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HomeMy WebLinkAbout2294-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25782 Date: 06/19/98 THIS CERTIFIES that the building ADDITIONS Location of Property: 270 SMITH DR S SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 76 Block 3 Lot 34.3 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 13, 1964 pursuant to which Building Permit No. 2294-Z dated FEBRUARY 13, 1964 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is Lssued is ADDITION AND ATTACHED SHED ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & ELIZABETH APRILE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A uilding Insp~tor FORM NO 2 TOWN OF soUTHoLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL ~OMPLETION OF THE WORKAUTHORIZED) , : 2294 Permission is hereby granted,to: ' V~n. :~,...Smi.~..~,/0.....~t,he~.t,.. ~,e~.....~ ....... ............. ~Ol~t,~l~ .................. ~..' .......... ct premiseS located at ,...~,l~i,(~..'&..'~.,i..;l~°~:..]~.:!E~&~e~.i .......... ~ ........... ~.., ........ ~...... ................. . ............. '...: ............ '~...~e .~e~" ............................ : .......... · ................................ i ...................... ,80~tt~o;~t t....,~,~.,. ............................... ...., ................................. pursuont to al~plication doted ....................... ~......~1~,....~.0.~ ........ - ..... 19...i~, and approved by the Building inspector Fee $.~..~O~.0~...'t...... . Building Inspector 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). 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 · Vpre-existing" land uses: 1. Accurate survey of property sh~wing 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. Fees 1. Certificate of Occupancy - New dwelling $25,00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Sw~n~ing pool $25.OO, 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 - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..................................... tew Construction ........... Old Or Pre-existing Building .... .~.~P. .......... ,ocation of Property...~?.0. ~'~u~ ~. House No. Street Hamlet )nwer or Owners of Property ................................. ~ ......... . ............. ;ounty Tax No 1000, Section .......... Block ....... Lot.. ;ubdivision......--o...- ........ . ,.....,,...... Filed Map ............ Lot ...................... Date Of Permit Applicant .......................... 'ermtt No · ·' Approval Underwriters Approval ......................... lealth Dept. --- ................... --- - ~lanning Board Approval .... Final Certicate.. X lequest for: Temporary Certificate .......... ; · ........ ~ee Submitted: $ ............................. . FOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOU'II'HOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at E/l~'""l~m't.t~..I~..l~.ot~t,h ......................... Street · se l~eck Est MoI~(~j ....................... ~l~cek~ No ........... ~ .......Lot No ..................... SOt~tM.],~ ,...~,.~., .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................................ F~l~.~,y....109..(~+. pursuant to which Building Permit No. ~gIt. Z .... dated .................................. Fe~' ...... .'l.O.., 19...(:~+, was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ ............... l~'~'v'ate" one· .£~m~.ty' · .d~e.:[.t ~,~ g .................................................................................. The certificate is issued to ...... ~l.j:~,~l~c..j~.ChO~,jj ........ ) ............ ;"'""~P~I~"": .............................. Lowner, lessee or tena:nt) of the aforesaid building. Building lnspe r ~ J FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. Approved ................................ ..~....., 19..~..~ermlt No ................................. Disapproved a/c ............................................................................................. Applicatlon No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. ~ ..~.....~.....~....~..~.., 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, 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 shell 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, building code and regulations. ............ (Address df 6pplicant) / ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. / Name of owner of premises ..... t,:l.~~:...4~..~.......,.~:. ...................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which .proposed work will be done. . at No: .................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .,~. ,.~.: ...................................................................................... b. Intended use and occupancy , ./' 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ............. Repj:ir .................... Removal .................... Demolition .................... Other Work (Describe) ................................. 4. Est ~ .................... Fee ..... ..'~......-~... ............ mated Cost (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, Jf any: Front ....~ ............. Rear .....~ ............. Depth ....~ ............ XHei~ht ....... /~ .......... Number of Stories .........~ .............................................................................................. Dimensions of same structure with alterations or additions: Front ......... ~...~ .............. Rear ...... Depth ................................ Height .............................. Number of Stories ........................................ a. ~i~nsioms o* onfire new construction: Front ...... ~.~. ............Roar ......... ~:...~... Depth ....... ~..~....~... Height ...... '..',~ ........ ~umber of Stories .......... ~ ................ 9. Siz* o{ lot: FrO~t ....~.~ .............Rear ....... ~.~.~. .........D*pth ....... ~ ......... ~ 10. Dot[ of Purchos;'. ........... Z.,~.~:~ ....................... ~ame of Former ~n~'r~~~~,.~S~.. 11. Zon'e or use distdct in which premises ore situoted..~ ........................................................................... 12. Doe¢ proposed construction viol*te ony ~n~ ~ow, ordinonce or reoulolion? ...... ~.~. ............. 13. Nome of Owner of premisos~.~(.~*~Address .~(r,~..~(~*~hone No Name of Architect ..... .~....... ....................................... Address ............................................ Phone No. Name of Contractor ~cl..~,.~.2 ....... Address ~t~.~.~. ~.~.~9.~.. Fhone N ~'/' [ PLOT DIAGRAM Locat~ clearly and distinctly all buildings, whether existing or proposed, and indicate oll set-back dimension: property liDes. Give street and block numbers or description according to deed, and show street names and indi~ whether in~erior or corner lot. STATE OF' NEW,~,'O~(,,/*) ~ c c C°UNTY rOF~~ ......... ~ .~'~' ~ .................. ,'~,/~..~......~ ...................... ....being duly sworn, deposes and says that he is the appli( (Name of individual signing application) above na~ed. He is the (Contractor, agent, corporate officer, efc.) of said owper or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all stQtements contained in this application are true to the best of his knowle~e and beli. and that the work will be performed in the manner set forth in)he application filed therewith. // Sworn to ~efore.~e this ~ // ~ ~ ~// ~ / .............. ........... Notary Public~~~2ou~"'~ ..... (Si~nat~~'~:'b ....