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Home My WebLink About23898-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25098 Date JUNE 20, 1997 THIS CERTIFIES that the building ADDITION Location of Property 17130 MAIN STREET NEW SUFFOLK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 9 Lot 28.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 30, 1996 pursuant to which Building Permit No. 23898-Z dated JANUARY 22, 1997 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 AS APPLIED FOR. The certificate is issued to MICHAEL & SHANNON SIMON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ///16ild'ing Inspector Rev. 1/81 FORM No. f 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) :. . ... N® 23898 Z Date .............. ................. 19 „•, Permission is hereby granted to* ... r• `.. ................. .......�''.��.�...... ... ................ ........ ......... ..... ....... ... . .,4 .....f.. . ..G ..... ............................................... ............... ........................................... at premises located at ..................1.�f..l. Z .... �;� C-c.y?.. ............................................ 'e.......................................................1..F...:..C1. - -................................................................. .......................................................................................................................................................... County Tax Map No. 1000 Section ........ / ......... Block ......., 7.......... Lot No. ... �.. ..•. pursuant to application dated ............. .. .... ..a�' ............1 19 1 and approved by the Building Inspector. Fee ..... ..$./...eG ............ . ................ Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of _proper.ty 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. 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. ,1C 2. A properly completed application and a consent to inspect signed by the applicant. Lf 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 - 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 Buildins - $100.00 3. Copy of Certificate of Occupancy - .25r,. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . 1�°. . .J.v.^l.E:. . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . .. . . . . . Location of Property. ..V . . . . . . . . . . . . . . . . . . . . .1� 145:W. tJ F—o J-K . . House No. Street Hamlet Onwer or Owners of Property. . .,/. .4,G!/ L-. . . . .� /��N�!�. . .:§��/v) Q te . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.�?l .Z. .Date Of Permit. .. ,/9 .�. . . . .Applicant. .��G�l��L. . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . Fee Submitted: $a S'. 0�. . . . . . . . . . . . . . . . . . . . . ic/ . . . . . . . . . . . . . . . . . . . . . APPLICANT 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING �,41NAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE INSPECTOR T65-1802 BUILDING DEFT. INSPECTION [ � FOUNDATION 1ST [ ] ROUGH PLBG. [ ] ,FOUNDATION 2ND [ ] INSULATION [✓] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: �0,� DATE S �Z / � INSPECTOR ��✓y� 765-1802 BUILDING DEFT. PECTION [ �FOUDAT10N iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /1 �- z /1�� Oe� DATE � INSPECTOR I` IIiI.0 IINiI.U;I IUII Itl!1'UI(T DATE' P(,I,Il1)AT I I,N Ol I'I.Iltlil I NO C ----,n—m m+•------nr_mnm-,mnn a,m a,r•...r.... :ten--r. --v---- r.,�r.+r--••,_n--,n—� �' Y Y _..