The URL can be used to link to this page

Home My WebLink About14711-zFORM NO. 4 TOWN OF SOUTflOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14872 Date September 12, 19.86. THIS CERTIFIES that the building ...C.o.n.s..~.p.u.c.~...ri.e?...f.o.u.n.d..a ?~.o.n...&..~.e..p.a.i.~.. d. ?.c.k. 1380 Leeton Drive Southold, N.Y.. Location of Property ~S~ ~)~o ......................................................... s . Street Hem/et County Tax Map No. 1000 Section 058 .Block 02 .Lot 002 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated F e b r u a r y 19, 19 86 pursuant to which Building Permit No. 14711 Z dated March 28 86 ...................... 19 .... 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 ......... .N...e.~..f..o..u.n.d.~ .~.6.n..&...d.ec.k.r.ep.a..ir ~.o. ?.x~.s..~.i.n.g...o.n?..family dwelling. The certificate is issued to ·. .Alfrg.d Ay?tell Jr ....... ?oY.'e;, ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ................ .iq/A. ............................. . Rev. 1/81 ..~...~f /// Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER.~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1 ?11 Z County Tax Map No. 1000 Section ..'~"..~..~., ....... Block ....~.....'~... ....... Lot No..¢~..(~.....'~.. ......... pursuont to oppJicotion doted ...~. ......... /....~. ......................... , 19...~...., and approved by the Building Inspector. u ing nspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions BLDG. DFPT TOWN OF SOUTHOLD ..~ This application must be filled in typewriter OR ink, and submitted ,- ~ 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 topographic 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: ~1. Accurate survey of p~"operty showing all prope,rW lines, streets, buildings ,a. nd unusual natural or - ~opograpnl~¢.e~u ;'~a.~ - - 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacan~ Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date New Con__s truc tTM ...... Old or Pre-existing Building ~ Vacant Land Location of Property ............................... House No. Street Ham/et Owner or Owners of Property ..... .~..~¢..~'..~..~7~, .....~..~..~T~.. ~ .... .~..~Z¢.., ............... County Tax Map No. 1000 Section ..... ,~..~. ...... Block .... ~ ........ Lot ..... ~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. \ fi .~..Ii..~. Date of Permit..~. I~.~/.~.~pplicant...~..T-..f¥.'~. J..~....~.. *. ~r~[~ ~ Health Dept. Approval ...... ~ i ~ .Labor Dept. Approval ~ [~ Unde~riters Approval ....... ~ .[ ~ ........... Planning Board Approval ..... ~ I.~ .......... Final Certificate ~ Request for Temporary Certificate ............................................ Fee Submitted $ ....................... '~'~i ' Construction on above described building and,~/~t meets/~l/~plica)~le codes and ~gu I,a~ns. A p p I ica n t/J ./.'~.. ~.'~. ~~~ ............. Rev, I0-10-78 coz IWe FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE 4. / 'INAL COMMENTS ADDITIONAL COMMENTS: STEVE G. TSONTAKIS ASSOCIATES Consulting Engineers BOX 1180, 632 ROANOKE AVENUE 1781 KING EDWARD DRIVE RIVERHEAD, N.Y. 11901 K1SSIMMEE, FL. 32741 (516) 727-7411 (305) 846-0455 Building Department Town of Southold Main Road Southold, New York 11971 March 06, 1986 TOWN OF SOUrHOLD RE: Alfred B. Averell, Jr. Leeton Drive Southold, N.Y. Gentlemen, Enclosed please fins a check in the amount of $30.00 for The the Permit Fee in regards to the referenced project. application was submitted to your office on February 19, 1986. SGT/bp Enclosure cc: Alfred B. Avereil, Jr. Yours Truly, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . J~/~.. ....... ,19~. Approved · .~ ............... 19 ?.. Permit No ........ Disapproved a/e ' (Building Inspector) APPLICATION FOR BUILDING PERMIT U B~.oG o[~r. otl~ [...~owN or'sour" ~ece±ved ........... ,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 ~ 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 of applicant, or name, if a corporation) .~..~...~.~ .~.o., .~ .33..¢.e.~..~..~..