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HomeMy WebLinkAbout26711-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27250 Date: 08/16/00 THIS CERTIFIES that the building ADDITION Location of Property: MUNNATAWKET AVE FISHERS ISLAND (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 6 Block 3 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 2000 pursuant to which Building Permit No. 26711-Z dated AUGUST 10, 2000 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN C & SUSAN E M CLAVIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A 77 ed S' nature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26711 Z Date AUGUST 10, 2000 Permission is hereby granted to: JOHN CLAVIN & AND. NEWBURY,MA 01951 for CONSTRUCT DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#14699 . at premises located at MUNNATAWKET AVE FISHERS ISLAND County Tax Map No. 473889 Section 006 Block 0003 Lot No. 003 pursuant to application dated AUGUST 10, 2000 and approved by the Building Inspector. Fee $ 75 . 00 A h ri d Si nature ORIGINAL Rev. 2/19/98 Do TOWN OF SOUTHOLD BUIDING DEPARTMENTG TOWN HALL 5 2000 i 765-1802 ELDG DEpT. APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD A. This application must be filled in by typewriter OR ink and submitted to the bui inspector with the following: for new building or new use: I. Final survey of .property with accurate location of all buildings, property 1 streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 f, 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system conta less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar bu and installations, a certificate of Code Compliance from architect or engine, responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. �y B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildi.n� "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building an( unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the appli If a Certificate of Occupancy is denied, the Building Inspector shall state t reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, t Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate 'of Occupancy on Pre-existing Buildina - $100.00 3. Copy of Certificate of Occupancy - .25r,1. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential GG$15. 0, Commercial $15.00 Date . . . . O J�.� d�. . . . . . . . . . . . . . . . . . . New Construction. .. . . . . . . .. Old Or Pre-existing Building. . . l`�. . . . . Location of Property.. S�tt 5 . .` 's �c, :. . .. . . . . . .. . . . . . . . . . House No. Street ff Hamlet Onwer or Owners of Property.. . . .A, CL,J, SvSan. . .Clavi,r\ , , , . , , , , , , , , , , , , , , , , , , County Tax Map No 1000, Section. . . . Q(-�.. .. ..Block. . . . . . . . . . . .Lot. .�. . . . . . . . . . . c�Subdivision. . . . . . . . . . . . . . . . . . . . . . .. . . . . . ./.y.�. .. .Filed `QoMap. . . . . . . . . . . .Lot. . . . . �10 l l; :C� 0;i'. .L!o . . . . . . . Permit No. . . . . . . .Date Of Permit. . � .Applicant. . . . . . . . . . HealthDept. Approval. . . . . . . . . . . .. . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . Planning Board Approval. . . .. . . .. . .. . . . .. .. . . . . . Request for: Temporary Certificate. . . . . . . . . . . FieCerticate . . . Fee Submitted: $. . . . . . . . . . .a5o . . . . . . . . . . . . . . . . . . . . . Form No. 6 TOWN OF SOUTHOLD 1 ! BUILDING DEPARTMENT TOWN HALL 765-1802 ' APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the fo: lowing: for new building or new use: 1. Final survey of _p.operty with accurate location 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 elect:-ical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations„ a certificate of Code Compliance from architect or engineer responsible for th+e building. 6. Submit Plannine Board Approval of completed site plan requirements. B. For existing buildings; (prior to April 9, 1957) non-conforming uses, or buildings and '-'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed -application and a consent to inspect signed by the applicant. If a Certificate o ' Occupancy is denied, the Building Inspector shall state the reasons therefor iii writing to the applicant. C. 1 Fees �1. Certificate of OccuRancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwell.Lng $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessojry building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- - $100.00 3. Copy of Certificate of Occupancy - _ .25c. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00 Commercial $15.00 IDate . . . . . . . .�a[00. . . . . . . . . . . . . . . . .. . . . . . . . . New Construction. .. . .... Old Or lPre-existi/n�g Building �.�. . . . . . . / Location of property. .l.".lK .nti;ta�.. _i1J4;/�. rS .?T.�. S� !�:.�,� S�.�. . . �. . .. . . House No. i .. .'Street �• Hamlet Onwer or Owners of Property.. �,o{n .. .. ....s e.'� �a:'::� . . .. . . . . . . . . . . . . . . ... . . . . . . . I-cxA-f No: y-73$ 9 County Tax Map No 1000, Section. . . . . . . . .. . . ..Block. .. .. . .. . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . 11''��'' qq Permit No. q(12 .!QQ. . . . .Date Of Permit. .3 '� $ . . . . .Applicant. . . o ... . . . . . . . . . . Health Dept. Approval. . . .. . . .. .. . . . . .. . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . .. . ... . . .. . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . .• • • . • tCerticate PLICANT FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 14699 Z Date ....... .P�A.......a.. .......... 191 Permission is hereby granted to: (� .... ....... 0.....ta-...,................................ ....... .. Q..x.►. .............................................. �.A� Q.. .. G- ......................... �..�'......J ,Jt:. .... ... . .... �4-•` =!:,. ..., :fit... ......,. .. qff l. at premises located at .......X�J..tA41 Y ra ' . . ................ .......... ... ................................................................................ ................................................................................ ................................................................................................................................................................. County Tax Map No. 1000 Section .......Q..(P......... Block ...... /Lot No. ... ............... pursuant to application dated ......�} ..C�.rI.C.,Y'1....�..P............. 19141, and approved by the Building Inspector. Fee $. ................ /( G a-C. ... ..................Building Inspector.jL ......................... Rev. 6/30/80 08/04/2000 13:41 631-7885519 ROBERT E WALL PAGE 01 womawl- 7WUU INIIL,DING Dom• ; PEcTIO .,] FOVIi1DAT1IST ( ] ROUaN PL O& L FoUrADAinCiN 2ND L I IN8UL.ATI0N C ] FRAMI NQ t FINAL REMARKAI - � �" DATE d -INSPECTOR � FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . . . 19 4. Q(C'] t a- Received . . . . . . . . . . . , 19 . . . Approved . . �c ?. �•, 19$4. Permit No 17 7- : Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT R Date . .rn . . . ., 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 a 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 insp ctions` (Signature of applicant, or nam if a corporation) ,c. . . .�o (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general. contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . J,4n. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . BYO°. . . • . . • Ct• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . .I . . . . . .. . o. '. . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy • `�• ' • • . . • • • • • • • • • • • • • • • • • • • • • • ° • Ir 3. Nature of work (check which applicable): New Building . . . . .I. . . . . Addition . '\• . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . , Demolition Other Work . 4. Estimated Cost . . . . � ( .. (Description) . . . ..P . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . a<0�. . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . Rear Depth . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front Rear Depth . . . . . . . . . . . . . . . . . . . . . . Height . Number of Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . Rear . Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . .Depth . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . 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: 13. Will lot be regraded . Will excess fill be removed from premises: Yes • No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address .Phone No. Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . .Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . 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 show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . . . . . . S.S . . ~ C v being duly sworn, deposes and says that he 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 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 will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . . . . . . . . . . . .day of A IL G 4! . . . . . . . . .. 19 ..6:. �G 1�''L/s Notary Public, 5 . . . . . . . . County . . . .'. . . . . . . . . . . . . . . . . . . . (Signature of applicant) � / r it/oTi; Coo/i0/N,1�T6 OI.rT.a.✓CEJ A/1E i"lB�.IrJ.Q60 4:2P,4JrA.vO 4CAfo49ET14C JU.9✓EY T/2i- -ANG v<.� T/On/ STA. 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