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Home My WebLink About22345-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23250 Date SEPTEMBER 28, 1994 THIS CERTIFIES that the building ADDITION Location of Property 55405 COUNTY ROAD #48 GREENPORT, NY House No. Street Hamlet County Tax Map No. 1000 Section 44 Block 1 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore . filed in this office dated SEPTEMBER 2, 1994 pursuant to which Building Permit No. 22345—Z dated SEPTEMBER 23, 1994 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 FOR A DECK ADDITION TO A ONE FAMILY DWELLING "AS BUILT". The certificate is issued to HENRY PETERSON (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A I uilding Inspector 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.... N_ 22345 Z Permission Is hereby granted to; fll�..�/.... ....... ...:..... 1 ........................... ......................... ..... ��...... ...................................... :. .a............�.: ..,....... /19�1.... r! ..... .............. .....................-.�-��..........., .r� . ............ -r .................................................................................................................................................................. .... ................................................................ ......& .......................................................... at premises located at............. ......... !?rr .... �.. ......... .................... ...................................................................... .-,��i� �"... ."............................................ County Tax Map No. 1000 Section .....1�.'.�.`rL........... Block........a/............. Lot No. .......4/.............. pursuant to application dated ..... -!�r '......a........p pp ................. 19...... and approved by the Building Inspector. Fee $......................... . Building Inspector Rev.. 6/30/80 Form No. 6 TOjgN 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 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. B. - For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and it 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1 .00, Commercial $15.00 Date . . . .�79 � New Construction. . . . . . . . . . . Old Or re-existing uild' g. ✓ . . •.r. . • . . • • . . . • . Location of Property. . . ,�. .�. . . .-��.�G . . . .� . . [1. • -71 House No. treet .. Hamlet. . • . • • . . . • . • Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . ]; . . . .Block. . . . , ./ . . . . . . . . .Lot. . . . . . . �l , . . . . . . . . . . . J,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: $. L APPLICANT- . D-3 765.1802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL REMARKS: �.✓J DATE INSPECTOR i:OMMENTS 1"' . ITIDATION — y ;( 1st77, JIIDATIOJJ `' .'.:•:.. . - (2nd ) _ c 'GN FRAME & LU� ' H ULATION PER H. Y. II STATE ENERGY •• +) - - �. CODE J •_� •FINAL I _ ADDITIONAL COMMENTS : 70 x �► ' H o +:i.11-�y+++eG�^i_X-�r.S'L1.'+.r/.+i:-•'J.1i::a.nt t`y_'S�ti: ,. r'L t:..r .- :r, .. 1 .. . ... - .� .-. BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . _ . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NGT I FY ; '7� CALL . . . . . . . . . . . . . Examined . . . . . . . ., 19 � MAIL TO : Approved . . .��/� . . . . . . ., 19/. Permit No. '�i �j�` [� Q .M:.. . . . . . . . . . . Disapproved a/c . . . . . . � � Pp . . . . . . . . . . . . . . . . . . . . . . . . i�jI `� 1994 �F f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . li . !!r' . . . . . . . . L=BLDG.OE THOLD {�OF SOU (Buil ng Inspector) APPLICATION FOR BUILDING PERMIT t � Date . . . . . . . . . . . . . . . . . .. 19 . . . 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 Ordinance of the Town 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, buildin code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec i ns. �. . . . . . . . . . . . . (Signature of plicant, or name, if a corporation) (Mailing address of applicdnt) i t State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . � ✓. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IPP OVER>�S�IO�ED. . . . . . . . R Name of owner of premises . . . . . . . . �!. :QAT . 