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HomeMy WebLinkAbout10813-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-17335 Date: 09/21/88 THIS CERTIFIES that the building DECK Location of Property: 1652 BRIDGE LA/qE (HOUSE NO.) {STREET) County Tax Map No. 473889 Section 118 Block 1 Subdivision Filed Map No. Lot NO. CUTCHOGUE (HAMLET) LOt 4.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 4, 1980 pursuant to which Building Permit No. 10813-Z dated AUGUST 7, 1980 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 DECK ADDITION TO EXISTING DWELLING. 7/29/10 UPDATED FOR ADDRESS CHANGE AND LOT NUMBER CHANGE. The certificate is issued to ROSEMARY TRENTALANGE (OWNER) of the aforesaid building. SUFFOLK COUN~rYDEPART~T OF HEALTH APPROVAL EI~t-rKICAL U~KTIFICATE NO. PLIghtERS u~KTIFICATION DA'rmu N/A ized Signature Rev. 1/81 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 Department with the following: A. 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). 3. Approval of electrical installation fl'om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% 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 Plannlng Board Approval of Completed site plan requirements. B. For exisfingbuildings (prior to April 9, 1957) non-conforming uses, or buildings and ,pre-existing' land uses: I. Accurate survey of propet~o/showing all property lines, streets, building and unusual natural or topographic features. 2. A properly co.mpleted application and ceusent to iuspect signed by the apphcant. If a Ce~ficate of Occupancy is deuied, thc Building Inspector shall state thc reasons therefor in Writing to the applicant. Co 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. CertificateofOc~mpancyonPre-existingBuilding- $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 tXlew Construction: Old or Pre-existing Building: ~ (check One) House N& Street Owner or Ownem of Property: /'~.: ) 1~ ~'r~ ~' ~ ~ ~ be · ~'~8~J' I .t sUffOlk County Tax Map No 100~, Section [1~' [ Lot Ham{et Block- Subdivision Filed Map. Lot: PermitNo. I C~C~ I'~D DateofPermit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~O -00 Final Certificate: (check one) (THIS pERMIT MUST BE KEPT ON 3'H,E PRE,MI:;ES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) os~ z ~, .,~ ~......~ .................. Permission is hereby granted to: ,o ~.~..,~...~,~...~,..;~ ~.,../~.~:.~,~ .................. ..~~.~ ........... ~ ......~....~~/~~ ........ at premises located at .~Z.~.~ ......... ~L~ ~.,...~~) .................................. .................................. ~.~.~.~~ .. ~..,.; ............ t...~.../2~ ............ Bbilding Inspector. ee ........................ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 features. 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 Enqineer responsible for the building. 5.Submit Planning Board approval of completed site plan requiremer~ts where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pzOperty 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. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwellin§.$25.O0, Accessory,S10.00 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.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land .......... Locat oo of.roper ...... House No. Street .... Hamlet Owner or Owners of Property ......... County Tax Map No. 1000 Section ............... Block ............... Lot ................ t I IDw Subdivision ..... ~. ~ ......................... Filad Map No .................... Applicant .................................. Permit No . Date of Permit Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Tempo rary Cer}ificate ..................... Final Certificate ....................... Fee Submitted $ ........................ Constructmn on above described build ng and pern~t~t meet/-I, ..... /, .... ?~? , dppiIc/aDle coaes ano regulations. 0.., 6-'?-'1 . FORM NO. 6 TOWN OF SOUTHOLD Ru|JdJng Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: I. Final sUrvey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 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 property showing ail property lines, streets, buildings and unusual natural or topograph ic 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. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling~$25.00, Accessory.;SI0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ............... New C one t~ ruc t i on ...... Old or Pre-existing 8u Hd~ng ............ Vacant Land .......... ooat on of Property ......... ¢ Z:) ..~.~treet ..... County Tax Map No. 1000 Section ............... Block ............... Lot ................ SubdivlsJon ................................. Filed Map No ........... Lot No ........... Permit No. 1.~..