__—__._—____ .. ... . .. ......._..__--.•_. _ i� I nr;ul.n•r I cl►I t�r.lt t! . v . .. .. ...... . . . ..... ... t:(ll)I.". --,ram-,,---R»nR-—n-ti,-=-„n.nn ---- -- _ n�,-,.nn.,,,n -•r� ,,,,,,n-,n nn r-..,mn--- m FINAL -------------------- ----- ,n--- - _„� �,,,�„T ------- -- ----,m.,�� ADD[.1'I t)tlA1. t:(1FIt11;t1'1!1 _..-a-. —n-•----n m m,srmmn m------nn--n--------— � h ®��gUFFO�,�cOG cc 2 Town Hall,53095 Main Road p Fax (516)765-1823 P. O. Box 1179 y� O� Telephone (516)765-1802 Southold, New York 11971 4 �a OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD June 12, 1997 Michael A. Simon -P.O. Box 303 New Suffolk, N.Y. 11956 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons : XX ' An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is (not on file. ) $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 23898-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD ' TOWN BUILDING DEPT. TO: Southold Town Building Department FROM: Michael A. Simon 17130 Main Street PO Box 303 New Suffolk 11956 SUBJECT: Building permit for deck DATE: 15 January 1997 1 am hereby enclosing revised sketches,as a supplement to my application for a building permit for constructing a deck behind my residence at 17130 Main'Street, New Suffolk. The original application was filed on September 30, 1.996. If there are any further questions, I can be reached at 734-7237 or(212)666-1090. ,]AN � 6 SURVEYED FOR:- 10A/ti/ G. �E.�/N/E BD1,/N.4,2 i LOCATED AT it/EK/ TOWN OF "SpL/Th/OLc) SUFFOLK COUNTY N.Y. LOT MAP OF CO. CLK. N0. FILED SCALE I" = eO' SUFFOLK CO. TAX MAP DATA:- SE c cYli ST'eEET ' DIST./000 . SEC. //7.DO BLK. 090e LOT OeB001 — u I CFFSETS FRG..1 STRUCTURES (� _ a"'G""eGif. 1 tout.• wacc. . . • U� • TO RELATIVE 60UNDhY LINES, �J //7 ON SURVEY, ARE FOR A m O o I Ga ems'N _ I AND r� O SiiCI-C USE ONLY, ; A •. StiCDU:D 143i oc USiD FOR ! oo..c•ac. S COivSi U..T,OIN OF fi:NCEs OR Oili:: STnUCZJ:tES. 4 be 4 p F•2dME i 70 6� ; X 0/ME 45.4 V/ S 844/K C)C/�EW .eA!:' I `� QJ�' �j Q•(�(� wood cu�B A:?5 I SURV:`-YED SCAj'Bi 191:58BY - - - - WILLIAM R. SIMMONS JR. P/O BOX 377 q SEP 3 0 i�� JAMESPORT, L. I., N. Y. 11947 PAGE • aL !` FILE NO. I9.9� 24 GRIDe-,59 I� DRAWN BYf' _ - _ HOARD OF II13ALTII R'* ET FORM NO. 1 3 SS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . J s�p e� o �� r0 -- BUILDING DEWARTHL14T CHECK . . . . . . . . . . . . . . . . . . . . . . . . . I, TOWN IIALL SL'PTI.0 FORM . . ... . . . . . . . . . . . . . . . .1.. SOUTHOLD, N-Y. 1 197 1 J TEL: 765— I802 NOTIFY: CA ja,3-7 I:x:tinirxcK6l .L��. 19.... MAI1. rrD - - �(_3 . i �%�Aplrroved_._ � .,l 19.... Penni t No. �1_, Disapproveda/c .................................. ................................... ................................................ ..• V B,?Vi DE Dle. aiding Inspector) / Do-z9 APP . CATION FOR BUILDING PERMIT 9�j ])ate. v� . . . . . . . 19/. � INSTRUCTIONS / a. 'Illis application mist be empletely .filled in by tYpewriter or in ink and submitted to the Iklilding InslreeLor w 3 sets of: plans, accurate plot plan to scale- lee according to schedule. h. Plot plan showing location of lot and of Imildings on premises, relationship to adjoining prmiises or public streets or areas, aril giving a detailed description of layout of property mist be drawn on the diagram wlriclr is Ikirt of this application. c. The work covered by this application may not be camrenced before issuance of Building Pennit. d. Upon