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Home My WebLink About18911-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22981 Date MAy 3, 1994 THIS CERTIFIES that the building Location of Property 527 FODNDERS PATH House No. County Tax Map NO. 1000 Section 64 Block 2 Subdivision Filed Map No. ADDITION SOUTHOLD, NEW YORK Street Hamlet Lot 36 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 22, 1990 pursuant to which Building Permit No. 18911-M dated MARCH 27, 1990 was issued, and conforms to all of the requirements of the applicable previsions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWNLLINGAS APpLIRD FOR WITH LATTICE PANELS. The certificate is issued to of the aforesaid building. MARION KOPHEN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A Building Inspect~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 18911 Z / Date ..... !l..'-' ................ , 19.-~...~. .~ .~Z ........................ Permission is hereby granted, to.'/~ ~ //? ,~./ , ., /~ ~~~~......~......~~..~~ .... ,~...... ~..,~,,...~..~ ..................... , ,....~~~....~...~....~ .,, . ................................................... :~~ ....................................................................... County Tax Mop No. 1000 Section ......... ~...~.,. .... Block .......... ~ ...... Lot No.....q:~....-~'. ............. pursuant to application dated ....~.../....:;~... ......................................... , 19...~...~., and approved by the Building Inspector. ~--~'~/' Rev, 6~30~80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 all 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 electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and t'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 Occupancy on Pre-existing Buildinz - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial ~15.00 J Date .... - · . New Construction ........... z~ Old Or Pre-existing Building ........ 2~f/i'~ .... Location of House No. Street Hamlet · Co~x ~ ~ ~o ~o00, s~o~..~.~..~.~.~Zo~...9.,~L~.? ..... ~o~ .... ?.5~.~.:'.Z ..... .............. ~ s~ ~,..~5~ .................. ............ D ~ '~ ......... ~ .......... FORM NO, 1 D No SO THOL BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1802 Examined . .~..~..7. ........ , 19 ...~ Approvcu .. ~ ......................... ~ .. Disapproved a/c ..................................... BOARD OF HEALTH / suRveY ........ 4M::! " c.~c~ ........ 27.'~. .2 ' NOTIFY CALL . . MAIL TO ~'-~,' '~'' (B uilfl/fig Insp~or) ' APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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 th.is appli- cation. ¢. 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. e. No building shall be occupied or used in whole orin part for any purpose ~vhatever until a Certificate of Occupamcy 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 ~'emoval or demolition, as herein described. The applicant agrees to comply with all applicab'~e laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Sig t applicant, r nam ifa corporan (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~..~.r?. 0.m ................ ' ......... . ................................. (as on the tax roll or latest deed) If applicant is fi co~oration signature of duly authorized officer. (Name ~i~d title of corporate officer) Bu ,der's License Z'W * Xi. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done · /[oui/~;m ger ' Street Ha,nlet County Tax Map No 1000 Section ~ ~ . .' ' BlOck ~ ............... · ................ ~ot. i~.4. ............. s~u~i,i~io~.. ~eno. 4.~v.~,: .~s~*.~?.: ........ m~a M,p ~o.. ~..~¢~ .... ~ot d,Z~. (Name) ........... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use and occupancy ... ~ ~'/:~ ~ ~ b lntended use and occupancy (~?(4~ ~/~ ~ ~ ~ ' ' · Nature of work (check which {applicable): New Build n- . ' dition .~'~- Q[5~. Alte~atioa ~ !,'t' Repair ...... Removal .............. Demolition 4. Estimate'd Cost .... o.o.. · ' 'r .......................... Fee ..................................... I (to be paid on filing this application) $ If dwelling number of dwellin~ units Numberofdwellingunits ' · ' ............... on each floor If garage number of cars } ................ 6 If business commercial or mixled occupancy specif nature and extent .................. · ' , Y of each type of use 7 Dimensions of existing structures if any: Front .... · Height ................ Rear ............... Depth ............... Dimensi;~ ......... Nu~nber of Stories ........................................................ of same structure With alterations or additions: Front Rear Depth .... ,. Height ............................... .................................... Number of Stories ........ Dimensions 6f entire new consiruction: Front Rear ............................ Depth ............... He g ~t ......... Nu -'- 9. Size oflot: Front ........... !..' ......... Rear .. ' " .......... 10. Date of Purchase /./.~..F./$? i .................... Depth ............. Z ,. . ' . ' · '. ....; ................... Name of Former Owner ff.~q~.,~¢&..~F~'~a/' ' ' ' 11. one or use restrict In whtch pt'emises are situated ......... ' ' '" ............ 12. Does proposed construction viqlate any zoning law, ordinance or reaulat on' ~o 13. Will lot be regraded //'.o ~ .................................. ...... ~ .................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises ./-I/:4.~/.&¥ /c'$.~,q~ Address /a,,~,,5'~.~/z:~,-&,, ............................... /"t:~,Ph o n e No ............. amc of Architect . ...,.,...,.. [ .................. Address .. ~ Name of Contractor J/~.~/¢( /~:..~.,?'r~ ., , ;1 ........... ' ..... Phone No ............... · ' ' '1 ............... ,q. aaress . .,+q..J·~.%~F,~..g,e~..,f',~!~'Phone No.~.~4'?.~.~... IS.Is thxs property located within2]O0 feet of a tidal wetland? *YEll .... NO/~2. · If yes, Southold Towh Trustees Permit may be required. ... I PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether · 8. property lines. Give street and block number or interior or coruer lot. APJ~ROV£D AS F~OlrED 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE 2, ROUGH . FRAMING & PLUMBING 3. iNSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODEs. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, COUNTY OF ...... /.~ .... (Name of individual sigmhg contract) ..... above named· being duly sworu, deposes and says that he is the applicant Itc is the .~.~.~. ~.~.,~. c/-~ ~ ' ' (Contractor agent corporate officer etc) ......... of said owner or owners, and is dulyI author zed to pe,rform or have performed the said work and to make and file this application; that all statements contai~ned in this application are true to the best of his knowledge and belief; and that the · york will be perfo~ed in the m=ner]set forth in the application filed therewith. gWom to before me this ..... da · ....... 19 ........... · ~... County NOTARY ~JOLIC, Sht~ w ~ ~o. 4707878, suffotk ~ 0 ~ Tram F. xplra Mirth 30, ItL~/ (Signature of applicant)