HomeMy WebLinkAbout12151-zFORM 110. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z18494
Date OCT. 24~ 1989
THIS CERTIFIES that the building
Location of Propert~ 650 GROVE DR.
House No.
County Tax Map No. 1000 Section 080
Subdivision
ADDITION
SOUTHOLD
Street Hamlet
.Block 04 Lot 024
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOV. 22, 1982 pursuant to which
Building Permit No. 12151Z dated FEB. 10g !983
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 DWELLING.
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
The certificate is issued to EDMUND H. PRESSLER
( owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
H012395 OCTOBER ~0~ 1989
Rev. 1/81
/Budding Inspector
P~n~issiori is herebywranted
?
BUll
ar~d:~pproved by the
TO~ OF SOUTDOLD
BUILDING DEPARTHR~T
TO~ DALL
$OUTDOLD, NE~ YOR~
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY "
NEW COt;STRUCTIoN .. ..OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
''
ro~t~on o~ Prop~..,~..~.
· . ................ .~. ~.~..~.~..?~
HOUSE NO.
, STRE<T UAHLET '
O~ner or Ownerg of Property
~o~ ~ .~, .o. ,000 ~o~ go ~o~ ..~... ~o~-~ ....
gubdivtaion .......................
Ftled Hap ........ Loc ..........
..... ~are of Per.it .......... appt~canr .......
Ueaith Dept Approval
.................. ~nder~rieer~ Approval ..............
Planning Board Approval ................
Request for Temporary Certificate ....... Final
Fee Sub~i~ted: $ .... ~.~..~ ...........
Certificate
10/14/88
FEES:
I.
FOEHNO. 6
TO~N OF SOUT~LD
BUILDING DEPARTmeNT
TONN IL~LL
765- 1802
~PLICATION FOR CERTIFICA~ OF OCC~ INSTRUCTIONS~
'~s application must be filed in type~iter OR ink and mubmjitted to the B~ildlng
Inspectmr with the following; for new buildings or new ~se: ~
~. Flnal SU~ey ~f property with accurat~ location of all b~ldings, property
streets, and unusual natural ~r topographic features.
2. Final approval of ~ealth Dept. of water su 1 _ · '
3. Approval of electrzcal ins~-]~-' ~ ~PP y and sewerage disposal(S-9 fo~
~. Sworn mtat~ ~ ...... ~on ~rom ~oard of Fir~ UnHe~it,~
of I~ lead.
5. Co~erclal buildings, industrial buildings, ~ltiple residences and similar.' '
buildings and lnstallatlons, a certificate of ~Ode compliance from the Architect
or Engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan equzrements.
For existing buildings (Prior to April 9, ]9570 nOn-confomi~g uses, or buildings
and "pre-existing" land uses: .
I. Accurate su~ey of property shOWing all property lines, st;reefs, buildings and
unusual natural or topographic features.
2. A properly completed applicatlon, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title COmpan~ which shall
show single and separate o~ermhip of the entire lot prior~ to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector ~hall state the
reasons therefor in ~iting to the applicant.
3. Date o[ any housing code or safe*- : ....
pertinent info--rio .... ' - ~ ~uspecc~on of buildings~or premises, other
~ ~quzrea to prepare a certificate. ~ or
For Vacant Land'Certificate of Occupancy:
~' ~ appl~cation for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title compan~ showing single and
separate o~ership of the entire lot prior to April 9, 1957 shall also accompany
the application. If a Certificate of Occupancy is denled,~the
Building Inspector
~hall State the reasons therefor in ~iting to the applicant.
CERTIFICATE OF OCC~cy - New ~elllng $25.00, Addlti~ns to ~elling $25.00,
Alteratiom Co ~elling $25.00, Swiping Pool, $25.00. ~ccessory building $25.00
Addition to Accessory buildlngs, $25.00 - Businesses $50.00.
2.Certificate of Occupancy on pre-ex~sting dwelling - $100.00.
3.Copy of Certificate of Occupancy - $5.00 - OVer 5 years~'- $/0.00
4-Vacaut Land Certificate of Occupancy - $20.00
Updated Certificate of Occupancy - $50.00
6.Temporary Certificate of Occupancy - $~5.00 Residentiai
$50.0~ Co~ercial
~v.
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTttOLD, N.Y. 11971
To Whom This May Concern,
TEL. 765-1802
We are unable .to complete your Certificate
of Occupancy because .of the following reasons.
/--/ An application for Certificate of Occupancy
is not on file.
/~ No Underwriters Certificate On file.
/--/' The check is (outdated/not on file.)
/-/ No Ilealth Dept. Approval on file.
/--/ No final ins.pection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit t, I A -~/ .~ _~ Z
Building Dept.
***/Z/ No Plumber Solder Certifica:te on file.
( all permits involving plumbing being
issued after April 1,1984 )
~ i~ ' THE NEW YORK BOARD OF FIRE UNDERWRITERS.
'. ~ B5 JOHN STREET NEW YORK, ~E~ ~ORK t0~: ': : : ~.
