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HomeMy WebLinkAbout2044-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22709 Date NOVEMBER 5, 1993 THIS CERTIFIES that the buildinq DWELLING Location of Property 1130 (a/k/a 114) WASHINGTON AVE. House No. Street County Tax Map No. 1000 Section 41 Block subdivision Filed Map No. GREENPORT~ N.Y. Hamlet Lot 29 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 24, 1963 pursuant to which Building Permit No. 2044-Z dated APRIL 24, 1963 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 ONE FAMILY DWELLING WITHATTACHED GARAGE & SCREENED PORCH IN REAR OF DWELLING * The certificate is issued to of the aforesaid building. DANIEL J. LILLIS, JR. (owner, lessee or tenant) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL SEPT. 17, i963-R. Villa UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *THIS UPDATES CO Z-1771 DATED NOV. 12, 1963. N/A · ~/ jilding I~nsp~ctor Rev. 1/81 NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATe OF OCCUPANCY No. Zl.~.7~- ............... Dote ..................... No.v. ember.....12......, t9_6.3_ THIS CERTIFIES that the building Iocoted ot ..l~./~.....W.a~hir~E.t.or~..3Lv. e ......................Street Mop No...~ .......... Block No.... 'X~X~. ......... Lot No....~2%g~. ......... G~,e~n.po.!~.~.r..N.,..~., .............. conforms substontiolly to the Application for Building Permit heretofore filed in this office doted .................................... .A~t~,,], ......... ~+..., 19~3... pursuant to which Building Permit No...Z..20~..~ dated ........................... A,p~:~]. ....... 2~....., 19.~.., was issued, and conforms to oil of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ .P~ivat e..... ~ne....~.amll.3~......d.~,~elll~g ....................................................................................... ,, The certificate is issued to ....~n~e1..&..Rob~.ta.....L11lts. ................... Ogn.er.s ..................... (owner, lessee or tena,nt) of the aforesaid building. HoD. Approval ~ep~. 17, 1963 by R. Villa ........... /~..:.d..~.:../.........~!~.r:y ...................... Building Inspector ~ FOI~M NO. 2 TOWN OF SOUTHOLD J~UILDING DEPARTMENT TOWN CLERg'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? o44, Z Date ............. ~pr-.i.t .......... ~t, .................. 195.3... Permission is hereby granted to: Bay Build ~' ~...0.~ ·. ~.U$.~o. '~.. Z. ne .......~..~.....~ar~i~..Li11~ s ......... H~m~pt an..-Ba.ys ~......L.Z.. ....... : ................. to '-Buii~..n, ew..one'"£a~i.l'y...dwetTfr~ .................................................................................... at premises located at ....N/~.....~/~SI~I't~-~O~'--/¥~e ........................................................................... ........................................................... ~ ~'po~'~'" ~ ~- -~.~ .................................................................. pursuant to application dated .......................... A]Y~J~'~'""~ ................. 19.(~.3...,dnd approved by the Building Inspector Fee $.....~O,~00 ....... Building Inspector / Form No. 6 TOWN OF SOUTItOLD 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 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. Conm~ercial 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 625.00, 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 - $1OO.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.O0 Date ~-~. ~ }?~.~ ~ New Construction ........... Old Or Pre-existing Buzlding .... ~ ............ Location of Property ....... \~ ~-~-% - ~ ~ . ~_~ ~ ......... .................................................. House No. Street Hamlet Onwer or Owners of Property ........ ~ ~X ~ . ~,XXi % . ~ County Tax Map No 1000, Section .... ~.~ ....... Block ..... ~. ........ · Lot ....... ~.~.. . ....... ... ................................... Filed Map ........... Lot ................... Subdivision . l~ermit No Date Of Permit Applicant Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. T, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......~ .......................... , 19...~....~ Approved ~'~ 19...~/...Permit No. Disapproved a/c ......................................................................... ::.. (Buildingqnspector) APPLICATION FOR B~UILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 applica- tion. c. The work covered by this application m~y not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of th~ work. e. No building shall be occupied or used in whole or in pa rt 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. Bay Buildin~ of Suffolk Ine (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................... g.o. .o.r. ................................................................................................................................... Name of owner of premises .~.~J,~,],..~...[.~(~]g.Q~.t.a...Li.]..l:~.s ............................................................................................ If applicant is o corporate, signature of duly authorized officer. ............. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ....~.,7.~ ..............................Lot No.: ..... ~:~.~.. ......... Street and Number ...~./.~.....¥.~.~.~.~7~.~.C~..,~.~e.~ ....... Gz'.e~..~.~2.oz':~ ...................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ..... .~..~g.~.~..~....~...O.~ ................................................................................................... b. Intended use and occupancy ............ .O.~...~.~g?,~,].~L..c].~f.e~.].~i.l~ ....................................................................... 3. NatUre of work (check which applicable): New Building ...x;~.x;~ ..... Addition .................. Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4, Estimated Cost ......].]..~,8,QO,,,~,/~ ................................ Fee .......... ~,,0., (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .o...~.~ ................... Number of dwelling units on each floor If garage, number of cars .......... QD.~ ....... 6. if b~siness, 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 ...... ~'..0. ................... Rear ..... ~.g. .................... Depth ..... Height .............................. Number of Stories ..O~e ..................... 9. Sizeiof lot: Front ......... ~.,O~ .............. Rear _~0~ Depth .,,:~, 10. Dat~ of Purchase ................... ~.~.3 ................................ Na,m~ of Former Owner DeAlbert~ls 11. Zonb or use district in which premises are situated ..... 