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Home My WebLink About5098-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. ~TIFICATE OF OCCUPANCY No Z-23440 Date JANUARY 4, 1995 THIS CERTIFIES that the building ADDITION Location of Property 490 WINDY POINT LANE House No. Street County Tax Map No. 1000 Section 78 Block 6 Subdivision Filed Map No. SOU'£uOLD, N.Y. Hamlet Lot 11 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 9, 1970 pursuant to which Building Permit No. 5098-Z dated DECEMBER 10, 1970 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 FIRST FLOOR ADDITION TO EXISTING ONE FAMILY DWK~.ING The certificate is issued to PATRICIA BRANT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Building I nsp~t or TOWN OF $~UTHOLD t~UILDING DEFARTMENT ~TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PF. RMIT (TI-IlS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5098 Z Permission is hereby granted to: ......... tO at premises located at ..........~-O.~/~-..~-/~...~.~'~el~'...~i~ .......................................................... ........................................................ ~.~.~.!~ ..................................................................................... pursuant to application dated ............................. ]~a~ .............. ~l ...... , 19.~).., and approved by the Building Inspector. TOWN 0~* ~,_~?LICA?ION FOR C~TT~ICA~ OF OCCU?ANC¥ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 Bo i 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. 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 1. 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-existinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15?Q0,/Commer~ial $15.00 New Construction ~ Old Date ......../Y~ ~/~ ~ .~/Z .~. ................. Prop'''-''''~..erty---;~/.~.. Or Pr~-existin~ Building--.% .............. % ........ ........ Location of House No. Street Hamlet O nwer or Owners of Property...F2~.~.~.~.(Z~..o..~..~Z.~.~..~,....~.~./~t...~., ............. County Tax Map No 1000, Section .... /.~. ..... Block ........ ~. ...... Lot...//. ............... ~ubdivision .................................... Filed Map ............ Lot ...................... ermit No..~q.~. ....... Date Of Permit. ~J~.t. 7~ ..... Applicant ............................. ~alth Dept. Approval .......................... Underwriters Approval .anning Board Approval ........................ equest for: Temporary Certificate ........... Final C t ~ ...... .............. ~, ff ~ t~ ~/ ....... ~-...~..-..~r. ~.~..~ ............. Co --2.,2..::3 ~/~0 ~.~c~.~,~ TOWN OF $OUTHOLD~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. Examined l~Y~... J~.....0 19.y~.. ~ ........................................ , ,9..;.'.... ,.,m,, ...... ................................................. ................. & 0'-/& -/.- ~/'~ ~- Application No. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in ckpllcato to the Building Inspector.,ar b. Plot plan showing location of lot and of buildings on Premises, relationship to adjoining premim or public streets or ~ areas, and giving a detailed description of layout of property must be drown an the diagram which is part of ~hle 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. ~uch 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 purpoee whatever until a Certiflcato 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 pureuant to the'- Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lawl, Ordinances o~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, al heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature cf applicant, or name, If a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant Is o corporate, signature'/of duly authorized officer. ~k (Name and tit!e 'of corporate officer) ~ '~ ~ -..- ~ ti of land on whl ark wdl · done Ma No ~ . 1. Lace on ch proposed w ' b . p .: .l..~...~.~.. .....................LOt' No....J..'~.. ............... Street and Number .~'~.~....~..~,dm~ll....~.?.../~....U.~.....~...~~'~...~.' ' ~,7,............... 0 d/ / Municipality 2. State existing use a.nd occupancy of premises and intend~ed use end occupancy of propaeed construction: o. Existing useondoccupancy ....~....~ ...................... ~. ...... _ ...................................... b. ,ntendeduseandoccupon:', .~.......~......c~. ............ ~.,~,~mm,,~....-,~ ............................ 3. Nature of wo~k (check which applicable): New Building .................. Addition .....~... ......... Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost l~.~.~.. ~') ..~....,ff'l,) ' ....... ~ ................................ Fee ........................................................................................ (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, if any: Front .......~..~ .............. Rear ........ ~...~....'. ............ Depth .~,.2 ........... Height ...... L.~ ............. Number of Stories ....~ .............................................................................................. Dimensions of same structure with alterations or additions: Front ..... ~)~.....~. ..................... Rear ~....~. .................. i Depth ........... ......... Height ...... f..../. ............... Number of Stories ....~ .............. 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Eront ....... /...~ .......... Rear ......... /......~... ................ Depth ....... ~..~...~.. ............ 10. Date of Purchase ........... .......................... Nome of Former Owner ....~.~./..~..:..~ ................ 11. Zone or use district in which premises are situated .......... ..~......'7....~'~ ........................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ...~..: .............................................. 13. Name of Owner of premises ~..~-'~.~.r.~.~ddress ....~..(...~....~.... Phone No Name of Architect ...................................................... Address ............................................ Phone No ..................... ~..(~/~.~[ ........ Address ..~,t.~..;y Phone No .................... Name of Contractor 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 number or description according to deed, and show street names and indicate whether interior or comer lot. I 6~ ~ STATE OF NEW YJ~K~/~ J - J'~----'~'~'~'~ COUNTY OF .,,.'~('/I1~[~. ~'~ / .................. ~...~t~ ........... ~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application)' above named. He is the ............................................. '~ ~.....~.....' .................... ~ ...... ~ ....................................................... (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 thaz the work will be performed in the mannerset forth in the .application filed therewith. Swam ~o.b~fore me this /'~ , ...... .............. ........ /~ £UZABETH' ~flN NEVILL£ // I~' · ~ NOTARY PUBLiC,State of New Yort No. 52-8125850, Suffolk Cou~nt~ Term Expires March 30,