HomeMy WebLinkAbout2527-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
~TIFICATE OF OCruuk,RNCY
No Z-23708 Date JUNE 16, 1995
THIS CERTIFIES that the buildin~ DWELLING
Location of Property 1600 WATERVIEWDRIVE
House No. Street
County Tax Map No. 1000 Section 78 Block 7
Subdivision Filed Map No.
SOUTUOLD, N.Y.
Lot
Lot No.
Hamlet
33
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEP'£~4BER 21, 1964 pursuant to which
Building Permit No. 2527--Z dated SEP'£~iBER 21~ 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 ONE FAMILY DWELLING WITH ATTAC~K~ FRONT DECK *
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. PENDING
PLUMBERS CERTIFICATION DATED
HBETT A. & LINDA S. CARLSON
APRIL 2~ 1974 by R. VIr.T.A
*THIS UPDATES CO Z-5848 ISSUED ON APRIL 5, 1974.
Rev. 1/81
Building Inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Of/ice
Southold, N. Y.
Certificste Of Occupency
THIS CERTIFIES that the building located at . S/S Waterview Drive Street
Map No..xx ....... Block No. .X~,.... Lot No..XXX . .8..oLu..t.h.q~d' .1.4 :.Y., ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . ~apt 21 , 19 61~ pursuant to which Building Permit No...~.2.7Z
dated ..... .S.e.p.t . 2.~.. , 19..6~, was issued, and conforms to all of the require-
ments of the applicable provisions of the taw. The occupancy for which this certificate is
issued is Private one fa. mi.l.y..d?el.l.i.n.g ...........................
The certificate is issued to Glad. us Wexler Own .r (form. 9.rl.y. Ze.b.r. 9.s.k.i~ Sideman e~-
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval A~ril 2~. J. 975..by R:. V.i.l.l.a .....
UNDERWRITERS CERTIFICATE No.. ppn.d.i.~g ..................................
HOUSE NUMBER ...T6.QQ ..... Street .. ~,~.a..t.e.r.v.i..e.w..D.r..i.v.e .....................
Building Inspector/~''
FOl~ NO. 4
TOW~ OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N, Y,
Cerlificate Of Occupancy
No, .g5.8.~.~ ...... Date ......... A~ril .... 5 .... , 19.
THIS CERTIFIES that the buJlding located at . S,/.S Wate, ,ry~e.w., Dr.i.¥e, ,, Street
Map No. , .xx...;-,.. --, --,; Blobk ~o,'".", .x~..77 ,-. ',L6~ N'67~,-7' ...~. :~: -.' 5', ~"
conforms substantially to the Application £or Building Permit heretofore filed in this offtce
dated ,8el~t,, ~1 .... , 19.6L'.. pursuant to which Building Permit No,
dated ....... ~.a,p.~...2.~.. , tg..6.~,, was issued, and conforms to all of the require-
ments of the applicable provisions of the law, The occupancy for which this certificate is
issued is .P, ,r.~Y.a.~.9..o.n.e. fami~[
The certificate is issued to..0:ka.a.Y. ~, Ne, x,~e~...03,. ,re.e.? .(£9,r.m. gr3.Y, .~. 9kr, pg.k.~.,. ,8.~dq=an et
(owner, lessee or tenm~t)
of the aforesaid building,
Suffolk County Department of Health Approval 4P..v.~3, ..2~, .1.? .7.b...py..R.: .¥.~.~.~.a. .....
UNDERWRITERS CERTIFICATE N0..Pg.n~.~.rbg ..................................
HOUSE NUMBER ~.6.00 Street Waterview Drive
FORNI NO. ~
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? 2527 Z
Permission is hereby granted to:
,,'rul:Lua,....~eh~.c~k~ ..............................................
....... 8~uthc~t .....................................................
to ...... ~.~,.4...~ew...~n~.. faml~... ~t~J,:I~ .................................................................................
et premises located at ........~t~l~,... lg~l,-~.~el~..]iD~,-~-V~- ..............................................................
