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Home My WebLink About18825-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22485 Date JULY 29, 1993 THIS CERTIFIES that the building. Location of Property 13135 MAIN ROAD House No. County Tax Map No. 1000 Section 31 Subdivision ADDITIONS EAST MARION~ N.Y. Street Hamlet Block 5 Lot 10 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 20, 1990 pursuant to which Building Permit No. 18825-Z dated FEBRUARY 28r 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 SECOND STORY ADDITIONf DECK EXTENSIONr BALCONY & ALTERATIONS TO EXISTING ONE FAMILY DWELLING ASAPPLIEDFOR The certificate is issued to JOSEPH L. TOWNSEND JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-i62805-11/30/90 & H-035539-6/22/93 JULY 28r I993 - LAWRENCE J. LISO .... /~ldin~ Inspector Rev. 1/81 TO~N O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 18825 Z Date ....~./..~....~... .................................. , 19.~..O Permission is hereby granted to: ...... ~, ,~~...,=~:~.,.....~./..~ , - ~ ,o , /r ,/ ~ ~,~, ,~ ~,.~.~.~....~ ....... ~ .................................................... ........................................ ~[~...~-- ......................................................................... co~ ,~ ~p uo. moo s~,o~ ...... ~ ........ ~k .......... ~... cot Uo ........ ~ .......... 19~..., pursuant to application dated ......... ...~.//,.¥~,~-~.. ................................ , Building Inspector. and approved by the Rev, 6/30/80 IBL.DG. DEPT. TOWN OF SOUTHOLD___ · Fg,.r.~% No, 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 · APPLICATION FOR CERTIFICATE OF OCCUPANCY A. ~his application must be filled in by t~pewriter 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. B. 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 si~ned 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. Certificate of Occupancy on Pre-existing Building - $I00.00 Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~. ~.~..~.'.~. ~. .. . NewConstruction .......... 01d~0~- Pre-existing Buildings., ............... ~acat~o~ o~ ~ope~t~ .................................................. : ............... House No. Street 'Hamlet Onwar or Owners of Property... County Tax Map No 1000, Section .... ~ ...... Block ..... ~ ....... Lot...~.~ ................ Subdivision Filed Map Lot Permit No. ~ ..... Date Of Permit.. ~. ~..-~-'~..Applicant .... Health Dept. Approval ..... Underwriters Approval Planning ~oard. Approval... ~ .... ;'. ......... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $..~..%..~. ................... . APPLICANT TOWN OF SOUTttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 T~OWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION. (pi%ase print) / (please prznt) 'I certify thag tho solder used in the water supply systmm contains less than 2/10 of 1% lead. ... Sw~ b~fore me this / ~Zotary Public, S~3~. (plumbe~)slgnature) v 30SfP~ LA~;~RENCE TOWNSEND KO~'^RY PUBHC OF NEW YORK My Comm,ssion Ex~itas ~ 19 ~ . ~/ ' FOUI;DATIOX (1st) FOU!~DATIO~! (2nd) ROUGH FRAME & ·PLUMBING INSULATION PER N. STATE ENERGY CODE Fi:JAL ADDITIONA'L COMMENTS: J 'C ! PA~CU[_ 2 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] II~SULATION FRAMING [~FINAL DATE INSPECTOR~~_~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ['/]/~ULATION [ ] FRAMING [ ] FINAL REMARKS: DATE I NSPECTOR./:~ ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~'~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~RAMING [ ] FINAL DATE INSPECTOR BUILDING DEPARTMENT TOWN HALL -- -~'~- ....... I[ ' $OUTHOLD, N.Y. 11971 -- TEL.: 765-1802 Exami'ne~~ ........ , 1S~j- ...... 19~. Permit ....... Disapproved a/c ..................................... APPLICATION FOR BU I LDING PERM IT ~o^R~ or UZ^UTa 2 ........ suRveY ......... q'~ ..... c.zc~ .... .~. ~! SEPTIC FORH .............. CA [ .., ....... MAIL TO:. ~ .... .~..?~ ......... .... .~..., u~.~ ..... Date ................... I9. INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, witl 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 sere, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this cation. c. The work covered by tiffs application may not he commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wLll issued a Building Permit to the applicant. Such peru 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 agy purpose whatever until a Certificate of Occupan. 