Loading...
HomeMy WebLinkAbout24432-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25641 Date: 04/15/98 THIS CERTIFIES that the building ROOF ADDITION Location of Property: FOX LA FISHERS ISLAND (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 12 Block 1 Lot 1.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 15, 1997 pursuant to which Building Permit No. 24432-Z dated OCTOBER 27, 1997 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 ROOF ADDITION TO EXISTING TRAILER AS APPLIED FOR. The certificate is issued to DOROTHY M. NOYES (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ui ding Inspector 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 UN11L FULL COMPLETION OF THE WORK AUTHORIZED) Date......OCTOBER.......27.......................... 19...97.. 24432 Z Permission Is hereby granted to; HAROLD COOK A/C M.DOROTHY NOYET ....... ....... ... . .. .........PO BOX 661............................... . ...................... FISHERS ISLAND,NY 06390 ....... ....................................................................... to......CONSTRUCT A ROOF ADDITIONTOAN EXISTING TRAILER AS APPLIED FOR .........................................I.......• . .. . ....•„.....„ ..... ..... . •..........• .....• .• . .•„ •...•„........ .. ......... ......................................................I........................................................................................................... .................................................................................................................................................................. .................................................................................................................................................................. .................................................................................................................................................................. at premises located at.................................FOXLA FISHERS ISLAND. ............................................................................... .... ................................................................................................................................................................ County Tax Map No. ..,,,,473889 Section ..,,,012........... Block ......2001....... Lot No. .,001.002 SEPTEMBER 15 97..., and approved by the pursuant to application dated .................................................... 19....... Building Inspector, 84.20 Fee.$......................... Building Insp for Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD .� 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 following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusualnatural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) . 3. Approval of electrical 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 the building. 6. Submit Planning 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 of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00_ Additions to dwelling $25 00, -) . Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . . . ... . . . . Old Or Pre-existing Building. , . , .. Location of Property. . . . U,E-( :. .. . . . . . . . :GV.JZ-. .La-t,.J�.. . . . . . . . . . . . . . • House No. Street Hamlet Onwer or Owners of Property. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 3 000, Section. . . .O.J'3. . . . . .Block. �© ;5 . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . .Lot. . . . . . . . .... . . . . . . . . . . Permit No. .`1�. , , , ,Date Of Permit. .1P/ . . . .Applicant[�Jil�- �k� G 1�� Health Dept. Approval. . .. . . . . .. . . . . . . . . . . . . . .Underwriters Approval. . /. . . . . . . . Planning Board Approval. . . .. . ./A .. . . . . . .. . .. . . Request for: Temporary Certificate. . . . . . . . . . . Final Corticate. . . . . . . . . . Fee Submitted: $. . . . . : .. . . . . . . . . . . . . . . P I T• BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DAA l3 � IN8PECTOR BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . _ . . TOWN HALL SEPTIC FOR:I . . . . . . . . . . . . . . r J SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NDi I FY ; Examined . !. . . 19 .Y, . CALL . . . . . . . . . . . . . . . . . . . a MAIL TO : Approved ! . 0��.1-7, 19 . . . Permit No. d . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . .�. . . . . . . . ZAC . . . . . . : ung I Spector) APPLICATION FO BUILDING PERMIT Date. f . . .�� . ., 1a. 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 stieets 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 cod usin code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspection (Signature of applicant, or na e, if a corporation) . (Mailing address of applicant) State whether applicant is owner, lessee, agent, archi ect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . .1 �. . . � -�� . . . . . . . . . . ... . . . . . . . . . . . . . . :. . . . . . . Name of owner of premises . . . . . . . . M LI�� Q . JIQ�O�}�.r. . ./. V.Q.YIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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. . . . C . 