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Home My WebLink About10853-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~T~NT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCcu~AN~-~' No Z=24268 Date APRIL 8, 1996 THIS CERTIFIES that the buildin~ ABDITION Location of Property 3500 GRA~HWOHL ROAD House No. Street County Tax Map No. 1000 Section 110 Block B Subdivision Filed Map No. NEW BUFFOLK, N.Y. Hamlet Lot 4 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 19, 1980 pursuant to which Building Permit No. 10853-Z dated SEPTEMBER B, 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 2ND FLOOR ADDITION TO EXISTING oNE FAMILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOHN & LAURA BABAS~%K ~/A H-049289 -MAR~H 27, 1996 N/A Rev. 1/81 N°. BUILDING DEPART~EhJ, TOwbl iHALL ! SOUTH'OLD, N~. Y. E~!Ti BUILDING~ P (THIS PERMIT MUST BE KEPT oN IH,E PRE I.S[S UNTIL ~ULL COMPLETIdN OF THE WORK AUTHORIZED) 10853 Z Permission is hereby granted to~-~ ...~ ..... ..... ~._~...: ........ ,-~ .......... '¢':~"~'",-' ~. ,o ........... ~Z~. ................................... , ...................... ,..~ ~_~./2~...¢..~ ....... d.c.. ................ ~/~/~ ~ /,1~ , ~ , .......... ,~ ........ ~ ................ ................................~ .~ ~ _,.. ................................ ...... . ~.~ ~. ~ ~ ~ ~ ................ ,.,.~...~ ........... ~... ...................................... ~un~ Tax ~op ~o. 1000 S~ct~on ~ ............. ,..~. ~l~k ~ .......... .~kot ~o.~ ........................ pcrs~*n~ xo ~pp,uu,un;u~ ........ ~ .......... ..........~.%...._ ~..., ~nd ~pproved by ~he Building Inspector. ~ :: Form No. 6 TOWN OF SOUTHOLB 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 inspector with the following: 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 from 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 Planning Board Appluval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. ' If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. 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. Certificate of Occupancy on Pre-existing Building - $100·00 3. Copy of. Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 · ....... Date . . ~, .~.~.>. ~.~.~.~ ...... ~f New Construction .... ..~ .... Old Or Pre-existing Building ................. ~ocat±on of P~operty .................. ~,. ........ ~ ............. ¥~ ....................... House No. Street Hamlet Onwer or Owners of Prope .................. ty io ............... Block ............ Lot.. ~ .......... Coun Tax Map No i000, Sect ~ kk~ ~ Subdivision ..................... .. . ............Filed Map ............ Lot .................. ... . Permit No ...... Date Of Permit ................ Applicant ..... Health Dept. Approval ...................... Underwriters Approval .............. Plauning Board Approval . Request for: Temporary Certificate ........... Final Certicate..Y~ ...... Fee Submitted: $ .... ~... ;~. .................. 5to ¢ ........ · J~PPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS ~3~%'32[~] BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK. NEW ~YORK 10038 Date i'~C'~ ? ] ~ ~ ~9(~ ~pplication No. on file [~ ~/~ THIS CERTIFIES THAT o~y t~ el~trical equipment ~ ~srribed below a~ int~uc~ by t~ applicant ~m~ on the a~ve application number in the premhes of [AUR~ ~r3ASHAK, ~5(;~ GI4~HWO_L R'~AD, ~EW S~'FOL~ N,Y~ u~s examined on []~C} ] 2 ~P ~ J ~6 and found to be in compliance with the NaMona! ElectOral Code. NE~ ~3~}PPO1,K, NY, 1.195G Per-- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] IN..SULATION [~FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSU~U~I.ATION [ ] FRAMING [~]~NAL [ ] FIREPLACE & CHIMNEY DATE FIEL~ I~PECTION \ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY FINAL ADDITIONAL FO~M NO. 3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL To ~,~.,~,.:~,~.~ .............. '.-.~.........~.~...,.~ ............................ PLEASE TAKE NOTICE that your appJicatio,jofed .. ~.~ ........ ~.~ ......... , 19~ for perm,t to construc~Z~.~l~/~t the premises located at .................................... ~.~.~.~..:~....~L~.... ~oa ....... ~.~. ........................ .......... d~s~pproved on the ~oHo~,ng grounds ~.~...~.~_.~..~.~ ......... r ......................................... ~ ........ ~" '~ ................. . Building Inspector FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approve_ ...//..c~a~"~ ~. .... , .. Disapproved a/c ................