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Home My WebLink About23041-zFORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N£ BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] 2304J. Z D~te ........ ./.~ ...................................... Permlss on Is hereby granted to: .£~....t...~.4..~.~.~........8..o. ll.~.~.~zz.. ....... · .~!~,,.....,~,....?....~....~......d~.~....~ ,F,,. ........... ....... .... to ...~~:...w. ........... ~ ........... ~..~?...~.~ ~..,?r. ............ ~,r.~ ~ ....................... County Tax Map No. 1000 Secflon.,,,,,,'.'~,.3 ............Bock ....... ...~3 ........Lot No. ..,,,~.4~:.,,,~. ............ pursuant to application dated .~F,,~,,~ /,,~ ~4 19.....2..~..., and approved by the Building Inspector. ~eS..~.~ ........ '~'~' '/~pector Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. U~KTIFICATE OF OCCUPANCY No Z--23958 Date OCTOBER 17~ 1995 THIS CERTIFIES that the building Location of Property 805 KERWIN BLVD. House NO. County Tax Map NO. 1000 Section 53 Block 03 Subdivision Filed Map No. ACCESSORY GREENPORT~ N.Y. Street Hamlet Lot 17.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 18~ 1995 pursuant to which Building Permit No. 23041-Z dated OCTOBER 3, 1995 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is ~seued is ACCESSORY STORAGE BHII~NG AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ERICH & MARLANINA BOLLHORST N/A Building- fnspect~ TOWl~ OF SOUTUOLD BUILDING g EF ARTNSNT TOWN HALL 765-1.802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to th~ building inspector with the following: for ne~ buildiog or new use: 1. Final survey of property with accurate location of a~l buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-? form). 3. Approval of electrical installation from Board of Fire Underwriters. 6. Sworn statement from plumber certifying that the solder used in system contains less than 2/i0 of i% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installa'tions, a certificate.of Code Compliance from architect or engineer. responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey o~ 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 Occupai~cy is denied, the Building Inspector shall state the reasons therefor i~ writing to the applicant. C. Fees 1- Certificate of Occupancy - New d~alling $25.00, Additions to dwelling S25.OO, Alterations ~o d~elling $25.00, S~imming pool $25.00, Accessory building $25.OO. Additions to accessory building $25.00. Businesses $50.00- 2. Certificate of Occupancy on Pre-existin~ Buildine 3- Copy of Certificate o~ Occupancy - $20-00 4. Updated Certificate of Occupancy - 5. Immporary Certificate of Occupancy - Residential $15.00., Commercial $15.00 Mew Cons=ruc~ion..~ ........ Old Or gr~-axis~ing Building ................. ~ouse NO. Str~e~ Zoun~y Tax Map No 1000, S~c~iou .............. ~ubdivision .................................... Fi ted H~U~ ............ Lot ...................... Permit No 0~/_~ .Date Of Permit . .Applic;m~ ,,' 6 ~ UealLh Dept. Approval .......................... U.der~ri~ers Approval ......................... 'lan.lng Board ApOrov~;1 ........................ / '{equest for: Tomporary Certificate ........... Fi.at Certicate ........... cog~Tgq.fg .......................................... 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. I~ULATION FINAL [ I FIREPLACE & CHIMNEY DATE INSPECTO~_.~~/ ,/ ^ppro ed ..... XO/> ...... l ?i .%e it No. Disapproved a/c ' FORM NO. '1 TOWN QF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1197~1 TEL.: 765-1802 APPLICATION FOR BUILDING' PERMIT B~ARD OF HEALTH ..... ~ sEEs or P~s . su~vs~ ......... :.::: ~ CIIECK ............... SEPTIC FORH ......... CALL r .. HAIL TO: INSTRUCTIONS a. Tkis application must be completely filled in by typew~ter orin ink and submitted to the Building Inspector, wi gets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premisgs, relationship to adjoining premises or public st~. 'or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this '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. Such per 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 Occupm 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ, The applicant agrees to comply with all applicable laws, ordinances, building code, h_.~using code, aj3d regulations, and admit authorized inspectors on premises and in building for necessary inspections./f~_ . // (Signatur~ of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee/agent, architect, engineer, generai 'contractor, electrician, plumber or builde dg~v'A/C:,~ . APPIIOVEO AS NOTED ". .... : .................. :", .................. ":', ................ ~ .... ~' :'"'~.(,.'~' t p If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate of ceOCCUPANCY OR Builder's icense ................ gSE'l$' NL W Ut Plumber's License No. -WITHOUT CERTIFICATE E,eetric an's iconse ,o ............. 0g 0cOUP^NeY Other Trade s L~censc No ...................... "/65-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING INSULATION 4. FINAL - CONSTRUCTION MUST I~ COMPLETE FOR C.O. ALL CONSTRUCTION SHALL t~I~ET THE REQUIREMENTS .OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN QR CONSTRUCTION ERRORS Location of land on which proposed work will be done ........................... ' ...... :. ............... Itouse Number Street Hamlet County Tax Map No. 1000Scction .].::.~. .... . ...... Block 3 ' Lot.. /~'' Od) ~ Subdivision ........ . ............................ '. Filed Map No ............... Lot .............. (Name) , Stat~ existing use and occupancy of premises and intended nsc and occupancy of proposed construction: a. Existing use and occupancy /~F-,Vz~[£~/¢e" ' , .3. Nature of work (check which applicable): New Building ..... Addition Alteration ... . Repair .............. Removal .............. Demolition .. :.: ......... O~W~k ~'21~ .......... '' ' /~'~ ~'"'-O{) p~''%,' ..... ' (Description) 4. Estimated Cost ....... ~' ....... : ...................... Fee ....................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... . Number of dwelling units on each floor .............. . If garage, number of cars ...................................................................... 6. If business, commercial or mi.xed occupancy, specify nature and extent of.each type of use ............... ,... 7. Dimensions of existing structures, if any: Front ............ ;.. Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions of s~me structure~ with alterations or adiJitions: Front ................. Rear ................ Depth .... ~ .................. Height ...... J~' ' i ..... :.. Number of Stories ........... 2 ........ 8. Dimensions of entire new construction: Front .. i~.' ....... ; Rear ..../ff. ........ Depth .../.~! ...... Hmoht ............... Number of Stones ....................... , .............................. 9. Size of lot: Front ..... ./¢,~/ ........... :.. Rear ..... /.o.~.. ........... Depth ...~. ?,o..~.~..o. ~..J../ .... 10. Date of Purchase .. ~.~."/. (~../. ??.7..... ......... Name of Former Owner . .~.6'.C.~ o..F./~ .~.~.. ~ .00.~.{' .... 1 1. Zone or use district in which premises are situated....~..e~/'.~.¢'q.z-t.'.~.t-. ............................. 2 ..... .12. Does proposed construction violate any zoning law, ordinance or regulation: ...~.q ......................... 13. Will 10t bo regraded ....... .~.o~ .................. Will excess fill be removed from premises: Yes oZ~ //o ,fr o.f-,'C6,~u,;,; ,,77. h ~.77 -0~,'.2 q . 14. Name of Owner of premises . . ~ ....... ~ ~. ...... Address . ~. ........... ~7~.... p one No ............ Name of Architect ...................... ~. ~... Address . Name of Contractor .~/.~.~.[.,~..~.o.~'. ~.0.0. O.. i~.t-.$.t ~. Address ~.'~".c.~.~}~Cl ~ .~."i~'~ ~i~Ph°nePhone No.N° .............. '1..~.~. :',~.O.~.~., 15.' I$ this property within 300 feet of a tidal wetland? *Yes.~. .... No ......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAG R~MM Locate clearly and distinctly ~1 buildings, whether existing or proposed, and, indicate all set-back dimensions fro, property lines. Give street and block number or description according to deed, and show street names and indicate wheth~ interior or corner lot. STATE OF NEW YORK, S.S SOUNTY OF .............. /,.. (Name of individual signing contract) ~bove named. ............... ..". .......................... ' .......... i....... {e is the .... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly anthorized to perform or have performed the said work and to make and file th pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that ti 'ork will be performed in the manner set fortli in the application filed tlierewith. worn to before me this ............ .day of ....' .......... , 19 ...- o'tary ?~blic¢...~/~¢. ,~.-. HELENE D, HORNE . ~. '.. ..... ......... Notary Public, State of New York (Signature of applican No. 4951364 Qualified in Suffolk Commission Expkes May 22, 197-..~