HomeMy WebLinkAbout24161-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31883
Date: 09/29/06
THIS CERTIFIES that the building
ALTERATION
Location of Property: 1270 VILLAGE
(HOUSE NO.)
County Tax Map No. 473889 Section 25
LA
(STREET)
Block 1
EAST MARION
(HAMLET)
Lot 26.1
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
pursuant to which
Building Permit No. 24161-Z
dated
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 ALTERATION TO AN EXISTING PORCH OF A SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to DONALD A MCNEILL
(OWNER)
of the aforesaid building.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
~~~,=.
Rev. 1/81
".-.;-
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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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:
I, 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 2/1 0 of I % lead.
5. Conunercial 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 Plarming 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:
I. 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
I. 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 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, Conunercial $15.00
Date. 1/'t--r( 06
Old or Pre-existing Building:
.I
(check one)
()",;~....t
Hamlet
New Construction:
Location of Property: I ~ 7'" V: " '" 1. " ~~...
House No. Street
Owner or Owners of Property: p~~ ./ ~" JI' A.J I ,
Suffolk County Tal' Map No 1000, Section :I.). - ,- :1.1.)
Subdivision
Block
Lot
.
Permit No.
Date of Permit.
Filed Map.
Applicant:
Lot:
Health Dept Approval:
Planning Board Approval:
Request for: Temporary Certificate
Underwriters Approval:
Final Certificate:
( check one)
Fee Submitted: $
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Applicant Signature ~
.0.. NO. .
T~N OFSOUTHOLD
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~ 24161 Z
Dote ............... ... ............~................... 1:1.1
Permission is hereby graz Ii ~ ~/., d
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....;:;1::2. . ......./.ftfJ. ..5........................
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County Tax Map No. 1000 Section ........dl.s::..... Block ....L.............. Lot No. ~r;;:...:.I........
pursuant to application dated ........~~....?.................... 19.~.?., and approved by the
Building Inspector.
li-;;?_oo/
Fee $...........~..
.................~.................
Building Inspector
Rev. 6/30/80
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FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL: 76S-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
...::~:::~ Permit lb.clW~f,P
NOTIFY:
CALL ..................
HAIL TO:....................
Di
.mlr..ft '~'1E"0' VI :f[ r;:-V.....
nl '
!,.,U: MAY -91997 .'
,
CATION FOR BUILDING PERMIT
, ---.l
I BLDG.Q[Pr.
_T.r;WN OF SO:;~clO! I)
DateS;.I.J:.~. ~:-.,-;;>l~
INSTRUCTIONS
a. This application DUSt be ~Ietely filled in by typewriter or in ink arxI subnitted to the fuilding Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot arxI of buildings on premises, relationship to adjoining premises or public
streets or areas, arxI giving a detailed description of layout of property 1IlISt be drawn on the diagran which is part of
this application.
c. The l<Orl< covered by this application ""y not be <.,,,,,.,,lCed before issuance of fuilding Permit.
d. Upon approval of this application, the fuilding Inspector "ill issue a fuilding Permit to the applicant. Such
permit shall be kept on the premises available for inspection throughout the work.
. e. Ib building shall be occupied or used in whole or in part for any prrpose whatever until a Certificate of
(kcupancy shall """" been granted by the fuilding Inspector.
. APPLlCATI<JI IS IEREIlY MAlE to the fuilding DepartDEnt for the issuance of a fuilding Permit pIl"suant to the
fuilding Zone Ordinance of the Town of SouthoId, Suffolk Coonty, New York, arxI other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for reooval or demlition, as herein
described. The applicant agrees to ~ly with all applicable laws, ordinances, building code, hoosing code, arxI
regulations, arxI to adnit authorized inspectors on JIl'81Iises arxI in . ing ~~~~:~~~~:.................
gnature of applic~, or nane, if a corporation)
...r.. p.;. SQ/>... .1.j!.6. -!:... Jo..I1.'-:'/' '-f../?:..
