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HomeMy WebLinkAbout11968-zFORM NO. 4 TO%A~ OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24498 Date JULY 16, 1996 THIS CERTIFIES that the buildin~ ADDITION Location of Property. 21275 SOUNDVIEW AVE. House No. Street County Tax Map No. 1000 Section 135 Block 1 Subdivision Filed Map No. SOUTHOLD, N. Y. Hamlet Lot 2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 23, 1982 .pursuant to which Building Permit No. 11968-Z dated OCTOBER 18, 1982 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 ADDITION TO EXISTING ON~ PANILY DWELLING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ANDREAS N. KA~ACOSTA$ N/A PENDING - JULY 12, 1996 Rev. 1/81 Inspector ,: FORM NO, 9 TO~N oF sOU~r. OL~ BUILDING DEpARTMEN'r TOWN HALL ' ~ SOUTHOLD, N~ Y. N©. 11968 BUILDING PERMITi (THIS PERMIT MUST BE KEPT ON TH,E P'I~EMISES UNTIL EULL COMPLETION OF: THE WORK AUTHORIZED) Date . Permission is hereby granted to: ...... :.......~,zc.,..~...:..~:. t..'~a.~ ~'~ ..'..:..~. :'.'.~..: .. . i ' _ . ........................ .,.........._...,. ..... .,.... ............... :, _ ,o .~.~.r.:.*........~d.:..:..r~:~. ....... ./,~ ......... ~.zz.~z/:~...~_x,~./~..~. ........ ................ : ......................... '""'"';": ................ ~'"~'" '"'": * ...... ~'""~ ........ '~; '~':'i~ ....................... 7 .............. ................ ~ ............................................................................... ..:~....~~,....~..~_.. Coun~ Tox ~op ~o. 1000 S~ct~on ........................ Block ~,..~. ~ ot ~o ........ ~ 7~'~/ ~ ~ ~pproved by the pursuant fo application dated ........ ~.~ ................ ......... :~....?....., ]9......., and Building Iflspector. Fee ~/~ : ........................ Rev. 6~30/80 'Final su~zey of properu7 w-!zh acaurzua locaziom of ail /i~a! A~provai from ~e~ch Dean. of ~a~r supp!7 and i~prova! of a!acur~ca! L/sua!laz~ou fro~ Board of Fire !ass chon !/I0 af Li responsible for ~e For =--~mscz~== buildings (pr±or =o A.ur~i! 9 .~ ) uou--confo~n~ uses, br build~s ~d Accuraua su~e7 of pr~per~ ~now~g =,, propert7 ~es, '-r--~- ou~!~ ~d unusu~ ~acura! or ~opogrmp~ic faa:ures. i. Ceru!ficana of Occupancy - .~e*~ ~%-el!in~ S25.00, Add!%±ons :o dwe!l~ $25.00, '~ t ~ ~= S25.00, S~n~ pooi 'S25.00, ,%czassor~ bu~d~ S25.00, iddi~io~s co acaasso~ bu~d~ SZ~.00. Bus~esses ~0.00. 3. Copy of Car~icgca of Occupancy - ~ .25c, .'- ,-a-la ~-,~., Oeoc.. ADor0vai.. .......................... Jnderr,-r~ aars Aoprova!. ................... .... · - '!an~!a~ 3oard Approval ........................ I'%FLD ~INSFECTION 1. FOUNDATION {1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS: UILDING DEPT. INSPECTION [ ] [ ] [ ] FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. FIREPLACE & CHIMNEY [ ~,~ULATION [ -"] FINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location af lot and of buildings an premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicuiion. 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 work· e. No building shall be occupied ar 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessaFy inspections. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ame of owner of premises ..... ............ ' ....... If applicant is o c.orporate, signature of duly authorized officer. (Name and title of corporate off~ice~ Builder's License No ................ ~.~.. ...................... Plumber's License No. u......._?...7...~....~.. ......................... Electrician's License No....-~..T...~......~.Z~:~...~...(-- Other Zrade's License No ............................................... Subdivision Location of land on which proposed work will be done. Mop No.: ........................................ Lot No ......................... Street and Number ~1 ~ 9¢. ~¢~ ,4y ~g ~our/4a .......................... : ........................................................ q,O.9.P.l.~ ....... ¢.~...,...,~ .............. ,...Lt,9,,/,/.: q, Municipali'ty State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... .(~...~....4.~......'~..d,//...C~./.'..~.y..,.~...~..../4/.~.... ...... b. Intended use and occupancy £&x~,/.,o~t4~' ~..~.. .~..~..,f~,~ County Tax Map No. Dist. 1000 Section ~ Block ~ Lot 3. Nature of work (check which applicable): New Building.. ................. Addition ........... Alteration ~....'..,...:: ..... Repair Removal' Demolition .................... Other Work (Description) , Estimated Cost ........... ~..'.~,~O.,. ?. ~'~(~...... -,~. .......... Fee .................................................................................... (to be paid on filing this application) If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ....~ ................................................................................................................................... 6. If business, commercial or Imixed 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 structur~ with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new cohstruction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories .................................................................................................................. 9. Size of lot: Front ................; ....................................... Rear .......................................... Depth ................................ 10. Date of Purchase O~.T, ~'~,1~/?.~, N~ .... f F,~r,~,,, r~ ...... 11. Zone or use district in whichlpremises are situated .................................................................................................... 12. DoeS proposed construction violate any zoning law, ordinance or regulation: ...~.~.: ............................................ 13. Will lot be regraded .........-~....,,~..0. ........ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ....~..~...b....~.~.t..°...L..~ ........................ Address .fl$[[G~e,/~Z'.! ............ Phone I~ ' ~z~_ No(.a{..~.~;.~? Nome of Architect ............~ih.~...~.: ....................................... Address .~...°..~.~ ..... Phone No. ~.9'...9..~.(.&...,,?~,.... Nome of Contractor ............ ..,~..,.~....,~,.~...~.!.~ ......................... Address ................................ Phone No.; ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and bl?ck number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF:NEW,~,.~.... ~,,.,~f~YORK i- ' ' ................. : ........... ,: ........ :~ ........... , ..................................... being duly' sworn, deposes and soys that he is the applicam (Name of inSividual sig~ing contracO 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 oll stotementf contained in this application ore true to the best of his knowledge and belief; and tha~ the work will b$ performed in the manner set fo~h in the applica[ion filed therewith. Sworn to befoze me this ,, ~ i ~ / . ....... o, ................ -: ~,~., ~,,.~'7 ~, ~f~-~ r~,,~, x ~ .................... : .... ...... ' ...... ' ................... :7'?7"r%j~.:-"' ....... ~~Z;~"~:~o.t~ ................ L T ~[ll.i~[ C[RTIFiCATE 6F OCCU~,~NC¥