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Home My WebLink About30602-ZFOR/~ NO. 4 TO~N OF SOUTHOLD ' BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y_ CERTIFICATE OF OCCUPA~CY No: Z-30413 Date: 09/09/04 CERTIFIES that the building ADDITION Location of P~operty: 615 R~3MMEL A~E SOUTHOLD (SOUSE NO. ) (STREET) (}LAMLET) County Tax Map No. 473889 Section 63 Block 2 Lot 19 Subdi~sion Filed Map No. -- Lot No. __ conforms substantially to nhe Application for Building Permit heretofore filed in th_is office dated AUGUST 9, 2004 pursuant to which Build/ng Pemit No. 30602-Z dated AUGUST 27, 2004 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 DWELLING AS APPLIED FOR "AS BUILT". The certificate il issued to C STEVEN HALL of the aforesaid building_ (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRIO~i CERTIFICATE NO. PLUMBERS CERTIFICATION D~£KU N/A N/A N/A Authorized Eignature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 30602 Z Date AUGUST 27, 2004 Permission is hereby granted to: C STEVEN HALL SOUTHOLD,NY 11971 for : AS BUILT DECK ADDITION AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 063 pursuant to application dated AUGUST Building Inspector to expire on FEBRUARY Fee $ 300.00 615 HUMMEL AVE SOUTHOLD Block 0002 Lot No. 019 9, 2004 and approved by the 27, 2006. Auth&~ized ~nature ORIGINAL Rev. 5/8/02 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPA~RTMENT TOBrN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Tiffs application must be filled in by typewriter or ink and submitted to the Building Department with the following: For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unnsual natural or topographic features. ~." Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrieal installation from Board o f Fire Underwriters_ 4. Sworn statement fi-om plumb'er certif55ng llmt the solder used in system contains less than 2./10 of 1% lead. 5. Commercial building~ industrial building, multiple residences and similm buildings and/nstallafions, a certificate of Cod,e ComPlimme from arclfitect or engineer responsible for the building. 6. Submi~ PLarming Bbard Approval of completed site plau requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: l_ Accurate sur~,ey 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. Il- a Certificate of Occupancy is deni'ed, 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, Swinmaing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $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. New Construction: Old or Pre-existing Building: (check one) ~} House No. Street Hamlet OwnerorOwnersofProper~,: d- ?0'~'~'"~'""-' '~"¢ t( Suffolk Coanty Tax Map No lOOO, S~cfion /w/"-~3~?}'~ O~k ~(~ ~-~ Lot C)¢* Subdivision , Filed Map. Lot: Health Dept. Approval: Undemdt ers Approval: Plamfing Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (cheek one) ALL CONSTRUCTION SHALL ., MEET THE REQUIREMENTS OF :[HE. ROES o~ [ : · I-' ~ ' I' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE ~ ~m ~PANCY ¢/ ApP ov AS,, 0T ¢ _ 765-1802 8AM FC, 4PM FOR THE FOLLOWING iNSPEC FiONS: h FOUNDATJODJ - TWO REQUIREB FOR POURE~ C. 3DJCRETE 2. ROUGH - FRAM;NG & PLUMBING ,3. INSULATION 4. FINAL - :~ ~x/5 7-/4,,/~__,43 E c/e_ .. !~7.~'~7 ,.~-YLz.,~ 7,d~/_· -~--Iz',~--. · ~, ~ TAIO_~.L)._ ~__~.. ...... ':..._L .' :L .... architects, planners..InleHor design' QUAKERTOW~',I, PENNSYLVANIA ALL CONSTRUCTION SHALL ~ mEET THE-rREQUIREMENTS OF THE'. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE' ,~OF OCCUPANCY ~ l ' AI:),/PROyED AS NOTED 4.. N~TLFY Bij,LE, iqG :E:':~TMENT AT 7~5-~80~ ~AM TO ~ ~.~,,'~ FOR THE FOLLOWING IN,. ~, ~O ~S. ~. FOUNDATION - THO REQUIRED FOR POUBED 2. ROUGH: FRA,~i,;G & PLUMBING 3. INSU~T]ON ~. FINAL - CONSTRUCTION ~UST QUAKI=RTOW[,1, PENNSYLVANIA 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG, [ ] FOUNDATION 2ND [ ] INSULATION / [ ] FRAMING [V~'FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE , i FIELD 12N $PEC TIOlg'REPORTI DATEI C0~I~S .' ~O~ATION ROUGH ~G & PL~G ~S~A~ON PER N. Y. STATE ENER~ CODE ~ -. ,~,~ ~ . ' ~" .' .