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 ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances- ~Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descri'~e fdhe applicant agrees to comply with all applicable laws, ordinances, building code, housin~_~lations, and · . ./.- . . · /7' ......... ;,W.' ,' 'j' '~'" · ' .%,ffr~........ z ....... · /L~ uv~aidn~ address o~ appticant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. '" '(~'{a~e ~nd title of corp(~r'ale ;fficer) uilder's License ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ................. 1. Location or, land on..which proposed work will be done; ' tlouse Number Street Hmnlet County Tax Map No. I000 Section .~/ . BI¢ck ........ Lot .... ~ . " Subdivision ........ ~ ....................... ~ilcd Map No ............... Lot ............ (Name) 2. State existing use and occupancy of premises and intended use and Occupancy of proposed construction: a. Existing use and ................................... occupancy '' · usc and occup~nC~ 3. Nature of~vork (check which applicable): New Building .......... Addz/ion ~.' ........ A. lteratlon. · v' , --¢mAl'ti-- . . . Swimmin~ oo01 . ,. Repair .............. R~mo at ............. l~ to ~ ~n ........... ~ ~ · ....... Tennis Court .. ~,~ ..... Accessory Building ...... Fehce~ · -.~ gb~o~ ....... 4. co. .... .......................... .... ......... · -- l(to ~applcution) 5. If dwelling, number of dwelling umtS ..... ~ ........ Number of dwehmg dints o~eacn noor~. If garage, number of cars ............. ~/~ .................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each tvp~ of us~ ... ~ .... 7. Dimcnsionsofexistingstmctures, ifany: Front.., ............ Rear ............... Depth ............ H~ight ............... Number o f Stories .................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .............. Depth ...................... HeiSt ...................... Number of Sto5cs .................. 8. Dimensions of entire new construction: Front ............... R~ar ............... Depth Hm~ht ............... Number ol Stones .............. ~ ........................... ~ ......... 9. Size of lot: Front .~ P~- ~ ~ no.th I0. Date ol Purchase .... Zo/~ ................. Naa&eft[Foyer Owner . ~q~. I I. Zone or use district in which premises are situated .................................................... ~yo 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~.~ ......................... · 13. W~I lot be regraded ................. ~ ........ Will excess fill be remov~om premises: _ Yes ~... No 14. N~e or Owner of premises . ..~.~K .4..Ze~c~a~s$ ~ Z _iZcc hone No. ~Z& e~&... N~e of Architect . ~(~ ~'~(,. ...... Address . .¢~.~.~.~ .... Phone No ............... N~e of Contractor ................. ~ ........ Address ................... Phone No ..... 15.Is this property located vithin lO0 feet of a tidal vetIand? ~gS .... NO .... · If yes, Sou~hold Torn Trustees Perm5~ may be required. PLOT DIAG~M Locate cle~ly ~d dist~ctly fll bufld~gs, whether existing or proposed, ~d, indicate ri set-back d~ensions fro~ prope~y ~nes. Give street ~d block number or description accord~g to deed, ~d show street nmos and ~dicate whethm interior or comer lot. COUNTY ...... , ., (Name of individual signing contract) above named. sworn, deposes and says that he is the applies bleisthe ...~.....~.F..~7 ............................... ' ..................................... .. . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed tile said work and to make and file tl application; that all statements contained in this application are true to thc best of his knowledge and belief; and that t WOrk will be performed in the manner set forth in thc application filed therewith. Sworn to before me this ....................... day ........ Nota Public . /C/t- d/~-~_- ount .._ ~ . .~r~..~.~ ....-~_.=~..- .;r...-~_.=~....;r ........ _~,?0/87~, Suffolk Co~¥.._ // L~=namre Ol appuc= . . ,rmF. x,resM~t~htO, lq. '~, . ~ .