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HomeMy WebLinkAbout15787-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19498 Date NOV. 13~ 1990 THIS CERTIFIES that the building. ONE FAMILY DWELLING Location of Property 260 FLINT STREET GREENPORT House No. Street Hamlet County Tax Map No. 1000 Section 048 Block 002 Lot 025 Subdivision GPT. DRIVING PARK Filed Map Noo 369 Lot No. 81 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17, 1987 pursuant to which Building Permit No. i5787Z dated MARCH 21r 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 ONE FAMILY DWELLING, AMENDED TO INCLUDE 2ND FLOOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED FLINT STREET CORP. 87-SO-46 MARCH 1, 1990 N002756 JANUARY 21, 1988 PAUL DINIZIO JUNE 20, 1990 Rev. 1/81 I~OE,~[ NO. 1~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15757 Z Date .........I ............................................. ' ' Permission is hereby granted to: .............................................. at premises located at .~....~....~.......~..~...o~ ....... ..,~..~.~ ................. County Tax Map No. 1000 Section ..... ..(~... ............. ~;~ Block (~ ~ Lot No. a~. ~ · .....~ / 19.?..~...., approved by the pursuant to application dated ......... ~....C.~ ......... .~. .......... , .. and Building Inspector. Fee $. ,~,,.,~, .,~.. ° ?. ~) Rev. 6/30/80 Form No. 6 7~o____~ 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 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 Approval of completed site plan requirements.~ For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. 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 iI~ Y":'?~ Date ................................ . . Jew Construction.....~. ..... Old Or Pre-existin~ Building ocation of Fro e t,, ............ House No. Street Hamlet o n rs o, ;ounry Tax ~ap ~o [000, Section .......... B~ock ......... ... . . *~ot ................ ...... ;ubdivision ....................... .. . ..........Filed Map ......... ... Lot ...................... 'ermit No...~ '. ..Date Of Permit. An~lic~r A/ [ealth Dept. Approval ...Underwriters Approval lanning Board Approval ....................... . equest for: Temporary Certificate ........... Final Certicate...%. .... eeSubmitted: $~ ....... J~.~.~.~.~- ............ i ...~.'.~-.g( ..~..~..~?~7.~ .;~'.~..~..J ~'~'~ ~,,~,fl~. ~o z/~ , . ............ , ......... APPLICANTv TOWN OF SOUTIEOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No._/~7~7 2. (please prl~t) , Plum~er .... (please print) I certify that the solder used contains less than 2/10 of 1% lead. in the water supply system Sworn to befor~ me this 19~ NOtary Public, County (plumber's sig~ture) Notary Public No._4707878,.Suffdk._C~nly~. Expires M~mh 30, J-~ ;'; OU~IDATION {l~t) OUNDATION (2nd) OUGH FRAME¥// PLUMBINd iNSULATION PER N. STATE ENERGY CODE FI~IAL · ADDITIO~I~L MMEN[ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING-- FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~/INSULATION FRAMING FINAL REMARKS: DATE INsP?C??R-/~ "._.~BBU765'1802 ILDING DEPT. INSPECTION [ ],~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION AND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ F//OUNDATION] IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] F~RAMING [ ] FINAL DATE _ INSPE~C_TO 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION /~/FRAMING [ ] FINAL DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N,Y. 11971 · TEL.: 765-1802 Approved .}/'~ O-~cg-~O & / 19~.?. Permit No / Disapproved a/c ..................................... ...................................................5'~ ........ Ooze (Building Inspector) APPLICATION FOR BUILDING PERMIT Received. ........... ,19... 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 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 building for necessary inspections. ........... (Signature of3p~licant, oA' name, if a corporation) ............ g~,...z4/.~ z'... ,..s?/ ............ ....... ........ ifi~-~/ifi~' aadres~ '3~' ~licant 5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · .O..vo.W.4.'2. ................................................................................... Name of owner of premises.. E/!'.'~/./. .... . .~. '. .... .~.' .0.('..~., ............................................. (as on the tax roll or latest deed) If applicant i~.orpo~i, on, signature o f % authorized officer. .......... ...... ........ (Name and title of 6°orporate officer) Builder's License No ........ .~.~./.~ ............ Plumber's License No ......... ,S.'.e[ ?. ........... Electrician's License Ne ....................... Other Trade's License No. ~'e/f '1. Locationofland onwhich proposed work will be done .... ~L~¢... ~.¢ ........ 5..~.~,.~e,4....xix.~./..~.¢/ House Number Street Hamlet County Tax Map No. 1000 Section ....~..? ........... Block .... ~ ........... Lot...'.~: .'~5... .......... Subdivision ..................................... 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 ..... . .~'.&.~.~.~../0..75.. ............................................... b. Intended use and occupancy ~. ~&.~( 3. Natureofwork(checkwh~ch!apphcable) New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ' '!~ ' '~ ' rD ripti ) '. ".'_ esc on 4. Estimated Cost ................................ ~..,~ .~.OO Fee ............................. -.. ...... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .~. ....... Number o f 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 struct¢res, ifany: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same stmcture~with alterations or additions: Front ................. Rear ................. Depth ................ : ....Height ..... .~ ...... Number of .Stories .... · ' ' : ' ont ~ ~. ' Re r o2 ~ - Danth ............. 8 Dnnenmon of n F · s entire new constructlo r ..... a . .~.0 r. Nflmber of St rie .~w.i ............. - ............... Height o s .................................. 9. Size.of lot: Front ........ .'-~..O.,.r ......... Rear ...... .,.~-.O../ ........... Depth "'--...~.4'~'/"""""""""'~' '"~.'~t} ........ 10. Date of Purchase ..... .~.~. ................. Name of Former Owner ...,J..g:p.,a.~/ ......... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............................. 13. Will lot be regraded ....... i.,~ ·. tt/~. ............. Will excess fill be remov,ed from premises: ~ No 14. Name of Owner of premises . i[':./(i~... ~...f-..~..OcP Address .~[~O.og.~..~.. <~'.,,~,.,,Phone No ~Z~-~.. Name of Architect ~¢{~...l~q~,.~...~.ot.'/~O¥-) '-q~a',~},~ddress ~,.~ z//~vv~' Phone ~,,' ~¥r ..... Name of Contractor ......... ,~./.~. ............. Address ................... Phone No ................. 15. Is this property locate~ within 1100 feet of a tidal wetland? * Yes ..... No~¢~,. · If yes, Southold Town T?ustees Permit may be required. 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 N~r~/ORK, COUNTY ~~-Y~ ~S . ....... .......... above named. being duly sworn, deposes and says that he is the applicalt .e the ........................ · .................................................. / ~gent, corporate officer, etc.) of said owner or owners, and is dgly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application am true to the best of his knowledge and belief; and that the work will ¢e performed in the mantlet set forth in the application filed therewith. Sworn to before me this i .......... ~. · .~. ...... day6f ...... ~.. , 19 ~..~ ~ ~.5~tat,,e<~_.N.e~w_.Y.o_~. ' (Signature' o f applicant ) , No. 52-8125850, Suffolk COulllP/~ ' I Term Expires O~tober 31, 19 '~' '