HomeMy WebLinkAbout23796-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24752 Date NOVEMBER 20, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 370 FISHERMANS BEACH ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 1 Lot 13.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 17, 1996 pursuant to which
Building Permit No. 23796—Z dated NOVEMBER 1, 1996
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 EXISTING ONE FAMILY DWELLING "AS BUILT"
AS APPLIED FOR.
The certificate is issued to MARIAN J. PRAUS
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
i
uilAing Inspector
Rev. 1/81
roam 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)
N° 23796 Z Date ........... .... ..... ..............................
Permission is hereby granted to,
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A7%r.. ... . .. .. ................ ...............
..........�Q............ .... . .................
..............
��. ......... ..
at premises I
at
at .........................:.3.7ra.... s ....... �9C�i.
................................................................................................................................................................
County Tax Map No. 1000 Section ..........///...... Block ..........1........ Lot No. / ...(..........
pursuant to application dated ...................(S,/ &44-.1.7........ 19-26 and approved by the
Building�f Inspector.
Fee 5.../.. ............
.... .. .. .. .
Building Irupector�`�
Rev. 6/30/80
Form No. 6
TOWN OF SOUTH
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 - .25re,
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 AS(tIR77.a . . . .
c ,
Location of Property. . . . . . . . . . . . . . . . . . �.U. r . . . . . . .
House No. //�� Street Hamlet
Onwer or Owners of Property. . . . . . !��'Jwl. .t^^'j/ . amv.•. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . 11.1 . . . . . .Block. . . .t. . . . . . . . . . .Lot. . 40-.134. . . . . . . . .
Subdivision. . .ftlAWCr.6.7. ./*PreT(4.. . . . . . . .Filed Map. . . . . . . . . . . .Lot. . rte. . .
Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . 141A . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . .
Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(? 5-=� � . . .ox . . . . . . . . . . . . . .
C,A -& a�l 15a APPLICANT
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I'0111,t,A't SON In I
POUNDATIUN ( 2rlb)
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Town Hall, 53095 Main fioadp ( Fax (516) 765-1623
13 0 Box 1179
Soulhold New York 11971 G'llp 0Telephone (516) 765-1602
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OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 18, 1996
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 . ( Enclosed)
No Underwriters Certificate on file .
The check is (not on file . ) $25 . 00
No Health Department Approval on file .
No final inspection has been made .
_ No Plumber Solder Certificate on file .
(All permits involving plumbing being
issued after April 1 , 191984 ) .
BUILDING PERMIT #`,;� �3 7 �F�/
Please contact our office on this matter. Thank you for
cooperation .
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] NSULATION
[ ) FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
4
DATE INSPECTORd,(AA a�A�
r
+ BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM No. 1 i SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
7 il'(.•`') BUILDING DEPARTMENT CHECK . . . . . . . . . . . I . . . . . . . . . . . . .
TOWN BALI. SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTUOLD, N.Y. 11971
TEL: 765- Iff(17_ NOTIFY:
(� CALL . . . . . . . . . . . . . . . . .
MAIL TV —
Apgnrne(l... .. ....,`..,, 19. Fermi
Dirrapprowda/C .................................. ....................................
.ART. . .. ........
J
-1 01
Iildhg Insplector)
FOoT 7 APPIR BUILDING PERMIT
�o
y#,;_. Date. . . . . . . . . . . . . . . . . III. . . .
INSTRUCTIONS
a. This nitrification nnlst fie, colifAetely filled in by typx+Triter or in ink aixl sofxnitted to Ilse Banding Inspector Willa
i c;nls or plans, accurate plot: plan to scn1e. Fee according to schedole,
IE plot plan shoiaing lot-11ionor for aril of Inildings On prcnnisec„ relit ionship to mijoining premises or prblit-
sl mets or arear„ arxl giving a detailed at-scripti(m or lay(nt, of property nxtsl be dram on the dingr;xn rahich it lino( of
this application.
c. "file (v(rrk covered by this application pray Tnt be corience(1 before issuance of Buildinig Permi(.
d. - UpoO approval or this nlgd icaHo , the BoiYding Inspector A If issue a ISuiltfing Peeinit LO the applicant.. Simb
permit: shall be kept on the prollises nvnilable for inspection lhroolo)t the work.
C. No boitdirry; .0mll be. mcapied or used in whole or in par( for any purpose whatever (ntit a Certificate of
OQrolxnxy shall haVe leen granted by Ox 11011ding lnspector.
AVVIACNIJON IS 1117,101Y MADE,to the Building Derxirinlent for the issuance of a Poilding permit pnsuant (o the
Ipnil(ling 7.(ne Ordinance of the Toad of. &nClnid, Suffolk Comfy, New York, aril other applicable r,aws, Ordin.aocps or
RegilaGoas, for Lim ccnst:rantion or lnildinpn, additions or alterations, or for ronovnl or dennlition, as herein
ilescribcd. the applicant agrees to canply with all applicable lnws, o"IilLaneea, boilding axle, Ixnsing colo, an(l
re(nrlati na, anxl to admit: notborized inspectors On lrrernises no(1 in lnildir ror pecessary in reclivrts.
a? . r.. 4 ,�.....
