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Home My WebLink About23075-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~.~UYANCY NO Z--24583 Date August 20, 1996 THIS CERTIFIES that the buildin~ addition Location of Property 290 Cleaves Point Road, East Marion House No. Street Hamlet County Tax Map No. 1000 Section 38 Block 2 Lot 34 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 10~ 1995 pursuant to which Building Permit No. 23075-Z dated October 19~ 1995 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 "as built" to an existing one family dwelling applied for. The certificate is issued to Frank To-w-~eini (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A FORM NO.$ TOWN OF SOUTHOLD 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-° 23075 Z Permission Is hereby granted to: ,/x'.~,~..~/~.~..(..~.J.~.,e,~...:~....7"..~.,r,~,~',,~,' .~.~.,...~ ...... ./...~...~ .................................... ,o.~.~ ..... ~~.~.~....~...~~ ...~~.....(.~~..~..~.~,2..../~ ,~.~~ ..~~....) ....... . '~........~....~...~~ o,,,~m,~,,o~o,, o, ........ ~....~ ........ .d.. ./..~~..X...:....~... :~..~.... .................. ...................................................... ~-?.~ ....... ~~ .................................................. ~o,,~,ox~o,,o. ,000 s,,.o,_~.~ ...... ~.~, .......................... ~o,,o ....... ~ .............. Building Inspeotor. F. $ . .11~ .......... Rev. 6~30~80 Building Inspector / Bo i: : No. 6 TOWN OF Sou'rHOLD ~ I 6 ]~.:J~ [. :, BUILDING DEPARTMENT TOWN HALL BLDG. DEPT. ~ 765-1802 TOWN OF SOUTHOLD j ~ 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 instaIlation 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, 1.957) 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 signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - ~50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ................. Location of Property .... .~.~..~. ........ · .~.~/~ .~/~L .~. ~---~'~"I'' .~...~...C~7...~..~. .... House No. Street .Hamlet Onwer or Owners of Property....~..'.~..~)../~./~/~/. .............................. County Tax Map No 1000 Section .... .~.~....Btock.. '-~ '- .~...~. , ..~-.~ ......... Lot ................ Subdivision .................................... FilDd Map ............ Lot ...................... Permit No..~6.~..~..~..~.Date Of Permit...?/../?/...~...Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ......................... Request for: Temporary Certificate ........... Final Certicate ..... Fee Submitted: $ 2~,~.~ ~~~ (~ a -- ~q8 (~.~ APPLICANT .... ~: 7..~ q TOWN HALL 19 ~.,.~ " ' Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK SEPTIC FORH NOTIFY; CAL~ . td,~..w~~... 5~, O... i~. t~ ....... INSTRUCTIONS a. Tl~s application must be completely filled in by Wpewfiter or in ink and submitted to the BuildMg Ifispector, with sets of plans, accurate plot plan to scale. Fee accoMing to schedule. b. Plot pl~ showing location of lot and of buildMgs on premises, relationship to adjoining premises or public streets or areas, and -' ' ~ cation, arvin, a det~led description of layout of property must be drown on the diagram which ~ pa~ of t~s apph- c. The work covered by t~s application may not be commenced before issuance of Building Pemit. - ' d. Upon approval of this application, the Building Inspector will issued a Building Pcmit to the appfic~t. Such pe~it shall be kept on the premises available for inspection throu~out the work. e. No bulldog shall be occupied or used in whole or in part for aoy purpose whatever until a Ce~ificate of Occup~cy shall have been granted by ~e Bulldog Inspector. APPLICATION IS HEREBY MADE to the Bulldog Depmment for the issuance of a B~Iding Pemit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other appIicable ~ws, Ord~ces or Regulations, for the construction of bufld~gs, additions or alterations, or for ~emoval or demolition, as here~ desc~bed. The applicant aerees to comply with all apptica~e laws, ordinances, bufld~g code, ousin~ code, and regulations, and to admit authohze~ ~specto~ on premises and ~ bulldog for necessa~ inspections~ , . · ..' ........ .' g: . t .... (Mailing address of applic~t) State wh~ther applicant is owner, lessee, agent, ~chiteet, engineer, general contractor, electrician, plumber or builder. ....................................... (as on the tax roll or latest deed) Ir applicant i~ a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No. Electrician's License No ....................... Otber.Trade's License No. Location of land on which proposed work will be done~ ," o ;~., .' ....I5.....~. ~Rt ..... House Number Street ' ' Hmnlet .......... · · (Name) · · Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed construct/on: a. Existing use and occupancy ..~{~0~ ~1~ ~ ' ........... .~.~ P~~ .~ ~,., ~ · 3. Nature ofwork (check which applicable): New Building .......... Addition ................... Repair .............. R~moval .............. Demolition .............. SW L'nming poo~r ............. Tennis Court ...~..~,. Accessory Building .......... Fence ....... Other Work; ........... . ;. Estimated Cost ...... .: .~ ~.~ff~>... ..................... Fee ..................................... ' (to be paid on filing this application) 5. If dwelling, number of dxvelling units ............... Number of dwelliqg units on each floor ................. If garage, number of cars .... ~ .................................................................... 6. If business· commercial or mixed occupancy, specify nature and extent of each type of use ...................... 7. Dimensions of existing structures, ifany: Front.., ............ Rear ................ Depth ................ Hei'_ht ............... Number of Stories ......................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ ; .. Depth ...................... Height ..................... '. Number of Stories ....................... 8. Dimensions of entire nexv construction: Front ............... Rear ............... Depth ................ Hei,_'ht ............... Nu~mber of Stories ........... /.. / .......................... /: - .:~--... · > ...... 9. Siz~cflot: From. ..... .,~f~ ....... .. --.. Rea-"· .~k..~..~..-~. .... ........ Depth . .Z~.~')..~9...L:~-.'~...~..7... .... or ....... ......... Name of Former O,v, r .... .......... ....... (i·3. f~one or ;~;e distilct in which premises arc ~tu:ted.. ~J~V~J~ ......................... ,-~:, ..... ,. 2. ['oe~ pro[ osed cc :,m'uction violate any zoning law, ordin~~lation: . .~ ................ ,:- ,'.. ~-- -- 3. Wg. 1 lot be regmded ~: U~¢.~. ~.~. ~~[~ fill be removed eom premi.ses: Ye~ ~.. No.. 4, N~e of Owner of p~ises ~OVA~I ..... : ....AddressZ.~..~.~ .~:.. Phone No. ~2, ,~.. , i4~e of Architect .. (~~.~.,~ .... Address ........ ; .... ; ..... Phone No. 4~-,.~ .~... N~e of Contractor .......... ~ ..... 2 ........ Addrem .......... ......... Phon~No. · ~, ...... ; .... 15.Is this property located within lO0 feet of a tidal wetland.* YES...2NO .... mil yes, Southold Town Truateem Permit may be required. PLOT DIAG~M Locate cle~ly ~d d~ctly MI bulldogs, whether existing or proposed, ~d. indicate ~! set-back d~ensions from property ~ne~. Give street ~d block number or description accord~g to deed, ~d show street ames and hdi~te whether interior or comer loL STATE OFN COUNTY I.k, s.s · . (Na~ne 6f individual si§niu~" contract) above named. l'}e is the ................... ~~ .... ... ........ (Con o orporate officer, etc.') of said owner or owners, and is duly authorized to pe,rTorn~or have performed the said work and to make and file this application: that all statements contained in this application are tree to the best of his knowledge and belief; and that the Work will be performed in the manner set forth in thc application Qlcd therewith. ' .,. · ~la~ L ~ _ Qualmed in Suffolk County (Signature of applicant)