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Home My WebLink About17449-zFORM 1~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19714 Date FEBRUARY 7, 1991 THIS CERTIFIES that the buildingb ADDITION Location of Property 625 PVT. RD. #1 STEVENSON RD. House No. Street County Tax Map No. 1000 Section 17 Block 01 Subdivision Filed Map No. ORIENT Hamlet Lot 08 Lot No. conforms substantially to ~he Application for Building Permit heretofore filed in this office dated SEPT. 19, 1988 pursuant to which Building Permit No. I7449Z dated SEPT. 20, 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 ENLARGE GARAGE TO A TWO CAR GARAGE. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED BEVERLY & JOHN LOMAS N160596 NOV. 14, 1990 - Bui-~ding Inspector~' Rev, 1/81 ~OE~ NO. ~ 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) Building Insl:mctor Rev. 6/30/80 BLDG, D~PT. ' APPLICATION FOR-CERTiFICATE OF OCCUPANCY ,!~ .. TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN NALL 765-1802 This application'must be filled in by t'ypewrtter OR ink and submitted to the building inspector with the following: for new building or new use: I. 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 %lectrical installation from Board of Fire Underwriters. 4. Sworn tatement from plumber certifying that the solder used in system Contains less than 2/10 of 1% lead. 5. Commercial building, indus, trial 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 (p~ior to April 9, 19~3) non-conforming use~, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building ~nd Unusual natural or topographic features. 2.. A properly completed application and a consent-to inspect signed by the applicant. If a Certifica~ ~= - . .= ua oCCupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwellln~ $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. Certi~icAte of Occupancy on Pre-existing Building - $I00.00 3. Copy of ~ertificate of Occupancy - $5.00 over 5 years - $I0.00 4. Updated C~r~ificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ............... Old Or Pre-existing Bu~ldin- ....~.' -- ' [{ealth Dept. Approval... '''*'''* ............... Underwriters Approva . ' ~ , ?lanmfng Board Approval .......................· (e~uest for: .Temporary Certificate .......... ~ Final Certicate..,.~ 'ce Submitted: $' ' ' ' ' ~.~7,~. z Fy 7zv YIELD FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Ill THE NEW YORK BOARD OF FIRE UNDERWRITERS i ~)()f)"~'] ~' BUREAU OF ELECTRICITY ~- 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date ~O¥~'~'~J~ ~ '~ ~ } ~c)~) ~pplicatlon No. on file '~ ) :~(~ ~)/~0 ~ ~ ~,0~::)~ THIS CERTIFIES THAT onJy the electr]caI equipment ~ ~scribed below and introduced by t~ appl~ant ~med on the a~e application number in the premises of n thefollowl, gl,ca~ion ~ Basement ~ Ist FI. ~ 2nd FL (;~/C({'~' Section Bt~k Lot w~s exami~ted o~t ~{)V$~' ~ [;;~ 0(~ ~ 1 ¢~J(} a~tdfound to be in compllu~t'e ~ilb the requlre.~ents ~f tb~s Board. DRYERS RANGES .'OOKING DECKS OVENS EXHAUST FANS SYSTEMS NO. O~ FEET E S E NO O~ERCC~'COND'] O~ CC. COND A+W.O. NO DE NEUTRALS A.w O OF HI-LE~ OF INEUTRAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY IfakN~lER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:3 :. ;, Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ., ..................... SEPTIC FOBM ................ NOTIFY CALL ..................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 1-~yout 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. 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 inspecti~p.s. · .~/(.r/../~. ~ ........... ~A~~ ~? /~(Sigrtature o~ applicant, or name, if a c~rp~Lakkqn) · -~.. - . (Mailing," add~s of applicant) - , State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises...~. &~~.~....-~.. ...... .................. (J (as qfi the ~x roll or late~t ~ed) If al~P. licant is alt, prporg~ion, sjgnatuj~ o f duly authorized officer ,,~~ .... . .t¢:C..--:-. ~ fl(/....~;~...-(... ,/..~ ........ ,, . (Name and title of corporate officer) Plumber s License No ......................... Electrician's License No ....................... I. Location of land on which proposed work Will be done;~t ........................ ........ ............ House Number St tx~,.,,~~et ,/~/( _ County*a~ ~l~p No. 1000 S~ction ...... /.7. ....... B~oc~ ........ / ......... Lot...' f.. ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. , ' ' g p' y P ' ' ' ,~ 'y ofproposed construction: State ex~stm · use and occu anc of remtses and intended usc and occupanc - a. Existing use and occupancy .... · · · . ..... b. Intended use and I [ / ~ occupancy ............................................................... v~epmr .............. Removal .............. Demolition ~ .... Other Work .............. E '" · ! Or~ ~'V ~ ~ (Description) 4. stimate'a ~.ost ']' r 0.~r~ ..... Fee %,~..O g P'X,/. . .. / (to be paid on filing this application) · rig, nu e welhn gs .............. timber of dwelling units on each fl oor .g ........... 6 Ifb ........... · usiness, commercial or mix;ed occupancy, specify ture an ex eno h typ 7 D .... na d t t feac e of use ................ · m~ens OhS of existing structures, ff any: Front ............... Rear .............. Depth ........... H "gl i f St el it ............... Number o eries ................... Di With OhS .... .' ."'i ............................ mensions of same structure alterati ddt . or a ttons. Front .............. Rear .............. 8. Dimensions oftentirenewconsirnction:Front ..... Rear .... /,V. t..Depth. ~g / ''' Height.lb..:......... Nulnber of Stories .... (. ~. ...... i. ' ........ 9. Size of lot: Front .......... i ..... Rear ....... Depth 10. Date of Purchase ~ ..................................... I~ ', ..... :" ','.','"i'". ................ Name of Former Owner ............... "' '~°ne °r use atsmct ~n wmcn premtses are situated ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... '_~.~ .............. 13. Will lot be regraded ...... : · ~' -' ',',~ .... ~ · J. ...... Will excessdill~be removed from premises: ~es No 14. ,N, ameof~,Ownerofpremises~r~~ ~dress ./.~ .. PloneNo~,'~ · If yes, Southold Town 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 property lines. Give street and bloc number or description according to deed, and show street names and indicate whether interior or'comer lot. STATE OF NEW YORK, COUNTY OF ................. S.S .......... ('~ ................. ; ................... being duly sworn, deposes and says that he is the a cant amc of individual signing contract) ppli above named. ' lie is the , : (Contractor .......................................... agent corporate officer etc ) ' ' of said owner or ownei's, and is duly! authorized to perform or have performed the said work and to make and file this application; that all state~nents contai~ed in this application are true to ttm best of his knowledge and belief; and that the work will be performed in tile manner Set forth in tile application filed therewith. Sworn to before mc this ' U£t£n R. DE VOE NOTARY PUSUC, State ol New York No. 4707878, Su~lk Count~ Term E~pires M~reh 30,1~ a~ (Signature of applicant)