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Home My WebLink About17373-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17265 Date 8EPTF~MBER 6, 1988 THIS CERTIFIES that the building Location of Property. 270 House No. County Tax Map No. 1000 Section Subdivision ADDITION SMITH DRIVE SOUTH SOUTHOLD Street Hamlet 76 Block 3 Lot 34.3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 30, 1988 pursuant to which Building Permit No. 17373Z dated AUGUST 30, 1988 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 RICHARD MC DONALD (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FOB~ NO. B TOWN OF $OUTHOLD 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~ 017373 Z Permission is hereby granted to: .... A.~......:.....~.~...~.~// .... I..7.~t....~....~ ............. ...... ~~./...~.......~..././.z¢~.. ....................... ~ ....... ~~..~./._./~,..~ ............................................. County Tox Mop No, lO00 Section .,., .~,,.~ .......... Block ...... ~ ........... Lot No. ,.. ,~..,.~...~,.,,, pursuon, ,O opplicotion doted ...~ ............... ~.~. ........ , 19~..~, ond opproved by the Building Inspector. Building Inspector Rev. 6130180 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-iS-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate sUrvey of property showing all property lines, streets, buildings and unusual natural or topographic featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25,00 POOLS $25.OOALTERATION $25.00 1. Cer~ificate of occupancy New Dwelling.$25.O0, Accessory.iS10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ....................... NewC°ns truct'i°n. Old or Pre-existing Building ............ Vacant Land Location of Property .....-~.~ ''''j ?--~' 2~ ~~-~ ......... i'' '.. Hou~ No. //~ Street Ham/et o o ~y '.~/~c~ wner or whets of Prope .............. County ra× Map No. ~000 Section ..... .?-- ~. ...... mock ... ~ .......... Lot .... ~.~3 ....... Subdivision ................................. Filed Map No ........... Lot No .............. OIZ3 ~.. Date Permit No .... of Permit .......... Applicant ................................ .. Health Dept. Approval . Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Cer[ f cate ........... Final Certificate Fee Subm t~ed $..~.~. ............... Construction on above described building and p. cr~i,t meets all applicable codes and regulations ~ ~__ Applicant.../~. ;~..~_ .................................... Rev. 10-10-7a FO U N D ~S~=~ON __ (1st) FOUNDATION 2, (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: USE L.' i~.~?~.i!i,~',WFUL WIT[';~:¢LFi' C~RT~FICATE OF O::/!{;U?ANCY A.PPIIOYED A~ ~ ' 765-1802 9 AM ~ 4 ~ FOR THE FOLLOWING ;NSPEcTIoNs: FOR POURED,CONcR~,. 2. ROUGH. FRAMING & LUMBING 3. 4,FINAL _ CONSTRucTiON MUST 8~ COMPLETE FOR C O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTs OF THE N ~ STATE cONSTRUCTiON & ENERCy CODES. NOT RESPONSIBLE FOR DESIGN OR CONstRUCTiON ERRORS ..t 0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ~u4~...)..~.:.., 19~fPermit No.//. ~.. ~.,ffT. ~ Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ............ , ......... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .................. 1.9 a. This application must be completely filled in by typewriter or in ink find submitted to the Buildifig Inspector, 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 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. c. The work covered by this application may not be commenced before issuance of Building Permit. t 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 or in 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 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, a,.d. ditions 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 i)a~o~tinns. · ..... · t~i~;t~ai~'a~plichfit', ~)r ~ame, if a'corl~o'ranc~n')' ' ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner o£ premises . ./.~..~...".~... ~ ......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of~orate officer) Builder's License No ..... ~ ............... Plumber's License No ......................... E ectncmn s L,cense No ....................... Other Trade's License No ...................... 1. Location of/land on which proposed work will be done ................ '. . -.............. .. House Number Street H~nlet County Tax Map No. 1000 Section .... . .~...~.. ..... Block ~ ,~,. ,~. ~ Subdivision F'led Mai No Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrt~ction: Existing 3. Nature of work (check which[applicable) New Buildin · · · '. Addit n Repair , , g ...... i.o. ....... 'r Alteration ......... .............. Removal .............. Demolition .. , · e Work ....... 4. Estimate'd Cost ........ , .... Fee (to be paid on filing this application) 5. If dwelling, number o f dwelling units ............... Number of dwelling units on each floor .... If garage, number of cars . ' ........ 7. D,mensions ofexistin~ stn, ctures ifanv: Front , r~ ,,. yp o se, .,1,. V~':",? .......... ut ~,t ............... INqlnoer of Stories ....... Dimensions of same structure with alterations or additions: Front Depth ! lteight ................. Rear ................. 8 ..................... ' ..................... Number of Stories .......... , Dimensions of entire new construction: Front Rear .......... Height Nu' nber of Stories .............................. , Depth ........... 9 Size of lot: Front .................... '" ........... Rear Depth .... 10 Date of Purchase ............................................ · ' ........ ~ ................... Name of Former Owner 11 Zone or use district in which 'remises are situated ...................... Does proposed construction viblate any 7oning law, ordinance or regulation: 13. Willlot be regraded ....... 2 .... ' ............................. 14 N f O f P ............. Will excess fill be removed from premises: Yes Nc · amc o wner o remises .. ........ · Name of Architect ..... I .......... Address ................... Phone No ................ Nam cfc ...................... Address ................... Phone NO ................ e ontractor · · .I ............ Address ................... Phone No ................ IS.Is this property loc ed within 300 feet of a tidal wetland? *YES .... NO .... ~If yes, Southold To~n Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property Lines. Give street and bloC: number or description according to deed, and show street names and indicate whether interior or corner lot., STAT~ OF NE~,?%~'~RK,~_~/~ -- COUNTY OF '~--~.'/~d~' . S,.S '~,,, ~ . · ting. , mu:v;dual signh~jg contract) duly sworn, deposes and says that he is the applicant above named. He is the .................... t~-C,e.,e~ (Contractor agent corporate officer etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make hnd file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manneriset forth in tim application filed therewith. Sworn to before me this ............ ~...day of Term F. xpires October 31.19