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HomeMy WebLinkAbout15469-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22581 Date SEPTEMBER 10~ 1993 THIS CERTIFIES that the buildln~ Location of Property 255 GLENN COURT House No. County Tax Map No. 1000 Section 83 Subdivision ADDITION CUTCHOGUE~ N.Y. Street Hamlet Block 1 Lot 3 Filed Map No. Lot No. conforms substantially to the Appllcatzon for Building Permit heretofore filed in this office dated NOVEMBER 5, 1986 pursuant to which Building Permit No. 15469-Z dated NOVEMBER 7r 1986 was issued, and conforms to all of the requzrements of the applzcable provisions of the law. The occupancy for which thzs certifIcate is Issued is DORMERADDtTION TO EXISTING ONE FAMILY DW~.T.INGAS APPLIED FOR The certificate zs issued to JOANNE BRYAN (owner) of the aforesald building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-803370 - APRIL 13~ 1987 N/A Rev. 1/81 Inspector l~Ol~[ NO. =1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 15469 Z Permission Is hereby granted to: ...~.~...~..~,~ .......................... Co~n~, ,~ ~op s~ ~~o0o s~,o~ ~_~ ~k .... ~.[ ...... ~ot ~o..~..~ ........ Budding Inspector. Fee $. ~ ,~ ........ Building Inspector Rev 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Thzs application must be filled zn by typewrzter OR ink and submztted to the buzlding inspector with the following: for new building or new use: 1. Final survey of property wzth accurate locatzon 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 installatzon from Board of Fire Underwrzters. 4. Sworn statement from plumber certifying that the solder ~sed in system contains less than 2/10 of i% lead. 5. Commercial building, industrial building, multiple residences and szmzlar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the buzlding. 6. Submzt Planning Board Approval of completed site plan requirements. For existzng buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showzng all property lines, streets, bulldzng and unusual natural or topographic features. 2. A properly completed application and a consent to inspect szgned by the applicant. If a Certificate of Occupancy is den~ed, the Buzlding 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, Swlmmlng pool $25.00, Accessory buzldzng $25.00, Additions to accessory buzldzng $25.00. Busznessas $50.00. 2. Certmficate 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 ~P~-. ~, 1993 ................ New Construction ........... Old Or Pre-ex~sting Building ................. Locatzon of Property .... 255 Glenn Court Cntchogue, ~.~... .................. House No. Street Hamle~ JOA~E BRYAN 0nwer or Owners of Property .................................................... .. .. . .... . .. .. e ' 83 ! ~ County Tax Map No 1000, S ctlon ............. Block .......... Lot .............. Subdivision ...................... .. . . ... . ......F~led Map ............ Lot ...................... - 15469-Z .Date Of rermzc ................ app±zcant ............................. Permzt ~o ............... ~ _ NOV. 7, 1986 , . SUNRISE CONSTRUCTION Health Dept. Approval .......................... Underwrmters Approval ................ Plannzng Board Approval.......,... ............ . Request for: Temporary Certificate ........... Final Certzcate ........... Fee Submitted: $ .... ~.-~. ................... Joanne Bryan ............................................' ' " 1000784 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICFTY ~1[ ~.3V ~.~7 85 JOHN STREET, NEW YORK, NEW ~8 THIS CE~IFIE5 THAT SERVICE DISCONNECT I NO OF I S E R V I A~T A~aP ~t~ ~lTl~p~ t~2W~I,~3W 3~r3w 3~4w HOOF CC CONDpER~ oFAWGNDcC CO NO O~ HILEG .o OF Fm f2 ¢ E P. O. Box t45 Aquae, N.Y. 11931 Lic~869E S~N'~ Per-- / Th~s cerhficate must not be altered ~n any manner, return to the office of the Board if incorrect Inspectors may be *defltffle~ by their credenh~ls COPY FOR 13UILD~NG DEPARTMEllT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED iH Ally OUNDATION ( 1 s t) OUNDATtON (2nd) OUGH FRAME & PLUMBING iNSULATION PER No Y. STATE ENERGY CODE FINAL ADDITIONAL COM~NTS: 76S-1802 \ BUILDING DEPT. INSPECTION, FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~-~L / ~/l ._~.~' /' // ~ I - DATE ~///~ ~ INSPECTO~,~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND £ ] INSULATION FRAMING REMARKS: [~NAL DATE~//~7 INSPECTOR~~:~/ 2'65.'1802 BUILDING DEPT. INSPECTION VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (5 I6) 765-1802 FAX (516) 765-1823 Town Hall. 53095 Main Road PO Box 1179 Southokl, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD NAME: JOANNE ADDRESS: 255 RE: DATE: MARCH 6, 1989 BRYAN Glen Court, Cutchogue BUILDING PERMIT ~ 15469Z --DORMER SEC. 83 BLOCK O1 LOT 03 This Building Permit has expired. You are now in violation of the Town of Southold Zoning Code. Please contact our office, this matter must be corrected. Yot~rs truly, Victor C. Lessard Principal Inspector r"rl J / Examined 0 ,,~a~~ ] Approved I~ ~'~ Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.. 