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Home My WebLink About19079-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22995 Date May 12, 1994 THIS CERTIFIES that the building. Location of Propert~ 630 NAKOMIS ROAD House No. County Tax Map No. 1000 Section 78 Subdivision ACCESSORY SOUTHOLD, NEW YORK Street Block 3 Lot Filed Map No. Lot No. Hamlet 19.2 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25, 1990 pursuant to which Building Permit No. 19079-Z dated ~ 6, 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 ACCESSORY STORAGE SHED AS APPLIED FOR The certificate is issued to LESLIE GILES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 Bu~id£ng Insp~tor" FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22996 Date MAY 12, 1994 THIS CERTIFIES that the building Location of Property 630 NAKOMIS ROAD County Tax Map No. 1000 Section 78 Subdivision Filed Map No. ADDITION SOUTHOLD, N.Y. Street Mamlet Block 3 Lot 19.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25, 1990 ~ursuant to which Building Permit No. 19079-Z dated JUNE 6, 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 LESLIE GILES (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. TOWN OF $OUTHOLD BUILDING DEPARTMEHT TOWN HALL $OUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 19.~..~ Permission is hereby granted to: ~',~,, ~ ./~ ~/',,~...~..~ ............ ~ ........... ....... ~..~..o.......~.~~.....~ .......... . . .... ~.~.~.~.~.~.... ........ ~./.~/.... ,o ~~~....0~.:~..~.~,...~~.....~.../~ _ ~~...~~..~-,....~~.~~...=~..~.......~ at pre..m, iles ,..oc..ated at ..~..0.~.(~..~.~~......~...~.~... ................................................... ............................................ ~/~.~/.~. ............................................................................ Co,~n~, To,~ ~op No. ~00o Sec,on ........ .Y..~ ....... B~o~k ....... ~ ......... Lot No .......... ./.~......~-.. / pursuant to application dated ...C~...~ ................................ , 19 .~.4~.., and approved by the Building Inspector. Vg Inspect6r Rev. 6/30/80 TO~ OF ~OUTtlOLD BUILDING I)EPAR'ftiEN'£ 765-1802 APPLICATION FOR CF, ETIF[CATg OF OCCUPANCY This application must be filled in by typewriter OE ink and aubmitted to the building inspector with the ~ollowin~ for new building or new user 1, Final survey of property with accurate location of all buildings., property lin~a, etreets~ and unusual natural or topographic features. 2, Final Approval from Health Dept, of water sopply and soworage-di$posal(S-9 form), 3, Approval of electrical installs~lon from Board of Fire Underwritara. 4. Sworn statemcnt from plumber certifyin~ that the solder used in system contains less than 2/10 of Ii lead. $. Commercial building, industrial bulldin&~ multiple residences and similar bull. dingo and lne~allation~, a eerti§icate of Code Compliance from archite~t or engineer responsible for the building. 6, Submi~ Plannln~ Board Approval of completed site plan requtrementa. For existing buildings (prior ~o April 9, 1957) non-conforming uses, or buildings and Vprc-exiating' land uses~ 1. Accurate survey of property showing all property lines, atreets~ building and unusual natural or topographic feeturei, 2. A properly completed application and alconsent to inspect signed by the applicant. If a Csrtificete of Occupancy ts denied, the Building Inspector shall state the reasons therefor in writing to tho applicant, ~, Feae 1, Certificate of Occupancy - New dwellin~ $25.00, Additions to dwelling $25.00, Alterations to dwelling ~25.00, Swimming pool $25.00. Accessory building $2~.00, Additions to accessory building $25,00. ~usine~ses $50.00. 2. Certificate of Occupancy on Pre-exiettnt Buildins - $100.00 3. Copy of Certificate Of Occupancy ~ ~20.00 4. Updated Certificate of Occupancy $50.00 5, Temporary Certificate of Occupancy - Reeide~Ctal ~iS.00),¢ommercial re- New Coast uction .., , Old 0 s-existing Mo~ss No. ~t~eet Mamle~ Subdivision Flled Map ' Lot Permit , ...Date Of Peait.,,,,, ...... ,,,,Applicant.,.,,.,...' .... . .... .,,,,, .... Health Dspt, Approval..,,. ........... ..,,..,...Uudorwritera Approval ......... . .... ,,,.. ...... Plsnnins ~oard Approval .... . ............ ,,,,,,. ~ Request for~ Temporary Certificate.,....,,.,, Final Certicate,. .. CO ~ ~a q q ~ ADPI.T~A~T ¥orra HO.~ 6 TOWN OF 50UTIIOLD BUILDING DEF^RTMENT TOi~ H^LL 765-1802 APPLICATION FOR C~RT1FICATE OF OCCUPANCY Thi~ application mua~ be filled in by typewriter OR ink and aubmltted to ~he building inspector wiUl the followtngt for new building or new use: Final survey of property with accurate location o£ all buildings~ property lihes, acreetl~ and unusual natural or topoBrephic features. 2, Final Approval icom Health DCDC, of water supply and sewerage-disposal(S--9 form), Approval of electrical, installation from Board O{ Fire Underwriters. Sworn statement from plumber certifying tha~ the solder used ia system contains lass than 2/10 of 1% lead. ~, Cem~arolal building, industrial building, multiple residences and ~imilar buildings and in~allacions, e certificate of code Compliance from architect or mngine~r responsible for the building. 6, Submit Planning Board Approval'of completed site plan r~quirsm~nte. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ~p~-axlsting" land uses: 1, Accurate survey of p~ope~ty showing all prepor~y llnes~ streets, buildin§ and unusual ~a~ural oy ~opo{raphie features, 2, A properly completed application and a,consen~ to inspect signed by the applicator, If a Certificate of Occupancy is denied, tho Building Inspector shall state the reasons therefor in writing to the spplican~, C, ~ees ~ , 1, Certificate of Occupancy - ~ew dwellin~ $~5,00, Additions ~o dwelling Additiom* to accas*Ory buildlng $25,00. Basinessee $~0.00. 2, Certificate of Occupancy on Pre-existing Buildin~ - $100.00 3. Copy o£ Certificate of Occupancy - ~20.O0 4, Updated Certificate of Occupancy - ~50,00 ' Residential $15.00, Commercial ~15,00 5, Temporary Certificate of Occupancy - "" .... ................, '"'"' ~o.tton o~ F.pe.y...,.,,,. .... ~.~.~f~7~.,.~.,.,.,, ....... ,,.., ..... .,,, House No, Stree~ o_, o, o.,., ..................... ............... ~o~ ~ ~ ~o ~ooo, ~o~.~,,.,,..~o~,.,,-~.. ....... ~o~.,,~z~.~,, ....... Subdivision .... ,,,,.,.,,,.. ....... .,...,.,...,,Filed Map. ........... Lot.. ....... ,..0 ......... ~ermit ~o.,/~:.?.?..,~..~a~s o£ ~sr.~,, ............. ,.ap~ma.~ .... ,..,,,.. ....... ,, ......... Health Dep~, Approval ..... ..,,.,.,..,.. ........ Underwriters Approval,... ............. ,,.,,,,. ~lannin~ Boa~d Approval,.,, ...... .. .......... .. Request fort Temporary Cer~ificata ......... .. Final Cer~ic~e...~'., 765-1802 BUILDING DEPT. INSPECTION INSPECT~ 7rd~-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE. INSPE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. DATE INSPECTOR ~/~~ FOUNDATIO.~I (1st) FOU!IDATIO:! 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE E~IERGY CODE Fi:IAL , i , LJ APPLICANT: ADDRESS ................ TEL 2.5 197~ or formerly Henry W, Drum 6t Joseph, Solond HIA WA THA 'S lO0' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:2 / Examined · .~./.~. ......... , 19~'..~ BOARD OF HEALTH suRv~.Y .% ....... CHECK ,~.~i~.. ;5.'1.'~. SEPTIC FORH ................ NOTIFY: CALL MAIL TO: Approved ............ No. Disappr°vedg~/~0~t) AS'ItlOT~I) ........ /~ .............. ~ r~'2 L':: 1'2 i ........ 765-1802 9 AM TO 4 PM ~~~'(_:~-' '7 ........ l~l~J ~-~ · - / t~/u~umg mspec[or] 3. FOUNDATION - ~OREOUIRE~PPL~ATION FOR BUILDING PERMITL~ ,vw~ OFSOu¢NOLD 2. ROUGH - FRAMING & PLUMBING D=te .. ~. ~ .. 3. ~NSULATION 4. FINAL CONSTRUCTION MUST ~NSTRUCT:ONS or ar~Tf~[~ d-~~c~i~' n Undo of buildMgs on premises, relationship to adjoining premises or public' streets . ~g ~q~ g~ flayout of property must be drawn on the did-ram which' --~ COA¢~C ~rK c~fi ~t~lication may not be commenced before issuance of Ba~ding Pe~it. . ,, d. Up~~f'this application, the Building Inspector will issued a Building Pc~it to the app~c~t. Such pe~it ,hall ~~~~~spection throu~out the work. ' '%'~~~ ~p~gd~used ia w~ole or in part for any purpose whatever until a Ce~ifieate of Oceup~cy APP~~ HE~Eqb thc BuildM~ Dep~ment for the issuance of a B~lding Pc~it pursuant to t~e Buildin~F~~ Town of Southold, Suffolk County, New York, ~d other applicable ~ws, OrdM~ccs~r Regu~tiB~;~-t58~t~dMgs, additions or alterations, or for ~emoval or demolition, as hcre~ described. The &~s to comply with all applicable laws, ordinances, buHdMg code, housin~ code, and regulations, and to ~ BE COMPLETE FOR C.O. ~ ' ALL' CONSTRUCTION SHALL MEET ...... .THE REQUIREMENTS OF THE N.Y. - . (S[~atu;e ut ~ppHcan~, or ~ame, J~or~r~[;~' ' ' co~. ~o, ,~o,~,~ ~o~ ....... ~..