94F/7.-.. Y I , . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�� .L�� . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . : fp1 . . . . . . . . Block . . . . . . . . . .� . .. . . : . 1,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 . . .S.UMM +�.'•�' �� G .7 . . . . . . . . . ... b. Intended use and occupancy . . . . . . . . . . . . . . . SAME. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work(check which applicable): New Building Repair . . . . . . . . . . . . . Removal . . . ' ' ' ' ' ' • • • • Addition . . . . . . . . . . Alteration . : . . . . . • . . . . . . . . . . Demolition . . . . , , , , . . . , Other Work .Rip.-9 . 4. Estimated Cost . . . . . . . .plc (Description) ti.JC��? �O. . . . . . . . . . . . . . Fee . . . . S,:QC?If garage,number of cars . . . . . . . . . . . . . . . . . . . . .application). . . . S. If dwelling,number of dwelling units . . . . . .�. . . . (to be paid on filing this . . . . Number of dwelling units on each floor. . : . .I. . , , , , , , • � - 6. If business, commercial or mixed occupancy, specify nature•and extent of•each•t e.of use 7. Dimensions of existing structures,if an • Front . ' ' ' Height . . ."��.�. . . . . . . . . Y . . :`��: . . . .1, . . Rear . . . . . . . . . . . Depth . . . .1q: . . . . . . . . . Number of Stories . Dimensions of ame structure with alterations or additions: Front ,�J, 1 ' ' . ' ' ' ' ' ' . Depth . . . . .I . . . . . . . . . . . . . . . Height . . . . . . .� ;�U.N . . . . . . . Rear . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . ' ' ' ' . • Number of Stories . . . Height . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Number of Stories . 9. Size of lot: Frlu;it . . . . . .E(P. . . . . . . . . .-. . . Rear . . . . fi� ; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase ' ' • ..• • • • • • • • Depth . . . . 15.1. , , , , , 11. Zone or use district in which premises are situated , Name of Former Owner . . . . . . . . . . . . . . . . . . . . , , , , , • _12. Does proposed construction violate any zoning law, ordinance or regulation: . . . 13. Will lot be regraded .. . . . . . . hl.4. . . . . . . . ... . . . . . . . . . . . . 14. N p . . • • • • • • • • • Will excess fill be removed from premises: Yes Name of Owner of remises . Address Name of Architect NON� � • � • ' ' ' ' ' ' • • • • • • • • • • • Phone No. . . . . . . . . . Name of Contractor ' ' ' ' • • • • • •Address � p, . . Phone No. � -!� .�—M. . . . . . . . . . . Address 1:.bA .Ph t .j 15. • Is this property within 300 feet• of a tidal wetland. *Yes. . �' • one No. . �4, ,��,;$5; � . . . . . No. �( *If yes, Southold Town Trustees Permit maybe required. " " 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. APRROVFDASNOT D b'u{ DATE: � I3.P# Kt { ,� 4 W NOTIFY UILDING DEA PIl' A 1A" '� �Sb_1802 S AM TO 4 FOLLOWING INSPECTIONS: E 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING :NSUi_ATION CONSTRUCTION MUST 8F COMPLETE FOR C.O. ,s',I_I,.. CONSTRUCTION SHALL MEET AGF, hEQ0IREMENTS OF THE N.Y. FTATE CONSTRUCTION 8s ENERGY NOT RESPONSIBLE FOR PFRIGN OR CONSTRUCTION ERRORS STATE OF NEV YO I ,,�.Q,�- COUNrrTtt Y OF ..-�. . ] ''• - . . S.S fig,WrR a L Co o�� being duly sworn, deposes and says that he is thealica (Name of individual signing contract) applicant above named. ieis the . . . ": . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) . . . . . . . . ' ' ' ' . . )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this-application are true to the best of his knowledge and belief;and that the cork will be performed in the manner set forth in the application filed therewith. ,worn to before me this . . . . . . . . . . . •;;)7,r . . ... . .day of. . . . . . . 19 7 a 7 rotary Public . • Cou . NO. 01W - Al L A9503185 • • • . . . . P(ij QUALIFIED IN SUFFOLK COUNTY TERM EXPIRES OCTOBER 31, 19re of applicant) LIN CT b z 4 s Ll t.t O� G T } 1. fi'�p � ... ... � t t j / / PtS+�E�S SL4liD Q .So`a•6 G`O" E / / mT�[C40�M�!4T Go�P; '� ..�, p� �*' ! CP { i rr ;, r_ // r sct1cx4i;: 4+5 fit+CC 'Co 0 I x 2 ' ( o�ar...a,UCO v,i5 0+ j , J( } r ., '-• + , � !� •?E:.�-.� � A:l� � -->> 6c+•4c�o►. v1S'T�1C'i. 4 F��C^t.'t,tS'tR.•c'[ Etc � t7 ; I ( SPoo r ` FIX-% O�SK1eKt 17 l\4Rttt•esim-k-� 4L. f J Rtcuse e\s'Ml%g..T .�I - _ � � � OL�. .UUN. - � i Q� ' r /SE��i� �J. g'T�.`•�. � i �'9 -. - � ' d N f �� (S C. �� r .•��, - f -{ 1 _ o �o . tie \ C"^'Pul� CV61tH8,gA. .0 t'111T,Bb ' 07.E ��� `. 4 } N• / to V Hr p r. tT '� e�,. "�`•. jo a� •C � S. 4. ` C 1�, P►1it�L J� 't�'!J 'bT AT I�tJ 'P '�. n °_+ /_- N11_ l fJ� .51,E kf res,. ria _ / PL.A►N `O F �'R. �' '�''� �;5 �} � t \S`-I tv 3 ; \ I MON Le , J C p uAub -far;•"<' :;� ..� Z � . ^c ,'I. ' -'. R'•�-.V l S�G.'. ' S Jsf Q n .. t.OY� 14'� .1' .r;;� Y : L - - _ _ F.' d .ti•'•"!-: r/.' �`"Y \ 'Y:�_,i .�..-,: };. �� � 1j .,�1 Y'y��•(�i.1.4 ,': .4�� :,•� •�. .��