(Sigoature or applicant, or a if ) corporation)
(blit ing address of applicaal)
Stnte uhvther 61+111cant is o>wnnr; lessee, agent, architect, engineer, genterat contractor, elect:ricimn, ploritor or Innildcr-
................................. .t'./.,.y...e.....3,.................... ..............---.................,...... .........
Nano. of (nmer of premise.^, ..... .. ....�� ......................................................
Or on the can roll or latest deed)
If apf)licant is a corporal inn, signatorr or (fifty autlnrizod officer.
....................................I...............
.....
(Nam rnxl 00e of ("oninrlce officer)
rffficer)
Builders t,irmw N). .01A1A../t..................
Vomiters I,icense ME ..A/A.................
Electricians License No. �,,tt ...
Other Traok?'s License No. ..�/:k'..............
1. location of lmxf oil which proposed work will be (kne..............................................................
.71J ........ SSI M ,i..� .. ..............!1"4j:7izil-c?Coe A?...............
....
Douse t3,xdxr 5treeC ff 1pLmlet
C ouoCy 'Tan Map Nit: RXX) Section ..... .7.�....... Block ......1.......... Lot ....1�a.l.....
hnlxlivisi(n .. ..... Filed Msip ME ;....'.......... Loc
(Nair)
Z. Stale existing use arxl ocagnancy of premises noxi intenxled use aril occupancy of proposed construction:
a. Existing use and occurvil y ....R.et?,510lidd. fxr .... ......................................0............
mb. Inlenrled use ill ocanpnncy ....�rG.?w.t��1A..•L..................... ...................................
r 30 ;: �,
I. i.iluu: of w(k (cl+eck %Auchalg1 �)
lllralble): N.n+ Isuilding ... ... .. .. . .. . . .. Alt eraiion .{�. . . . . . . ..
liclxli+ ..... .. . Ikelonl it loll ... . .. . .... . OIhcr ikn . l X�S�. .�..Vecl< . .. .
['(
Weller III ion)
6. Est iumled (Slat ..(r `�.�.. 1... . .... (`ce .
t . .. ... .... .. ... .. . ... ....i. ... . .. .... . .... .
(to le Ixrid on filini; Ibis app)it:al'ioo)
'). II' rhx:llinll, hiller of ihullinli�uailri .... ... ..... tknlx:r of: A,Iliog units (x1 each floor . . . . .. .. ... ... . .
11ganglc, lxrdler o(' cies ....,
b. It" litwilxss, cnulercial or mixed) rx:ruixuxiy, liq a,( l(y nature lux) exlenl of each ly(x: of use. ... . . .... .. ..... .. . . .
1. Uiux:n:,ilxls of exiarin(S al nxcun os, if any: Irrrxd .. . .... . .. . . . ... hear .... . .... .... . . Ik:pllo .. . ... .... .. . ....
lk:il,lll . .. . .... ........ .... .....1 Mairer of Sl or ies . . . . .. . ...... .. . ,. .. ..
Nimeusires of erne atuk:(ure Willi allelellooti or ilImitions: Front . ..... . . .. . . .. . herr .. ... . ... ......
lkrltIt ...... .. . .....�....y�r Ikki � +(. ... ..... .. .. . .. . . . . . Nailer of filor ..
ier+ ... .. . ...... .
(I. Pina:usirxos of enLire i (l(x19LIIVI'irx1: h0ut: Real ikplll . . .. ...... ....
IkighL .... .. ..... .............. laardxar of Sl oriel
9. tiize of lot : KI(Hit . .... . ... . . .. hear W,11th .. ..... .. . ..... ... . .
10. Iklle 41(` 111r chase .......... .. ....I�i..... Raw of Vollwr (kaer ..... ... . . . .. ... . . .. .... ... . .. .. ... .. .. .
Il. %Axle: or w:e lilt;(.r Irl. In rAlirb plullisea are situated .. ... ...... .. ... ... . . ... .. . .... . . ... .. ..... .... .. . .. .. . .. . . . ..
12. Ihxa peelx)1u:d erxl:n nxa irxl viol at 4i ally youiull IcK4, oldinauec or ragulat loo; . . . . ... .. ... .... ... . ....
I'1. )Jill lot le r'egrexk:d ... ........ . .... ... Will excentl fill Ix: rolmud fraa prrmrisn»:IJ�iAYI%S flit ,t
IA. I'Lli (it Qarx:r of prnain1.{
es ,�/te��j..P041gt1T.. .... lxks
lrrs 5F('f�JVJ.�EA7rYc14.Np12... .. Nro+x: �y�4_
Ntur. oil Ardillecl . . Alk.k.. .I?.G�'t: A'�'.T�Z. . . ... Ah)rv:ss .eZ.7$�4G. Cu( k�!IY�.SQ4l.7,i'!'4nllxxx: No. .0y��*x. 1.11.
