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HomeMy WebLinkAbout6920-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22484 Date JULY 29, 1993 THIS CERTIFIES that the buildin~ NEW DW~3~.ING Location of Property 2398 PRIVATE ROAD #18 SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 1 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 24r 1973 pursuant to which Building Permit No. 6920-Z dated OCTOBER 11~ 1973 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 DW]~I,LINGWITHWRAPAROUNDWOOD DECK~ GARAGE UNDER & ACCESSORY GARAGE STORAGE BUILDING. The certificate is issued to WALTER R. & PAULAM. MILLE~ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTM~/~T OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 H-029245 - JUNE 10g 1992 N/A // Buil~ding Inspector FOI/.M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N; Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6920 Z Date ........................... 0e-~ ....... .'J.~j ......... , 197.3... Permission is hereby granted to: ..... .~ a3~t. ezt · · ~ .~3.ez~ ......................................... .......... · ~? ....... ~e~.-ae~ ............................. ~. .............. H~;~*;o~ ......... .1.1.?l~3 .................. t o~ ~__]_d., ~t...i~'e. p3.~ce~e.~a~.)...,~tte... J'e,l~.~y.. ~ ~ ..................................................... ~t premises located at .... ,JJ~..~Jl~kt.~..]~..~j>.~...]j~J..~ .......... ). ................................................ ........................ ~9~.~.~.~...P.g~.n..~ ..... ~a~hoJL~L ........ I!~:Z, .............................................................. pursuant to application dated ........................... J~J).~....~k .......... 19.~..~..., and approved by the Bull.ding Inspector. Fee ~:J~ ~.1~ .............. 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). 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. 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-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 $I5.00 Date ....................................... New Construction ........... Old Or Pre-existing Building ................. Location of Property... ~/.Zz~.-~...z-...~. p.,gt~.. ..... ~.p.e.77. e/X' .~.~/.,%z...~.. .... .~..~. ~..7~..,~.e~..%~..' House No. Street Hamlet :nwer or Owners of Property. ............ SK//~ /z~. ~ ,~,~z_ / -- /~ ]ounty Tax Map No i000, Section.P~...z.~. .... ~..Bloc~ ................ Lot ...................... ;ubdivision .................................... Filed Map ............ Lot ...................... 5~/,~)/.-~ 7 .. P/ ~z /~.. ........... ,A~z~ ~ .~- tealth Dept. Approval .......................... Underwriters Approval ......................... 'lanning Board Approval ........................ lequest for: Temporary Certificate ........... Final Certicate ........... Submitted: $. ~P~P .... ........... · THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE ~ 8033223 BUREAU OF ECECTI~ICITY ~-- BE JOHN STREET, NEW YORK NEW YORK 10038 THIS CERTIFIES THAT o~/y t~e ef~tric~ ~ulpme~g ~ ~i~ ~ ~ int~ by g~ ~nt ~ on t~ o~ =p~r~ ~u~r in t~ p~m~es o~ WALTER MILLER, PUTNAM ND.OFF HYATTS RD., SOUTHOLD, N.Y. u~sexamlnedon ~ $5t[~92 andfoundtobeincompllancewlththerequi~menlsofth~B~' MXTUII$ "'ixTutE OUTLETS ~cm^cm sw.c./s SERVICE DIS~C~INECT S :l I V I C e ;RTIRE HOUSE-1 'gO VIEUAL DN~ECTS= 'An electrLc&! survey bas been made of the exposed electrical equ'lpaent in the premises indicated.' 'No obvious unsatisfactory condition was found. WALTER MILLER. PUTNAM RD.OIF HYATTS RD., soUl'HoLD, NY, 1199[ 12 Per This certificate must not be altered in any ~,,G~,;,~.r; return to the office of the BOard if incorrect. Inspectors may be identified by their credentials. FOB,~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No..~...~.....,~...,.O. ............. Approved ................ t.) ........ t.! ............ , 19..../...~, Permit No. ~_~...~...2,..~..~,,,,,=.. D~sapproved a/c ............................................................................................ .-------" -- (Building Inspec~r) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled m by typewriter or' m ink and submitted mn triplicate to the Buildin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of buildings on premises, relahonsh~p to adjoining premises or pubhc streets c areas, and glwng a detaded description of layout ofproperty must be drawn on the diagram which is part of this apphcatio~ c. The work covered by this application may not be commenced before ~ssuance of Building Permit. d. Upon approval of this apphcahon, the Budding Inspector wdl ~ssue a Budding Permit to the apphcant Such perm shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Buil&ng Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Budding Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances · Regulations, for the construchon of buildings, add,tions or alterahons, or for removal or demolihon, as herein describe, The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ....... ..... (Address of opplicontg ' , ' State whether opphcont ts owner, lessee, agent, architect, engineer, general contractor, elecmoan, plumber or builde Name of owner of premises ..