HomeMy WebLinkAbout14750-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17083
Date JULY 13, 1988
THIS CERTIFIES that the buildin~
Location of Property 50 WASHINGTON AVE.
House No.
County Tax Map No. 1000 Section 041
Subdivision
ADDITION
GREENPORT, N.Y. ,
Street Hamlet
Block 01 Lot 036
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 14, 1986 pursuant to which
Building Permit No.14750-Z dated APRIL 21~ 1986
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 ENTRY PORCH ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to JAMES FINNO
(owner,)~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N014232-DATED MAY 27~ 1988
PLUMBERS CERTIFICATION DATED N/A
"/ ~Bui~ding Inspector
Rev. 6/88
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, H. ¥.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF TH[, WORK AUTHORIZED}
N.o 14750 Z
.......... Z.J.~...~/...~. ...................................
....r ,,, ~..o... ~. ~.~_ ,~..~.~.. ................
...~~.~.,.:~.:~ ........ ~z~.~. .......
,o ....... ~o~.~x~..~..~......~..~.~......~,~.,.......,.~.o.....~.~...?..~.~
~..~...,...-..~...,~..i.~..~...r.... .......................................... -~ ~ ~ ...................... :.. ................... .../
at premises Ii)coted ot ......
./...
................................................................................................' .~.~.~o~..~.. ~.....~. ..........
County Tax Map No. 1000 Section .~...(//./.. .......... Block .... .~. ,/. .......... Lot No...(~,.~....~.,. .........
pursuont to application dated ....~...../~..~.(,,~. ........ /(..~... .............. , 19..~..., ond opproved by the
Building Inspector.
Building Inspector
Rev. 6/30780
F~)RM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N,Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. 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"
lend uses:
1. Accurate survey of p:mperty showing all property lines, streets, buildings and unusual natural or
topographic featu res.
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 POOLS $25.00 ALTERATION $25 .00 1, Certificate of occupancy New Dwell±rig $25.00, Accessory tS]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 $]0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..~ .............
NewConstruction ...... Old or Pre-existing Building ........... ¥ Vacant Land .............
Location of Property
House No. ~1 ,---- Street ~ ~/ Ham/et
Owner or Owners of Property
County Tax Map No. 1000 Section ..... ./.~./. ...... Block ...... [ ........ Lot ................
Subdivision ............................ ./...Filed Map No ........... Lot No ..............
.... App licant~ .~.P~..~..~. , .-~, .\ ..¢~..~. 9. ............
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $. ~9 <9
Construction on above described building and permit meets all applicable codes and regulations.
Rev. 10-10-78
R c.
RITERS
~~ B ~ ~,~ES JOHN STREET, NEW YORK, N ¥~. I~ ~..038 ....
Da ~ ~ppl~eti~ No. on fi~
~s examln~ on and found to be in compliance with the requirementn of this B~rd.
FIXTURE tKEPTA Si WITCH J FIXTURES
OUTLETS (LB s Es i~C~HO~SCmrIFLUOeESCEN~i
~N~ES
WfCIAL EEC'PT
I~ ~THER APPARATUS:
COOKING DECKS OVENS INSH WASHERS
EXHAUST FANS
1~T' ~. ~.P.
OF CC, COND.
OF NEUTRAL
Per
'his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDIHG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.,~
BUiLDiNG DE~T. ~.u,~ ~*~ ~ y
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND []INSULATION
FRAMING []FINAL
~ FYE ["~ INSPECTION IDATE COMMENTS
FOUNDATION ~_r~.
PLUMBING
~ODE
L~/z¢ ~,~ ~
FINAL
ADDITIONAL COMMENTS:
TOWN OF SOUTtlOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/_~ An application for Certificate of Occupancy
is not on file.
/_~/--No Underwriters Certificate on file.
/5/ The check is(outdated/not on file.)
/~/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit # l. ~ 7 -~ Z
Building Dept.
***/5/ No Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST []ROUGH PLBG,
FOUNDATION 2ND []INSULATION
FRAMING []FINAL
765-X80Z
BUILDING DEPT.
INSPECTION
]FOUNDATION IST [ ] ROUGH PLBG/~
] FOUNDATION ZND £~'I~LATION
765-1802
BUILDING DEPT.
