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Home My WebLink About23385-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24325 Date MAY 1, 1996 THIS CERTIFIES that the building ADDITION Location of Property 220 MECHANIC STREET SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 61 Block 4 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 199E pursuant to which Building Permit No. 23385-Z dated APRIL 24, 1996 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 SCREENED PATIO ADDITION, GLASS PORCH ALTERATION & GARAGE STORAGE ONLY ALTERATION TO EXISTING ONE FAMILY DWELLING "AS BUILT" AS APPLIED FOR. The certificate is issued to MARIE SMITH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 24, 1996 PLUMBERS CERTIFICATION DATED N/A Build ng Inspe or 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) Date .............. ....... 19. ..... NP 23385 Z Permission Is hereby grand ��.. .............................................................. .. ....... z. .. . , .... ............. ........... .. L . . ........ ........... ....... -Y„ .... .......... ....... .....!`...r. ...........Lda.. ... .....:............................................................................... .........I............................. atpremises located at........ a ...... .... .. ...... `?/1c- . .................................................... ..... ................ ....... �. ................................... County Tax Map No. 1000 Section ..........&/..... Block...... . ........... Lot No. .. m.. .......... pursuant to application dated .......................... .1 ..„ 19... .5 .., and approved by the Building Ins�/pe(ct�or. Fee$....../...`! ........ .. ... .. ... ...................... Building Inspe or Rev. 6/30/80 Form No. 6 TOWN O F ,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: 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 2/10 •of M 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. 2.• A properly completed application and a 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 - 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 - $5.00 over 5 years - $10.00 4. Updated Certificate. of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . ✓. .a. /:. . /.". . . . . . . . . .. .'. . . . . . : New' Construction. . . . . [.. . . 0 • Or Pre-exi tang Building. . . . . ao ' . . . . . . . . . � . . . . . . . . . . . . .. . . . Location of Property. . . . . . . . . , , , House No. 1 � - Street Hamlet 09 Onwer or Owners of Prop.erty.. . . . . . .t . . .&4L� , . . 1.County Tax Map No IOOO, Section. . . . . . . . . .Block. . . . ... . . 1. ... . . . .Lot.. ,/ , , , , , ; , , Subdivision. . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . .Lot. . . . . . .. . . . . . . . . Permit No. ... . . .. . . . . . . . .Date Of Permit. . . . . . . . . . . . .Applicant-. . . .. .. . : . . . . . . . .. . . . . . Health Dept. .Approval. . .. . . . .. . . .. .. . .. . . . . . . . .Underwriters Approval. . . . . . . . , . . . . . . Planning- Board Approval. . . .. . ... .. . . ... .. .. . . . . .. . Request for: Temporary Certificate. .. . . . . . . . . Final Certicate. ./.;. , , • • Fee Submitted: $, , , , •�11 . . . . . . . . . . . . . . . . . .. . . . . . .�. .:. . . . .. . . . . . . . . APPLICANT- co 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Jm D� DATE O? Kez�ll�f INSPECTOR ra n-2 1;11.1 FMIIIIIAT I Oil .......... Q t�� UU I I D AT 1011 (2111)) ------ --------- ---- ,on. ---------------------------- & ------------------------— -- ------ ——-—————-—-——--——————— ----------------- y . STATE nn....._..nnr...r,�.,..r,.n..m�_.n...�m.. ��a .nl _..., -.nn.,�.,.,.n.,..-.,..n...,_.....r.,.__.. n........r..,a.....,......m..<.,....�.n.r,....nnr..,. 1 F I IIAL ---------------- ---------- --------- ---- ------------------ 0 — A 1)1)1 T 1011 A 1.— 01 it f q I I'J'.9-- �x I---------- ------ --- -- ----- --- ———-—————-——--—— ---------- -------- — n .----------------------- 7S ................... ........... _!/ r V BOARD OF HEALTH . . . . . . . . . ! FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . 6 ` BUILDING DEPARTMENT CHECK: . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . fl4DG.DEPT. SOUTHOLD, N.Y. 11971 TO F MED TEL.: 765-1802 ' t:0T-L FY ; Examined _ 3 19��0 CALL . . . . . . . . . . . . . . . . . . . •, MAIL TO : Approved . .. . ., 1940 Permit No.C� 3. . . . . . . . . . . . . . . . . . ... . Disapproveda c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) AP L CATION FOR BUILDING PERMIT ,1 Date . . . . . . .��. . . . .. 19 Z INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or areas, and giving a detailed description of layout of property must be,drawn on the diagram which is part of this appli- cation. c. The work covered by this 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 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 Occupancy shall have been granted by the.Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone;Qrdinance:of;tlie:;Tow%n of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing ode, and re ulations, and to admit authorized inspectors on premises and in building for necessary i ctio s. — �, . . . . . c .�. . . . . . . . . . . . . . . . (Signatu a of a plicant, or nacorporation) ailing address of ap licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . : : .{ . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t Name of owner of premises . . . . . . . . I!'liL2� .� . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . -,(Name.•and title of corporate officer) Builder's License No. . .. . . .. . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . • , • . . , • , • , . . , , . . . . . .�a�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number Street / Hamlet County Tax Map No. 1000 Section . . . . . (0./ l. . . . . . . . . . Block . . . . . .7. . . . • • , • , , Lot . . .. . .I.7:. 1. . . . . Subdivision . . . . . . . . . . . . . . . (N . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . ame) :Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . .O/. I . . . . . . . . . . . . . .I . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . .l`: . . . .TAlteration �. � . . . . . Repair . . . . . . . . . . . . . . Removal . .I, , , , , . , , , . , . Demolition . . . . . . . . . . . . . . Other-Work. kP',.= . . . . . . . . . . (Description) 4. Estimated Cost . . . . .� �:t .i. . . . . . . . . . . . . . . . . . . . Fee . . 7�!. : . . . . . . . . . (to be paid on fPng;4thAll s application) 5. If dwelling,number of dwelling units . . q/ . . . . . . . . Number of dwelling units on each floor . Ifgarage,number of cars . . . . . . . . . . . . . . . . , 6. 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 . . . . . .1 S , , , , , , , , , Dimensions of same structure with alterations or additions: front Rear . Depth . . . . . . . . . . . . . . . . ! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Height . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number,of 5tories . ... . .� $ . . . . . . . . . . . . . . . . . . . r 9. Size of lot: Front . . . . . . . . �.�?Q. . � . .. . . . Rear . . . . . . . ,. . . . . . . . . Depth 10. Date of Purchase. . . . . . . . . . . . . . . . . . . . ... . . . . . . . . N,�me�f Former Owner 11. Zone or use district in which premises are situated . . . 12. Does proposed construction viola a any zoning law, ordinance or regulation: . . . Y1 .4.. . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . �. . �i Will exces sp�fi_ll�be removed rom premises: Yes 14, Name of Owner of premises 1�1! 1-I�. �St ddress . .l."1��`4440,. S`t. , . Phone No. �S 4.a-.a.. Name of Architect . . . . � . . . . ._ .i. . . . . . . . . . . . .Address . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . ame of Contractor . Address . . . . . . . . . . . .i . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . 15. s this property within 300 feet of a tidal wetland? *YeS; • . . . . No. . *If yes, 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. UNDERWRITERS CERTIFICATE - REQUIRED pis: Vy ou , AP RID OAS N DIED _ DATE: H FEE BY: r ��'�• tl U1 v NOTIFY BUILDING DEPA TAT t � r,3 A 1 pp 765-I S02 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET I THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTR CTiON EM,Of I STATE OF NEW YORK S S COUNT OF . . (?F � . . . . . . . . .I.�a�I fir . . . .• • p l�n � . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . .� . . . . . . . �. .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i (Contractor, agent,corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have-performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this It . . . . . . . . . . .4. . . . . . . . . .day of. . . . . . . . ., 1974P Y tary Public, . . 41" . . . . . . . County &E L AUSTI�d fttary Public,State of mew York j No.52-3203050 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Qualified in Suffolru my (Signature of applicant) Corr mla6ion E; irea I X 4-)'� R � N m Yz , • ' ��0�� A1 a6' a j;r 1" . N� 9"iig90 Irk u 9071 0 e l// h �+ A,�, d - ^^.y� sue. \ Itp a •.. `• a]p• 9 G Q \ _ Ile oGoa o 5 f 65ts 'Z�'3O O-( PN�G' �roo Nlo�F S b f' .9f ' AREA = 12,569 sq.ft SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1 "000- 611 17 - 04 - .1 Scale: 1"= 30' Mar. D N0V CERTIFIED TO" SONYA L YAW K#VG WAL TER'COLS BRIGHAM 111 ii��P1�R 6 ` AOUEBOGUE ABSTRACT CORP. �" 632-S-5079 j GEPT. F U 'HOLD j ANY AL IERAIXIY AR ACWM m INS SLRWr A A PWA MY AT SEC77M 7209 OF AE AEI YOW SrAM 9XV 7XW LAW, `v MMpr AS PS MCMV 7209•SL♦Ip'OM Z ALL MUM WN �'S LIC. NO. 496/e IEREON ARE VALD foR IM MAPIIfRE P AAD MES W Ott Y f r SARXISF• nW s E Arffsso MM sEAt or IIE scRVEraP EC P.C. ACaMNAUY rO MWEY wIN SAD LAW 17E MW AL MU 0)- l516) 7 1R,(sr dE 1.(SED BY ANY AAV ALL SLRYEYORS UUJMW A CQ°Y P. 0. BOX 909 A°AN0rM$PJ?Wr=Wf- n"4SLOTAS7QECTW'AW 123O TRAVELER STREET Ii40mr ro-w 1E'ARE AUT N cq{ u4txF im rW LAI, SOUTHOLD, N.Y. 11971 OR _ 1.q.xi /Pa/Ve CJ T6 N T ILI APR 1 6 1996 BLDG. 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