-.A.~. e., .~:: ~ .~.~??.,. (Mailing address of applicant) i Ir~~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of o~ne~ of premises ..................................................................... (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... ?..~. ?. ................ Electrician's License No...'~.1~..17 ................ Other Trade's License N01 ?..~. ~. ............... Location of land on which proposed work will be done .................................................. .... ! 3B.O .................. ¢~ .~. . .o.¥. ~ ~:~ ............... ~?~ y.~. .~.c. .~. ................. House Number Street Hamlet County Tax Map No. 1000 Section ..... ~.~..~ .......... Block ..... ?-. ........... Lot .... .~...'.' ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Ex~stmg use and occupancy ....... * ..... .~-~rO. ~.M...C{.~ ~i~.~.~. ~ ............ , ......... . 3. ~4ature ofw.or~(check which applicable): New Building ..... ' ..... Addifion ,., ..... '.'.. Al{bration Repair ...~ ........ Removal .............. Demolition ..... . ....... :... Other Work-. .... " ~ (Description) 4. Estimated Cost ~ ) .~..O .O.C_? ~ Z .C). ~ .... t · .x oo Fee ................ (to be ~aid on filing this application) ~"~} 5. If dwelhttg, number of dwelling umts .~..I..M.% .L.~. Number of dwelhng units on each floor.<~ ] N ~.~ If arage, number of cars hl /~ ............. 6. If business, commercial or mixed occupancy, specify nat})re and extent of each typic of use . [O./.,A~..,~.. ;, ......... 7. Dimensions of existing structures, if any Front...~.~ ......... Rear . j .Z.~..i ....... Depth....47. .......... Height . .~.J.~. ......... Number of Stories ( ................... , ..... Dimensions of same structure with alterahons or add,hens Front '~.~r. Rear Z-~. Depth ....'dc.~'. .............. Height ..... [ ................. Numbe~; of;Stories .... I .................. ~' 8. Dimensions of entire new construction Front .. '.~,.4-. ........ Rear . .Z,..~....: ....... Depth .~'O J .... Height ...~2~ I ~ . Number of Stories I . .:i... 9. S~ze of lot: Front . . . .~'...: .O. ............ Rear .. ~..O.,.(¢?. ~. ...... ~.. Depth . J ~..2....C?. / .......... 10. Date of Purchase .[~..D.~..~....c~..~..T.~%.T'~. ........ Name of Former,,Own~ '13.~,.~ .¢.'r.~?.~.~4. ~-.~'~ 11. Zone or use district in which premises are situated .... '..~.. :~..' .~.t5 .S).~..~J,g?.~.4k ¢~. ..... ~ ...... 12. Does proposed construction violate any zoning law, ordinance or regulation: M.Qi..'., .................... 13. Will lot ~be.~a_cl. eO_ .?~g~:_.. ....... .~ ............. Will excess fill be removedXro~'r;l~ises: Yes ~'~ 14. Name o~'~r_eV~}~ss~.~.~9..~..4R~-.gt;?...L)x. Addressr~o* S.~g,e FrY) .~"/~. ,~Ph~ne N,, 'TT,,~- 40~4'~''' Name of-~ ........~J.. ,~.. e..~. ~ ......... I&~!~ ....Address ..~.....~. 9 ...... ; ....Phone No.'~.a.D...-7.~..I .~ ..... Name of Contractor ...~. ~.P .................. Address .................... Phone No ................ 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 shoo street names and indicate whether interior or corner lot. STATE OF NEW COUNTY !57 S.S , ......... .~. '[ ,'~.~.~..fi,:.~....G?.,..'~...0..v~.'T.f?.eT.~' .......... being duly sworn, deposes and says thathe is the applicant (Name of individual signing contract) above named. He is the . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the s/fid work and to make and file this application; that all statements contained in this application are true to the best ofhi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ /.c~. ............ day of. · .~.~..{~..~..~.~Y...~. ..... , 19. Notary Public, County ._ ........ ... 1~.~.4~?