INSPECTION
ROUGH PLBG.
ATION tST [ ]
FOUNDATION 2ND [ ] INSULATION
FRAMING
[ ] FINAL
LOT-lO
~OOT~4 pL.
1'7
10
EDWARD COPIN, IR.
62 Washington Avenue
Greenport, New York 11944
477-1676
BLDG. DEPT,
TOWN OF SOUTHOLD,,
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
,TEL.: 765-1602
'
me,mi,
Disapproved a/c .... ~-..-~. · ...... ............
(Building Inspector)
, TOWN OF SOUTHOLD
Received ........... ,19...
APPLICATION FOR BUILDING PERMIT
Date ..... .~..'7./. ..~.. ..... 19a~.
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 applfcant, agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
. admit atith6fized_inspectom on premises and in building for necessary inspectionsy/ , /z f
(Signature of applicant, or name, if a corporation)
(maz]~ng address of applicant]/
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .,~)..Or.P/J.g.S. ....... .t}.0 .....................................................
(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 .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ..................................................
.... .... ..4s ....... ././?. ..........................
House Number ~/ Street Hamlet
County Tax Map No. 1000 Section ~'~ I Block ........... I. Lot...
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Ex,st~ng use and occupancy .~.O1.~..~; .~'.~..' ~' ~...~.d~.. ~.~.,...'~.
b. Intended use and occupancy .~.'?~. ,~Z"~.,.~.:c.;%., .....
3. Nature of work (check which applicable: New Building .......... Addition .......... Alteration ..........
Repair [ ..... Removal ~.. ........... Demolition ............ .'.. Other Work ...............
' (Description)
4. Estimated Cost/,/~.~-,~. · .................. Fee ........... : ........................
Ere be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor .............
If garage, number of cars ............................................ i ...........................
6. If business, commercial or mixed occupancy, specifg( hat_ute and, ~xtent o f each ~;y.p~ of use ............. t./ ........
7. Dimensions of existing structures, if any: Front ./fi~fd~. ,ff"J,4~'.' Rear . .~.q~. i ...... Depth...~...~f-A'~.. .......
Height . .. Number of Stories ', ....... .~.. .......... .~... i ................ ,/. ........
Dimensions' ' of structure with' alterations' additions:'../.a~/.~. , , ,~' 77' ' '
same or Front ..... ~ .... Rear../~...~. ..........
Depth ...................... Height ........ ., ............. Number of Stories ............ --t ~ t ........
8. Dimensions pf entire new construction: Front../j.~'.r~. ....... Rear ........ j ...... Depth ./& .~. ........
Height ./b t lo ......... Number of Stones ............................ i ................ /. ..........
9. Size of lot: Front ......................... Rear ...................... Deoth ...................
10. DateofPurchase ~.../~.7/~ ......... x)Nan~e*of~Foj'merOwner
11. Zone or use district i/~ which premises are situated....p~~ .. .......... i .............................
12. Does proposed construction v. inlate any zoning law, ordinance or regulation: . ~. ~.O. ..........
13. Will lot be regraded ..... /lJ.O.. ................... Will excess fill be removed from premises: , Yes
14. Name of Owner of premises '?~..~,,,t2)t/)~0 .... Address ............... j . .. Phone No. q~.7.'~r..~i.q.~. .....
Nme of Architect .. ~J_Pc ....... ~ .............. Address . .x~ ............. i · · · Phone No ........ ........
Nmne of Contractor. ~'"'~(~. ~-~4~..'~. ........ Address .[]J.-~C.O~.i..~. ....... Phone No. ].~t.~.~. c~[.O. .~.~..
15. Is this property located within t.00 feet of a tida~ ~etland? * Yes ..... No ~JO..
· If ~yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, end, 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.
t
STATE OF NEW YORK, S.S ;
COUNTY OF .................
................................................. being duly sworn, deposes and
(Name of individual signing contract)
above ~ramed.
says that he is the applicant
He is the .........................................................................................
(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 hi,, 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
Notary Public, . ........ County
#rlEN K. DE V(E
NOTARY PUgtlC, ~ate ef New Yedt
No. 4707878, Suffolk CouQ~
Term Expires Me, ch 30,
(Signature of applicant).
\VA 6' ~: "' '
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