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HomeMy WebLinkAbout2516-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25739 Date: 05/26/98 THIS CERTIFIES that the building ADDITION Location of Property: 1077 BAY HOME RD SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 56 Block 5 Lot 39 Subdivision Filed Map No. __Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26~ 1964 pursuant to which Building Permit No. 2516-Z dated SEPTEMBER 14, 1964 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 ATTACHED SHED ADDITION TO A ONE FAMILY DWELLING. Z.B.A.~710. The certificate is issued to IRENE MARY WARNY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Buildin~Inspector ~ Rev. 1/81 FORM 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? 2516 z Permission is hereby granted to: .............. .~,t, lto~ ............................................. .............. .(...appr. ow:.e~..b~...Jaoa~4!...o;r...A~p~-~I, e .) ........................................................................ at premises located at .~.~.....~.~.~..~JlLC~ ....... O~.~'...~/'~.....Jj~t~r..~...~(~;~ ............................... ............................................................. t~.,D~tbxg.~. .............................................................................. pursuant to application dated .............................. ~Jkl~l~. ......... ~., 19.6Jt~., and approved by the Building Inspector ~,ui aing inspector ~ Form Ho. 6 'IOWN OF SOUTIIOI,D BI. JILDING DEPARTHENT ][OWN IlALL 76'~-1802 API'I, ICATION FOR CERTIFICATF, OF (}Cf:III'ANCY 'l'h[,~ application mu~? be filled tu by typ~wrttor oli I,~k nnd red,minted In the h~llldln~L street~, nmi uouqnnl nntural or topographic [entureg. 2. Flnm~ Approv~] [~om Health Dopt. of water supp]y nad gowernRe-d[spo~nl (S-9 form). 3. Approval of electrical installnttou from Board of F[~e Undetw~ Ltet~. 4. Sworn mtatement from plumber certifying that the molder .sed In gy~tem contnJng le~ than 2/[O of 1% lead. 5. Co~ercial building, Industrial building, multiple remLdeucem a.d similar [,.[Idln~g m~d installations, a certificate of Code Comp liauce from architect or engineer reqponsfble for the building. 6. Submft Plnnnlng Board Approval of completed ~te pJnn re¢lutr~m~nr~. For existing bui]di.g.~ (prior to April 9, 1957) no.-~..formlug uses, or b. lldt. R~ nnd "pre-ex]~ttug" land uses: I. Accurate survey of proporty showing all property linen, streetR, buLJd]ug mud unusual natural or topographfc ~eatures. 2. A properly completed application and a col~sent to lo.peet ~igned by the nppLicnnt. I[ n Certificate oF Oecupnncy is deuted, the But]dl,,R Innpector mhnl] ~tnle the renqonm therefor tn wrltJng to the appltcnnt. C. Fees 1. Certificate of Occupnucy - New dwel]it~g ~25.00, Addlt[on~ to dweI[tng $2~.O0, AJternt~on~ to dwellfng ~25.OO, Swimming pool ~25.OO, Accessory b. tldL.g ~25.OO, A~Jditiou~ to ~ccessory builclJr~ $23.OO. 2. Certificate of Occupaucy on ['re-ex{mtiug BuildJu~ - $[O0.OO ]. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.OO 4. Updated Certificate oF Occupnucy - $50.00 5. Temporary Certificate of Occupancy - Rogidentlal Date ..t~l...~ ................................ New Cons~ruckJou ........... Old Or Pre-px~s~.g Bul[dt.g ......~. f ........ House No. Street llm. I et Sobd Irt s:lon .................................... Fi. led ,1:~1~ ........... 1.o! ...................... Permit lqo .......... Dat~ Of Permit ...... Appl tcn.t ............................. tlenlth Dept. Approval .......................... Underwriters Ai, provnl ......................... Plmmlng Board Approval ........................ Req.est for: Temporary Certificate ........... Flnnl CertlcnLe ........... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: [ ] ROUGH PLBG. [ ] INSULATION [ ~~FINAL DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY ROUGH PLBG. ] IN~JLATION ~FINAL REMARKS: INSPECTOR CON$1'~NT TO INSPECTION - Owfier(S0 Name{s} do(es) hereby state: That the underslgnr~d (is) (are) the owner{n) of the premises tn the Town which in shown nnd designated on lhe S.rfolk County tax map as District 1000, Seetto,, ~__. Bl.ek ~ ,.. Lot_~9 That the undersigned (has) (have) filed, or caused to be [{led. nn applica- tion in the Southold To~ Building Inspector's Or~iee [or the rollowh,g: ~ That the undersigned do(es) hereby give conment to the 13uildb~g