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Home My WebLink About19075-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z28047 Date JULY 2, 1991 THIS CERTIFIES that the building ADDITION Location of Propert~1825 BRIGANTINE DR. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 079 Block 04 Lot 60 SEC. 3 Subdivision HARBOR LIGHTS ESTS.Filed Map No. 5147 Lot No. 68 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25, 1990 pursuant to which Building Permit No. 19075Z dated JUNE 5~ ~990 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 .~/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 EUGENE C. & JUNE C. WLOCK / Building Inspector FORM ~qO, $ TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 'i ~9~)/~ ~ Z Permission is hereby granted to: ..~..~.~.L:)~.~.~...~.~.~ ......... ..~~...~..~.:.o..!.~.~..~J ................... ~-~ ~ ...... ~..~ ........... = ............. :. ................................. at premises located o, ...L..~..-)..[....~..~o.(~..)~....~., ...... .~..~~~ ................ County Tax Map No. 1000 Section ....... ..c:~...-I....~ ....... Block ...... .C~...~ ........ Lot No....~.~). .............. pursuant to application dated ................. ...~.........~...~....~ ............. , 19.~.~.., and approved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN I~LL --- 765-1802 "' BLDG. DEPT. . , TOW~ p,F,8OUTHOLO _. APPLICATION FOR CERTIFICATE OF OCCUPANCY 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-disposRi(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 tess than 2/10 of 1% lead.~ 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code C~piiance from archiuect or engineer responsible for thc building. 6. Submi~ Planning Board Approval of completed site plan requirements. 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. 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 - Residential. S15.00, Commercial $15.O0 -Date .......... .. ew Construction ........... Old Or Pre-existing Building... . o ation of House No. Street Hamlet nwer or operty.. . ............... :bdivision ....... ........... ~ ................. Filed Map ............ Loe ......... ' · .......~atn Of Permit ............. _ .......... ~ ................ : .... alth Dept Approval : ' ' ..... · ...... ~ ...... Underwriters Approval anning Board Approval quest for: Temporary Certificate .......... Final Certicata ........... e Submitted: ... ¢ o z oc¢7 ..................... TOWN OF SOUTHOLD OFFICE OF BUILDING IN~PECI'OR P.O. BOX 728 TOWN tlALL $OUTttOLp, N.Y. I l. b71 EUGENE & JUNE WLOCK 1825 BRIGANTINE DR SOUTHOLD, N.Y. 11971 TEL~ ,765~1802 To Whom This May Co,ncern, We are unable to complete your Certificate of Occupancy because ~of the following reasons. / /_~/An application for Certificate of Occupanc[; is not on file. . (ENCLOSED) /_--//~o Underwriters Certificate on file. /~ The check is (~-~/not on file.) $25.00 /_--/ No IIealth Dept. Approval on file. /_--/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Bui] ding Permit Building Dept. ***/--/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME ~ PLUMBING INSULATION PER N. STATE ENERGY CODE F I'N AY ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSU/I. ATI-0N FRAMING [I....]-'FI NAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ ] FOUNDATION~ 2ND [ ] INSULATION [ ~~MING [ ~'I~L L2 SUFF. CO. H~'ALTH D~PT. APPROVAL ";' :,~SUFFO~ CO~TY HEALT~ oa~ 'O[C.2 I'1977 ' '. .... Ohie~ of · ~,. . SUFF. CO. ,DEPT. OF HEALTH SE:RVIOI~S - STATEMENT OF IN'II~NT ~ HOL£ .......... ~ , Examined ... Disapproved sic ........ FORrVl NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD. N.Y. 11971 TEL.; 765.1802 BOARD OF HEALTIt ............ 3 SETS OF PLANS ............ (Building Inspector) APPLICATION FOR BUILDING PERMIT Builder's Liccnse No....0.?.p..~../~.. ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done: ..... ............. ...... House Number u ' Street County Tax Map No 1000 Section ...... Block ....... Lot /'~" · ............. ":' Subdivision .............. . Eilcd Map No. . ' (Name) .............. Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed construction: ' -- a. Existing Use and occupancy .~.~.~ ~ ~'~. -~.t.A. .t~w' ' ' ......................... v~ ~'~¢,~/. ~.~/~ ................ b. ntended use -'.d occupancy c ' , ............. " ................. ~ ~ · ', ,',~.~ ,~ :1~1~-/~ &Il . :2~'~'~ ~t~4~ ~ ............... ( INSTRUCTIONS a. Tlfis application must be completely filleit in by typewriter or in ink and submitted to the Building lhspector, 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 pubffc streets or areas, and giving a detailed description of layout of property must be draxvn on the diagram which is part of this appti- 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 app§Cant. Such permit shall be kept on the premises available for inspection throuv, hout the work. e. No building shall bc occupied or used in whole or ~ 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 pumuant to the Buildin= Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable J..avrs. Ordinances or Rcgulatio. ns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· Thc applicant agrees to comply with 11 apphcal5 e' laws~ ordinances, building code, housing code, and regulations, and to admit authorized inspectom on premises and in building for necessary inspections. · (S~gnature~ applicant, or name, if a co~'po'r.';l~o'n') ' ' ' {Ivlailing address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. fp . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. 3. Nature of work (check which applicable): New Building .......... Addificn .......... ~ltcrat:on ........... Repair .............. R~moVa[ .............. D~molition .......... Swi~~ .......... ....... .......... . .... ..... 4. Estimated Cest ............. ..................... Fee . . i (to be paid on ~~catlon) S. If d,,clEng, number of dwelling upits..~ ....... ; .... Number ef &veiling units on each ~r~..~ .......... Ifg~raee._ number ofc~rs ................................ . . If business, commercial or mixed occupancy, spccify nature 3nd extent o~cach type of use ........ H~: .~ ............ Nmn~r or Sto~s ... ~.~, ............... Dimensions ors, mc structure with alterations or additions: Front .. ~ Depth ..... ~ .......... ~l~ ,,k* t ~ ... .., ...... .......................................................... 8. D~mcnsmns of entire new construction. Front . ~ ~ ~o.~ Hm~ht ..J.~ ...... Nu~ ...... ~o. . ~ 9. Slzeoflot'Front I~.~;~ .... ~ . ~ 0 · .- ~ · .] ......... t~ea ..........;.] ........... Depth ~2~..'..~..~..7...' 10. Date of Purchase ...-L~ ~ ~r~ .... 11. Zone or us= d~strict in which premises are situated ................................................ 12 Does proposed Construction violaig any zoning law ordinance or regulation: 13. W~I lot be regraded .:. ~.~...~ .................. Will excess fill be removed from premises: Yes .... No~ ~,*:N~e of O,vner of premises ~.~; ~ 5)~. ....... Address t.4~.~kg~e~.<~.. Pbon~ ~o.~AO2 C~ ...... N~e'of A chite ' Add Ph N r ct. ........ . . i ............ .. . . ress ..... ............ .. one o ........... . .. . . . N~e of Contractor .......... i... ' ..... Address ................... Phone No ..... ~,'. ~;-.~..: . .. ~If yes, Southold ~ovn~runtees Permit may be required. , PLOT DIAG~M Lo~le gle~ly ~d dist~ctly ~1 bu~d~gs, whether existing or proposed, ~d. indicat= ~1 s~t-baok d~ension* from propeNy ~nes. Giw street ~d blook ~umber or de~hption aoeord~g to d~ed, ~d show street n~es and ~igat~ wh~ther inte~or or oomer IoL STATE OF NEW YOR. K, COUNTY OF..~.o.~r?~3.C; ..... ~.S ..... g,.o..~.-.qK..c.:.~.S~s~g................... being duly sworn, deposes =d says that he is the applicant · . ~Name or ndiv dual sign jtg contract) above named. ~ is the , (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly[ authorized to perform or lmve perfo~ed the said work and to m~c nnd file this ~pplication: that all statements contai, ncd in tiffs application are true to/l~e best of his knowledge and belief; and that the Work will be perforated in the m~ner~sct forth in the application filed therewith. .~. Sworn to before me this ~a~ (Signature of applic~t)