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Home My WebLink About23093-zFORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ............... .............. N9 23093 Z CounWTax Map No. 1000 Section .......... ,,~,,,.~....,~.. Block ....... ~ ............. Lot No..,~.....~... ................. pursuant to application dated .................. ~...,.~..,...~.,..., 19....~.,~nd approved by Ih, Building Inspector. // Building Inspect~¢' Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24714 Date OCTOBER 29, 1996 THIS CERTIFIES that the building Location of Property 575 HILL ROAD House No. Street County Tax Map No. 1000 Section 70 Block 4 Subdivision Filed Map No. ACCESSORY BOUTHOLD, N.Y. Lot Lot NO. Hamlet 29 conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 22, 1995 ~ursuant to which Building Permit No. 23093-Z dated OCTOBER 31, 1995 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 SHED IN REAR YARD 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 SALVATORE & LUCIT.T.R GRANFORT N/A N/A Bu'i 1 din~ fnsp~or Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY · 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. 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 Buildinm - $i00.00 3. Copy of Certificate of Occupancy - ~ .25~.~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....... ~f ~ .~.~ ~. ....................... New Constrnction..O.. . . Pre-e isti= Building Location of Property.EY..~..Q!. E.~. .... ~?.~. .~. !.~ ........................ ................ ' .. House No. Street Hamlet Onwer or Owners of Pro~ert~ County Tax Map No i000, Section....~.~ ....... Block .... ~. ........... Lot ..................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... ~ee Submitted: $...~..~.'..~.~. ................... ~L~..I 765-1802 BUILDING DEPT. INSPECTION FRAMING [//'] FINAL FIREPLACE & CHIMNEYs DATE //~/~///~// INSPECT~ I'[FI' ~.l)'~lJ'l,~[e ~;~"L'~,[I. OI'I RI~,[~ORT FOIJI'H)~.T l Otl ( I~OUNI)A'I' I ON (2NI)) I)ATE COHJ~IE NT ,S 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLUG. REMARKS. ~~ Colonial' TOWN 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT; TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1802 BOARD'OF HEALTH ~'-- 3 sETs OF PLANS ~SURVEY "'~' CI1E C K ................. CALL Date .................. 19.,. INSTRUCTIONS a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 sets of pans, 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 stkeets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approva! of this application, the Building Iuspector will i~sued a Building Permit to the applicant. Such permit shall be kept on the premis'es available for inspection threughout 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 Buildiug 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 Southbld, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for thc 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, hzgusing code, and regulations, and to admit authorized inspectors on premises and in building for neCessary inslqectio}~s. //_ .... (Signature-'' ''of al~plicant~nam e,. i~ a corporation) State whether applicant is owner, lessee, agent, architect, engineer, generaJ contractor, electrician, plumber or builder. ~ '~ (as on the tax roll or latest deed) If applicant is a corporation, signature, of du y aut ~o,iied officer. (Name and htle of corporate officer) Builder's Licen~,e No .......... , ..... ............ Plumber's License No.. ...... ~ ......' ............ Ele~trician3s. License. No..',~.. ! .~.... ............. 1. Location~6f land off ~vhich pr0'poged Work wilhbe dohe .................... , .................... .......... ...<q.<'.'..... .............. . .................................. . lfouse Number Street ttamlet Cotulty Tax Map No. 1000 Section . .'.7.~O. ........ Block ..,,.~, ........ :... Lot,~. . ......... SubdivJslon .... Filed Map No. Lot (Name) 2; Stat~ existing use and occupancy of premises and intended,use and occupancy of proposed construction: a. Existing use and,occupancy .