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HomeMy WebLinkAbout15206-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 8outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17980 Date APRIL 28~ 1989 THIS CERTIFIES that the building Location of Property 3325 YOUN~'S AVENUE House No. County Tax Map No. 1800 Section 55 ADDITION Street Block 5 SOUT~OLD, NEW YORK Hamlet Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 11~ 1986 .pursuant to which Building Permit No. 15206-Z dated AUGUST 28r 1986 was issued, and conforms to all of the requ3_rements of the applicable provisions of the law. The occupancy for which thls certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DW~I.LINGAS APPLIED FOR The certificate ~s issued to GARY & JOAN REMPE (owners) of %he aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DAT~3 N/A ~,-64~ - ~ulldlng .... Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERA41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~5206 Z Permsss~on ~s hereby granted to .... .............................. . .,.... . ... premises located at ....... ..~,...~...~.....~.~~ ~', -.~L,~-. ....... .~~ ........... County Tax Map No 1000 Sect,o/p-~CD~'.'~. Block ...... ¢~..~.. .... Lot No .... ~.'~. ..... pursuant to opphcatmon dat~ ~..~.. l/ ....... , 19.~g, and approv~ by the Budding Inspector Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Budding Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcat~on must be filled ~n typewriter OR ink, and submitted in duplicate to the Budding Inspec- tor w~th the following; for new buddings or new use' 1. Final survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage d~sposal-(S-9 form or equal). 3 Approval of electrical installation from Board of Fire Underwriters. 4 Commercial buddings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a cerbficate of Code comphance from the Architect or Engineer responsible for the building. 5. Subm ~t Planning Board approval of completed s~te plan requ ~rements where apphcable. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey of peoperty showing all property hnes, streets, buddings 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 buddings or premises, or other pertinent informa- t~on required to prepare a certffmate Fees 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exmtmg dwelhng or land use 3. Copy of certificate of occupancy $1 00 $5.00 Date ~...~.~i.L.../c~./. ?. 7..~..~.. New Budding ........ Old or P_cre-exmtmg Bu~dd.!..ng .. Vacant Land .......... Locat,on of Property . ~ .~..~..~.... ~9.~ ~. S...~.~ ~, ........ ~P. ~O ./4. ,. ~. ~ Hou~ No. ~ St~t Hamlet o~.~. or O~n.r.o,,.o.~ ~.~ ~ ~ . G.~.~ ...R ~ ~ ~. s ................ co~ty,~ u~ ~o. ~0oo s~,o~ ... ~.~. ....... ~,o~ ... ~: ....... ~ot...~ .~ ......... Subdivision ........ Fded Map No .... Lot No ............ Permit No. OJ.'7~.J.. Date ofPerm,t r/b..~/~¢~..Appl,cant .~..¢'~t.. h...~J~ ~.~ .~. ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ................ Planmng Board Approval ................... Request for Temporary Certificate ................ Final Certificate ...................... Fee Submitted $ ~.-i ¢7¢ ............. Construction on above described budding and permit meets all~,phcable codes and regulations Applicant...//~0~/1,~....~(-~& ...................... Rev 10-10-78 ee, 3313 %O e ~?~7~ ri£LD i~S!ECTiON FOU~DATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMME TS: Examme~Z~ ~' a. Appro~ t..