~ /~ D~'/'~ /,/ ~ (Signature of applicailt Application Received 19 Disapproval Issued 19 Permit # 19 FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT IN THE TOWN OF SOUTHOLD l. Type o% oeve±opment Proposed: Addition and/or Alteration New smructure {lnc£udmng storage'~tanms Flood Proof Below Base Flood Elevation Other (specify) e Elevation Data in relation to above mean sea level Of: (a) Lowest floor elevation, including basement ~- feet O inches (b) In a V Zone, bottom of lowest structural member ~... feet O inches 3. FIRM--Flood Insurance Rate Map, Zone designations 4. Owner of Premises ~ ~ ~ ~¥~_~ ~, 5. Location of Pmoperty: House # Street Hamlet County Tax Map No., Dist. 1000, Section ~_~__ Block ~ Lot(s) Subdivision Filed Map# Lot (s) 6. Permission to be granted: __ Owner as above __ New Owner Under Contract __ Lessee __ Contractor -- Phone Name if not given above Mailing address 7. Approval DEC Health Services Building Permit from other (s) before Permit is issued: Wetlands (Town Board) ~ ~ Planning Board ~/~ 8. I, ~T~ ~.~--~O~TA~%% , the applicant, am the Owner __, Co-Owner __, New Owner __, Under Contract . , Lessee __, Agent ~, Contractor __, and agree to comply with all applicable sections of the Code of the Town of Southold; County, and State and to admit authorized inspectors to premises 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 my knowledge and belief and that the work will be performed in the manner set forth in the application filed therewith. STATE OF NEW-,YORK CO NT SWORN TO THIS ~otary Public Applicant's mailing · address and phone # if not given above 11/85 SS DAY OF FORM NO. 10 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 P.O. BoX 728 Southold, N.Y. 11971 ~ APPLIQ~.T!ON FOB DEVEL~PM~N.T PE~MT~ Town Hall Main Road Southold,N.Y. Instructions: The application to the Building Inspector includes (each in duplicate) 1. Form No. 10 filled out in ink or typewritten, 2. Sur- vey of premises withlelevations above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show that 'the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards asirequired in Section 46-17 of the law to minimize flood damage: A. Anchoring oflstructures, including tanks and mobile homes B. Use of construction material and methods C. Design and l~cation of utilities D. Subdivision ~roposal with drainage, public utilities design and base flood~elevations ~pecific Standards a~ required in Section 46-18: A. Residential 6onstruction B. Non-residential construction C. Mobile homesi The applicant must submit plans and specifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure h~s or will have the lowest floor, including basement/ cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the base flood level the structure is water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of!buoyancy, 3. applicant must submit certification by a registered professional engineer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal High Hazard.,!area (V Zone) 46-19. Applicant shall submit plans, specifications including the required certifications and such other in- formation as the Building Inspector may require in that the provisions of 46-19 are complied with. Mobile homes are prohibited. The ,lowest portion of the structural members of the lowest floor cannot be lower than the base flood elevation!with all space below open except breakaway walls. Sand Dunes. If sandldunes exist on the premises and the applicant pro- poses to alter same,!plans and specification must be shown in detailed nature of any alteration submitted. Building Permit. A Building Permit is also required for any structure. Both a Development a~d a Building Permit must be issued before any work can start in a special flood hazard zone. A written disapproval or a permit must be issue~ within ten (10) working days. During construction, lthe inspector shall be notified in time so he may make the required inspections. Upon completion, work must be 'approved. 11/85 thei required certification of the final elevations and submitted before the approval to use or occupy can be (Fill 9ut the form on the back of this sheet) addition to this document is a vlot~tion of ~ecfion 7209 of the New York State ~ducation Copies of tb~ document not bearing [be ong~n~er's inked seal or embossed semi sha~l not be considered valid copies, .9 -9 ~ ~ ' , violation of section 7'209' of