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HomeMy WebLinkAbout14947-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16782 Date April 11, 1988 THIS CERTIFIES tb ilding ALTERATION & REPAIR at the bu ................................................ Location of Property 1435 Smith Road Peconic, New York House No. Street Ham/et County Tax Map No. 1000 Section 098 .Block 04 ..... Lot 16. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 22, 1986 14947 Z ..................... pursuant to which Building Permit No ...... ' dated . . .J.u.n..e..7.,....I 9.8.............6 . 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 ......... REMODEL & REPAIR EXISTING ACCESSORY BUILDING AS APPLIED FOR The certificate isissued to MICHAEL & HARRIET GREENBERG ..................... .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO p e n d i n g -. 8 / 1 0 / 8 7 . PLUMBERS CERTIFICATION DATED: April 7, 1988 - Mattituck Plumbing & Heating Corp. Budding tnspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERJv~IT MUST BE KEPT ON THE PREMIS£$ UNTIL FULL COMPLETION OF THE. WORK AUTHORIZED) N.o 14947 Z Permission is hereby granted to: .......... .~..~.~.~.....~.~...~...,-/....j.(..~.,..~ .......... ..~~....~....,.._~ ...... .~..~ ............. .;..~ ........ , .............................. at premises located at ..... L~....~....~.....~......~ .............. ~ ........................ pursuant to application dated ...... ~..~.....'~.....2~.. .................... , 19..~..(e.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 765- 1802 L/,~ 0~f~,~ ;~. APPLICATION FOR CERTIFICATE OF J . i ,.struct:o.s A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograp~iic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pz~operty showing all property tines, streets, buildings 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 buildings or premises, or other pertinent informa~ tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling~$25.00, Accessory ~.$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 'f/P--.~ / 5.Updated C.O. $ 50.00 Date ......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. ¢ /'Vd. t Location of Property ...................... ~1 ................ c~ .............. House No. Street Nam/et OwnerorOwnersofProperty L~. ~. /~ ~ ( ,ET ~ /~ l ~' ~¥/~ E. L County Tax Map No. 1000 Section . Q ~.~...~..C). .... Block . C)..~...~...o. .... Lot...o. { .~ ...~..o..(... Subdivision ................................. Filed Map No..?..~..(. .... Lot No. PermitNo. [.~,?~+7 . Date of Permit GIT/2~j .Applicant /-//~/E..7[..~. c~IA&/- Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. j .(~.'.-7~.. .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant . . ............ Rev, 10-10-78 FIELD INSI~ECTION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye ADDITIONAL COMMENTS: TOWN OF SOUTE~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL 8OUTttOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner i',~ (please print) Plumber ~, ~ ~p~e~e I certify that the solder used in the water supply system ~ontains less than 2/10 of l%'lead. Sworn to before me this Notary Public,~9oll< _County (p ~ zgn~q~u~e ) TOWN OF $OUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 119 TO Whom This May Concern, TEL. 765-I 802 We are unable to complete your Certificate of Occupancy because.of the following reasons. /~/An application for Certificate of Occupancy is not on file. cW J No Underwriters Certificate on file. The check is(outdated/not on file.) ~]~©o No Health Dept. Approval on file. No final inspection has been made. Please contact our office on this matter, Thank you for your cooperation. ~Building Permit # ~ .f// ~ J/ ~ Building Dept. /~Co~ i~; ***/~No Plumber Solder Certificate on file. C ( all permits involving plumbing being issued after April 1,1984 ) Z~ io~ ,06'091 oz l°7 NvION.I FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTh/IENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined . .~. ~1,~05~.~. ..... , 19 .~.~. Approved.. ~/~A,~-4..~. ., 19~..~. Permit No. ! .~..CI.~..~.~. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BLDG. DEPT, TOWN OF $OUTHOLD Received ........... ,19... INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 oh 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 g~anted 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 neces~~ (Signature of applicant, or name, if a corporation) z. .................. ,4e_ae / / .? . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... .......................................................... : ................... Name of owner of premises .~. { .C.~.0.~../-. ~. ~.At..~.~. I..~ iT...~...~.~'.-~..~.~.&o. 6:./.~;;.~~ .4 ... ~. ~l~'~'O,~/. · .~.'../?'-?. o..o. 4~. g.. (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....P...~. ]. ! .............. Electrician's License No.. ~.~.. ~. 7. ~ ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · ................... ........................ House Number Street Hamlet Ol ~. O01 County Tax Map No. 1000 Section ...~?.c/..~..'..O..O. .... Block .. ~.~.: .Q.Q ....... Lot...CO../.(o..O.O. { ...... Subdivision...~y)~.....o,~... ~...~.~ ..... Filed Map No....~..~...! ....... Lot .~.O..'. ~ .c~.... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. ?0..C. ~..~, .~.~..o.?..~....~..O./..~..~.J../~. ~ ................................. b. Intended use and occupancy . .[6't.O..~.K.:..~...'~./~...,:q...~..67./9..). ~.~.,5~ ~ .~..O.O..,~.....qS....-~..~..Q?.~. ~-..~. ...... ! 3. Nature of work (cheek which applicable): New Building .......... Addition .. ~ ....... Alteration .. [ ..... ..ccC'. Rem al Demolitio Other Work Repair ............. ov .............. n ........... ! .......... i ........ ~ i (Description) 4. Estimated Cost o'~/~, C) O Fee (to be Paid on filing this application) 5. If dwelling, number of dwelling units ..... ~ ........ Number of dwelling unit,s on each floor ..... If garage, number of cars ......... 77... ............................... i ............................ 6. If business, commercial or mixed occupancy, specify nnature ~n~d extent of each ty~e of use ....... 7. Dimensions of existing structures, if any Front...q~.,,, ~,~.T. Rear ...~-. ~.,.~.F.q¢.T. Depth. ~..:~. .... Height .... .- .......... Number of Stories ...L .nc. .4 ~ ............... : ............................ Dimensions of same structure with alterations or additions: Front ...~.C>.: 4..~.e.'°~.~7. Rear ...~..d),: ~,..~...e:.~'.. Depth...~-.~.., ,~..../~.*-.3~ ...... Height ..... .--. ............... Number of iStofies...I..nc. ~ ~.-~. 'lC. ....... 8. Dimensions of entire new construction: Front .... /~..O.,../~.~...~ear ..~..O.,.~i...~.~Depth ..~..~..:..~;~..F.e;.~. Height ~ Number of Stories ~ .'.~ .gr..o ~ i 9. Size of lot: Front .. ].C.C.. ~:..~.fF ...... Rear ../.O~.~. 15~-../~-~..~. .... Depth . ./..~. d?.. ~.~..~.~/'. ...... 10. Date of Purchase . ./V.~W.. j.t~ .~.. ............. Name of Former Owner f4::l~'/~.~.~.~.'T/v'tT.z~4q...~. ¥&~.~... 11. Zone or use district in which premises are situated . . ~&-5'(~0.~.,~.-F./,y~c&. ...... ! ........................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ....~..~ ................. ' ........ 13. Will lot be regraded ...... ~t~.z.O.,;' ...... .. ....... _... Will ex,~c.e~ofiJ,lpe.,~ro%mo~from premise% , Yes No 1 4. Name o f Owner of premises c~g.~.~ .q.~.o. 0~ Address e~Z~: t~%X~...~ :J~'~.¥. Phone No.(57/.gD $ ~ B. x .~2~..~. Name of Architect...............~ ............Address ............... ~....PhoneNo ................ f C '~' Add Ph Name o ontractor .......................... ress ............... ~ .... one No ................ 15. Is this property located withinl.00 feet of a tidal wetland? * Yes ..... No ...~. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fi'om property lines. Give street and block number or description according to deed, and sho~ interior or corner lot. //vT', 1o£ , street names and indicate whether t_oT32- ' I00 ~ STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............................................................. i ........................... (Contractor, agent, corporate officer, etc.)I of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wilt be performed in the manner set forth in the application filed therewith. Sworn to before me this ................ · ~..~. .... day of ........ ~'~J .C~..,k ...... , motaryPublic, ...~..~.'../~..~.4t~- ..... ~ County .... f/' i~ign~ure of ap~li;in'ti