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HomeMy WebLinkAbout24176-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25390 Date: 11/26/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 690 VILLAGE LA ORIENT (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 25 Block 1 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16, 1997 pursuant to which Building Permit No. 24176-Z dated JUNE 10, 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 ACCESSORY STORAGE GARAGE IN REQUIRED REAR AS APPLIED FOR. The certificate is issued to RICHARD P. & JUDITH B. BOARDMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Ouil ing inspector Rev. 1/81 Foam NO. a 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) N4 24176 Z Date ............................. IV.. Permission is hereby grants torr ...................... ...... ... ......... .. ............ to '16S ...�.. .. ................ . .. . ................................ .......................................................................... . .................... ............ ............................... Q .. . at premises located at............... ...f.. .......F... GY ... . u/d�t' ................ County Tax Map No. 1000 Section ......(274F ... Block ........... ..Q©. Lot No. ... ............ pursuant to application dated ........... l �..................... 197.4. , and approved by the Building Inspector. Fee $.•• > �••• ........0 �. `�... Building I S Rev. 6/30/80 P utw Nu. b 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 unusual natural 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 Buildine - $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 Date . . . . . . . w.J. 1.� )��. . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . .!. . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. . �q.a. . . . . . . . . . . .\jA0\4� � G �Q. . . . . . . . . . . . . . .a21E b\-j"'. . . . . . . . . . . . . . . House No. \ Street Hamlet (� Onwer or Owners of Property. . ,4 �� S vA` `� l�! . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . . . . . . . . . . .Block. . . . . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . /. �.Locrt_. . . . . . . . .(.�. . . . . . . . . . 3 Permit No. 41 7z.6.� . . .Date Of Permit. . . . . . . . . . . . . . . .AppIicant. .:4!� :� �. '. >':)R� Health Dept. Approval. . . . . . . .. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . X. . . . . . Fee Submitted: $. . . . . . . .�z.�'. . .��".�`�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT co �a53�6 IIt 1,11 Illli l'1;1;111111 III;1'11111IIA 11 1'Vlll lull l';I ••\���(((��� uuuunrlull ( I!rl'I � I 1 UIIIIUn'I'lull ^( 1110) « t 1111111 I'IIAIII:f.A ��\,,,777 sf 1•LIIN'II i II(I --- p _ IJ :;;III,A'I'lllll 11 Kit 11 , Y . !I'1 A I'R 1'.il1',IIIIY 1;IIIIV, RN cla I' l IIAI, ------ .,.,_ AIIIIITIOIIAL (;011tll;ll'l'lil SJ .. -- _.,_ .s-- __--------__...__...._.........,,,------._„.._.,--------------- .._...,__,_.,.,...... I 1 1 -- -0 1 r f” IV .. Q a5 tam -44: 'a on of IFW oa of ole N ow York Pu1. UnN., is survey milj"4uiiv, joes ir4wd sbal Of a rafid true copy "Jill zntees inclWcd heftn sr.-ar no -no person lw w' A On W" sc� 4 !Wo$ QQOGO' J4rf7► 9% • NN i!�M Ct i 49�­_ 41� ul ZZ 7 - t rI 1�,7 -W_ S_� iJk • see-IF oz -ta- C Z, Wf,._ .7 IA��" -7.77 4,77-7, M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION � [ RAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: 69�� z ` DATE �� �� INSPECTOR - ---------------- -- ---- ---------------- --- - - --- -- t`----- r----6' -- - -- ! its - >' x$ 'GOC - --- --- ---- 2D. -_ - ---_ _ --- s436 . -- - - f7�_ FIvSC 6��u 1 2% 4 64Cq ix8 Shp leq flint - — f l'LoIley GCfl - `I, 3c�. _ + - �Clc�na�c F. �'olwCtva.v� _ - _- uo scala, No- Salt o2tfNr �y IwS7 Si 4'1 1-11-1----.- . BOARD OF HEALTH . . . . . . . . . . . . . . . � .AJ, FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY y,, BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . MAY 161997 _ TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 BLOG.DEi3T, TEL: 765-1802 NOTIFY: Tr,I OF SOZII IOt - PI---• - CALL . . -2-1 . . Examined.r .. ....`i!9 MAIL TO: . . . . . . . . . . . . . . . . . . . . C., 19 Permit No. C.. <.� ................................ Di c ......................?*CATION .................................... ..... _ � ...-..... .. Inspector) R BUILDING PERMIT Date.'Mc�y. . .I5 . . . . . 19R7 INSTRUCTIONS a. Ibis 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 application. 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 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 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, Yom........................ (Signature of applicant, or name, if a corporation) ................................................... (Mailing address of applicant) State whether applicant is owner, lessee, nt, architect, engineer, general contractor, electrician, plumber or builder. ..... Wn 4 !'