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HomeMy WebLinkAbout23472-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RT~NT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24403 Date JUNE 7, 1996 THIS CERTIFIES that the buildin~ ACCESSORY Location of Propert~ 620 PARADISE SHORE ROAD House No. Street County Tax Map No. 1000 Section 79 Block 5 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 10, 1995 ~ursuant to which Building Permit No. 23472-Z dated ~AY 30, 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 ACCESSORY SHED "AS BUILT" AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF EE~LTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED BTE~EN & GLORIA MENOUTIS N/A N/A N/A /~ ~uilding Inspector Rev. 1/81 FOIJM NO. lB TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. N.o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 23472 Z [~ate ~0 ,9.F~ County Tox Mop No. 1000 Section .......... ~...?.. ...... Block ..;~ ........... Lot No ........O...,~... ........ pursuant to application dated....~. ......................................... , 19:..~..~.'..'~, and approved by the Rev. 6/30/80 Form No. 6 TOW%~ OF SOUTIIOLD 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 requirement..s. · B. For existing buildfngs (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 Inspect'or shall state the reasons therefor in writing to the applicant. i' C. Fees i. 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 - $I0.00 4. Updated Certificate of Occupancy - $50.00 5, Temporary Certificate of Occupancy - ResYdential $15.00, Commercial $15.00 Date August 10, 1995 New Construction ........... Old Or Pre-existing Building...S.h.e.d. ........ 620 Paradise Shore 'Road Southold Location of ~roperty , House No. Street 'Hamlet Steven Menoutis and Gloria Menoutis Onwer er Owners of Property .................................................................. County Tax Map No 1000, Section .... 7.9. ....... Block. 05 · 03 ............. LOt. Subdivision .................................... Filed Map ............ Lot ...................... Permit No Date Of Permit ' ............... · ............... Applicant ............................. l[eal~h Dcpt Approval Underwriters ' ........................ Approval ....................... Planning Board Approval 0 1995 3. Nat[ua of work (check WI c i applicable): New lluitding ...X ....... 2(dditioo .......... Alteration .......... Repair .............. Removal .............. l)emolition .... : .......... Other Work ............... 4. Estimated Cost $ 500.00 ' . (Description) (to be paid on ' ' ' fill lei[Ins', pphcat~on) 5. If dwelling, sumber of dwelling units ............... Number of dwell[se units on each floor ............ · Il' garage, number o£ cars 6. If business, commerciBI or mixed occupancy, specify nature and extent Great ty )e of t se 7. Dimensionsol`existingstnmtures, ifany: Front ............... Rear .......... Depth .......... l leight ............... Number Gl' Stories ........................................................ Dimensions of stone structure with alterations or additions: Front ................. Rear .................. Deplh ....................... Ileight ........... . ......... ... Number of Stories ...................... 8. Dimensions of es[ire sew construction: Front .............. ; P, ear ............... Depth ............... lteigl~t ............... Number Gl` Stories I0. Date of Purchase ............................. Name of Former Owner ............................. I1. Zone or use district in which premises are situated R-40 Lo~ Density. Residential 12. Does p.'oposed construct[Gu violate any zoning law, ordinance or regulation: ....N,o ........................... 13. Will ldt be regraded ....... ; . . . ~,.., .............. Will excess fill be remove~d from premises: Yes No Na mofArc~ ecl Ardreo, LM,44'~,k& A,",/ /c::~¢¢,. ,, ,. ' ........... Name of Contractor . ......................... Add~ess ................... Phone No. ' 5, }'S this property within 300 feet of a ti(Iai weCland? ~Yes ........ No ......... *If yes~ Sou[hold Town Trustees Permit may i>e required. PLOT/)lAG/tAM Locale clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensious from m>pelty lines. Give street and [>lock ntlmber or description according to deed, and show street names and indicate whether nterior or come* lot. see attached survey ;TATE OF NEW YORK, :OUNTY OF. ,S.u,f,, f. 9,1,k, ....... S.S ...?o..n~.l.d.. ~I....H.e.G..a.y.h.~y..~..~.s.q.: ................. being duly sworn, deposes and says tlmt he is the applicant (Name of isdividual signing contract) bore nanled, [e is the agent (Contractor, agent, corporate officer, etc.) l` said owner or owners, and is duly authorized to perform or }lave performed fire said work alld lo make and file this pplicalion; lhat all stalemenls contained in this'applicatios are true to lhe best of his knowledge and belief; and that the turk will be perl'onned in the rammer set forth is the applicaHon filed therewith. worn to bel'ore me this 10th .day of August 95 o~yl · ' ' ................. County JOSEPH H. GIBBONS" '.. . ............... NOTARY PUBLIC,So. S2461026sStot° of NOW York (.. / (Signature of applicant) ~ORM NO, 1 TOWN OF SOUTIIOLD BUILDING DEPARTMENT; /~U6 I O IO~ I TOWN HALL TEl.,: 765-1802_ I;xamined ........... , if) I)isal~provcd. a/c ' ' ~ ' /~"~-"~ '.5 ~ (fiufldin8 ~mctor) APPLICATION FOR BUILOING'PERMIT l}0t~R[} OF IIr. ALTII . .. 3 SE~S OF PL;~NS ......... SURVEY .................. CIIEcK ................... SEPTIC F O F. II ............. Date..A.u.g.u.s.t..1.9 ....... 199. 5.. INSTRUCI'IONS 'a. This appficalion must be compl.etely filled in by typewriter or in ink and subh)itted to the Building Insl)ector, with 3 sets or plans, accmate plot plan to scale. Fee according to schedule. ,b. Plot pla. n show ~ g ocatlon of lot and of buildings oil >remises relationship to adjoini,g pre nlSeS or pubIlc sti'eets or areas, and glvtng a detailed descri )tlon of layout of property nnl~t be drawn oil the diagram which is palt of this appll- cation. ' ~ ' c. The work covered by this application may not be COl.lnellced before JssuallCe of Building Permit. . d. Ul)on approval of thts applicalign,.the Buikfing Inspector will i~sued a Building Permit to t la ~pp ca t Such permit shall be kept on the premises available ['or mspectio Ill 'otlg lot t tile work. ' . e. No building shall be occupied 6r used in whole or in part for a,y purpose whatever mltil a Certificate of Occupancy shall have been granted by tile Bulkling~nspector. ^PPI^CATION 1S IIEI{EfiY MADE to the Buiklhlg Department roi' the issua,ce of a Building Pmmit purseant to tile Buikling Zone Ordinance of tile Towniof Southbld, Suffolk Cotmty, New York. and other applicable Laws, Ordinances or ?.egulahons, fm the constmctmn or btuldmgs., additions or aHeratlons, or for removal or d~n~ht~on as herein descrlbed. I'he applicant agrees lo comply w t i a npphcable laws, o~dinances ~buJlding code, hou¢i~ cctde,.41nd leutllalio~ s n t to ,dm,tauthorizedi,lspeoto,sonpremise,al,di,,buildt,,g£ornedessar,;¢~or¢.f~ ~J~_. ." ' ... ................ (Siglmtul~?f applicm~, or ~mme, if a corporation) P.O. Box 981,. 5/4075 Hain Rd., Southold, (Maih g address of applicant) 'N'~' '1'1.'~{ 7 ].' State whether al)l)licant is owner, lessee, agent, architect, engineer, ge.eraJ contractor, electncim, l)lumber or builder, Agent [ Nameofownerofpmmises Steven. Menoutis and Gloria Menoutis (as on tile tax loll or latest deed) I[ applicant is a corpolation, s~gnature 9r duly authodi, ed officer. (Nanle and title of coq]orate ofhcer) Butlde' s L, cease No ......................... l'lumbel's License No ......... ~ ............... Electrician's I,icense No ...................... Othe' 1) les Lice,se No. Location of land on which ~loposed work will be done ........................... 620 Paradise Shore Road, Southold Ih)use Number [ Sh'eet llamlet County Tax Map No. 1000 Section~, 7,9 , Block 05 ' Lot 03 Subdivision ' ' ...................... Filed Map No. Lot State existing use and occupancy oflpremises and intended use nnd occupa.cy ct proposed construction: a. Existing use ami occupa,cy ............ , .................... b. Intended use all(J occupancy ·..I ........................................... . ......................