Loading...
HomeMy WebLinkAbout12188-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT. Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUpANcY No Z-18168 Date JULY 6, 1989 THIS CERTIFIES that the building ALTE.RATION Location of Property 54235 & 54255 MAIN ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 61 Block 2 Lot 10.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 13, 1983 pursuant to which Building Permit No. 12188-Z dated MARCH Ir 1983 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which ~his certificate is issued is ALTERATION (STAIRWELL & DECKING) AT ~ OF EXISTING STORE. The certificate is issued to ARTHUR G. ~ ~ILLICENT D. GOSSNER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A pLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspector SOUTH( Pertnissio~ is hereby Dote at pi~rem~ses located at .: ........ '...... and approved by the TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN BALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BU!LDING''~'VACANT LAND ........ Location of Property 5~%~, ~% NA~,o%~ .~..~ ............... . ....... HOUSE NO. STREET HAMLET Owner or Owners of Property. ' County Tax Hap No. 1000 Section ...... Block Subdivision ..... ~l Filed Map Permit No ........... Date of Permit .......... Applicant Health Dept. Approval ~-~x~¢,~ .................. Uoderwriter~ Planning Board Approval -~t~,~ ...... Lot' ' ........ Lot Request for Temporary Certificate ....... Final Certificate ................ APPLICANT .... rev. 10/14/88 FORH NO. 6 TOWN OF SOWEHOLD BUILDING DEP/~T~NT TOWN RALL 765- J802 Be APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for uaw buildings or new use: ]. Final survey of property with accurate location of all bui%!diogs, property lines, s~reets, and unusual natural or topographic features. 2. F~nal approval of ~ealt~ Dept. of water supply and sewers e:-dis - ' Sworn statement from plumber certifying thaC solder used in; system contains less ' than 2/10 of IZ lead. $. Commercial buildings, industrial buildings, multiple residehces and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (Prior to April 9, ]9570 non-conformingl uses, or buildings and "pre-existing" land uses: I ' I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A ~roperly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title companyiwhich shall show single and separate OWnership of the entire lot prior to April 9, 1957. If a Certificate of Occupancy is denied, the Building InspeCtor shall state the reasons therefor in writing to the applicant. 3, Date of any housing code or safety inspection of buildings Or premises, or other pertinent information required to prepare a certificate. For Vacant LandCertlflcate of Occupancy: I. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company!showing Single and separate ownership of the entire lot prior to April 9, ]957isball also aCCOmpany the application. If a Certificate of Occupancy is denied, t:he Building Inspector shall state the reasons therefor in writing to the applicant!. FEES: I. 3. 4. 5. 6. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Addition~ to Dwelling $25 00 Alteration to Dwelling $25.00, Swimming Fool, $25.00. Accesser bui ' ' ' , Y ldxug $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. Certificate of Occupancy on pre-existing dwelling - $100!.00. Copy of Certificate of Occupancy - $5.00 - OVer 5 years $10.00 Vacant Land Certificate of Occupancy - $20.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - $15.00 Residential $50.00 Commercial _,v. FIELD IN F~F E C ?~I ON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY %ODE FINAL ADDITIONAL COMMENTS: 765-1802 FOR P 'LJ~ED 4. FORM NO. 1~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved/~..~..-/~/../..~.., 19 .~.~Permit No...//..~?. ~.d'~ Disapproved a/c ...... ~} ........ ~ ......... .~.. ...... // (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... Application No.../'d/~...~.C ...... 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 must 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 issued '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 Reguiations, for the constru'6tion of buildings, a. dditions or altera~tions, or for removal or demolition, as herein described. The applicant agrees to comply with all applicatSle laws, ordinances, build~ng code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa~ inspecfidns. , I (Signature of applicant, or nmne, if a corporation)' (Mailing'address of applicant) State whether applican~ is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C ............................ (as on the tax roll or latest deed) If applicant is a corporatioI1, signature of duly authorized officer. ~ (Name and title of corporate offf~rer) Builder's License No ........ ~...~../ ........... Other Trade's License No. '~ .... Location of land on which proposed work will be done..P .~. ~..~...~... ~..C(~...~.n~ ........................... House Number Street Hamlet County Tax Map No. 1000 Section ..... .~.). ~.~ .(. ...... Block .... ,~. ~ ......... Lot..Q .I.2: .?.~.,-.~. .... Subdivision .... X ............................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~.. [..~)...~..& ................................................... 3. Nature of work (check whach apphcable): New Building ..... ~ .....Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ...... r ................... Fee ...................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling pnits ............... 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 ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth. ................... !.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...........I ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... i .................. Name of Former Ownar ............................. 1 1. Zone or use district in which pr~mises are situated ..................................................... 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 ................... Address ................... Phone No ................ Name of Architect .......... ~ ................. Address ................... Phone No ...... ~ ...... ~ . V 2'7 Name of Contractor ........................... Address ................... Phone No ........ .O.~. PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. : STATE OF NEW YORK,/ J , / ! COUN OF .~.. . · S ............................ being duly sworn, deposes and says that he is the applicant ~of individual signing contract) 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 cont~ined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne~ set forth in the application filed therewith. Sworn to before me this .......... / ~..-..':day cfi'.. ~..~ .... , 19ff.h Neta~P_ub, lic,...._, n..,--~ ......... ~. County I ~:[ I' '~"':lll hr, IN NEVI E ....... ; ' ' ~%. 5Z-81258§0; ,%flolk ~ (;ountlt T{)rl. Expires g~,!rl:h :10, 19~ ! - ~~__ ' .,~-~¢, ..;, . ~ . - ~,. ,-. - ..... ,· .~_ ,... . .' ..,._ :/ ~'~-":'~- -' ," 4:., ~ 1 * ' ~ ' ..... ' .... ' *'* ~" ' -' ' - / ~"~ ' ' ~ ~ ~' , ~ ~ ' ~ ~ ~,. -. r~ . ' ~' , · ----~ ~ · . , . . .~--~ ..... ~ . ~ .~ 'r. ~ ~ ~. , , ' , ._~ ~.~ ~ .~ ~~.- '- -~-.-~ ~-~=-- .. .~ ..... ~ -.--- ~ - , ....... ,. ~ ~ ..~;, . . ,, - ', ~ " '~ ..... r'r t' ~ '1, ' ~ ". NOTIr'' ~' 'u-,,,,..q ~,7~ ', .PANTME?T AT ..................... . ru . .. :" :" ~FCTIO~S: . '~ "L ._ ~ ~ LTHE R~' ,' ' _ ' ', ~ ~] . . ~ ..... - LuDES. N~T RbSPONS:B!_~ FOR ~ /~ ~=~'~ DESIGN OR CO':}TRIJCTtoN ERRORS.