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HomeMy WebLinkAbout15943-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. um~TIFI~AT~ OF O~uuPARC¥ No Z-24475 Date JULY 1~ 1996 THIS CERTIFIES that the building Location of Property 2165 BAY AVE~u~ County Tax Map No. 1000 Section 31 Subdivision ADDITION & ALTERATION EAST MARION~ N.Y. Street Hamlet Block 17 Lot 5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in th~s off,ce dated APRIL 17~ 1987 pursuant to which Building Permit No. 15943-Z dated APRIL 28~ 1987 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 ALTERATION & ADD TO POP~H ON EXIBTING ONE FAMILY DWELLING A~ APPLIED FOR. The certificate is issued to DONALD & JEAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N-821647 - JULY 23~ 1987 N/A lding Inspector / FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 15943 Z County Tax Map No 1000 Secti~.....~...~. ...... Block ........ .~...~. ....... Lot No ....~...~.~.. ......... pursuant to application doted ....... ]L..~. ..................... , 19.~...']., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWi~ OF SOUTHOLD BUILDING DEP ARTMEzNT TOrJN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~YCY Jl,I TOWN Thas applacataon must be failed zn by typewr:ter OR znk and submztted to the bualdang znspector wzth the followang: for new bualdzng or new use: I. F~nal survey of property w:th accurate locataon of all bualdings, property lanes, streets, and unusual natural or topographac features. 2. Fatal Approval from Realth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electracal znstallataon from Board of Fare Under, raters. 4. Sworn statement from plumber certzfy~ng that the solder used zn system contaans less than 2/I0 of t% lead. 5. Commerc:al bualdang, Lndustraal bualdang, multzple reszdences and s~ma!ar buatdangs and znstallations, a certafzcate of Code Complaance from archatect or enganeer responszble for the bumldang. 6. Submat Ptannlng Board Approval of completed site plan requarements. For exzstang buald~ngs (prmor to Apral 9, 1957) non-conform:ng uses, or buald%ngs and i. Accurate su~gey of property showzng ail property lanes, streets, buzldang and unusual natural or topographac features. 2. A properly completed applzcataon and a consent to anspect szgned by the apptacant. If a Certafzcate of Occupancy zs denaed, the Buzldmng Inspector shall state the reasons therefor zn wratang to the applacant. C, Fees 1. Certafacate of Occupancy - New dwellang $25.00, Addatzons to dwetlang $25.00, Alterataons to dwellang $25.00, S~rzmmang pool $25.00, Accessory bualdang $25.00, Addataons to accessory bumldang $25.00. Busznesses $50.00. 2. Certafacate of Occupancy on Pre-exast~nR Bualdanm - $100.00 3. Copy of Certificate of Occupancy - . .25~ 4. Updated Certafacate of Occupancy - $50.00 5. Temporary Certafacate of Occupancy - Resadentaal $i5.00, Commercaal $15.00 Date .... .~.: .~. ?.: ~..~. ........................ New Constructaon...~. ...... Old Or Pre-exastang Bualdang ................. :ocataon of ................ ...... ........ Eouse No. ~treet H~mlet Onwer or Omers of Property ~~.~, ............................. County T~ ~p ~o 1000, ~eetaou .... .~/. ...... Block .... XZ ........:or .... ..'¢2--. ............... Subdav:sion .......................... % ........ Fzled Map ............ Lot ...................... Pe=~at :o ............... ;a~e Of ~ealth Dept. Approval .......................... Underwraters Approval ....................... Ptannang Board Approval ........................ Request for. Temporary Certafzcate ........... Fznai Cartacate ........... Fee Submattad: $..~..~..~.