approval of this application, Lhe Milding Inspector will issue a Wilding Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No Wilding shall be occupied or used in whole or in part for any purpose wlraLever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPI:ICAI'ION IS MU:13Y tM% to tine Building I)eparuwnt for the issuance of a Iuilding Pennit pursuant to Ole Milding Zone Ordinance of the Tani of. Southold, Suffolk County, Neva York, and other applicable laws, Ordinances or Regulations, for tale construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to ccnlrly with all applicable laws, ordinances, Wilding code, housing code, and regulations, and to a&it authorized inspectors on premises and in lxrilding for necessary inspections. 14 (Signature of applicant:,�or narrr�, if a corlx)rat iioon)) �U 1�OX.3.03..:! 5!✓-. IJFF aLKi N�. Nailing address of applicant) SLate xJWLher applicant is owner, lessee, agent, ar(Ititect, engineer, general contractor, electrician, pluiirer or builde OR ............................................................................................... Nail e of owner of preini ses N/f C N A /M U._N........_.. .... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly auLlrtrrized officer- ..................................................... Kim- and title of corporate officer) Iluilders License No. ......................... Plurirers License No. , Electricians License No. ..................... OLher Tiade's License No. I. Iocation of land on which proposed work will. he done......................................_........................ 11-2 ................•............... ............. Ikxrse Umber Street Q llanilet Cxxrnty Tax Map No. JOOO Section ._I-� .O.P... Illcx-k .�.l.•.O-0.... LOL � -g Sulxlivision ...................................... I.'I LetI U-1p Ncr_ ........ I.ol' ............_.. (Nme) 2. State existing use and occupancy of prcinises and intended use and occupancy of proposed construction: a. Existing use and occupancy -_. R4ES.1.DE tit.4.�E;..--"_.Un/ ...FA.M1.L.'y....................... 1). Intended use and occupancy ....... .................... .. ' ............................. N)IifIe of t.t)lk (check iJiicIi aI.I)Iicahle)- Near Ikiil(Ii ill,,. ..... ..... Ado ilioil ✓�o��,�> Alteration ... .... ... liz!pa i I. .. ...... .._. 14111crva 1 ............. DenfoI i t i on ............ Other 1•k.)i k ..................... ....... ... . .. (Ikscripticxt) h.sl iuvtted (or;1: �v Ov ............. fee (to be paid on fi l ilig Ihis 11I)1)1 icat:ion). 1 f threl I inn, otsiber of th•ml l inn uni is . . .. `------ Illoiber of AMI I log tmi is cxt enc:h floor. ... .......... ... IF 1"m age, 1xnIx31- of cars ........ .. .. ... ...... . ............. . . . If Imisilx'.Ss, ciYmr_rcial or mixed (.X:(:tlk7Wy, specify rvi(Aire aril extent of each type of use....... .... .. .... ...... I)inx!nsimn of existing; vLt%K:tUr'e;;,• if any: ...... Rear r.... ... Depth 31•.1..... . ....... Ik!il;llt . .....................: _ 141rrlx-r of St.orie.r.. ............ . .. ... .. ..�• Ilin,ensions of sivw stitx:ture with alleraHoos, or additions: Proof . . .... hear lktpllr 0 ........ Ikilltt: .. . ... ........ . .. ... Nuttier of Stories, .. ........ ..... itx) of l e rxto ctsn :ic : Px)I: ......._ lcar � .... .... ..�C..0...... .1)itwo elAh Ik ig)it ....................... .. IJrrri er of SLories .. ... ... . .. .... . . .._ . / 1 i / � q r Sire of lot:: I"ronl . .. -7 3..._ ._.. Itenr ...