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No../.~ ~. ~.~. ...... 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 of lot and of buildings o~n premises, relatmnship 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 wilt issue a Building Pern~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 Occnpancy 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 i~ns.__,.~ (Signature of applicant, or name, if a corporation) (M'ailiA~ address o~ appii~a~t)¢ ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .............................................................................. Name of owner of premises . .~.o.. to...~ .'.-'~ f)~o.O-.~¥~g ~.. ~p.t~..~.~q..O..~..'~t2]~5'~:~.. .............. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...,~ .~.~. ~.~ .............. Plumber's License No ...... ~ ................ Electrician's License No../z~j .~. ) ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................. House Number Street Hamlet County Tax Map No. 1000 Section ... [.l~. ......... Block ...~...~ ......... Lot ..... ~..~. ......... Subdiwsion ................................ 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., rgr.3¢....~[',~ .r;~..;1 ~..C~¼>.~.~[I ~ ~)0.~ ...................................... ~ , b. Intended use and occupancy ... 3. Nature of work (check which applicable): New Building / , Addition 'Alteration Repair .............. Removal .............. Dem/61ition .............. Other Work ............... ~ / (Description) 4 Estimated Cost ~ i (to be paid on filing this application) 5. If dwelling, number of dwelling units .. J..f'¢. q~:~. ..... Number of dwelling units on each floor ................ If garage, number of cars . ~t¢~ .................................................................. 6. If business, commercial or mixed occupancy, speciI?.,nature and extent of e~a~ch type of use ..................... 7. Dimensions of existing structures, if any: Front....~ i~. {"{: ...... Rear . ~. ~. {~'~: ...... Depth .~.~. f. jt... ....... Height ............... Number of Stories . .~.~ra .................................. .~...~ ~ ......... Dimensions of same structure wi[h alterations or additions: Front . .~'~. f.~. ......... Rear..,..~ .~..~: ........ Depth...&..q..C¢~.. ........... J. Height ...................... Number of Stories :. ~ .............. 8. Dimensions of entire new constr~qction: Front ............... Rear ............... Depth ~ .............. Height ............... Number of Stories ........................................................ 9. Size of lot: Front .... ]~o~ ~.O.~.~.~: ..... Rear.../.OQ.'F-i~, ............. Depth . ~i~.'..~.. ~.~.'., ......... 10. D,ftc of Purchase . ./938~/. ~.. i .I.~ .~.o ............ Name of Former Owner . . .--2'0/~.. ~..~t .Sq.~. ............ 11. Zone o~ use district in which premises are situated ...................................................... 12. Does prbposed construction violate any zoning law, ordinance or regulation: .. A/O ........................... 13. Will lot be regraded ....... ~ ................... Will excess fill be removed from premises: . Y,e~s, .. ~ 14. Name of Owner of premises .~'o h~.. I~l:Qo. o.~ )-,~.~... Address ~o~ 6 ~;¢. N.q,~,. ~.a[/~ Phone No. 7.,~ ~.'..S.~. ~ 2..'~. Name of Architect .... ,5.'q..r~.i .~?..~.~?Y.~. ......Address ...; ............... Phone No ...... ~. ...., .... Name of Contractor ~-O/>. ~t~?-~2. i ]'(~.44. ( .~,/~.4.~.~. .... Address ff~. (~...g~, .., ~¢-~.~no, j~ Phone No..?.~.~ :../.8.$. .~... PLOT DIAGRAM ,, Locate clearly and distinctly all ~buildings whether existing or ,l~tropq~ed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to d'Ood, and show street names and indicate whether interior or corner lot. STATE OF NEW YQ~K, ~! /~l ~ ~ '_ ............ ~. ~.~.. ~ ........ ~ being duly sworn, deposes and says that he..is the applicant (Name of individual signing contract) above named. ~e is the ................. ~ ............................................................ (Contractor, agent, corporate officer, etc.) of s~d owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application;:that all statements contained ~ this application are tree to the best of his knowledge and belief; and that the work w~l be perfomed in the m~ner set. forth in the application filed therewith. Sworn to before me this ,' ........... ...... ....... Nota~ Public, ................. ...~~ County . . I No, 52.8125850, $~ffo[~ : Term Expires March 3~1~ (Signature of applicant)