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Home My WebLink About23503-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26839 Date: 12/15/99 THIS CERTIFIES that the building ADDITION Location of Property: 1365 JOCKEY CREEK DR SOUTHOLD (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 70 Block 2 Lot 19.12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1996 pursuant to which Building Permit No. 23503-Z dated JUNE 14, 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 ADDITION TO AN EXISTING ACCESSORY SHED AS APPLIED FOR. The certificate is issued to RICHARD L & DEBORAH CONRARDY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspe or Rev. 1/81 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) N? 23503 Z Date ......... ................ 19SA Permission is hereby granted to: ............. ............. .... ... to ... ........ .... . ... . .... .. ..41.-RN .. . . .............. ........ ......... ... .. . ...................... at premises located at ......... ...... ........... ........ X�.......................... .... ......................................................� ............. .. ..... ..5.r.1......11P.7z.................... ................................................................................................................................................................. County Tax Map No. 1000 Section ........7 ........ Block ......A.......... Lot No. (Z' pursuant to application dated .............. .1.7........... 19...,.� and approved by the Building Inspector. Fee ;Z§........... ........... ... .................*... . ....... ..... ........... 7Lior ..... ......... Building Inspector Rev. 6/30/80 + 0rJj1 Wi\f-can rorm NO. o 1365 �oyG p4, TOWN OF SOUTHOLD L BUILDING DEPARTMENT. {1, 76j5--1802LDG.DEPT. ��pp LIC ION FOR CERTIFICATE OF OCCUPANCY F S UTHQ[� A. This application must be filled in by typewriter OR ink and submitted to the buildin; 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildir 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 an "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 Buildine - $100.00 3. Copy of Certificate of Occupancy - 4.. Updated .Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . .. . . . ... . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . New Construction. .. . ... .... Old Or Pre-existing Building. .... . .. . . . . . . . . . P . Location of Property.. ./: G�. ... . . ...hoc.. .. . . . ..... c_.. . . . .. . . . . . o v. •� al`� . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of. Property.. . . .. . . . . . . . . .. . . . . . . . . ... . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .� . . . .. .. . .Block. ..2.. . . . . . . . . . .Lot. . X�yi,r2; Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .Filed Map.. . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . - - Permit No.°�.:3��_�. . . . . . . .Date Of Permit.6. . .9. .6. . . . . . . . .Applicantti2fP/1.�(17Y HealthDept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . .. . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee �ubmitted: $. . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPL-CANT ,-2 3 765-180: BUILDING DEFT. INSPECTION [ ] FOUNDATION iST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [� [ ] FIREPLACE & CHIMNEY REMARKS: 6,c DATE Z INSPECTO �� BOARD OF REALT11 . . . . . . _ . . D LS lr1 L5 II V sa5', FORM NO. 1 -w a SET" OF P L'N"?'s . . . . . . . . . TOWN OF SOUTHOLD -•SU1tvEY . . . . . _ _ . . . . . . . . . . . BUILDING DEPARTMENT —CIRECR . . . . . . = . . : . . . . . . - TOWN HALL SEVTIC FORK . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 BLDG.DEPT. TEL.: 765-1802 t:OT I'PY A.� TOWN_ OF SOUT-OLD f CALL . • • . . . . ' Examined . . . 19r MAIL TO : Approved . . . . . . I91�errnit'Nc�. . � . . . . . . . _ . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . Disapproved a/c (Building Inspector) A P ICAT iON FOR, BUILDING PE;MIT Date . . . . . . . . . .. 1974. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 street: or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli i 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 permi' shall be kept on the premises available for uispection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc) 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 Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o; Regulations, for the construction of buildings, a.dditions'or alterations,I or for removal or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in building for necessary inspect'cl "5' �-r/ :.. . . ... . . . . . . . . . . . �? °�. . . . . . . . . . . . . . . . .. . (Signature of applicant, name, if a corporation), h. (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, 'electrician, plumber or builder. : . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . Name of owner of premises . 1l t1 HPA. :bil`A. . .��1I��!1� �c��Pf12�t)y . . . . ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ,y . . . .. . . . . . . . . . . . . . . . . . . . I . . . . . . . I . . . . . . . . . . . . . . . (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. . ./"W— , y„Cm�x. 4e, , , ; , , , , , , , , , , , , , . . . .. . . . . . ... . .J.®. �-X��. . 44&-. !r • ,44 . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . House Number Street Hamlet f County Tax Map No. 1000 Section . . . .d . . . . . . . . . . Block .moo Q . . . . . . . : . . . Lot .• . . lei S Subdivision . . . . . . . . . . . . ... . . . . . . . ... . . . . 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 •�YaD+�✓}G� �I'H � .. . . . . . . . . ... .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy G�� •: ,\ �mrma. .•rssae��'Rrr�.a*sw^•. •3. Nature of work check which a -; � ( pplicable): New Building Addition . . . . : . � terata tb! Repair . . . . . . . . . . . . . . Removal . . Demolition " F.:_ ?��'.. :..#T. : . . . Other Work . . . . . . . . . .. . . . . •.,; :4 (D6'es41- i,on) 4. Estimated Cost : . . . . ��[ 0. . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . .... . . . \(to �)e paid on Aling°th'is:ap.plication) S. 1f dwelling, number of dwelling units . .. . . . .. . . . . . . . . .. .. . Number of dwelling units on each'fioor _ If garage, number of cars . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of-each typ6.of use 7. Dimensions Qf existing structures, if any: Front: .%�: Rear �% , Height , �t Depth . . ./. . . . . g • • • • . • . . . . . , Number of Stories . . . .. Dimensions of same structure with alterations or additions: Front y• Depth . . . . •.8�. . . . . . . . . . . . . . . Height . . .�� . . . 14. . . . . . . . . . . . . Rear . . � . . . . . . . . . . . 8. Dimensions of entire new construction: Front Number of Stories . . . . . . 12- . l°Lr . Rear . . .I.PL . Depth . . ��. .Height . Num_ber of S•,�� tories . . 9. Size of lot: Front Rear. . . . d'1 �. : . � . . 10. Date of Purchase . . . . . .P t. ^ir. . . .�. . . . . . . ... . . . . . . . Depth . . . . . . . . . . . . . . . . . . Name of Former Owner 1&R.. e_f. X4 gT�SEA/! PA�eI 11. Zone or use district in which premises are situated , .12.. Does proposed construction violate any zoning law, ordinance or regulation: ��. . . • • • • 13, Will lot be regraded �o . . . • Will excess fill be removed from premises: . Yes 14. Name of Owner of premises KJOPPA, , (;Q,�K,gl'.dJ No � `�. . . . Address �a6S'.�ira4��, .�,6i , Phone No. Name of Architect Do.K4x4. . . . . . . . . . . . . . . . AddreSDIAm4;Aff 41 Aft.91Y 0AI. Phone No. Name of Contractor . v . . Address 15. Is this property within '300 feet of a tidal •wetland? " " " Phone No. . . . . . . . . . . . . . . . *If yes, - Southold Town Trustees Permit ma be re uired. . . • ' ' No. .X. . . , , 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 interior or corner lot. according to deed, and show street names and indicate whether E-oow, -0�,,oo PR�Fos'e�t Ge Klocs • paaPG�r`� ;�•?, � S3_ �. KOLAS� ; �•-y • i ��R�ETI C . • a,•aS" �I�- ILT� T zl(fE CTUK I)a TATE OF N YO //� OUNTY OF . S.S C . . .> :a. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) )ove named. eisthe . ... . . . . . . . . . . . . � . . . ... .. . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer,.etc.) said owner or owners, and is duly authorized to perform or have performed the 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 .)rk will be performed in the manner set forth in the application filed therewith. vom to before me this � 7 G day of. . /.� 19 J Mary Public, . , , , , . . . County CLAIRE L.GLEW \ Notary Public,State of New York �, , a� No.4879505 ... . . . . . . . . . . . . . . Qualified In Suffolk County (Signature of applicant) Commission Expires December 8,19 A , W1 s 4Z9444 " � + - ! 2 ,f(ti�A t7� , lt K�o. yjl:x! GC714� ( jc iol4 -j31.� co0a5 , T j - 2• -Gn►��-'TIE,...�"� .�..�,�no .�sf -off `� "Tv�) `'1--_.._` � � " � 5d►L . 17i1i or_fL 3• .�l.r -�� -ram c r4*44 .TZ7 i,doll .- 1c.41. . r�►+�way �- ;_- Ist•�17 L-Il�'��Zvt�2�'T�25 �1•'t"(ci• I --- --- , . 5►�Y�•T � �-- 10 _ , G. 1�LL 'Mt H O .fa, Lew ML FrA►�- I r X- . CERTIFICATE -,;r-r� of s _ ,I � p o(� �� R ED AS NO D REQUIRED —_--.- e DATE: B.P.# FEE: BY: �I, NOTIFY BUILDING DE PA ENT A - i k N I f 765-1802 9 AM TO 4 HE FOLLOWING INSPECTIONS: to 1. FOUNDATION -. TWO REQUIRED � � ox � ut. r FOR POURED CONCRETE . - ' •- t-1 ��"`' -- ..___ '�fit. ita-�;�..j.� �': � _ � � � � 2. ROUGH - FRAMING & PLUMBING o 3. INSULATION e p. 4. FINAL - CONSTRUCTION MUST + �SS ~• s�� { . BE COMPLETE FOR C.O. -- @ 3 -- _. _. . ALL CONSTRUCTION SHAM MEETtj Cie THE REQUIREMENTS OF THE N.Y. �' 2"6� - ___ -- S STATE CONSTRUCTION & ENERGY a CODES. NOT RESPONSIBLE FOR x QESIGN OR CONSTRUCTION ERRORS + 7 k I f%V 0 OCCUPAllft,I UK IS UNLAkNIFUL VVITHOWT CERTH ICATE � N ' o - 1. VA (*? /y �'vrwo Wtrr9 5 Gr l.5 _ } Ste" (� "(K/c,d►� S}•1•(7�r _ Fi - p u, � '��,.STD••� cQ��"o G `v 5 t o& F 0 aED ARCy'T A. kp�9 FPS >7�/FI Pi p K s -tj /' ��.►I ,ft o,� . i x {��„ i 1.�„ � . - t/��I _ !IY�„ _;' 1 9