OCTOBER 20, 1989 64706289/8" :: ~
Date
THIS CE~IFIES THAT , <.~.:~' ~:;~j ,"
o~y t~ ~lec~rical ~uipment ~ ~scribed below and lnt~uced by t~ ap~licant ~d on the a~e application number in the prem~es of
~DMUND PRESSLER, GROVE DRIVE, REYDO~N SHORES, SOUTHOLD, N.~,- ,-, , -
~sexaminedo. SEPTEMBER 2 ,1989 a.d~oundtobeincompianceWiththerequlreme~lsofth~sBu.rd.
RX;UEE BX~URE~ RANGE~ ' FANS
This ~ertifi~ote must ~ot be altered in any manner; return to the
FIELD INSPECTION
DATE COMMENTS
ADDITIONAL COMMENTS:
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
4.
FINAL
EN¥. No. //,,.F~, ,MAP No
r O'~lV, E'
SURFEYED FOR*~O~ ~ .~¢~ ~, ¢~.
-' ' ' -~ [ I~ ~ ' " ~ ~ ~ ~"~
"' LOTS: ~ ~ ' '~ BLOCK: ~, ~UA~ANTEED TO: ,,~
DATE
FORM NO. 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180:3
Appro ed ........ l?Z, Permit
INSTRUCTIONS.
a. This application must be completely filled in by typewriter or in ink and submitted.~ to the Building
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, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property mugt be drawn on the diagram which is part of this appli-
cation.
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 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, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary inspections.
(Signature of applicant, or name, if a corporation)
....
(Mailing address of~plicant)
State whether applicant is owner, lessee, agent, architect, engineer,~ne~al co~_~tra~br, electrician, plumber or
builder.
(as on the tax roll or latest deed) --
If alyi~i~nt is a cj~13or~'g~at ~u~r~e of duly authorized officer.
(Nart~ and title of corporate office~
Builder's License No..., .~-../. g.~. .............
Plumber's License No..,~.....~....
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
ouse Number "' Strm Uamtet
County Tax Map No. 1000 Section ...... .t~...~..~. ..... Block .. ..... ~. .........Lot .... ~ ~-. ..........
..... ~ ..... (Name) -. ' .......
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... g. .,. ........................
b.
Intended
use
and
3. Nature of work (check which applicable): New Building .......... Addition .... Alteration ..........
Repair .............. RemOval .............. Demolition .............. Other Work ...............
i (Description)
.
4. Estimated Cost .......................... ee ................
(to be paid on filing this application)
' Z~. N her of dwelling units on each floor
5. If dwelling, number of dwellinglunits ............. um ................
If garage, number of cars
6 If business, commercial or mixed occupancy, specify nature and extent of each Wp, eof use .....................
· · ' : ' 3 pth
7. Dimensionsof,.exisarlgstrnctures,~fany: Front .... ,/6 ....... Rear ........ De ........
;:~ ct/. '- N mb est
'ght '
Hel ............. u er o ones ..................... t' '- ............... ' ' '; '"' ' 3. ....
Dimensions of same structure With alterations or addi~i~)ns: Front .... /.Q...(* ...... Rear ..../.~.... ~ ........
Depth ....... .~· .c~.' .......... Height .... ~?..~.'...,. ......... Number of Stories ...... ~ ............
8. D~mens~ons of e.n~ire new construction: Front .... l'. ~ ...... Rear ........ ~ ..... Devth . .. ~:~. O...¢. ....
.,H.e~ght .../.~.. ........ Nu_m_be.~r of Stones ........... .~. ..... ~ ...................................
9. S~ze of lot. Front ....... ./.'.778 .......... Rear ........ /. ~..$ ......... Depth ... ~...~. ........ .t. ....
10. Date of Purchase ... ..... Name ?fFormer Owner . . dr~.~,..~.k~ ..
11. Zone br use district in which premises are situated.., t~.~-..~, t. ~ .~t~'~c?~.{. ............... ~r~.
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. Will lot be regraded ...... ~.:..,,, ..... ~ .... Will-excess,fill be removed from premises: . Yes No
14. Name of Owner of premises . ~d')'~''''''~ ~/f6. ~..tt. ro. ~ ~ (. v'7. Address ...~.~.. ~qe...-q,. Phone No.. ~. ¢$7-. :'-./'.
Name of Architect ......... i .................. Address ....... ~.q¥,3i'~rr ~-{. Phone No ................
Name of Contractor . .~--~}~. ~ ,~., .............. Address ' ~5"'~.~' ' ' '-' ....... Phone No. ~Y~ 7.7 ~. 7.c-./..
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 corner lot.
STATE OFNEW x~ORK/ . / 'S S
· .[.% .,/....r· ..t,~ . .. ~.O.d..~'lq'~ ..... : ..... n ..... ''
(Name of individual sig~ing contract)
above named.
being duly sworn, deposes and says that he is the applicant
He is 'the .....................
:, ~gent, corporate officer, etc.)
of said owner or owners, and is duly authonz'~c'd°eo~perform or have performed the said work and to make and file this
application; that all statements contained, in this application are tree to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before m~t,~s
........ · '~. ¢...~. ...... day o~-..~~', ,"19 .~..°'~'
Notary "ub'~ .~4'...
Nota~ Public, State of NewYo~ ' ~ .......... ~ ......... ~ ''~'''~ ....
~m~isslon Expires March 30, 19~ '
GY
DRAWING NUMBER