HomeMy WebLinkAbout5089-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEP~TMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-34103
I~ate: 12/01/03
THIS u~TIFIES that the building ADDITION TO DWELLING
I~cation of Property: 1370 JACKSON ST
(HOUSE NO.) (STREET)
County Tax Map NO. 473889 Section 117 Block 10
Subdivision
Filed Map No. Lot No.
NEW SUFFOLK
(H~24LET)
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 24, 1970 pursuant to which
Building Permit NO. 5089-Z dated DECEMBER 3, 1970
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 ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to JAMES P & EILEEN G MANNING
(OWNER)
of the aforesaid building.
SUFFOLK COUN]Uf DEPARTMENT OF HEALTH APPROVAL
ELRt-rKIC3%L u~K-rIFICATH NO.
PL~ C~RTIFIC~%TION DA'r~a3
N/A
N/A
Rev. 1/81
FORM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 5089 Z
Dote ......................... J~., ......... .~ ......... , 19.....~0
Permission is hereby granted to:
..........
at premises located at .............. ~.~T~,,Jr, JtJlll..~l~ ............................................................................
pursuan$ to application dated ................................. JJU ....... ~' ......... , 19...VQ, and approved by the
Building Inspector.
Fee $ .~.e..(~. .............
Building Inspector/
Form No. 6
TOWN OF SOUTHOLD
BUILDING 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or built
1. Accurate survey of property showing all property lines, streets, building and
features.
2. A properly completed application and consent to inspect signed by the appli,
denied, the Building Inspector shall state the reasons therefor in writing to t/
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling ~25
BLDG. DEPT.
. .IQ_W_ N_ Q[ S~UTHJQLO
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, Commemial $15.00
Dme. May 4~ 2009
New Construction:
Old or Pre-existing Building: X
(check one)
LocationofProperty: 1370 Jackson Street, New Suffolk
House No. Street
Hamlet
OwnerorOwnersofProperty: James Manning
Suffolk County Tax Map No 1000, Section 117
Subdivision
PermitNo. 5089
Date of Permit. 1 2 / 3 / 7 0
Block 10 Lot
Filed Map. Lot:
Applicant: James Manning
10
Health Dept. Approval:
Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate
Fee Submitted: $ 2 5.0 0
Final Certificate: X (check,~pe)
-/" App'-l'i~6~tF~glj[dture J /'
/ ~Yames E. F(l/~gerald, Jr.
/./Agent
765 1802 ~
INSPECTION
[ ]FOUNDATION 1ST
[ ]FOUNDATION 2ND
[ ]FRAMING / STRAPPING
[ ]FIREPLACE & CHIMNEY
[ ]FIRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
[~FINAL
[ ] FIRE SAFETY INSPECTION
[ ] RRE RESISTANT PENETRATION
DATE ~-f'7'- ~ ~ INSPECTOR
TOWN OF SOUTHOLD BUILDING DEPT. ~~
765-1802 ~ ~
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ]INSULATION ~
FRAMING / STRAPPING ~FINAL ~-~
FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTI
RRB RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE
SURVEY OF
PROPER T Y
AT
NEW SUFFOLK
TOWN OF $OUTHOLD
SUFFOLK COUNTY, N.Y.
1000- 117- 10- 10
Scale 1" = 40'
Sept. 28, 1988
JACKsoN STREET
FIRST FLOOR ELEV*4TION' ~5.9
·ROUND FLOOR, ELEV. · ES. 70
CONTOUR LINE AND FLOOR'ELEVATIONS
~RE REFERENCED TO N~V D~TUM.
GREAT PECONIC
ELEVA TION$ I0-1E-88
AREA = 47.203 ,q, fl: to tie fine