HomeMy WebLinkAbout23464-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPkNCY
No: Z-29365 Date: 04/17/03
· ~tIS CERTIFIES that the building ADDITION
(aka ]90 Old Saddle Lane)
I~cation of Property: 1275 GOLD SPUR ST NL~TTITUCK
(HOUSE NO.) (STREET) (H3~MLET)
CollIlty T~ I~ap No. 473889 Section 95 Block 4 I~)t 18.10
S%~division Filed ~4ap No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 6, 1996 pursuant to which
Building Permit No. 23464-Z dated MAY 22, 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
· ~ne certificate is issued to THOMAS A & DONNA A HENNESSEY
<OWNER)
of the aforesaid building.
SUFFOLK CO~A1TYDEPARTM~T OF I{EAL~APPROVAL
ELEt-r~ICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'r~u3
N/A
N/A
N/A
riztd Signature
Rev. 1/81
I~K~ NO. B
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
{THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLL~I'ION OF THE WORK AUTHORIZED)
N.° 23464 Z
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approved by the
Rev. 6/30/80
TOWN OF SOUTHOLD
BU1LDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 consent to inspect signed by the applicant. Ifa 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,
Swinmfing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. CertificateofOccupancyonPre-existingBuilding- $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
New Construction: '~ Old or Pre-existing Building:
Location of Property: 7~)
Hous~ No. LStreet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section ~ ~'~
Subdivision
PermitNo. '~ ~/~,¢ DateofPermit.
Date.
(check one)
Block Z~ Lot ]
/
Filed Map. Lot:
Applicant:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for: Temporary Certificate
Fee Submitted: $ ,.~ ~- ~3~
Final Certificate:
- ~ (check one)
Applicant Signature
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] IN/SULATION
[ ~'~INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
INSPECTOR
FOIUI fi(). I
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Date ................ , 19 ....
IBLDO, DEPT.
.__ ~o__~~~__-
J
AP. PRIWED AS NOTED ..
FOLLOWING INSPE~ON~:
2. ROUGH- F~MING & PLUMBING
3. I~ SUCTION
4. FINAL CONSTRU~ON
BE COMPL~E FOR C.O.
ALL CONSTRU~ION SHA~ ME~
THE REQUIREME~S OF ~E
STATE CONSTRU~ON & ~ERGY
CODES. N~
DESIGN OR