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Home My WebLink About23452-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24625 Date SEPTEMBER 11, 1996 THIS CERTIFIES that the building REPAIR Location of Property 3600 VANSTON RD. House NO. Street County Tax Map No. 1000 Section 111 Block 5 Subdivision Filed Map No. CUTCHOGUE, N.Y. Lot Lot No. Hamlet 12 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 1996 pursuant to which Building Permit No. 23452-Z dated MAY 16, 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 REPAIR & BESTORE EXISTING BATH-HOUSE & STAIRS AS APPLIED FOR The certificate is issued to BURT LEWIS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FO~M NO,3 TOWN OF SOU'[HOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 23452 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) . ...... .: at premlms leeatod at ............................................................................................................................... ~ou~,TaxMapNo. ~000 S~t,on...../.../..,4.. ........... ~,oc,¢ ....... ~...~.... ....... Lotto ..... ../..~ ............... pursuant to application dated ................ .~.~.. ............................ 19..,4..~f. ..... Building Inspector. 2 Fee $.. ~..~~" '~- .................. and approved by the ~~g Inspector Rev. 6/30/80 Forra No. 6 BUILDING DEPARTMENT TOWN HALL ~ ~ ~ ~,~..~ ...... ~"~'~ ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-Risposal(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 - $I00.00 3/Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 .4.Update~ Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .-... ................ .... ....... New Construction ....... - .... Old Or P~e-exis'ting Building ...... House No. Street Hamlet ...... Onwer or Owners of Property ' Z~J~' lOOO /J. ( ' County Tax Map No , Section .......... Block ........... Lot ...................... · · · ............ ............. No. ~..~.~5.~.~..Date Of Permit... i. ~...~...Applicant ,_~..~.. 7~ ..~..~....~.. Dept. Approval ......... ~.J .I..~. .... ~:F--'~C ' ' O~/~J~:~e ............. ,,ea.h ....... ude riters App oval...NZ. .... ........... Planning Board Approval .... Request for: Temporary Certificate ........... Final Certicate ....... .... ee Submitted: $ .~.. ...................... I:OUIIl)fi'l' I (,~II (21N)) lll!tlll.^TI(]ll I'lill II. ¥. (;()111~ F I I1~1. ADD I'1 I (}11^1. (',()lllll!ll l',[i: x Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 i~ '~d~ing Inspector) APPLICATION FOR BUILDING PEFIMIT INSTRUCTIONS SURVEY ..,.v ........... SEPTIC FO%I.~ .............. CALL ............... HAlL ~. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with3 sets bf plans, accurate plot plan to scale. Fee according to schedul9. ~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, iSuch permit shall be kept on the premises available for inspection throug ~out the work. ' e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of O y 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. . .E. k; m .,c.,, .... --' (Signature of applicant, or name if Ii corPoration) .............. ............ (Mailing address of applicant) State whether applicant is owner, lessee,, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~t_~p~.'~...(-'r..~. · '~' '\~... ~ .~......~. !.h~..~ .~-.~..L.-0_&.~.,~. ...... . ................. ' //'~1 (as on the tax roll or latest deed) If appl'~}~c~l~j!~sj~)at_ure of duly authorized officer. '-~ (Name and title of corporate officer) Builder's License No...'.~..'5~.~. /JJ-_L-- Plumber's License No ......................... Electric. ian's License No ' Other Trade's License No ....................... I. Location of land on_which proposed, work will be done ......................................... . ' . .............. · House Number Street Hamlet County Tax Map No. 1000 Section .... I~ I ...... Block .. . ~ .. Lot . . Subd~vision~.~M,..~-..~...~....~'....'~./~ tN .~Filed Map No. /..~.~. . Lot ',~,/ (Name)~. 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: E isti nd occupancy a. X ng Use a .... . ...................................... .... ..... .......... ...... b. Intended use and occupancy(~. ~ ~ ~ ~ .~'x~d,_ I t~ ,, . ,.3- ~.,:,:.,, .,.~.~ . ~ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...... '.: .... Repair .............. Removal .............. Demolition . Other Wor~.., 7' .¢;~'; . , ~ t~escnpnpn) ~ ~ ~ (to bepaid on fili~ 5. If dwelling, number of dwelling ut~its .......... t~ ~ Number of dwelling units on each floor.. .............. . If garage, nmnber of cars ...... 2 ................................................................. 6. If business, commercml or m~xed qccnpancy, space, nature and ext~n) of~each type of use .............. 7. Dimensionsofexistin structures ffanv: Front ~5 ~t~~ ~ ~x Depth Height ............... Numbqr of Stories ................................................ ........ D~ensions of same structure wit~ alterations or additions: Front ................. Rear ................. Depth ..................... ~ Hei~at ...................... Number of Stories ............... ~ ....... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. H gl N b4 fst - , ei it ............... um r o ories ....................................................... . ge o or: Front . , ~ ......, ......... ear... . ........ De i ....... , .......... 10. Date of Purchase ............. l ....... · ......... Name of Fomer Owner ............................ . Zone or use district in wluc remlses are s~tuate ; ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~ .......................... · d ~.D ' N Will lot be regrade ....... ~ ................. Will excess fill be removed from premises: Yes o Name of Owner of premises~ .L.~ lq ........... Addresf~/~..--~.. ~.66.~gtq,~Phone NoJ .'~. Name of Architect ;-; .' :. ...................... / Address ................... / Phone No ......... ' ...... Nmne of Contractor~.~gO: .~. h~ .......... Addrest~ql~5o.V./.~0j ~q~.//~.~.q~..~t~lhone No. ~.3. f.'. ~. ~.~. ~: Is this property w±thin 300 feet of a tidal watiand? ~Ycs....-,~... No ......... ~ *If yes, Southold Town Trustees Permit may be required. : ' I PLOT DIAGRAM i Locate clearly and distinctly all b~ildings, 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. ;TATE OF NEW YORK, ~OUNTY OF ................. S.~ .......... ' ..................... i ................. being duly sworn, deposes and Mys that he is the applicant (Name of individual signingicontract) bove named. t, corporate officer, etc.) ,f said owner or owners, and is duly auttrorized-~rm or have perfortned 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 vork will be performed in the manner salt forth in the application flied therewith. ;worn ..t° before~ me this , .......... day of.. ~ ~ ' ' ' '/t' ..... L-' JOYCE M. ILKIN~ ' No. 4962246, Suffolk CoullI~.~ term i~pires June 12~