�nay��...�YS�4 a 94X1jkr( ............................................................ Nage o£ owner of premises ((�� t(�,, 4 \\ ��� \\ UNDERWRITERSCERTI_PI X .! I............................J � ' '........... YO! 1M^1111........ (as on the tax roll or latest deed) REQUIRED If applicant is a corporation, signature of duly authorized officer. ED AS ®TED �J........................................... DATE:;,VVR0 U.i � 74O(Name and title of corporate officer) OCCUPANCY OR FNEr..4CTIFY MLDJNCx EP E AT USE IS UNLAWFUL. 765-1802 9 AM TO 4 P R THE Builders License No. ..z�-1.22 -.H T Ol.l(:WING INSPECTIONS: WITHOUT CERTlFICAT I FOUNDATION m 7WOREf UIRED Plumbers License No. ......................... OF OCCUPANCY FOR POURED CONCRETE Electricians License No. ..................... A. R04JGN " FRAMING & P(.(l1sIIBiNC, 3. :IISIUL TION Other Trade's License No. .................... 4. FIslAet , CONSTRUCTICDA4 MUST E:r."a"C'�iiyn FIF FOR.CJ? .. I. Location of land on which proposed work will be done.............................1111-...............ALL. EE AI.Ia (°ON>" (1CT1R31lI �eIlA1.1.. L3EE1" 490 Vr\�a .. n Q eriG L I 1 NT OF THE,N.Y.. ..................................... 111......................1 Horse Naber Street !"V " ":TF111C 9Ok1 ENE'Il()Y (rt" RESPONSIBLE FOR County Tax Map No. 1000 Section ................ Block ........1111.... Lot . `i�fi A 4l$d xTItIJCTi�DIa;E6iHC113S Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy off.7premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....1(�`r,2�i "n L9........................................................... b. Intended use and occupancy ..... ` . u(f�af�- ................................ .. mv ....... Ymr+:rex tl .:3YC47n'J YlCEYAM1i'�5'71k4H 3. Ntl'ure of work (check winch ali Aicable): New Building ...X..... Addition .......... Alteration ........ .. Repair ............ Removal .,i,........... nennlition ............ 01her Work .................................. (T)esc�il�Cion) 4. Est invited Cost ... , G�:I'�? ...... fee ........... (to he paid on filing; this application) 5. If dwelling, metier of dwellir♦g units ............ Mnber of chrelling units on each floor ................ ifgarage, timber of cars ...I'.r...........I. ................... G. If business, mnrercial or maed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing atnx:lrjres, if any: Front................ Rear ............... Depth ................. llo Depth .. Nurber of Stories ........ Dimensions of 1m Dimesfstn gire with alterations or additions: Front ...A AS ....... Rear ............... lc .... ght .....ZLJ.�.......... Ntnber of Stories ...`ter`..... 7 8. Dinensions of entire new c.onstl �ruc:Cion: 11'cxaC ...� ...... '•..•ltear ....�Z......... Depth ..�©........ P neidit ......I-1...............,., Ntrdrer of Stories .... 9. Sirs of lot: Front .9................ Rear .. 77,fjrC......... Depth ...�25:2 �......... '76.30 1(l. Date of Purchase ........ Name of Forar:r (Mier It. Zone or use district in uidch jaremises are situated .... .................................................... 12. Does proposed construction violate any vining law, ordinance or regulation: ................. 13. Will lot be regraded ..... �i " Will excess fill he rmewed from prenises: YES p gLs�n�A� n� �..�,r,VtlYtvr\10rklress 690. J11\q �y�1 QtlPyl . 17naue w. 23,1221 Name of ArddtecC .....:......SII.................... Address .............................. I'iaoae lb. ....., tom" /� ` I ............. Nine of CnnLractor .!1�,•'1�!, ...k"?�1\?.�v-1�........ Acklress .69O.VII�Af�Q (,dclM �YhP`n� 3�g�2 ..................Plwne lb. .. �.. 15. Is Ihis property within 300 "t of a tidal. wetland? * YES .......... c a ) ..x...... *IF YES, S(JU111H1) 1101M 114GIEMS PE1441'r MAY 193 Rfd(plog). I PLOT DIAGRAM Irx:are clearly and distinctly all Imildings, whether existing or proposed, and indicate all set-back dimensions flan property lines. Give street anil black nuiber or description according to deed, and shoo street nares and indicate cduether interior or corner lot. I . SWIM MMIGNU 0301UP30 51'A'N; DR NIU Y(A(K, (XIMIY OF .......... SSI � �aay rnta\v. being duly sworn, deposes and says that he is the applicant (Nate of uxlivrdual signing contracC)� alMe RM d, Ile is the ...QWA:.IJ.f.. �A A r.......................... ............................... (Contractor, agent, corporate officer, eLe.) of said owner or cwixirs, and is duly jwlhoriml to perform or have ix�rfornxd the said wink awl to make and file Ibis application; that all stalerenLs contained in this application are tr e: to the best of his knowledge and Ixalief; and (hal the work will I e i erfornred in phi• scanner set: forth in the application filed therewith. Sworn to before me this «? .......drry of ........ 1999 . Notary Puilrlic (Signa Lure of Applicant) fir Ybt I I