(Hail ing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor. electrician, plumer or bllilder.
.......................................................................................................................................................
HalE of owner of JIl'81Iisesyntl....l1c.Mti.?............................UATE~.. p . ~A~:OTE
(as on the tax roll or latest deed) . . .
If 1.. .. f ....1 tho'zed ff' FEE: BY:
app lcant IS a corporatIon, SIgnature 0 uu y au n 0 lcer. NOTIFY BUILDING DE
--r-'. /' 705-1802 9 AM TO 4
.. ..v./A>....Ce 11.(77...... ..... ... ......... ... ... .... FOLLOWING INSPECTIONS:
(!lane and title oVcoIl"'rate officer) OCCU 1. FOUNDATION - TWO REQUIRED
PANCY OR FOR POURED CONCRETE
Builders License 1b.l.;?t?~J.II.J.......... WIUrHSEou'Sr CUENRLAWFU~ ~~~~~T;;:AMING 8r PLUMBING
OF TlFICA;ffFIN.AL -' CONSTRUCTION MUST
Plmilers License No. ...:.:-................... OCCUPANCY BE COMPLETEFOR C.O.
Electricians License lb. .. =. .. . . . . . . . . . . . . ALL CONSTRUCTION SHALL MEET
,. _ THE REQUIREMENTS OF THE N.Y.
Other Trade s LiCense lb. .................... STATE ';;ONSTRUCTION & ENERGY
I. IDeation of larxl on which proposed l<Orl< will be done..I.Z.7..~... '"'-. ~ L 1/ ~.Es6..<tltllU~ElESE'QNSIBLE . .fOR .
~ . DESIGN OR. CONSTRUCTION ERRORS
... .::::~; .W;1;.;'~""""" 'S;;;';';' vt'i;~'F" t~-;;L"""""""""" 'Hri~;" ~.;;:; r..............
Coonty Tax Hap lb. UXXl Section................ Block ................ Lot ................
Subdivision.... _................................. Filed Hap lb. ............... IJJt ...............
(HalE)
2. State existing use arxI occupancy of premises arxI intended use arxI occupancy of proposed construction:
a. Existing use arxI occupancy .. ./:I.I).~'/.~...............................................................
b. Intended use arxI occupancy ..!It. INt./"... ;"J.V;!~rJ" ./1'/../lP. K-!:. If................................
1.
tJ..lllle of wOlk (doeck ..hid. applicahle):
l(epair .:/?C....... Removal ...........--
New Building .......... Atklition .......... Alteration ..........
Den,,] i tioo ............ Other Work ..................................
(Description)
I,.
..,!:.-
EstiuEted C.ost . ..1/.t?A...............
fee
(to be paid on fil ing this application)
5. If d...elling., [u.ber of dwelling ,milS ............ tl.nher of (I\.lelling \milS on each floor ................
J f garage., 1w.J1'Joer of cars ................................ _ . . . . .
6. If business. (':(IIIrercial or mixed occupancy. specify nature and extent of eacll type of use......................
7.
llhrensions of existing structures, if any:
Front. . .. . . . .. . . . . ... Rear ............... Depth
l1eigllt ...................'....... l'lJ:.j>er of Stories ......................
Ilimensions o~ ~re ~tifture with alterations or additions: Froot................ Rear...............
Depth ...~...;.tl:-:...'~',;... Height _....._..._......... N..li>er of Stodes ..._._.__......
8. Jlimensions of entire new construction: Front ........._...... near ............... Oepth ............_.
lIeight ..... .................... l..dler of Stories.....................
9.
Size of lot:
Front .................... Rear .................... Depth
10. ll.-'lte of l\Jrchase ..................... ricJre of' ]i"onrer Cuner ..................... _.. ............... .
II. Zone or use district in wlidl premises are situated ..............................................................
12. I10es proposed construction violate any ",xling law. ordinance or regulation: ........................
13. Will lot be regraded .................... Will excess fill lle rewoved fran premises:
YES
m
11,.