~o. ..................... ~'e.a~z/y 75 OU~DATIO~ (~ OUI~DAT I 0~ ( 2nd ) OUGH FRAME~~'~'~' PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 46 Roundabout Road Smithtown, NY 11787 April 23, 1987 Southold Building Department Southold Town Hall Main Street Southold, NY Att: Mr. V. Lessard TOWN OF 'SOUT~pLD Dear Mr. Lessard: Please find enclosed three (3) sets of blueprints (3 copies of each) for your office files. After conferring with our builder, we have revised the front porch dimension to 14 feet rather than 12 feet. This change is reflected on the new prints. tn a telecon today I advised Gary Fish of this change. We wish to thank yon and your very pheasant staff for their help and courteous assistance we received when we filed for our permit last Friday. Very truly yours, d Don Vazquezu// 2165 Bay Avenue East Marion, NY .31 THE 1135064 D,t. July ~3, THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 1~5 JOHN STREET, NEW YORK, NEW YORK 10031~ o~y the e~ectrtcaJ equ~oment as described below a~ int~uc~ by t~ a~[cant ~m~ on the a~e appl~cat~ nu m~r ~n the prem~s of T[acK li~h[Lng 8'-0", 3 li~ Moziches 5ay Elect. 55 P~%e ~dge Dr. E. Moriches, N.Y. 11940 Lic # 34 76E Per Th~s certificate must not be altered in any manner, return to the off~ce of the Board if incorrect Inspectors may be idenhfled by thmr credenha[s COPY FOR BUILDING DEPARThiENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] I~ULATION [ ] FRAMING [~ FINAL [ ] FIREPLACE & CHIMNEY DATE [ ] FRAMING REMARKS: 765-1802 BUILDING DEPT. ~ INSPECTION / ~FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE .~/'~/~ ~ INSPECTOR/~'~~/~ Examined ~,X,O~. ~.~ . Approved ~.. Disapproved a/c . .. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY C, OUTHOLD, N.Y. 11971 TEL,: 765-18013 CALL ................ MAlL TO: ,19. ] (Bmldmg Inspector) APPLICATION FOR BUILDING PERMIT Date ./.7 .,~,P,,~/.d-. ..... 19' INSTRUCTIONS a Ttus application must be completely filled xn by typewriter or in ink and submztted to the Buddmg Inspector, wi~ sets of plans, accurate plot plan to scale. Fee accordmg to schedule b. Plot plan showing locatmn of lot and of bmldmgs on premises, relationship to adjommg prem:ses or pubhc Sir. or areas, and gxvmg a detmIed description of layout of property must be drawn on the dmgram which m part of this at: cation c. The work covered by tlns applicatmn may not be commenced before issuance of Budding Permit d. Upon approval of this apphcaUon, the Building Inspector will issued a Bulldmg Permit to the applicant. Such pe~ shall be kept on the premises available for inspection throughout the work e. No braiding shall be occupied or used in whole or m part for any purpose whatever untd a Certificate of Occup~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Braiding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmance Regulations, for the construction of buddmgs, additions or alterations, or for removal or demohhon, as herein descnl The applicant agrees to comply with all apphcable laws, ordinances, buddm~g code, housing code, and regulations, am admit authorized inspectors on premises and m bmldmg for necessary lnspe~l.6ns ~ ~ / ..... (S~nature of apgkeant, og.,~me, ~ corporation) (Malhno address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or built · . ............................... Name of owner of premises /.~p/JdL~ c~, .~..~.~.,~..AT..d~ .P.d.Z.~.&'~:,~ ....... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and t~tle of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No . ./,tP."~. ~/L2.tg'.,l' ......... Plumber's License No Electrician's License No Other Trade's L:cense No 1 Locatmn of land on which proposed work wdl be done :~ i~]..