~;~,, ... Date of Permit .......... Applicant .................................. Health Dept, Approval ............. Labor Dept Approval Underwriters Approval ...................... Planning Board · ' Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ Construct on on above described buildin- and er ~t~me z g p ~n _ ets ¢11 applicable codes and regulations. COMMENTS __~__ FIELD [NSP~TION ~ FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. INSPECTOR FORM NO. 1 TOWN OF'SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ....... ,19 Approved .,~../.6(.~... ~. ........ Permit No ............ Disapproved a/c ............. ; ..................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ~?..f./..~. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in mk 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 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 Buildxng Per, nit. 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 Certihcate 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, Ne~AZorlr;m-Kd other~cable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterationS, or for rempval or. ~em~!iti~, as herein described. The applicant agrees to comply with all applicable laws, ordinan/Cg~, b. uild'm~ co~5, housi~. ~ .~. n~.~gula~ns, anti to admit authorized inspectors on premises and in buildings for ~~ ). C .o.2.s. ....................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engine lectncian, plumber or builder. If applicant is a corporation, signature of duly authorized officer· (Name and t~tle of corporaJp officer) Builder's License No ..... ~....~. · ./...~. ~.~ ·.. Plumber's License No ........................ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................. House Number Hamlet County Tax Map No. 1000 Section ...~].f. ~>'. ...... Block ........ /. ........ , Lot....~....". ........ Subdivision .... .~. · .c:N. · .~. ~..~?. .~.~.f., ........ Filed Map No ..... ].~· .~... Lot .............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ...... ~ ........................................... b. Intended use and occupancy .......... : ~ ....... ~..~. ........... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration! ..... ~,~.... Repair .............. Rempval .............. Demolition .............. Other Work...~-'..~.~... '-~r~ ,--- ,~ (Description) 4. Estimated Cost ..... ~.~.~..~...1~... . . ~ ............ Fee. .'~..~.. .................................... (to be paid on filing this application) 5. If dwelling, number of dwellingi units ............... Number of dwetling units on each floor ................ If garage, number of cars .... i ................................................................... 6. If business, commercial or mixeld occupancy, specify nature and ex.tent of each type of use ..................... Dimensions of_e>;isting structures, if any: Front.. ~ ~ ..... Rear . .~...~.. ..... Depth . .c~J~..~.. ...... 7. Height . .~-..~. ........ Number of Stories ......... A ............................................ '"' Dimensions of ~ame structure With alterations or additions: Front .... ¢..c~ ...... Rear...:...~. ~ ........ Depth . .~..~. ............ ~ .. Height ... ~-..~. .............. Number of Stories ...... ~...~.~ r~.,, .... 8. Dimensions of,entir£, new construction: Front ...... ~..t~. ...... Rear .... ,/..~. ....... Depth . .~.'~..~...~. ...... Height .. ~..~...~. ....... Number of Stories ........................................................ 9. Size of lot: Front .......... ~ ........... Rear ...................... Depth ...................... 10. ,D, ate of Purchase .......... '. .................. Name of F~rr~er Owlet ............................. 11. Zone or use district in which premises are situated ..... ~..~..~. { .~.. ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~.O ...................... 13. Will lot be regraded ....... -~-!~.'. .... . ........... Will excess fill be removed from premises: Ye~.~s ~ No 14. Name of Owner of premises . ~,~ i~,.~..~ddress .. ~ .~-:.~..~.. Phone No...'~..~..~.-. Name of Architect ......... i ........."Y .........YAddress ............ ;. ~ .... Phone No ................ Name of Contractor... ~..D~, .~.~.~ ~ ~ .~..~.~ddress . .~..~-.. ~ .~-..~..~ .... Phone No..~. ~ .c/.~ .~. q~.'2. ~.. 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 OF NEW Y,~RK,-- .... COUNTY OF ..~~. .... .x~..~..~...~ ~ ~'-7~J2~ ~. ~g~ ~ .~.~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual Sighting contrac~ above named. ' He is the ......................................................................................... (Contractor, agent, cerper~e ~ficer, et~.) of s~d owner or owners, ~d is duly autho~zed to perform or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~n{r set forth in the application filed therewith. Sworn to before me this ........ D~ ....... day o~. ~~.., 19. ..... FOLt ~/lb-lG iNsPECTIONS' 1. FOL''N?~'~wI©~I "TWO REQUIRED F~ ~Ilo~D coNCRETE ~, ~4'G'-' - nRAMI~IG & pLUMBING ALL CPN'~ .... ~O~ s~-AI-L. MEET TE CONRTRUCTION & ENER~Y~ Southold, New York 11971 516-765-3252