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Home My WebLink About23578-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~KTIFICATE OF OCCUPANCY No Z-24567 Date August 12, 1996 THIS CERTIFIES that the buildin~ addition Location of Property 725 Rosewood Drive~ Mattituck House No. Street Hamlet County Tax Map No. 1000 Section 113 Block 2 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 20~ 1996 pursuant to which Building Permit No. 23578-Z dated July 12~ 1996 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 a deck addition to existing one family dwelling as a~.lied for. The certificate is issued to....~re~or~ and Kathleen Scholand (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTy DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ~/A N/A Rev. ' /~il~ng Inspector IFOB3f NO. lJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT COMPLETION OF THE WORK AUTHORIZED) 23578 Z Date ..... ~'~... ................................... , 19....~.?' County Tax Map No. 1000 Section//....~.,., ............ Block .......... ~ .... Lot No .........~... ............. pursuant to application dated ........... ~./~. ............................. , 19..~,, and / Building Inspector. approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN tIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This appIication must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or uew use: 1. Final survey of preperty with accurate location of all buildings, property ]ines, streets, and unusual natural or topographic features. 2. Final Approval from I{ealth Dept. of water supp]y and sewerage-disposal(S-9 form). 3. Approval of electrical instaJlation from Board of Fire Underwriters. 4. Sworn statemeut from plsmber certifying that tbe solder used in system coutains less than 2/10 of i% 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 p]an requirements. For existing buildings (prior to April 9, ]957) uon-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing ali 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 tile reasons therefor iu writing to the app]fcant. C. Fees i, 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - . .25¢ 4, Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ... ~.:/.2..~ .......................... New Constructioa O ,Old Or Pre-existing Building . L o carlo n ofP~ s p ~;;; iiii ~'~277~ .... ~..~--~..~2ki. ii' ii iii i i ii. ii'i i~.'~m.' ~.~';~ ..... House No, Street Hamlet ~.~ .......................... S~hdiv~sien .... .B~.?.~..~ ........... Filed~p ~'~¢~ .~e~. // ?-/~'f~ · ~'ca~t ..'T.. Permit No..~.~.~.Z.....Date Of Permit ................ ~pp · ~ ........................... Health Dept. Approval .......... ~ ............. Underwriters Approval ......................... Planning Board Approval ........................ Certicate. Request for: Temporary Certificate ........... Final Fee Submitted: $ ............................. ~ ................... Town Hall, 53095 Ma(n Road P. O. Box 1179 Southo[d, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD Gregox~r & [athleen Scholaud P.0. Box 1255 Hat~icuck, 1~ 11952 To Whom This ~ay Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: ~n~ An application for Certificate of Occupancy is not on file. (Enclosed) · ~x The check is (~t-d~tcd/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23578Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FIELD INSPECTION REPORT DaTE FOUNDATION (2ND) FOUffl)AT I ON (IS'r) ROIJGtt FRAHE & PLUHBIlqG INSULATION PER N. Y. STATE ENERGY CODE COI~ENTS ADDITIONAL COMMENTS: f 765-1802 BUILDING DEPT. INSPECTION ~/] FOUNDATION IST I ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMI~IG [ ] FINAL [ ] FIREPLAC~I~HIMNEY REMARKS:: ~ ,~ DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION DATE SOUTtlOLI), N.Y. 11971 TEl.: 765- {802 Bi~ ~[c .................................. .................................... APPLICATION FOR BUII,DIHG PEI~HIT 1 HSTRIIGT 1 OHS BOAI~,D OF IIE^LTII ............... 3 ~E'I'S (l~ ['I,^HS SU{IYEY ........................ CtIECK ......................... SEPTIC FORH ................... HO'l'l FY: HAIl, TO: .................... a. 3i~{s applicatica~ aa]st be co,l)lerely [ill~l in Dy tyFa~.rrlter or in ink u~gl ~fl~nltt~l to Ihe ~tilding 3 ~ts o[ plm{s, ~,rate plot plan [o ~le. F~ acco~lh~ to ~h,te. b. Plot pl~ ~{~ l~ati~, oF lot m~l o[ lmildi~s ~ prmi~s, relatiou~dp Lo ~.jolning prml~s or struts or areas, ~ giv{[~ a ~tail~ {~scriptira~ oF la~t o~ ptol~rty mJst 1~ dr~ ~ the diagr~ ~id~ is ~rt of c. 'H~e turk c~r~ 1~ this o~l{cati~ ~ ~t 1~ c~e~:~l l~[ore ism~e o[ lkfildi~ Pemit. d. 11~ a~al o[ this ai~lieati~, t{~ ~ilding Insl~ctor will is~ a ~ild{~ Permlt to Lite a~hicant. e. ~ I~,ildi~ ~mll 1~ ~pi~l o~ u~l in ~)le ou in fcc Fo~ ~ ~ ~mt~e~ ~il a C~il{cn~e AI~].I{~TI(M 1S l~ ~ to t]~ ~dlding l~rtn~nC lot the ls~mr~e of a h~ildi~ Pemit ff~r~mnt to the Ik~ildi~ 7~ O~lima~ o[ tl~ 3~m oF ~a{tlmld, ~ffFolk C~mty, ~ Ymk, ~ othor a~l icable l~s, O~lim~es I~dati~m, For ~I~ ~stn~ti~ oF I~dldi~s, ~klit]~ or altera~i{ms, or [orj~q[ or ~lil:io~, ns Imrein ....... ............................ (~il lng ~lress oF alii icnnt) State ~hetber applicant is ~x,~er, lessee, agenl, archileet, engineer, getmral contractor, electrician, plml~r or I~dlder (as ~] (t'~ tax mil or latesk de~) (i~me a,~l title of' corporate o[ficer) Ik~ildera License i~ .......................... l'lmtvers License }Io .......................... Electrieim,a License No ...................... Oilier lyric's License ~ ..................... I. lt×'atirm o[ lard on tl~ich PrOlr~sed ~a~tk will be done .............................................................. ..... ................... .......................... .................. Ilou~ 1,~ ~nl~er Street Ilanlet 113 County Tax l~q~ hto. 1000 Sectlrsa ................ Block a,,~ii,,~..,o,, ../~. :;~,;o..~..?7rr~ ............. ,~i,,,,i ~,,, ,,,. S',d..q..o. ....... ,,,t .... L( ........ ~. ~.~t,,~ ,,~ ~.~ o~..,,,~ .................. L.~:~?...<~....~ ......................................... /,,