~-., TOWN OF SOUTHOLD I-.,.,- ,,. ....... ~'' '; "-'~ Z~ BUILDING DEPAR:I'MENT ~ .... ~ ~ ~'3~ TOWN HALL /' . SOUTHOLD, N.Y. 11971 ' ~' / ~ -- TEL · 76~1803 o/g / " APPLICATION F( R BUILDING PERMIT Received). .......... ,19.,.' INSTRUCTIONS a. Tlfis~a~iSfica~n inust be completely filled in by typewriter or in ink and submitted to the Building Inspector, witli 3 ts 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 · areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- c. The work covered by tins 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 all 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 mil have been granted by the Building Inspector.~ APPLICATION IS tIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the .~ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ne .applican.t agr. ees to comply wit!~ all app. licab!e !aws, ordinances,.bu/i~ousing code, and regulations, aud to hint a~thor~zed ~nspectors on prenuses and m building for necessary (malllng address of applicant) tate:whetl~er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ame of owner of premises · · , -, .(as on the tax roi] or latest, deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder'~ License No ........................... Plulnber's License No. Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ..... ~.]. ~.. _~ .~. ~?./~..~..c~. ....~?..~.. ~ ~ .......... House Number . Street Hamlet ~ County T~ Map No. 1000 Section ~ ~ Block ~ . Lot /.~. Subdivision .................. : .................. Filed Map No. Lot (Name) State existing use and occupancy of premises and inteuded use and occupancy of proposed construction: Existing use and occupancy ' b lntended use and occupant- 3. ,Natu:re otw'brk (eh~ck which applicable): New Building ......... ' Addition ' A~er~tion ......... - ' Repair Removal .............. Demolition .' ............. Other Work .............. .............. t'~5 4~L~{ ]-]-'-~ C~ (Description) 4. Estima{ed Cost .... ~ ................................. Fee ..................................... ., (to be paid on filing this application) 5. If dwelling, number of dwelling Units ............... Number of dwelling units on each floor ................ If garage, number of cars .............................................................. · ........ 16. If businesS, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7_ Dimensions of existing structures,.if any: Front ............... Rear ............... Depth .............. Height.. ~ ............. Number of Stories ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 8. Dbnensions of enth-e new'construction: Front .,.; ........... Rear ............... Depth .............. Height _ .............. Number of Stories ...... : ................................................ 9. $i~e of lot: Front ~....: ................. Rear ...................... Depth.. .................... 0. Date of Purchase ............................. Name of Former Owner ............................ I. Zone or use district in which premises are situated .................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 3_ Will lot be regraded ............................ Will excess fill be removed from premises: Yes N 4/ Name of Owner of premises .................... Address ................... Phone No ............... Name of Archit~t ........................... Address ................... Phone No ............... Name'of Contractor ........ ; ....... . .......... Address ................... Phone No ............... 5. Is this property located within L00 feet of a tidal wetland? * Yes ..... No ..... · If ye~ Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fron ,roper'ty lines. Give street and block number or description according to deed, and show street nimes and indicate whethe qterior or corner lot. · FATE OF NE'~ YORK.· (Name of individual signing contract) )ove named, e is the on;fac or, a ent, corporate o cer, etc. · said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in th_is application are true to the best of his knowledge and belief; and that the ork will be performed in the mmmer set forth in the application filed therewith· yom to before me this ~~~o~ .. ' ' (;'~' i (Signature of applicant) N NOTES, .% JOHN C. EI-{LERS. LAND SURVEYOR EAST ~ STRBBT N.Y.S. LIC. NO. 5026v2