~,l/'- ~- ~ D~sapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y 11971 TEL.. 765-1802 , 19~¢ Permit No/'..S~"~° i;-~:: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN OF SOUTHOLD Application No a Tins apphcahon must be completely~ m by typewriter or m ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale Fe[l~ rdlJl&to schedule, b. Plot pl~ showmg locahon )~n~ ~ ~w~ses relatmnshlp to adjmmng premises or pubhc stye, or areas, and giving a detmled ~ ~ ~f~ [~o~~ ~ust be drawn on the dmgmm which ~s pa~ of th~s appl c. ~e work cove~ a: ¢1~ ~cOmmenced before ,~uance of Building Permit d Upon approval~T~ph ~o~ ~fi~spector will ~ssued a Building Pem~t to the apphcant Such ~1 be kept on the pre~s%~!a ~%~p~ ~%~ghout the work e. No building shall ~e~B ~ffd 4 ~r m p~t for ~y purpose whatever until a Ce~fficate of Occup~c sh~ have been granted by ~%~ ~ P' ~PLICATION IS HER~ ,~: Building Dep~tment for the lSSU~Ce ora Bmldlng Permit pursuant to th Bmldmg Zone Ordnance of th~ ~n~f Southold, Suffolk County, New York, ~d other apphcable Laws. Ordm~ces o Reg~atlons, for ~e constmc~o~ buildings, additions or alteratmns, or for removal or demohtmn, as hereto described The apphcant agrees to comply w~th all apphcable laws, ordm~ces, budding code, housing code, and regffiatmns, and tt admit authorized inspectors on premises and m bmldmg for necessaw inspections ( ignature of appbcan, or name, ff a corporahon) ' (Mmhng address of apphca~) State whether applicant *s owner, lessee, agent, architect, engineer,* general contractor, electric*an, plumber or bu*Ider Name ofownerofpreimses ~'~ e/. If apphcant IS a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's L~cense No ~' ~ Plumber's License No Electrlcmn s License No Other Trade's License No Location of land on which proposed work wall be done ./ _ a cc~De] $ ~E, House Number ~ Street County Tax Map No 1000 SecUon (as on the tax roll or latest deed) Block APPROVED AS NOTED ._ ..., NOTI~ ~ILDING DEPARTM~T AT t802 9 AM TO ~ ~ ~R THE OWING tNb~C~ON~: ~Otj~DATION ~O R~QUIRED 8~UG~ FRAMING & pLUMBING -~G~ 3F C~ .~S~uCTI~' ~RRORS ,. Lot. Subdlvlsmn Fried Map No Lot (Name) State exlshng use and occupancy of premises and intended use and occupancy of proposed construchon a Ex~stlng use and occupancy .~' 5 ; 4.~/q f~. b Intended use and occupancy ~ ..~ t?t F__ ,~ .. ' *' 3 Nature of work (check wluch applicable) New Budding ....... Addition ....... AlteratioB . .. Repmr . i ~ :'.~' . Removal .... Demohtlon ....... t . Other Work..~ ~...c.K. ·. }'lei,. {~e ,_//-.. /.~t X ] ~/ ~ (Description) 4. EsUmatedCost.. ~/y-- d~a, ~o .... (to be paid on f'fling this apphcation) 5. If dwelling, number of dwelling units. . [... Number of dwelling units on each floor .......... If garage, number of cars ..... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use .... 7 Dimensions of existing structures, if any. Front ~.' t'. . Rear .~t~.(' .. 'l~;ptt~ o,~'y./.'' Height .. Number of Stones Dnnenslons of same structure with alterations or additions Front ......... Rear .... Depth ...... Height ....... Number of Stones ............... 8. Dimensions of entire new construction Front ....... Rear ............ Depth .. Height Number of Stories .. 9 Slzeoflot Front tO'"'O~ 00.. Rear . . 10 Date of Purchase ~&h.~, ]q~& . Name of Former Owner ....................... 1 1 Zone or use district in which premises are situated ............... 1 2 Does proposed construction violate any zomng law, ordinance or regulation' ../4~. ................ 13. Will lot be regraded .................. Wall excess fill be removed from premises Yes N 14. Name of Owner of premlses~q~-~, ,1 ~ 1- ~t. ]~f~)~Address Name of chi ¢t ......... Ad re Pho eNo mame of Contractor /x] r~.. ./c{, /'~.t./,.~. Address PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and xndicate all set-back dimensions fro~ property lines. Give street and block number or description according to deed, and show street names and indicate whethe mtenor or comer lot ~ ~- I STATE OF NEW YORK, COUNTY OF. SS (Name of individual s~gnmg contract) above named. being duly sworn, deposes and says that he is the apphcan He is the ................ (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi apphcatton, that all statements contained m this apphcat~on are true to the best of his knowledge and belief; and that th~ work will be performed in the manner set forth m the application ~ed therewith Sworn to before me this I, ttl.~ ~ I~ VI~ ................................... NOTAIW rustic. Stat~ d Hew Y~k (Signature of applicant _ ~ 4707878. Sm'f01k Count~7 '7 Term F.x~es ~arch ~6, ) ~ ~Z o,q ~ AT' ,5o u TZUOt. O. /,7. ~.".