~.~.. D~SIGN OR CONSTRUCTION .ERRORS (Mailing address of applic~t) State ~h~ther applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder.~ Name of owner of premises ~.~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....... :' ' . ._ CUPANcyR ' IS U WFUL Electrician's License No Other Trade's License No Location of land on which proposed work will be done; [louse Number Street, ........ Hamlet County Ta., ~l.',p No. I ooo S.c.o. ~ ' .4.~. . .,~....~. .................. Blpck ..... L bdi Su vision ..................................... Riled Map No. (Name) .............. Lot ............... State existing t~se and Occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and ~ ' ""~, ..... occupancy.. .... .. .............. ..., .... ~ ~ ~,,, B. Intended use and occupancy ..... 3. Nature of work (check which a'ppli~able): New Building Addition ....... Alteration ....... Repair ........... g~mova! .............. Demolitioo ............. Swimming pool .............. '.' b ildi (ff~ .~a.~. ' Oth k Tennis Court : .... Ac essory Bu ng .... Febce ....... er Wot ; ........... 4 Estimated Cost ' ... Fee · ' ' (to be paid on filing this application} $ If dwelling numberofdwellingunits .............. · Number of dwelling unitson each floor ................. If garage number of cars ............................... - .......... 6. If business, commercial or mixed o,'ccupancy, specify nature and extent of each type of use ...................... if any: Front ' Rear Depth 7 Dimensions of existing structures ............ Height Numbelr of Stories .............. Dimensions ..... ' Front Rear of same structure withi alterattons or addtt~ons . Depth .' l'Ie gilt Number of Stories ........... 8. Dimensions of entire new construction: Front ........... ,. .... Rear .. .............. Depth .............. e it .... ~'~t',''.. ..... um ;r ones ...... ear'..~''''; ~'""" ......... ' .........] ........... ~ i]] ] Si f I F R "' ' " ' 9. zeo pt: font ..... ........,........ :. ............ - ................... . 10 Date of Purchase ' Name of Former Oxvner 1 I. Zone or use district in which premises are situated ................ '; ....... ~ ......................... 12. Does proposed construction violat¢ any zoning law, ordinance or regulahon: ....,~..~ ........................ 13. Will lot be regraded .......... ! ................. Will excess fill be removed from premises: . Yes .... No.. 14 Name of Owner of premises . .",... Address . Phone No ............... Name of Architect ........... , ............. . . Address .................. . Phone No ................. Name of Contractor .......... 4 .... :.: ........ Address .......... Phone No ..... ,~ ......,~ .... IS.Ts this property located w~.thin fOP ~eet of 'a'~t~i~l~'f wetland? *YES .... NO.Z.. · If yes, Sourhold Town ~rustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all bluildings, whether existing or proposed, and. indicate all set-back dimensions from cription accord_Lng to deed, and show street ntmaes and indicate whether COUNTY OE ................. ........ / · ~.......~ ........... being dulyswom, deposes =d says that he ~ the applicant (Name of indivi&ual signi0g contract) above na~ed. ~ is the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly,, authorized to pegform or have perfo~ed the said work and to m~ and file this application; that all statements contaihed in this application are true to the best ofhls knowledge and belief; and that the Work ~v~l be performed in the m~ner~set forth in the application filed therewith. ./ Sworn to before me tins ~ , ' ,, Nota~ Pubhc .... ounty ~o, ~9~ ' ~ (Signature of applicst)