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Home My WebLink About31168-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30970 Date: 06/09/05 THIS CERTIFIES that the building ADDITION Location of Property: 2750 PINE NECK RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 10 Lot 3 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 26, 2005 pursuant to which Building Permit No. 31168-Z dated MAY 26, 2005 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 ADDITION TO AN EXISTING ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to HELEN MACNISH of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPRO~-~J~ ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'£~U3 N/A N/A N/A Authorized Signature Rev. 1/81 Form No. 6 TOVqN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by t~q>ewriter or ink and submitted to the Building Department with the tbllowing: 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 lqb lead. 5. Conunercial building, industrial building, muhiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible tbr the building. 6. Submit Plmming 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. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - Nexv dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swirmning 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. June 9 , 2005 New Construction: x x Old or Pre-existing Building: LocationofProperty: 2750 Pine Neck Rd (check one) Sour:hold House No. Owner or Owners of Property: Helen Macnish Suffolk County Tax Map No 1000, Section 7 0 Subdivision Pernfit No. 3 I 16 8 Health Dept. Approval: Plarming Board Approval: Request for: Temporary Certificate Fee Subnfitted: $ 2 5.0 0 Date of Permit. Street Hamlet Block Io Lot 3 Filed Map. Lot: 5 / 2 6 / 0 5 :~ Applicaut: Under~'riters Approval: Final Certificate: xx (check one) ~.p~'li~a~t Sigt~ature - 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. 31168 Z Date MAY 26, 2005 Permission is hereby granted to: HELEN MACNISH PO BOX 492 SOUTHOLD,NY 11971 for : ADDITION TO EXISTING ACCESSORY BUILDING. THIS PERMIT REPLACES BP 11251. at premises located at 2750 PINE NECK RD County Tax Map No. 473889 Section 070 Block pursuant to application dated MAY 26, 2005 Building Inspector to expire on NOVEMBER 26, SOUTHOLD 0010 Lot No. 003 and approved by the 2006. Fee $ 75.00 / Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 2 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) ~1~25J Z Dote ............................ ..~...~.../...}~ .............. .~," 19...E/ Permission is hereby granted to: ~ -~.~-,: '~ ~t' ~'~C~~ ro ...... .~..~ .......... ~ ~ ......... .~.~..~.~.E ~ C..~.C C ~.2.E ~L ~ ~..Z ........ ~:L ~ L L ~..~..~.'.: L.C%....: ................... County Tax Map No. 1000 Section ~7 0 Block I 0 Lot No. ........................................................ 19/'.~....., and approved by the pursuant to application doted ,.J'/,,t '-~ /, Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FIELd} ENS~ECTION REPORT I DATE I FOUNDATION (1ST) FO~ATION (2ND) ROUGH F~G & PL~IB~G ~SL~ATION PER N. Y. STATE ENERGY CODE .~DITION~ COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ..... ~9/-..t ..... 19 .cd./Permit No ...... ~ ..... .... --. .... .... ..... .~-¢..~:~ ..... ,/.... ...... . (Building Inspector) APPLICATION FOR BUILDING PERMIT INS'[ RUCTIONS Application No. //-~ 5// Date ~..~ ......... 19~/ a. This application must be COlnpletely filled il). by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan -hewing location of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn oil the diagram which is part of this ap[ cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Such peru 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 any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe ]'he apt;licant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. ........ (Signature of app. licant, or name, if a corporation) (Mailiag address of app~cant/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. (as on tile tax roll or latest deed) If applicant is a corporation, signature of duly attthorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's Licens? No ......................... El.:'ctrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ ..... .............. g.g.., .......... ?. ............. House Number Street Hamlet County Tax Map No. 1000 Section .... ?..~'?. ........ Block .... /?'J Lot c ~_) 'SubdMsion ..................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a- Existing use and occupancy ...~...~...~.f~. .............................................. b. Intended use and occupancy .7..t5~/....~ .................... L Nature of work (check whicl, applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .~ ,. ~ '3' ... (Description) Estimated Cost f?'7 - ' Fee ...... L.: .......................... (to be paid on filing this application) ;. If dwelling, nmnber of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ If business, commercial or mixed occupancy, specify hature and extent of each type of use ..................... 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 ...................... Nutnber of Stories ...................... Dimensions of ..'ntire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ...................... Rear ...................... Depth ....................... Date 6f Purchase ............................. Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regnlation: ............................... Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ...... '...: ......... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whgther tcrJor or corner lot. being duly sworn, deposes and says that he is the applicant is the ...................... ~a-,t.,avo.~,T~ ........................................................ (Contractor, agent, corporat,~' officer, etc.) said owner or owners, and is duly authorized to perform or have peuformcd tile said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the · ork w~l be performed in the m~ner set forth h~ the application filed tiaerewith. worn to before me this ~ ~RY PUBLIC~I~ ~ N~ y~ ~' '= .............. [: ,' ...... :- .% ~ I.' .......... - d ~ 52-8125850. ~folk ~ Si nature of aD lican