1443. . . . 8P.t."'��Jf�i zz (as on the tax roll or latesd 7 , riv; - If applicant is a corporation, signature o duly authorized officer. NOTIFY BUILDING DEPARTMENT AT 785-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . S. INSULATION 4. FINAL - CONSTRUCTION MUST Plumber's License No. . . . . . . . . . . . . . . . . ... . . . . . . BE COMPLETE FOR C.O. ALL_C_ONS_ R CONSTRUCTION SHALL MEET Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . THE REQUIREMENTS OF--THE-:N:Y--- f STATE CONSTRUCTION & ENERGY Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . „ . . . . . . . . . . . . . . . . . . . �/]v. . . . . . . . . . . . . . . .So[11 �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . F House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . 121. . . . . . . . Block . . . .4 . . . . . . . . . . . . Lot . . . . .14 . . . . . . . . . . . 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 . . . . ��/ .S(1. . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . Alteration . . . . . . . . . . Repair . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . �/� (Description) 4. Estimated Cost . . . . . . . . . �". . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . ... . . . . . . . . . . . . . If garage,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 . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . .Rear . '. . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . .1. Height . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . ... . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 /� . . . . . Will excess fill be r o ed from premises: Yes . 140 14. Name of Owner of premises 6. P. . . . . . Address .lp e . -Y�. :�:� -. . .Phone No. •.5/6.�.7.6.��53v2 Name of Architect . . . . r . . . . . . . .Address . . . . . . . . p. . . .Phone No. . t� . . Name of Contractor . �iU. .: � - . . . . . .Address r7.�. . . . .Phone No. . . . .r. 1�7.�d ff S, 15. Is this property within 300 feet of a tidal wetland. *ye . . . . . 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. ;u°..�py, :..•. rl - .r 5':�;� ✓",S't4 S'r^t L1�'�i'.,'.�J a7 .! _ -STATE OF NEWTOR- W MT OF'. c� -�•� ::':�;`� .H -,_ • :;•;M :.,asF ^� . . . being duly sworn, deposes and says that he is the applicant pp i ant ;individual:�iging contract) above named:`.=�:i:._a2.�>�.�: :;',,: ' b� '•r��»--.: Heis the . . . . . . . . . . . . . . . . . . .DUQYL._ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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—i day of . . , 19 . !Z-f- Notary Public, . . . County ClAIRE L GLEW Notary Public,State of New Y •�, No.4879505 . . . . . . . . . . . . . . . . . . .. . . . . . . +Qualified in Suffolk County (Signature of applicant) Commission Expires December 8,1� ti i �� Ter-ro q � S ?� SQ 11 I 9 C1 A . 1 L_cAaN S. AND N AWN V BOUGH-70 % V) AT r -To'v N OF `JOU-T"01-0, �l l". y � i ' ►`Wo WcstE y J q // 1 i 'r i # SS°UL^,}iGRI�E�ALTEf AiI^N CA AD]Ii1GN 1 I `�C.. fy'l ••q O _ .- — n TO THIS SL;:'::I 15 A SECTION 72C7 CT THE plEW YC;K STATE EDUCATION:A,,/. COFLS OF THIS S,-VcY r.A7 fi.Y _!AZjNG T D 5 :..:Y i 1-:•:D SEA..HE !A. CA f } Xfi o ,/1 SGCA Iln SEA E U z: y fl hti o 1 1 I.1 w eh `TO BEA NLY TCTrtc ,r..t:c� Eo F:Ec!c.r: S::au RUN ''� t •s YO+l ti Tv TFi_ �[ TH5 SUA',c I.v S�rc�.r..e t�o�ma f; ;aEFa.cEO, A:.L G.;F;., LEHi:F TO THE TR:E ..Cre lV.T. V_..: .i CE•'::.Y At: UNDKf TC TH:'ASL.Cr:EES OF Th-,Dr.gD:;4ZLi TUTION GUA¢ANTEFS A:. NOT IV (c 10 AD:;:TIUNAL INSi liuilONS Cl St;t:EQI':-. . � iF I t •I �l# C �uuy" x�cec� fo �h� t►-iL�Y G�LiH+t� So.O ¢ ( iYle GucuY6"iL} � INk0Y cu<,IL c:Q. CAVICI � Ls.. A-4.c= c;ufho Sicy sclv ir� Lark S.7�0 03 ZU Vd. �Abuu+ 1440'fro ex+. t-1y o4 V+'tLy Ur I 11H.c U4 A.Ibc v�sc++'s Lathe QS SLtYVEI'�'d MQLi -=> 19�7. 1 Oita \-(. VCA" LI G e t-, S•_Cl L cl In d `n Lf`C`J C L3 G Y S 6s SF;cf o1v 73 A c < l 7//Y " u1i�5 //y'f/ Ije 1 __- -- --------�- �� - i' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE ._ �► �'' OF OCCUPANCY N ' i 0 PeAl n, �l k) - UI�j cU 'ra- A-N �� s�/N� ,�-Tlo �� v/ � pp�ox Ll lvcgT To S c N'F 9/1/o u