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HomeMy WebLinkAbout24488-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25738 Date: 05/26/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 1655 OLD FARM RD ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 26 Block 4 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 3, 1997 pursuant to which Building Permit No. 24488-Z dated NOVEMBER 14, 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 SHED IN THE REAR YARD AS APPLIED FOR. The certificate is issued to ELIZABETH THOMPSON & ANO. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Bu' ding inslgcto 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) NOVEMBER 14 97 24488 z Date............................I................................. 19........... Permission Is hereby granted to, ELIZABETH& ANO THOMPSON .......... ............................................................................... 270 LAFAYETTE ST SUITE 1303 ........................................................... NEW YORK,NY 10012 .......................................................................................... CONSTRUCT AN ACCESSORY STORAGE BUILDING IN THE REQUIRED REAR to.............................................................................................................................................................. YARD OF A SINGLE FAMILY DWELLING AS APPLIED FOR ..................................................................................................................................... . .......................... .................................................................................................................................................................. ....................................................................... ............................................................I........... ..................................................... ................I.............. 1655 OLD FARM RD ORIENT atpremises located at............................................................................................................................... .........................................................................................................................................I...................... 473889 026 0004 001 County Tax Map No. Section Block ................. Lot No. ........................ OCTOBER 3 97 pursuant to application dated .......................................................... 19................ and approved by the Building Inspector. 35.00 Fee$......................... ............... '!Y�.. .. . .......... Building Inspector Rev. 6/30/80 Form No. 6 [:F TOWN OF SOUTHOLD BUILDING DEPARTMENTTOWN HALL 765-1802 ,DEPT 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 unusual natural or topographic features. 2. Final Approval frw� 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 dwellin �00Alterations to dwelling $25.00, Swimming pool $25.00, ccessory building00 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 - : .251C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . .3.;/tell�?. . . . . . . . . . . . . . . . . . . . . . . . . New Construction. .Y :?. .. Old Or Pre-existing Building. NP. . . . . . . . . . Location of Property.. . j ..'5.5; . .. . .. . ... .. . . . . . . . . . . .. .�l_:t.�wr. . . . . . . . . . . . . House No. m�'''' Street. Hamlet Onwer or Owners of Property.. . .. .�. T$PK) • . . . . . .. . . . . . . . County Tax Map No 1000, Section. . A44. . . . . . ..Block. .. .. .. . . . . . . .Lot. . . ]. . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . .. . . . . . ... . . ... . .. . . .. .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . e-oer.? �- Permit No. . . . .Date Of Permit.� .��.`�.� . .Applicant. Health Dept. Approval. . kX7 .W0"M M . . . . . . . .. . .Underwriters Approval. . ?. . . . . . . . . Planning Board Approval. AJ;A. ..UA.tom. ... . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . Z. . . . . . Fee Submitted: $.Z.4. . . . . . . . . . . . . . . . . . . . . . . . . "tom � � S�� . . . . . . . �. . . . . . . . . . . . . . . At ( 5��1 � APPLICANT h 111,11 I Il;il'I;l;I hill ltl:l'llll•t' M%fl l:Ulllll 117:) I InurllnT1111I ( 1:.'I•) �\ I�uurnln�t'luu (luu) �_ .1 I•.1 M.,.1N MMn w_I.�NMA Aw-nww ...-+-...�.,� .w�•n+-t�r+.n.n h1�'R1T'nw.w+��we1.,.�,',►_Aw1w.w.+tr.�t-1Y,w --x 11111 Il VRAM. X A 1'1.1111111 N(i ... Q ........--.,...-----.w_---n----w •.ir n n....n n• • .nn..rn-.w.r..., --------------------- ,. _,- � i II:IIII.A'I'I fill l'ICIt 11. Y _ (� ISI :l'1'A'I'I'. 1'.IiISIIHY 1;1111 I! �' v ----------------- At 11 I IIA1. �..-w-_--. -..rn -w__w_- w-w...._.,- , ------.,___- ---.--__-_ww-_-_w-------�w AI111 I'1.1 U11A1. (;(111N1;11'I Ii t w-----.----..__-------.--_-------_ -rnw_-- w-----w_----_-w '.I I : o --- to - t , ass-ieo2 suiwiNc DE". INS CTION [ XOU ON iST [ ] ROUGH PLBG. TION 2ND [ ] INSULATION G [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: l 4AV-o y � ave) DATE*Zl!! INSPECTO BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] UNDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE �� y l�8 INSPECTOR _i��G��' �� BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ j FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE� !7S IN8PECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 4-"- :::�:,jjjjj r DATE INSPECTOR suauiNa DE". SPECTION [ ZFOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 6 CHIMNEY REMARKS: /J DATE IN8PECTOR suiwiNa oar. INSPECTION [ ] FOUNDATION IST [ j ROUGH PLB6. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ V]'flNAL [ ] FIREPLACE & CHIMNEY REMARKS: �i" �O, DATE 11198 INSPECTOR 7 BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: 1V ,997 CALL . . ��J",3 3� Eimmined.. 0)J. 19.... MAIC. TO: . . . . . . . . . . . . . . . . . . . . �f -/-�/• 19 :l'erG ... .... Approved--- .................................... nisappmveda/c ..... :.......................... .................................... ..................................... .... r.- II'ui l ding•Inspector). A KATION FOR BUILDING PERMIT qq qq INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector witi 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 lxiblic streets or areas, and giving a detailed description of layout of property must be drawn on the diagram Which is part of this application. c. the work covered by this application may not be convened before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 HERBY MAIZE 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 7buil 'jf sa r esinspections. .............. .... .. ..... (Signature of. applicant, o name, if a corporation) w (Mailing address of applicant)" 100 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................................................................... Name of owner of premises uZc9 'tN...lk !�� 1N. J :G.Yt4lt ............................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. Location of land on which proposed work will be done.............................................................. ...�k ........... .'r.9�-.M>?.:.......................................Q1 c.eNT........................... House Number Street Hamlet County Tax Map No. 1000 Section ... ......... Block ...4.......... 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 i171J71 .A:�...r.-st r-).................................................. b. Intended use and occupancy ). �?.n h11-:i •. ............................................... YNw 3. Kiture of work (dheck whid► applicable): New Wilding .1t ...... Addition .......... Alteration .......... Repair ............ Removal ........... Demolition ............ Other Work .................................. (Description) 4. Estimated Cost ...�r.l o'+ ............. fee .............................................. (to be paid on filing this application) 5. If ohaelling, midier of dwelling units ............ tiud►er of &Felling unitsei each floor ................ Ifgarage, number of cars ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of��eea�ayyd► type of use...................... 7. Dimensions of ting structures, if any: Front....le!........ Rear .Kt7........... Depth -k?............. Ikight .... ................. Rmber of Stories .4� ................. Dimensions of saiim structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Umber of Stories ............... 8. Dimensions of entire new construction: Front ........ Rear ....1�....... Depth .2.C.1........ Heigint ....1 .................. Numimer of Stories .1.................... 9. Size of lot: Front .................... Rear ..................... Depth .................... 10. Date of Purd►ase ...JON I............ Name of Former Owner .. .,crM...>�Mox.................... ll. Zone or use district in which premises are situated .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .P q.................. 13. Will lot be regraded ..N Q.............. Will excess fill be removed from premises: YES Iii. Names of Owner of premises ... AddressP;OA.Zk°(•4)Rlls-►UT►.���19�� Pt►ohe Nos 16;S z�;�,�3, Mane of Ardnitect ............. Address ZAQ15F14WKl T.PN.lt.4.. Plione No N.-.ZMAM. lata hZ Name of Cort ractor .T: :A......................... Address ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * WS .......... NO .X...... *IF YES, SOLM rHD 1U 4N ITWITLS PEEHrr MAY BE RE4HRMi . PLOT DIAGRAM Locate clearly and distinctly all buildings, whetlher existing or proposed, and indicate all set-back dimensions from properly lines. Give street and block number or description according to deed, and show street nacres and indicate wlhetlmer interior or corner lot. SLATE (A' N. I (UJNIY (R' ....... I..b 4'. SS •••••-•- •-`•�ZF�. ! ..... S.� Iheir cul sworn deposes aril says t.iu he i s time applicant Y I Y (N4-nme of individual signing contract) alxnre rkrmed, ileis time ............ .................................................................... (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 aLplicatioo; that all statements contained in this application are true to the best of bis luxmledge and belief; ahxl that tlhe work will be performed in the mxhrnmer set forth in the application filed tlherew.itlh. yworn to before me this �j ........c�.Y ay ..... 19....1 Notary R is .... ... ......... ' (Signature of Applicant) ••••. . � O N r �- t- -- - - - - - - - - - -art=P � t l - I ti �FL r \VGS'( �l.�V�1'IoN �RxYIs�TD m 't1T WO,?,4488 _ AHgpvrpc PL kp figuAlioH 15I,IZAP6n TN M rsou - APZ,4IT64 klP h� .o U� io i I � SJ`i s, .E 7 N�6 n _ - BE, + q 4 + t \VEd flkE2YAWL EY °�tl Eft UJPold ; 2'r,PH5uW, ,:,-3O-GII _ wlvpz - r. 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