765-1803 ,19~. , 19~. Permit No } ~ ~ ~-' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ......... 19... INSTRUCTIONS a Tlus 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 showmg location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and gwmg a detmled description of layout of property must be drawn on the diagram which is part of this apph- cation. c. The work covered by ttus application may not be commenced before issuance of Bufldmg Permit. d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the apphcant Such permit 5hall be kept on the premises avarlable for mspectmn throughout thc work. e No bmldmg shall be occupied or used ~n whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Bmldmg Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buildlng Permit pursuant to the Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of bufldm~, additions or alterations, or for removal or demolition, as hereto described. The applicant agrees to comply w~th all apphcable laws, ordmances, budding code, housing code, and regulations, and to admzt authorized mspectors on premises and m buildmg for necessary inspections (Signature of applicant, or name, if a corporation) .-¢. . .-7. .............. (mailing address of applicant) State whether applicant IS owner, lessee, agent, architect, enggneer, general contractor, electncmn, plumber or bmlder . ........................... Name of owner of premises -~--O & t~ ~e-, '-~t'-cl O-,~- ...................... (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer (Nmne and title of corporate officer) Braider's License No Plumber's License No Electrician's License No .... Other Trade's L~cense No Location of land on which proposed work will be done .... House Number County Tax Map No 1000 Section ~( Subdlv~sion ~/~-C_~ 2 Street Hamlet ~ ....... Block ~ .. Lot .... ~. (Name) ...... F~led Map No .. Lot ..... State existing use and occupancy of premises and intended use and occupancy of proposed construction a Ex,sting use and occupancy '~¢.~JC~q~'~ ~[ .................. b Intended use and occupancy '~C-~ ,.cO e~¢.~ ~_.1 . .o2-~ .~ ........ 3 Nature of work (check which applicable) New Bmldang .. Addition ..... Alteration ~'. .. Repatr .... Removal .............. Demohtton .............. Other Work ............... 4. Estmaated Cost 5. If dwelhng, number o f dwelhng units. ./~ ,..~ ~,~,~ (Description) Fee ............... (to be paid on fflmg this application) 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 36,' , ... Rear .~(ot ...... Depth .2.~'~'.'. ... Height ,~ ..... Number of Stones . . .Z ............. , ........... Dmaenslons of same structure with alterations or additions Front . ~/~ ...... Rear. i,~dal ........ Depth . .2~o' .~" . ...... Height ~&' . . Number of Stones . . 8. Dimensions of entire new construction Front . . l~i. . Rear . .I ...g' . ... Depth .?-~ ...... Height . .~.' ~[' . ..... Number of Stones. 9 Size of lot Front ~,o' Rear I0 Date of Purchase ~to-~. ~., t.qi'~.~.... Name of Former Owner ...... 11 Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation 'i. t~¢' i' i. iii i. i ........... 13. Will lot be regraded ..... ]'9..O. .......... Will excess f'fll be removed from premises Yes No 14. Name of Owner of premises Or*H .r?5 . .M..~ .~q. o_~.. Address .~10~ ~4~c~ .Ctxl~.. Phone No..'~3.~- ~¢-/..~ . . . Name of Archltect 5.~ct~e~t ~. ~¼~.o.-., ..... Address tlq..c~9Oe~...:~..l~x~e~ Phone No .......... Iqame of Contractor~CW~o~----~ .~r~.ru~r.~ ~ ...... Address .~. ~o~ .~ g. ~-'b~i~. Phone No..-1.~.q. 7.Gq .~q... 15. Is th~s property located withinl00 feet of a tidal wetland? * Yes ..... No .~. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and, indicate ail set-back dmaenslons from property hnes G~ve street and block number or description according to deed, and show street names and red,cate whether mtenor or corner lot. ~e_ CLC: ~.c-l,,~ STATE OF NEW YORK, S S COUNTY OF ........ . .~"~\ ~ e~-, ~...~_.~O~2~rn~ .......... being duly sworn, deposes and says that he is the apphcant (Name of ~n&vldual signing con~act) above rimed He is the . ~~~ ~ ...................... (Contractor, agent, co~orate officer, etc ) of said owner or owne~, ~d ~s duly authomed to perform or have perfo~ed the mid work and to m~e ~d file t~s ~pphcatmn, that ail statements contmned m ~m apphcat~on ~e t~e to the best of bm ~owledge and behef; and that the work wgl be perfomed m ~e m~ner set forth ~ the apphcatmn filed therewith. Sworn tobefom me th~s z . ..~.~-- ......... ,. ddT of., X~~ ..... 19.~ , ~H CHERE~W)CH ~ t~ -- ,,,, o, ............. (S~amre apphc~t)