Loading...
HomeMy WebLinkAbout17121-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217137 Date July 29, 1988 THIS CERTIFIES that the building ADDITION Location of Property 5500 NEW SUFFOLK RD. NEW SUFFOLK House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 02 Lot 19 Subdivision XX Filed Map No. XX Lot No. XX conforms substantially to the Application for Building Permit heretofore filed in this office dated June 8 1988 pursuant to which Building Permit No. 171212 dated JUNE 17, 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 SHERWOOD & BARBARA COOPER (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NJA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 Foes xo. s 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) (v 0 ~ 1.712 Z Dare ~ 1911..f.?. Permission is hereby gr ted to: . . . . . . ~ ' ~ ...1~. . . at premises located ot ...4.l..~? County Tox Map No. 1000 Section ...I~..7......... Block Lot No............~/....... pursuant to application dated ........,~Z~ 19~.~~.., and approved by the Building Inspector. A ' Fee Buil g ctor Rev. 6/30/80 aa, y. FORM NO. 6 ~Q~ TOWN OF SOUTHOLD VV Building Department BLDG. DEPT. Town Hall TOWN OF SOUTHDLD Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~r~ to the Building In~ec- torwith 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-(S-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 installs- tions, acertificate 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 features. - 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 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 $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ]0.00 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 . New Construction, , , , , ,Old orPre-existing Building ~ Vacant Land Location of Property ..J`~.5.4 b......... N~.k!~'v tr><•.4 ~~-~~../.~~:....'V `-,N, ~ o ~,F° G/C. Nouse No. Q~,, ~ Street Hamlet Owner or Owners of Property :-!~!~!~00-D, ~"~fl /~6ff-i~%. ~oO,~e~ . County Tax Map No. 1000 Section f.~. 7....... Block Lot . Subdivision .................................Filed Map No. ..........Lot No. . Permit No. I ~I ~ Date of Permit ..~~(~lRRApplicant :~L,`.`~`.u"; , ;/°'~!!"~'v?/CB? ,~©®a?;¢;t'" Health Dept. Approval ........................Labor Dept. Approval , , , Underwriters Approval ........................Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ . ~ ~ . Construction on above described building and ermit meets all applicable codes and regulations. Rev. 10.10-7a / , .U • , .tea ~ ~ ,e.o. ziyi3 `7 ,/s y/~~ / rsS-1802 BuaDiNG DEPT. NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: I~ DATE o2® INSPECTOR ~t.~t lELD It:S:'ECTiU:J ~~UATE ~ %OMMENT° ~ -o .1 ,e m H - FOUIIDATION ilst) N Cl d FOUNDATIOtJ ( 2nd ) _ m~d 2. z _1 ROUGH FRAME & o ~1 Q PLUMBING ti H 3. ~ ~ C c~ INSULATION PER N. Y. y STATE ENERGY CODE ~ "~V a ~ ,a( C.4 0 m~ 4 . FIidAL O z ADDITIONAL COMMENTS: x ' x H 9 H H V O\ Z ~-~l R] a\ • r~\ H x e7 m v H t ~ h~,a , ~ r~; t . ~ t v ~ ~ _ J.,r~ +h ~i ~ ~ X ~ + ~ i ~ ' _y___ f ~ E ~ ~ ~ ~ ~ J1 ~ ~ ~ ~ r J. Y./-~ I s a lj i i ~ ~ 3~ ~ . i _ ~ I' I i z- r -I ~ err ~,E Y~~~ O ~ t 1 ~i / iOlra C+ 4~N 7 br n ~ P ~ Jmf~~ '1~ n ? 1cYi ~T 111 d ¢ j ' • ~ m o~ RI 1 's. ' 1,, ~ I ~ ~ ~ - - ~ Q ~~rr+ ro ~ ~ ~ '1 (°i .fir ~ Ot'i,W N .1 Cn I ~1,j ~i =c,'-. 111 Dl~N ~"1 C1 I J / * 5 T T9 n L."„~ ~ P I •n• r r ~ n; ,I 41 I ~ ~ O ~ . I ~ j~ ~ ._..i r I 1 E, ~ 1 i 1 I.~ I , ~ N ~ r l~7 _ I L I Exl.fa+~_ K ~t,: N_ NE'.? ;r f"t)LIG I7~A1? ~>;`1 LAt.1C. ;5i~ ' b _ I T a ~ _ - - - - ~ noorgr I ~~6.1:) 1-iR~t~-,'G' JCS'. 1~+~ ~ y 0 2C>A,4. 2 N~~l> Z I I I~ I G91,e 7no~or 1,~~3e ;~y~l, / i FOR r Yd ' ° r ~ ~ ~ ° ~ ~ 1 " . `e ~4sza ~ I ~s;' l I I 1 ~ ITS ~ + ~ ~ ~ 5 t ~ P) f - ~ )LI ~i J ~ t ~ ~ ~ ~ . ~ , l i ~ i 11 U ' L~ t i ~ 1 ~ i I p t1 ~ ~c n~ iQ I~ ~ y..~ ~ a ~ ~ ~ ~ ~ ,1,~ t _ " ~ - ~ r ~ 1 I ~ ~ I I v ; ;'.j I i ~ , 4 ` ii 1 c, y, ~~i, r {r1 r a; 5~ ~1,, ~ ' ~ Iii, ~1.,,..,~11 ~'3".~~: , , ~ ~ ^ v1 L„ ; ~ c ~ v^° ~"I ~ " ~ I u~ L c~' ~ ~ Y " 1 t_ ( s,z~' ~ ~ ~ 4A, k _ _ BOARD OF HEALTH ~~~~~~~,~~~-J~,,~~ 3 SETS OF PLANS FORMNO.1 SURVEY ~ _v N TOWN OF SOUTHOLD CHECK . `8~ ~ BUILDING DEPARTMENT SEPTIC FORM . TOWN HALL BLDG. DE^T. SOUTHOLD,N.Y.11971 NOTIFY 7~~ TOWN UF-SOUTHOLD TEL.: 765-1802 , , ,7~~,-~f~1, q Examined . f/. • . • • 19L~~i~ MAIL TO: Approved ...lo~~1......., 190ZJ. Permit No.~.~~'`'. ~ .~J Disapproved a/c uildin Spector) APPLICATION FOR BUILDING PERMIT / Date ..~'.1. 