ~cs. Giw street ~d block ~um~cr or dcsc~ption accosting to dccd, ~ show street n~es and ~dicat~ STATE 0 F N E~,~,R l~'-~f'~ /// - ~ couNy% ................. · ','~ ~ ........................... being duty sworn, deposes and says that he is thc applicam (Name of individual signing contract) above named. He is the ................. ' (Contracto~;corporatc~ officer otc ) of said owner or owners, and is dul~ authorized to pe,rform or have performed the said work and to make and file this application; that, al'l statements contained in this application are true to the best of his knowledge and belief; and that the Work will be perforated in tile mannerisct forth in tile application ~tcd therewith. Sworn to before me this .............. ..... ....... ~llfled In Suffolk County ,~7/') ENWel De(~mbl~ ~, lO.&~ (Signature of applicant)