Inspectors of the Town of Southold to enter upon the above deserH>ed property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determln~ that said premises comply xvith all of the laws; ordiunnees, r. le~ and regulations of the Town of Southold. The undersigned, in consenting to such hmpections, do(es) so with the knowledge and understanding that any hfformation obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regnlations of the Town of Sou[hold. Io~thold Torn BOird o~ ApU, eaXs -3- I. T~o imildLr~ shall be lo~a~4d 25 fe~t from ~he 14~n it.d. Vo~o~ the BOMBS &yeos-~r. O/llLep/o, N~. B4rgon, ~4g. ~ The ChiLrmmn openod the heirJ~g by re~dlAg 8pplLeiLLon for ~ GBA~iINCSILe h IpplLGi~lN~ OpOikl for Ltlelf. foot ~n rroougo, nr. Or~thvohl or. id th~ the proposed location mm the shay feOdBLbio p~8oO Of pu~LLng the (~bore mm no roopoooo.) ICUTnIO&o ~ Boerd of Ap~ -4-- SeptEmber XO, L'1,64 (~bere ~so no reo-~pu~oo. ! ~ f~. Vo~4, Of the Boardm Aye~m N~. OtlXtltp:Le, fir. IBSOLVBO that. tho SouthoXd ~qoqu, n Board of AppN,mb oot Tm)0 i% (I.D.I.'f'.), 'J~huEoday, l~ 34, l~, at b ~ ~M, ~* 307. ~ ~n~ ~ arm b ~e ~ ~ ~ ~ ~f Vote of the Board, Aymmm-Atr. GAXX~ulpLo, M~. lie~. tlr. Hah NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. r Approved,, PermitNo ........... i ............. ~"~'" ~ ' T'~ ........................ ........................... .................... · ....... ......... ~~"i;;¢;;;;;i ................................. Application No. '~-/~/ APPLICATION FOR BUILDING PERMIT Date ........................ ,~Ug~.~ ..~-~ .............. , 19.~.~ ...... INSTRUCTIONS a. 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, end giving a detailed description of layout of propertymust be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. 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 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of appligant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... age~....-....h~l~ler ................................................................................................................... Name of owner of premises ....... .L~...~...~.~.:~'I.D,~OD, ......................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which pr~osed work will be done. Map No: ..... ~ ........................... Lot No: .~ ...... Strem and Number ..~....~T...~.,.O,~,...o~..~..~a~..~.o.~..~a~....~D~tho~ ................................. ~unicipali~ 2. State existing use and ~cupancy of premises and intended use and ~cupancy of proposed construction: a. Existing use and ~cupancy ........... D~I~ ..................................................................................................... b. Intended use and occupancy ................................. ~..~Q~ ................................................................ 3. Nature of work (check which applicable): New Building .................. ~ddition ..... ~ Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ...................................... 4. Estimated Cost ..... .~O0..~./~ ..................................... Fee ..~ ...................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... gX),e .......... 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 .......... ..~. ............... Height ........ .~. ................. Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ "A" Dist 1 1. Zone or use district in which premises are situated ................................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ................. [~.~. .............................. 13. Name of Owner of premises .....~........~..e...~..~..~?.o..~.. ....... Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................ · ................ Phone No ..................... Name of Contractor ...~.].],~.~C~'.~..~'.~f.9.~-....Address ........ .~..9..~.~.o...~..C]. ................. Phone No ..................... 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~01~,~, .,_ ~ S.S. COUNTY Of ..... ~...'L~...z., .o.., .J~., .......... .............................. ~,~,.~.~g~'.~b...~'.~L~/.¢l]~3~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........... ~e~..e,...l:~i,~:].ez'. ......................................................................................................... (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 ........................... - ........