........................................................ ~l~ttth~d ....................................................................................
pursuant to apphcation dated ......................... ~e~t~. ......... ~ ..........19.~m~.., and approved by the
Build~ng Inspector
Form No. 6
TOWN OF SOUTHOLD
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 I% 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
"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 sig~ed 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 Building - $100.00
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 $15.00
Date . .F.e.b.r.u.a.r.¥. 22, . 1995
New Construction ........... Old Or Pre-existing Building..U.P.D..A.T.ER .C..E.R.T.!FICATV' OF OCCUPANC
Location of Property.. 1600 Waterview Drive Southold
House No. Street Hamlet
County Tax Map No
I000, Section. 07p.~0..Block. 07.~0 ..Lot 033.000
Subdivision .................................... Filed Map ............ Lot ......................
Permit No. 82~2Z .Date Of Permit ........ Applicant ....
Health Dept. Approval N.R. .Underwriters Approval.N276193 03/30/76
Planning ~oard Approval ........................
Request for: Temporary Certificate ........... Final Certicate...X.X. ......
Fee Submitted: $...5. .0: .0.0. .................... //~ , /7
' · ....... ..................
APPLICANT
TOWN CLERK'S OFFICE ~7/~
~OUTHOLD, ". Y. ~-
~ / = Appl'ca o No ............. ;...~ ...........
Approv~ ........................................ , 19 ........ Permit No. ~..7..~...t~
.................................................................. , .
............................... _...........__._.. .............
{Suildt~ Insp~tor)
APPLICATION FOR BUILDING PERMIT
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 showin~ 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 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, b~uilding code and regulations. /7
......... ............... ....................... .......
...... ;. ' .. :.
of apph~ant) ~'%'"'"'"""'(Add~ress
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ..................~..~..~..~...~...~ ............ ~....~..b...~...~....~...~..i~. .........................................................
If applicant isa corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
1. Location of land on which proposed work will be d~one. Map No: ............................................ Lot No: .......... i .........
Street and Number ..... ~..~'"r~'"..~..V~......~....~ .....................................................................................
/~/ -- /~ 0 0 Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......... .~.~.. ~....~,,~. .................................................................................
b. Intended use ond occuponcy ............................................
Locate clearly and distinctly all
property lines. Give street and block
whether interior or corner lot.
3. Nature of work (check which applicable): New Building ......... Addition .................. Alteration ........... *. ......
Repair .................. ~ Removal .................... Demolition .................... Other Wol;k (Describe) ......................................
·
4. Est,mated Cost .~')~.~.,~d~'.(~)~.{~..~ ...................... Fee ................................. ~....~....Z~ ............................................
-- -~ -- '~, (to be paid on filingthis 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 b/pe 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 ........................................ ~ k~
8. Dimensions of enti,r~ construction: Front ...... ~...,.O.. ............ Rear ..~ ................. Depth
Height ...... l.J..T ........... Number of Stories ....(~l~J~.... ...........
9. Size of lot: Front .../.~).C~ ................ Rear ..... I.~.~ ............... Depth ..... ~.:..~...~.. .................
10. Date of Purchase ........................................................ Name of Eormer Owner ........................................................
11. Zone or use district in which premises are situated .................. ~..~..~.~......~....(...~....~. ...............................................
12. Does proposed construction violate any zoning law, ordinance or regula, tion? ........ ~.~ .......~./. ..........................
i3. Name of Owner of pre!~se~ ~.)~.~°...~.~,~.~..Y~.(;.AddreSS ..~.~.(-.tLh~.).4 .................... Phb/n' N~..~'.~..~..~...~'...'?..
Nome of Architect ....~,~L~,~w~,,~'~ .............. Address ......... : ....... ' ........................... Phone No
Nome of Contractor ...~.~'~ .............. Address ....... '..'..~ ................................ Phone No .............. i ......
PLOT DIAGRAM
buildings, whether existing or proposed, and indicate all set-back dimensions from
numbers or description according to deed, and show street names and indicate
.......................... ~ . .~~..~ing duly ~om, dep~es and ~ that he s the app cont
above ~m~. H~he ........................................................................................................................................................
(Contractor. agent, co,orate officer. ~c.)
of said ~ner or owne~, and is duly authorized to Perform or h~e pe~rmed the ~id work and to make and file
this application; tbet ~11 state,nfs c~tain~ in this a~licotion are t~e to the kst of his kn~l~ge and belief;
manner ~t ~ ~ ~~
~nd thot tbe work will b~ ~o~ in th~ {o~h ~ th* ~pplicotion fil~ th~ith.
Sworn to ~{om m~ thi~ ~ . ~ m
Nota~ Public~....~;. ~LIC~:~';z ': ¥;a(Signa~re of opplica~t)