Ntrle of Gxllracior ...:........ .. .11....,......... ...... Address .... ... . .. . .. ....... ... . .......111ur)e No. . . . . ... .. ... .
h. Is Itis prolwrly within 300 feel or it (ilial mclil • YES ...... . . . . 9) .. .. .. . . ..
AW YES, :;(XIIIVXII MMN '11061F1!fi m-14-11'r ttAY tv RIL(illilwi).
�IVLOT MArIIAN
Ilxcale clearly fail dislilxaly all I�lildil%a, uAlelher existing or plolesed, wxl ilulicale all set back diur:nsiuns' r
luul plolialty lires. Give street a+xl bloOr 1Madler or tk&lxtilt irxr acconliug ro deed; and sdxra sLreet n.nies aoxl irrlicale
1Ael1utr interior or coviter lot..
App)011D AS NOTED
DATE. T�9. S.P.# L796;�,
FEE:— L _6Y:
}`� ,• �), n ° y �« NOTIFY BUILDING DEP Al
v, it,UH 765.1802 S AM TO 4 PM FOR THE
tl ,?I„ � - n FOLLOWING INSPECTIONS:
POUNUATION - TWO REQUIRED
iFOR POURED CONCRETE
' 2� ROUGH - FRAMING & PLUMBING
rll "I �� � 7L 3. INSULATION
4. FINAL. - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
!;VAIV, t + fMsJ WNW, STATE CONSTRUCTION & ENERGY
..._ s.J CODES. NOT RESPONSIBLE FOR
If If III
II,Y fol W.= DESIGN OR CONSTRUCTION ERRORS
.. . . .. ... . . .. .leiryl duly 1"1111, de(esce aoxl says Ural he is lho applieanl
(Nine: of iodividual sigoiuf, aunt tact)
alxwo wrn:d,
Ik! ill the ...�� �"V""+" " "" ' •�1 .. .. . . ..... .. . .... .. ... :. ... . . . ..: ..�.... . ...:. . .'.. . ...... .... ..
i
(tbnitaclol , n(Seor., curlxna�e officer,
of said lx+oer or ln.nxel s, u+>tl ix duly :ud huril�ed to Ixirfunn or have Ix:rlonreadifile said wra lc aoxl to nvAsc will tole Ihla
appl ical ion; till nll it in(lWolu cOrlallwd it Ihis application tilt. floe to the best of his luxxeltdge tux) Wliof; will
I1u11 the (xutc wilt lici 'IN ulonik�d ill the uruuwc� Set: forth in the application Iiied lhel(vilh.
fkn)I11
it) 1x;1111(! IIY+ IhIN
. . ,. ... .. . . . .day 11 . . .. . .//.//.... .�. 19 l/.5�F1.
Nell illy 11411X. .(h......-':y�.:..K.7" !.!.-...
0,11wtole ul' Applirtnd
CAROL A. BOHN
NOTARY PUBLIC, STATE OF N�(
QUALIFIED I01805064109
SULK COUNTY
COMMISSION EXPIRES AUG.5, 1W
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s NOTE
SUBO/V/S/ON MAP FLED /N THE OFF/CE
OF THE CLERX OF SUFFOLK COUNTY ON
APRIL /5, /93/ AS FILE N0. 786
\ �x
SUFFOLK COUNTY TAX MAP NO.
/000-///=/- /3.7
• :MONUMENT FOUND
-
ARYEA=,13665 J.F. ♦�
REVISIONS - ' OU,NG 4 YOUNG,
_ 400 OSTRAN-DER_AVENUE, 'MVERHEAD, NEW 'YORK
.i ALESEN.W.'YOUNG, _ - HOWARD W, YOUNG_
• i, PROFF,S W ONAL I4"Jt4g1EA ANO "'LAN D,'I5URV EYOR
LAND BURVEYOR. NTY.Vi LHC_INC), 12846 4LIC No. 45593
( � SURVEY FOR'
ONAUTHORRED ALTERATION ORA DITtON TO i '
�P N F H15 SURVEY s A VIOLATION F SECTION MAR/AN JEAN'PRA
L LAOS 9F 'HE NEW YORK STp-t i06CATIpP p
, - g
LAW LOT N0��. 29 � PAfiy'/Y�'�jDFL'j'OT NO 30
COPIG° OF THIS SURVEY MAP NOT BEARING "PECO/Y/C- 8-AY P!T{(/ER//ES, M^, "
fMt [ANO SUGVEYOP 3 INKED SEAL ORy
FMPbSSE' 9_A SHALBF.._ NOT p '1N:JFRP) S
TO eE ,. oA o rvuE cove AT ' '* GU/aRAN DEED T td
NASSAU P1 dNT �'
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SOUTWLO
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i 1
if SUFFOLK CO., N,-Y.
ft YS
20 ' ICATF
a ^„ OCT. 8, /99 X96.: OB3Y9 "
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