Loading...
HomeMy WebLinkAbout2124-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF No Z-22907 Date MARCH 17, 1994 THIS CERTIFIES that the buildin~ Location of Property 154 KING STREET House No. County Tax Map No. 1000 Section 26 Subdivision DWELLING ORIENT, N.Y. Street Hamlet Block 2 Lot 3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 6, 1963 pursuant to which Building Permit No. 2124-Z dated JULY 23, 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 OWE FAMILY DW~LLIN~ WITH ATTA~D SUN PORCH & G~RAGE WITH SHED ATTAu~O The certificate is issued to THOMAS & MARY L. KAVAZANJIAN of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PENDING - MARCH 14, 1994 N/A ng Ihspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 2124, z Date ...................... ~'b~..y.,. ,. ;~.~ ................. ] 9.~.. Permission is hereby granted to: L~R~y..~e~, ..................................................... ........ K-in~..S.t ....................................................... ................ O~,.~en.~. .................................................. to ........ Bu.5.1~ ...n e~.. one...t. ~i.lsr...~.],l.i~g. .............................................................................. at premises located ot "'R'~)w~'"~['i'n~'"~'~ ................................................................................. .......................................................... Or.2en~ ....................................................................................... pursuant to application dated ............................. ~.lll~....~ .................. 19~,~...., ond approved by the Building Inspector Fee $....],0,~00 ........ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instrucfione A. This application must be filled in typewriter OR Ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final auway of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic feature~ 2. Final epprovel of Health Dept. of water supply end sewerage dispo~al-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Unde~vriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. B. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land u~es: 1. Accurate survey of peoperty ~howing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn sta~ment of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / 2a_Certificate of occupancy on pre-existing dwelling / land US~ ~_~j3oPV of certificate of occupancy $1.00 --Fre-Existing C.O. $15.00 Vacant l~nd C.O. $ 5.00 __ i z12 ......... uaze ..... ~ ....~ .... New Building · ./~ ......... Old or Pre-existing Build, lng ............. Vacant Land ............. Owner or Owners of erope~...'/----.~.~. J~~~ ............................. SU~i~i~ion .................................. Filed Map ~o ........... Lot ~0 .............. Permit No. .~ !) ]~ Date of Permit · ~A pplicant · · · Heel~ Dept. ~proval ........................ Labor DepL Approval ........................ Unde~ri~rs Approval ........................ Planning Board Approval .............. R~ue~ for T~pora~ Ce~ificam ..................... Final Ce~ifi~m . .~. ..... ] ....~2' '~' ' Con.ruction on abo~ demribod buildin~ and ~mit meot~ all a~licabl~ 9~ ~r~oulation~ 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: !. 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. 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 i. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 - Residential $ 5.00, Co mercial $15.00 5. Temporary Certificate of Occupancy ..~.~:~:.~.: Date ............................. New Construction ........... Old Or Pre-existing Building ............... ~- Location of Property .... House~ '~' ' '~"No. ............. ~x..~.. ~.]~eee. ~.~":~..~.~ .... ii .... ~[Hamlet~ ......... Onwer or Owners of operty. X~ ....... ~& ~ L O~ ~,~ ~- ........................ ................ county ~x ~ap ~o 1000, se~r~o~.~h,~...~lock.~q~ ..... ~ot...~.~.~ ..... Subdivision .................................... Filed Map ............ Lot ................ ... ... Permit No a(~-~-~ ~ /~l~ · llcan- ~;.~...~ CL_~B~.~'- ......... ~ .... Date Of Permit ........ ~ ..... App ' ~ .... ~ ................ Health Dept. Approval ....................... Underwriters Approval ......... Planning Board Approval ........... Request for: Temporary Certificate ......... Final Certicate.~...o Fee Submitted, $ · · .~.' .~ ~'..~..0 ............ qo 7 ' FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Excmined ................. (Buildi~nspector) APPLICATION FOR [UILDING PERMIT{ Application No. ~.~..l ~ t( INSTRUCTIONS ~l ' a. This application must be completely filled in by typewriter or in ink and sub~nitted in duplicate to the Building ' Inspector. ,I ~ '~ b. Plot plan showing location of lot and of buildings on premises, relationshiff.to qdjoining premises or public streets or areas, and giving o detailed description of layout of property must bedrawn on the~/diogrqm which~ is part of this application. c. The work covered by this application may not be commenced before issuance of Buildin~g Permit. d. Upon approval of this application, the Building Inspector will issue o Buildin9 Permit Ye the applicant,. Such permit shall be kept on the premises available for inspection throughout the progre~ibf.the wor~t shall be occupied or used in whole or in pa rt for any purpose Ghatev~.r ~ntil a Cer}..fficate of Occupancy No building shall have been granted by the Building Inspector· ' ~ ~' \'~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of ~ Building Per'mit ,6~ursuant to the Bui ding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Eaws, Ord:nances or Regulations, for the construction of bu:ldmgs, addlt:ons or alterahons, or for removal on,~emolmon, ~ here,n described. The appl cant agrees to comply with all applicable laws, ordinances and regulations· ."~, ~', . (Signature of'applicant, ~ nome, if cl corporation) (Address o,f,opp[icont} State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e!ectrician, plumber or builder· Name of owner of premises ..... .~..~lt:e~'..(l~opel* ....................................................................... 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: ..... ~X.. ........ ............... Lo{- No' ~ Municipality , } State existing use and occupancy of premises and intended use and occupancy 9f 'proposed construction: a. Existing use and occupancy t b. Intend~ and occupancy ~e f~,~nil,2' d~e~.~.$~q ~! 3. Nafure of work (check whic plicoble): New Building ...~ .... tion .................. Alteration ............. Repair .................... Remova~ .................... Demolition .................... Other Work (Describe) ........................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .............................. Number of dwelling units on each floor ........................ If g,grage, number of cars ......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify natureand 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 ............................ Dep}h ............................ Height ................................ Number of Stories :..... ................................... 8. Dim~.ensions of entire new construction: Front ............ ~1,~ ................ Rear ........ i.:~5 ............... Depth ...26 ................ Height ............................ Number of Stories..~ .......................... 9. Size of lot: Front ................................ Rear ............................ Depth ........ "'"l ........................... 10. Date of Purchase .................. ~..~ .............................. Name of Former 0~?r ...... ~..J:~.~ll ........................ 11. Zone or use d~str ct n wh ch prem ses are s tuated ..... &~l $.j% 12. Doe~ proposed construction violate any zoning law, ordinance or reguld~on .......... ~.~.~. .................................. 13. Name of Owner of premises ...~.~9~.....q~.~.~.~.~ .............. Address ......f)~.~....... .................... Phone No ................. Narhe of Architect ...................................................... Address ', Phone ~o. Name of Contractor .................................................... Address ................................ ' ' Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, ahd ~diCate all set-back dimensions fn property lipes. Give street and block numbers or description according to deed,'a~d ~how street names and indic whether inferior or corner lot. ................................................................................................. being duly sworn, ,~eposes~,~ ~d says thet he is the applicc ~Name of ~ndividual s~gning application) .... (Contractor agent,.corpora~e~icer, etc.) of said owner or owners, and is duly authorized to perform or have perform~ the sai~ Work and to make and this applicgtion; that all statements co.~tained in this application are true'fo the best[faf his knowledge and beli and that the work will be perform~vi~s~~ ~ forth in the appHcatiSn filed therewith. Sworn to b~fore me this .............