9/~~......, 15... INSTRUCTIONS a. Tlus application must be completely filled in by typewriter or in ink and submjtted to t$e ~~t~ldin~ Inspector, with 3 sits of plans, accurate plot plan to scale. Fee according to schedule w t'',is ' "D~ ' ~ 'r r r?tr'~L:$~~l k:d1~4 b. Plot plan showing location of lot and of buildings on premtses, r~ldtto~lS i ~a ~ni~g ,~rBisps or public streets ox areas, and giving a detailed description of layout of property must' iirah ~ ~ lagitn t~y~ich~kis part of this appli- i,al? gat. .9[.., ~+ow ' CatlOri. f ~i1 °t "F16,". ~§'4. r'r{'t~k. ;°A. ~'a. c. The work covered by this application may not be commenced tie`(tore`l~s~t~~n~Ctek~i~~tld>,cgp Permit. d. Upon approval of this application, the Building Inspector wil] issuetd~2 l~~tif'~ing~Pern)1~tlo~ Xilp ~gpliaant. 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 arty` ' sxe~w t p y shall have been granted by the Building Inspector. ~ ~p~~~ 1~$tte of Occu anc ' c4?9lia~~R'~E~~mt.~C. ~~c~I APPLICATION IS HEREBY MAD-E to the Building Department fbr'th''~t~i~~of a " t g ermtt pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, NBvF 1~1~i~,iari'd'~~ft'~t~ gaf~~ s, Ordinances or Regulations, for the construction of buIldings, additions or alterations,e~oY~re'~noi~~'ladf e g~xor~;,,aserein described. The applicant agrees- to comply with all applicable laws, ordinances, bUiltlltrg,l~~~'eg" -us~' -d'e;rari~yregulations, and to admit authorized inspectors on premises and in building for necessary iti5~i`ections. ada~G:.. (Signature~'~ ~ ~ ~ if a corporation) (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. !)`uht-e-v Name of owner of premises . ~~~4<:4~~:~--. ~ ..'F. ! ~Y.°-?:!z:- ~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Name and title of co orate officer ( rP ) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done . . .5,5"00 ...P~ House Numbe ~ ~ Street H t County Tax Map No. 1000 Section I/., Block Lot ~ . Subdivision Filed Alap No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building , Addition Alteration . Repair Removal Demolition Other Work . (Description) 4. Estimated Cost 1.~~.Q..- Fee . ' g' be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwellin o'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 existin structures rf an Front , , , ~ ~ ~ ~ ~ • ~ • ~ ~ ~ • g ~ • Y~ Rear ' Depth . Height ...............Number of Stories.......... Dimensions of same structure with alterations or additions: Front Rear , a , , , , , , Depth ......................Ilei t............... of Stories 8. Dimensions of entire new construction Front . , , , , ~,q, , , , RearNumber Depth . , , , , , , , , , Height , , , , , , , , , , , Number of Stories . ' ' 9. Size of lot: Front Rear ....................l . Depth . . 10. Date of Purchase J,`I,2.~a . . E~~ . ""'G ...Name of Former Owner f.~ ~.4. 1 I. Zone or use district in which premises are situated , , , , . 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~ 4 . 13. Will lot be,regraded , ...!'1~.c?, , , , , , , , , , , , ,Will excess 611 be remdved from premises: Yes No 14. Name of Owner of premises • • • • • ' ' ' ' Address , ' ' ' 'Phone No. . Name of Architect • ' ' ' ' ' ' ' .Phone No.. Name of Contractor ..Address . ,Phone No. . 15.Is this property located within 100 feet of a tidal ',wetland? *YES....NO.•r?!4 *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al] buildings, whether existing or proposed, and~~indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL ~ DATE: /.R R ~ WITH®UT CERTIFICATE N~~ ° ° ' ~ T FOLLtriNINt31N$PECTIONS: ®F OCCI~~PANCY 78g-,~' AM R THE i. ~ IrOURT~~~~~~ 2. ROUGN - R>tr11MIN(i ~ MLUMSING s. INSUUrwN 4. FINAL - C~INSTRUCTION MUST ALLECONSTRt)C`ryON SHALL MEET THE REQUIREM~NT$ Of THE N.K STATE CONSTRUCTN~PI 8 ENERGY CODES. NOR RESPONSIBLE ROR DESIGN OR CON~TRUCTN)N ERRORS STATE OF NEW YORK, ~I COUNTY OF . S.S • • • • • • • bein dul sworn de • " ' • " " " " " " " " " • " ' • • • • • • • • • • • • g y poses and says that he is the applicant (Name of individual signing contract) above named. Eie is the (Contractor, agent, corporate officer, etc.9 of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are. true to the best of Iris knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before megqthis ~ ...day off/.. 19~~ Notary I~~>~li ~ .~~Y~:1~~ .Cl :..6-!.Q:.V.~... County t HELEN K. DE WE NOTARY PUBLIC, Sfete of New York • }mss :''Y~"-~ No.47078%B,SutfolkCouMY~ e ~ Y~ • •Y• • ~ • . Term Expires Memh 30,1 I (Signature of applicant)