~/~P/~-~ ........... ltouse Numbe' r Street Hamlet County Tax Map No 1000 Sect,on 03/ Block . '17 ......... Lot. Subdtvmmn Filed Map No Lot (Name) 2 State ex:sting usc and occupancy of premises and intended use and occupancy of proposed construction t a Ex,stmg use and occupancy 5,~'~ ~MIL/]"·./~z~'J~z{/.xP6 . .. b Intended use and occupancy .~-~--~/.~. t~-Q~I~ ....................... 3. Nature of work (check which apphcable) New Budding . .. Addition ......... Alteration Repair ... Removal .... Demolition ....... Other Work ........ (Description) 4. EsnmatedCost i~.J'~Qt2, r.Oq ............... Fee .................. · (to be paid on filing this apphcatlon) 5. If dwelling, number of dwelling units .5'./~(E' ...... Number of dwelling uruts on each floor ......... If garage, number of cars ~¥.0/9. ¢- ........................... 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ./va ........... 7. Dlmensionsofexlstlngstructures,~fany Front /~,~- , Rear ........ Depth ~ .......... Height /(9 ~..r-. Number of Stones .19-~ ....................... Dumensions of same structure with alterations or additions Front ./~fT- .4'./~0. .. Rear Depth .17 ~ . .Height ./&f?' ~Yt.~¢., ~.q~.~.g.'~a.~. Number of Stones. f, ca¢~. .......... $ Dimensions of entire new construction Front .. Rear ........ Depth ....... Height ............ Number of Stones ......................................... 9. Sxzeoflot Front ~57'. ,e;¢ ...... Rear ,.qW'~( ........ Depth ,X. tg¢.(.~ ........ 10. Date of Purchase ~f4~3ff./~.7¢' ............. Name of Former Owner .¢ff/l~ .t4/., :5,4/.a/.~ ....... I 1 Zone or use district in which premises are situated ........ 12 Does proposed construction violate any zoning law, ordinance or regulation .................. 13 Wiillot be regraded /4~ ........... Will excess fill be removed from~remlses. 14 Name of Owner of premlses~.~.'77 g..4Z-q9v'~Z- ..... Address ~O.~.~.~:r~. $~.'r~'~'e No .TZ.~.- Name of Architect .............. Address . . .~ ....... Phone No ........... Name of Contractor ~,~m~3 ~.ff..J~Jfg,)~.~ ...... AddressSy,4)',a~-fi.¢a .... . ~Phone No 15. Is th±s properW located w±~h±n 300 feet of a tzdal wetland? *Yes Y;.... bio *If yes, Southold Town Trustees Permzt maybe requ~_red. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back d~rnenslons fro~ property hnes Give street and block number or description according to deed, and show street names and indicate wheth. interior or corner lot. STATE OF NEWdgTDR~, /,/ ~ ,. COUNTY OF .~ . ~ a .. Z~ Cx/dl/....21._ ,v/i. _,~ (~,4.7d~q¢.Z. ........... being duly (Name of individual s~grung contract) above named sworn, deposes and says that he is the apphcar He is the ¢)~U.4/~/2~ ......... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file th apphcatmn, that all statements contained m this application are true to the best of his knowledge and belief, and that tl~ work wzll be performed in tl~e manner set forth in the application filed therewith. Sworn to before me this .. ./7. .. dayof../q-~.'~/.'( ........ ,19.~7 Notary Public ......... .~ .~ County ,? , .......... m, State w York (,,-/ / fdSggnature of apphcan Te, m £xp~res October 31~. 19 ~ 3 2 1" REVISIONS DATE APPROVEO D x_ c};. I.STlX[c~ 5T©op ,: r?£LuC:,.TE ) To'P VIEW OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE C B A 4 3 2 1 REVISIONS DESCRIPTION DATE APPROVED MA¥CN Ex. 15TI iq6, 'ROOF 5HiNaLE5 LOC~L)6T ~'03T3--' /~" o,C, ,,, ~--- 2 x 8 FLoo~ ~To~ST5 eON TRtiC TO~ : ON do,ve~'~T~ D C B 4 3 ,, 2 1 REVISIONS DESCRIPTION DAT£ APPROVED (~ELOeATE) E kaTRANCF- ~.ELOOATE) FRONT ELEVATION VIEW "A-A" IFT D C B