Nanes of Owner of premises ............................ II<klress
NclIne of ATdli teet: .................... _ . . . _ . . _ . . . . . . .. Address
Phone No.
Phone No.
Ntllle of f.(Xltractor ............................... .... hldress .............................. .Fhone til.
15. Is this property within J(XJ feet of a tidal wetland? k YllS .......... m .X.....
kIF YES. fnJJ1Un T!HI11l11S'IEK.'i PElMff M1\Y IlK RF1~IR1ID.
1'1.01' IlTAGRAH
IDeate clearly and distinctly all buildings. wlletller existing or proposed. and indicate all set-back dimensions
hUll prO(lerty lines. Give street and block lUIber or description acconling to deed. and show street nares and iDiicate
''''tether jnterior or corner lot.
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2.X j/ Dr., v/- I p t/ !J.P.e",
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JILL
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STA:m n' l'I!M YUU<.
A '/7/1..,12 SS
UlINIYll" ~
..............g.~.;f..~~J>-!.........beir~1 duly swum. deIXJ5eS and ..,ys that lle is the uppli"""t
(Nrl'~ of indivlaual signiug contra~~)"""""-.' ro .""""l'
idxJVe 1L:"TII?d.
Ik, ill the ..... ... ~..... ... .......... ........ .......... ..... ............ ...... :..........
(Contractor, agent. corporate officer, etc.)
of said (~ner or owners, find is duly authodzed to perronn or have performed the said ~)[k aid to mke arxl Ii Ie this
nppl icatiulI; that all stalerents contained in this appJ icat ion are tnJe to the best of his knuwledge and l,elief; and
lhilt the work will he perfonred in the manner set forth in the application filed therewith.
9....orn to he~ this .
.......9'......... .day of .J:J:v.,. 7.... .19. .97...
Notary l'"bliC~ffi..~
HELENE D. HORNE
Notary Public. State of New York
No. 4951364
,.. Qualified in Suffolk Collnty 97
\..cmmISSlon Expires r-~1ay 22,19_
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
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OWNER STREET 12:70 VILLAGE DIST.I SUB. LOT
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OMln(d A. Mrl'!e',11 10" '. I f)Yle':1 f 1)2<<, -----
i FORMER OWNER N Vidl-f Nos-hr1Hrl ~ (ta.. ~ )...e ACR. '1
~~I . -
S' W TYPE OF BUILDING
A i'l--( i,:~ M . L:.d-L"~,, ,< 1)( B.M~N-@./1111/)f, 0.14. w. c fIle;11 .f. ...-f.
RES. d V SEAS. VL. FARM COMM. CB. MISe. Mkt. Value
10
LAND IMP. TOTAL DATE REMARKS '. .
.
, () 0 If/oo /(. 01) 1/ /Z-d~ '/ S.,ld LihpI,- A ?"U c:,53'?2 (h<><"'i1S;!_'-~lcl"") ~Jf.o.,. ./;, ('v1c.H,.', tt'
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~ (;)-0 / 3-.::ro /(, <:>-0 / /.ZI /r../
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J#'l) ,/ VVJ> I /700 I
-
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AGE BUILDING CONDITION
---------------
NEW . NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
------
Tillable 1 .
----
I Tillable 2
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I Tillable 3
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--
! Woodland
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! Swampland FRONTAGE ON WATER JJ ...-;; f..3-'!- m.. .3'1 z/
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Brushland FRONT AGE ON ROAD
DEPTH
I House Plot
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I. ,,- . BULKHEAD
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Bldg, V. t( 9 :: '169 i- t 17). fi' / Foundotion OA e... Dinette /l ~
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enslon Basement Floors 1>.le -I-hr" J" K.
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Rooms 1st Floor BR. .::J
__,~1"11~k,,;~' I Recreation Room Nt> 4 e. Rooms 2nd Floor 2- FIN. B. /y e
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