-1�..°-6. . . ... . . Tkpllt .L .�.�:.�. /.. ..... . ). 11a1 e of 111rc: inse _!. �- .':s? ... l,law of hornx r (inter ... .. . . .. ,--. ..,_?.__ J C tit. ............. ... .. r.1 Al tt (Z 1. 7.cx)e or use district in xAd cl) premises are situated .... .. .... . .. ...... ..... ............................. .. ... . ... 1. Ih)es prolx).ned ccxtslrtx•lion violate ally zoning law, ordinance or. rellulal.ion: ... . ............... I. Will lot: he ve-gt xted ..... ........... Will excess' fill be removed from pr(-Inises: Y1''S 14) i. Nxrxs of (knrer of premises MIC1,1,L1CL jjtjbN.nIflN•fln� 'I ess �.��3.�. �/ s�4....... Pfxxx! rk). N.rtx: of Architect .... Address .. . . ..... ...... .... ........... I'ltorx. No. M■lie of Coul-racaor ... .. .... A(klress .... .... .. .. .. .. .... ..... ......I'llone flo. .. .. ....... ... .. '). Is this prc)lx!rty within YX) feel. of a tidal w-Oarxl? * YI?S ./V.v .... Nc) .. ..... ... *IF Yl's, 1T1If11xA1) 'ICII.IN '11XIIMITS 19's11t11'1' HAY Ill; la-!Apllarl). 1'I.0T DIAGRAM Image clearly nix] distinctly all lAdIdings, xAiether exisling or proposed, atx) indicate all set-back dimensions roil) Ill-operty lines. Give st:r-eet hrxl block rxrrdwr or description according; Uo deed, aril Otow street Hanes aril inxlicate nether interior or corner lot. SK7c0N 7 v 3ts o - v O � t. A os zY ANNf1 VA 1 NA'lh. (A- 1`114 Y(NlK, XAINIY (91 5-Ufi r l7 LIB . .. ` _ C- i��a. � �^ /��. u.!`! ..... ._ . .Ixdnj., dui taxi �a llurC he is he 'r )rl icsrnl .._.. ._. .. . �!. . . . . .:.. .� I. t !, yrrn, delxrse s any"; •I f ,Nntv of irxlividijal, silming cuolracl:) =rlx)ve n.nxxl, ' 'I V7 It! i!; Ow .... . .. .. .. . . . ... ...0 W!.cg.r ..... ._... . . ....... . ..... .... ... . .. ....... ................. .... ((oril.rnctor, :)gent:, corlxrral'e officer, etc.) If r;:tid (narx!r ot- o<.n)( rs, atilt is (luly :;Whorized to Ixtrfonn or have perfornie(I Lhe said work arxl to tivilte incl file'lhis 'ppl icntioll; 111;11: .111. st_1le+tx�n1_r; colltnioed in Ibis. nppl imiHoo nre tyiw to the IKIBI: of his krxxalczdg;e nrxl Nd i(!f; nlxl ;lint. lire work will Ix Irerfotmxxl in.lhe nvifloer set rot(l) in the applie:ation filed therewll.h. 'haorrr Icr I>�o; nr� Lhis �� '• _.. .. ... of ..... ... .... .. . I��... . .. lk)tary 1'tlhl.i . ..... .` ... ...:.... CLAIREL.IaLEIN (Signaltire of Appl.ic:u)1-) Notary Public,State of Now York No.4879545 Qualified in Suffolk County Commission Expires December 8,19 , r " I I I • 1 1 -7 3 D /144 ry Ncw Sur=FuLK ' - I I � I Ji • - l I I , • .a• _f-4 NOTED, ` �/ � •- nnrrr.—>. � -.�-;j---— _, . .. P `,; r,- I,;r ,too,:Flit! �j�y'f 1� !j(i b �(�07(A '3 r;V3.�a��1 k 17�•9�'s�l� 6� is `• _ `� -- ____ _ _ :- _ r ag H802 y-, A fluil TO 4 FOB `SHE r� tlVVING W&Ermokls, % 2 i(0 A.n e B, Q avA, B E F ,1.fib. I. . . , . ' . . . Y D'ad56GN OR.CO �S UCTl0�ERRORS j I ' ; � I I I I_. . i ''• � I I i I i AN I IdA �',, � I I I I I I I I i i i I I j i I I I , , �14,0A/ , ; , 1=c ' : (//. i 1 Ile- , � wed , s JAN ! 6 .f , : i -! ------------- S - - - — I i ' I i ,,� -- -i-073 - - -- 1 r 1 � � i � ; } l i , LEV 71a : I � 1 AA - - ! REVis�Dj ' r ! t- ! 1 I bD , —"'�-•--'°`ems. �:< :.�••r ��`/2��(!''�'."�,...,, �.�`""}Z..,. `�° 4 ,- „�.�. r i I � n : MEE To- 71 I u 1 � ! : I I I i i I , 1 ( � M : - ! I L YEA n1 vod M MVIN .s f Ncw .fv�r Lk M Q M SV.R o Lb S WNir/ W SILrjA/ 171.3(3 s PeoPosEP DECK , RcAR �El-E V47i o/) , 661� S a` � J F r4 O_ L1J