[. ~..~..~.,j~ .................... .3. Nature of work (check which applicable). New Building ddition Alteration .......... Repair Removal Demolition . Other Work ' ~ .//tr~-/) ' ~ ~ ~,, tgD (D ipti ) 4. Estimated Cost ......... '" (to be paid on filing this application) 5. Ii,dwelling, nu~ber?f dwelling units ................ Number ofdwelling units on each floor ....... 7. Dimensions of existing structures, if any: Front ............... Rear .............. If business, commercial or mi.xed occupancy, specify nature and extent oLeach type of use .................. Height ............... Number of Stories ............... ' Depth .......... '. Dimensions of shme structure witt~ alterations or additions: Front D ................... Rear ........ epm ................... He g ~t , ' Numbe .... ' .... 8. D~menstonsofentir~ ~e. wconstnction. Front I~ gou ~ ~ t~tl '~ } ....... He ht ~O ' ' . ............... Depth ..~. g ......... Number of Stones. .. .( ~c ~ve ........ 9. Size of lot: Front ............... a 10. Date of Purchase ...... , .......... '...' ......... Name of Fenner Owner ............. 1 1. Zone or use district in which premises are situated .............. ' ....... : ....... 12. Does proposed construction violate any zoning law, ordina ce or regulation: .M.Q, ' ....... Will lot be regraded .... ~¢. · .~ ...... .~.~ ...... Will excess fill be re'moved from premises: Yes . No 14. Name of Owner of premises . ~.,..~.~.. ~... Address X]~ ~/~[. ~ ... Phone No .J~- ~¢ff~ . Name of Architect ....................... ' · Address ..... Phone No' v .............. Nmne of Contractor .......................... Address ................... P~ No ................ 15. I.s this property within 300 feet of a tidal wetland? *Yes...~ .... No~ ...... · If yes, Southold Town Trustees Permit may be required. PLOT DIAG~ Locate clearly and distinctly ~1 buildings, whether existing or proposed, ~d, indicate all set-back dimensions from property lines. Give street and block number or description accord~g to deed, and show street nines and indicate whether interior or corner lot. . ~ ~'%~ t] ~, ,, ~ ~ ~ FEE: , , ~'-~,~ ~ ~.3~.~ ~ ~, ,~ ~,~J~ NOTIFY' BUILDING 765-1802 9 AM TO~E '. ~ ~'v~ ~[~[J~ ~'~f~ ~ ~'~"~(~ 1. FOUNDATION - TWO REQUIRED ~"~-g~ ~ ~ ~ ~ 2, RO~H - FRAMING & PLUMBING ~TAT~ OF NgW~R~ 3. INSU~ON ~OU~y OF..~.~[~, S.S~ 4, FINAL - CONSTRUCTION MUST ...... BE COMPLAN FOR C~O., ' ~ ~ .... ALL CONSTRUCTION. 8HAL~ MEET (Name of indivktual signing ~ontract) bore named. STATE CONS~UCTION ~ ENERGY co,;s. ,o,;o. te is the ..... . .................... *.. ................ ' ............ . f said owner or owners, ~d is duly authorized to perform or llave perfo~ed the said work and to'm~e and file this pplication; that all statements containe~ in tfiis application are t'rue tO ~he best o~his knowledge and belief, and that the ~ork will ?e~perfomed ~n thinner se~ forth in the application fi ed therewith. ' ' .......... ..... , [o.ta~ Public, ~ / "-' '.' WEST HILL RD. ~ ~ S. 88°5~'40' E. 45L00' Area = 24, 826 sq. ft to tie line CERTIFIED TO, LUCILLE W. GRANFORT COMMONWEAL TH LAND TITLE INSURANCE COMPANY ANY AL TERA TION OR ADDITION TO THIS SURVEY IS A VIOLA TION OF SECT/ON 7Z09 OF THE NEW YORK STATE EDUCATION LAW, EXCEPT AS PER SECTION F2Og'$UBDIVISION Z. ALL C£RTIFICA DONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ~fHOSE $IGNATURE APPEARS HEREON. ADDITIONALLY TO CO~L Y FI(TH SAD LAFI THE TERM 'ALTERED BY' MUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A CO?Y OF ANOTHER SURVEYOR'S MAP. TERMS SUCH AS 'IN~ECTED° AND 'BROUGHT"TO-DATE° ARE NOT IN COMPL~4NCE FILTH THE L,4 ~ '904O / I! / / / / / . / SURVEY FOR LUCILLE W. GRANFORT A T SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N K 1000 - 70 - 04 - 29 Sca/e, 1" = 30' June 30, 1~94 Aug. 3, 1994 (mons. set ) C I S~O/?VEYOR$, P.C. (516) 765 - 5020 P. O. 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