'A' c}:[ 12. Doe~ proposed construction violate any zoning ]aw, ordinance or regulation? 13. Name of Owner of premises .._D..~...~.i.~..~..t...s .............. Address .......... /$z:~?~e.n.Doz',~: ................ Phone No. Name of Architect .......... ~..~.,Y...~..Z..q)-.g ....................... Address ............... ~Jl.a...~).~.t....~.~),Z..s. ......... Phone No. Nar~e of Contractor Bay. Bldg Z:rtc Address " ............................................................................................... Phone No. PLOT DIAGRAM Loca,ie clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-bock dimensions f m property lines. Give street and block numbers or description according to deed, and show street names and indk te whether i~terior or corner lot. lo! I I STATE OF' NEW YOEK, ) COUNTY ©F .... .~..1~,.~,~..Q)..]¢ ....... ) S.S. ................ i. ............................................ be/no duly sworn, deposes and says that he is the (~qome of individual signing application) above nomled. He is the .........~.~r.j~...O.~. I, ~.e.r ~3.~],.~.~ ~.. ............... (Contractor, agent, corporate officer, etc.) of said owner or owners, grid is duly authorized to perform or have performed the said work end to make grid file tl~is application~; that all statements contained in this application are true to the best of his knowledge and belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ....~~.., ~~,~) .. ............... .~.... do~ of ................... .~.~.z'..~.~, ............. ,, 19...~.~. 'o, or P J, ............... . ............. ., ' ........................ IN ' y c ......... , ...... o No. 52.0344963, Suffolk Counb ~ *"~'~--/'~'/~ Caren, ssi011 EXl~lres March 30, 1~,~' TOWN OF SOUTHOLD BUILDING DEPARTNIENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..................................... , 10 ..... ~pproved ........................................ , ~9.....~..Permh No ......... Disapproved o/c ........ :~..,,~. .................. ~. ................... ~. ....................... (Building Inspector) Application No ............................. APPLICATION FOR BUILDING PERMIT I NSTRUCTI ON$ o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, rela¢ionship 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 applica- tion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon app*roval of this application, the Building Inspector will issue a Building Permit to the applica:nt. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in po rt for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS H.EREBY M,~DE 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, alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if o corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................... Cnz~caet,~z~ ...................................................................................................................... ............ Name of owner of premises fs ........................................................................................... If applicant is o corporate, signature of duly authorized officer. ...... ~,.... ,. ~/~,.~...,.. ~r.~.. ~.~:~ ....... .-~.~ ...................................... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No.: **,.3~3f. ............................ Eot No.: ...... ..~_. ........ Street and Number ***.~/.S.....b~as~.t~'l~.toz~**J~e.~ ....... G,~.e~n.~oz~.1; ......................................................... i~ .......... Municipality 2. State existing use and occupancy of pren~ises and intended use and occupancy of proposed construction. a. Existing use and occupancy ...... .~.f~.~t~..~,Q~. ................................................................................................. b. Intended use and occupancy .............. Qt'z~..~az~3.~..c~,/~.~.~Rt~. ....................................................... ~....~ ........ 3. Natbre of work (check which applicable): New Building ...:X~,~;~,,~.... Addition .................. Alteration Rep,~ir .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Esti~nated Cost ...... ~,~.~..0..0...~./..~ ................................ Fee .......... ,'LO. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .O...~..~. ................... Number of dwelling units on each floor If garage, number of cars .......... ~lr~. ........................... 6. If business, commercial ar mixed occupancy, specify nature .and extent of each type of use 7. Dim]ensions of existing structures, if any: Front ............................ Rear ............................ Depth Height ............................ Number of Stories ................ Dirdensions of same structure with alterations or additions: Front ................................ Rear Depih ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..... ~...~. ................... Rear .....~.Q ..................... Depth .....~,6~.~.~ ........ Height .............................. Number of Stories ..~:D~ ..................... 9. Sizeiof lot: Front ........ ~.0..~.. .............. Rear ....... ~.0.~, .................... Depth ..~,~,.0. .................... 10. Dat~ of Purchase ................ .],.~.~.,~. ................................ Na,me of Former Owner ....... ~.~.,/'~l,,~,~..'~k~ ................... 1 1. Zonb or use district in which premises are situated. 'IA" 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? 13.' Name of Owner of premises ..'.D..:......~....~:~..~. .............. Address .......... 0~.~e~l,D~.~ ................. Phone No. Name of Architect ......... .~...~.~...~.~.~ ........................ Address .............. ~]~)~...~.~,::?. ......... Phone No. Na e of Contractor ~a~' ~].~. :[rt~ Address ~ Phone No. :' PLOT DIAGRAM Locqte clearly and distinctly ali buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block numbers or description according to deed, and show street names and whether interior or corner lot. STATE OF COUNTY OF ~V..t~....x..?..~... ................ I ................................................................................ being duly sworn, deposes and says that he is the (Name of individual siflning application) a,bove na~ed. He is the ...... ....... ~g~.~.~. ~ (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 application; that all statement.s contained in this application are true to the best of his knowledge and~belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this A zil ........................ day of .................. ~ ............. , ........ , 1~.] .... : '?'"'"'"~'~t,~;'~"~f'~'~ ...... k";' ,. ,9,,, Y~ ~ignature of applicant)