HomeMy WebLinkAbout9766-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hail
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17142 Date
AUGUST If 1988
County Tax Map No.
Subdivision
THIS CERTIFIES that the building
Location of Property 750
House No.
1000 Section
Flied Nap No._
ACCESSORY
CEDAR POINT DRIVE EAST
90 Block 2
SOUTHOLD
Street Hamlet
Lot 18
Lot No.
conforms substantially to the Application for Building Permit heretofore
fiied in this office dated JUNE 5~ 1978 pursuant to which
Building Permit No. 9766Z dated JUNE 6, 1978
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 ACCESSORY DECK
The certificate is issued to
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ALBERTO & JOAN MONTOYA
(owner,
B~ilding Inspector
Rev. 1/81
FOP. i~ 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? 9766 Z
June 6 78
Dote ........................................................ , 19 ........
Permission is hereby gronted to:
Sidney Beebe
.......... ;?j'"'~':'"~'"~t~'~'~ ..............
to ................................................................................. (?....Z..~ ...............................................................
750 Cedar Poin~ i~*tve East
at premises located at ................ ~.~.~.8~..~.;...~.~..~,~ .................................................................
Cedar Beach Par~$ Map # 90 Lot
pursuant to application dated ....................................................... , 19 ........ , and approved by the
Building Inspector.
Building Inspector
100g-90-2,-18
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUP/~
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic featu res.
2.Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3.Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p~perty showing all property lines, streets, buildings and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling $25.00, Accessory '$]0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.Oo $ 20.00
5.Updated C.O. $ 50.00 Date ..........................
New C OhS truct i on ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property ~.~ .~.~.0
House No. Street Nam/et
Owme~o~O~me~sofP~operty,.. ... ..... ................... . .
f.
County Tax Map No. 1000 Section ~]0 B'ock ~ Lot
Subdivision ................................. Filed Map No ........... Lot No.
~armit No .......... ~ate oJ ~armit ...Applicant
~aaltk Pept. Approval ........................ Labor ~ept. Approval
~nde~ritar~ Approval ........................ Planning ~oard Approval ......................
~ ~quest for Temporar~ Oertificata ................ Final Oartificata .... '[~ ..................
Fee Submitted $ /~, O~ ~. ~-/ ~ - '
Construction on above described building and permit meets .alk~pplica~ble codes and regulations.
C,0 £7z I ^pp,oa t ......... '..
~1~o~ ~i4~ Z<~ ..... ~Z~Zb ..........................
TOWN OF §OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTttOLD, N.Y. 11971
December 14, 1987
Dr. Albert blontoya 7/~;~f
750 Cedar Point Drive /~_ ~
Soutbold, New York 11971 .~
TEL. 765-1802
This is to advise you that the job under building
permit no. 9766 Z issued to Albert Hontoya
on June 6,---]~/~r Accessory Sun Deck is completed
a final inspection has ~XXX) ~x~mx~xxx~x~ done.
and
In order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out the
eac)osed form, return same to the above office with a check
for 10.00 payable to the Town of Southold. Please indicate
to Whom the Certificate of Occopancy is to be mailed, and
arrange with this offibe for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Tbank you for your prompt attention.
Very trul
Victor Lessard
Executive Administrator
VI,: ga r
Remailed to: ]2 Shelter By Drive
Great Neck, New York
11024
FORM NO, 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN C,ERK'S OFFICE
SOUTHOLD, N. Y.
Examined ......... ~g,;g.~ .............. .~....., 19....~..~
Approved ~T~.t~e ~o 19...~.8. Permit No. 9766Z
Disapproved a/c ..............................................................
................................................ iiZZ Z . ............
(Building Ihspector)
Application No ......... ~..~...~...~. ..............
^FP,C^T'ON FO, ,Ut'DINe FE,MIT
INSTRUCTIONS Date . ........ ..................
a. This application must be completely filled in by typewriter o¢. in ink and submitted in triplicate to the Buildin9
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee. a,~cordi~ig to schedule.!.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoinin, g~ premises or public streets or
areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application.
c. The work covered by this application may not be commenced.beforeiissuance o( Building Permit.
d. Upon approva of th s app cat on, the Building Inspector Will i~s'u~ 0 Buildir~g Peri, it to the applicant. Such permit
shall be kept on the premises available for inspection throughout 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, as herein described.
The applicant agrees fo comply with oil applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and ir~ buildings for necessary/ inspections.
(SignaturbJof applicant, or name, if a corporation)
........... ..........
(Address of appli~,~nt)
State whether o/pplicont is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nome of owner of premises ....................
I{ applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ........ .~./../. .....................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
Location of land on which proposed work wiJ' be done. Map I~o.: ........... .~._....~.. .................... Lot No. /..~.'..~.~... ...........
Street and Number ..... ~Z..;~.. ........... C~'.~,.'!~-~L~,..t?'~.~-~. .......... ~f~'.'),-". ............ ~'~,C~ ....................................................
Municipality
State existing use and occupancy of premises an~in~.ended use and occupancy of proposed construction:
b Intended use and occupancy ............. w.~.. ................................................... / ...................................................
3. Nature of work (check which applicable): New Bu,ld,ng'. ................. Add,t,on ......~_. .....................
Repair .................. Removal .................. 'Demolitior .................;... Other Work.~rn,,~c~.....r...--,cr~,?.~"/'~'-'~'¢ ~ ~'~ ................ ....
....................... ' Fee' ~ 0 (Description)
4. Estimated Cost~f¢"~'4~-Fg...~..~r...=...~-. ...........................................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................ Numbcr of dwelling units on each floor ............................
Jf 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 sbucture with alterations or additions: Front .................................... Rear ............................
Depth ................................Height ............................ Number of Stories ................................
8. Dim~,sions o~ entire new co,,~ruc~ion: Fro,~ ...... ~..~ .....................R~=r ..~ ......................D~p~h ....<.~ .............
Heiflht .................... Number o~ Stories .....................................................................................................................
9. Size of lot: Fron~ ...~.~.~.~ ....................................... Rear ..~.O .................................Deplh .~.~.~ ..............
10. D~te of Purch~s~ ........................................................N~m~ o~ Former Owner ........................................................
1 1. Zone or us~ dis~ric~ in which premises ~re sffuo*ed .................................................................................................... "T'~-
12. Does proposed construction violate ony zon[nfl I~w~ ordinance or reflul=~ion: ....... ~ ........................................
I3. Will lot be regraded ...~O..=-.. ......... Will excess fill be removed from p~mises: ( ) Yes ( ) No
14.
Address
Phone
Name of Architect .~ ........................................................ ~ Address ................................ Phone No .......................
Phone
No.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ~11 set-back dimansions from
property Hnes. ~ive stree~ and bbck number or descr~tion according to deed, ~nd show street names and indicate
whether interior or corner lot.
STA-FE OF NEW,~,.O~J~,. ~ /7 LS S '
COUN'I~
................ .....being duly sworn, deposes and says that he is the applicanl
(N~n i [vdu~ signing contract)
above named.
He is the .......... ~/. · · · .---.................. .......................................................................................................................
(Contractor, agent, corporate .officer, arc.)
of said owner or owners, and is duly a~thoFized 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 applicatJ6h filed therewith.
Sworn eth
.............................