~..~...~..e.?..?.;....~.....~1,.~...&...l~.~ ............ If opphcant ~s a corporate, signature of duly authorized ofhcer. (Name and title of corporate officer) Budder's bcense No. Plumber's License No ..... ~ .................................. Electrician's License No. ~.e.~ .................................. Other Trade's License No...~.e..~. .................................. 1 28 ?o Location of land on which proposed work will be done..M, ap No.' .... = ............................. Lot No ...... ._ ................ Hol-~on' a Poin'~ 11~. ,~.11 /.'. f~r Street and Number .............................................. .'"r....l:rr.l.C.,r~?l..~,.'-.,O.c:.:%....f.~t.: ..... ~,..~.../. .... "~ - ' 'Municipality State exishng use and occupancy of premises and ,n.~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ......... '~....::.~...~.. ........ ~ ;~b.~ ..... ~.*--. ...... 11 ....................... b. Intended use and occupancy ............... .b'..°.~.s..e....C.q..~&~.e.~.~...'%.o.~.~mC~.m..t.],;2'...~.c~e ......................................... 3. Nature of work (check which apphcable): New Budding .................. Addition .................. Alteration ...... Repair .................. Removal .................. Demolition .................. Other W, ork .................................... _ ~ /--Z "7 ~ (Description) --, ' '~ t Sz~,00o.00 _ 4 r. sfmatea ~os .......................................................... Fee ............................................................................. (to be paid on filing th~s apphcot~on) 5. If dwelling, number of dwellmng units ............................ Number of dwellmng unmts on each floor .................... ff garage, number of ~rs ............................................................................................................................ 6 If business, commercial or mixed occupancy, ~pec~fy nature and extent of egch type of use ..................... ........... 7. D~mensions of existing structures, if any: Front ............................ Rear ................................ Height ...... ~.~. .............. Number of Stori~ o~e Dimensions of same structure with alterations or addmons Front ................................... Rear ......... Depth ................................ Height ............................ Number of Stones ................................ 8. Dimensions of entire new construction: Front ~' Rear 3G'. Depth ~0" Height 18' Number of Storzes b~n¢ ~ one sto~ ~.~ ~ ~ ............... ~ ............... ~-~ .......................... 9. Smze of lot: Front ...................................................... ear ....................................... Depth T0~' ...... 10 Date of Purchase ..... ~. ............................ Nome of Former Owner ....... ~.~..~.~.~ ........... 11. Zone or use district in wh;ch premises are s~tuated ...................................................................................... ~0 12 Does proposed construc~n violate any zoning law, ord;nance or regulahon .................. 13 WHI lot be regraded ............................ Wdl excess fill be removed from premises: ( ) Yes ([) No ] ~ ~ome of ~w~er o~ premmes ................................................ Address .......... ;~ ................... Phone ~o ...................... Name of Architect ...... ~er ---- H~¢i~on, ~.Y. ...................................... ~aaress ................................ Phone No ...................... Name of Contractor ........ ~ ................................. Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and d~st;nctly all buildings, whether ex~tmg or proposed, and ~nd~cate all set-~ck d~mens~ons fron proper~ lines. Gwe street and b~ock number or descnpt on accord~n~to deed, and show street names and indicat. ~hether inlerior or corner lot 7~ / % .... .// ...... STATE OF N~ / COUNTY tQ~ .~/.f~ ..... :_~.~ ~'~ ................ ~..:~....~.f.~.~. ........................... be,ng duly sworn, deposes and says that he ,s the apphcan (Namt of indw~dual s~gmng contract) above named /~,C.~' .,~ ~ He ,s the ...~.e.~ ....... ,.~.~. ............ i ............. i..'~,. ........................................................................................................ (Contractor, ogent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and this Qpplicahon; that all statements contained ~n thru apphcahon are true to the best of hm knowledge and behef; tha~ the work will be performed in the manner set fo~h ~n the apphcat~on filed therewith Sworn t~bef~re me this ~ ............ ....... .... , JUDITH T B©KEN Notary Pul M %~te of' J'J~-w York No 52 034/-763 Sufta,k Comrmsslon Expires March 30, (S~gnature of applicant) ,3 ~tOii-~F~-BUILOlNG DEPARTMENT AT 65-2660 9AM 3'0 4PM FOR R£QUIR- bsi-OR~- BACKFILLING FGUNDA- DR ~AR~ FRAMING u~rORE COVERING pIp~LINE r~NAL wHEN JOB coMFLETED RESPONSIBLE FOR DESIGN QR cON- SIRUCTION [RRORS