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HomeMy WebLinkAbout22489-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24353 Date MAY 13, 1996 THIS CERTIFIES that the building Location of Property ~RRCENT AVENUE House No. County Tax Map No. 1000 Section 6 Subdivision ADDITION Block 2 Filed Map No. FISHERS ISLAND, N.Y. Street Hamlet Lot 4 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 7, 1994 pursuant to which Building Permit No. 22489-Z dated NOVEMBER 25, 1994 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 NEW ROOF ADDITION OVER EXISTING FLAT R.OOF OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR.. The certificate is issued to ROBERT MEYER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~1 ding Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD 5UILDING DEPARTMENT TOWN HALL $OUTHOI.D, N.Y. N£ 22489 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) CountyTaxMapNo. 1000 Section ......... .~'. ............ Block .......... ~ ............ LotNo. ,...~.... ................... pursuant to application dated ........./.~../,'.~. ............ ' .................... 19....~.~..., and approved bythe Bullding Inspector, Fee $.....7..,.'-'~..~,~. Rev. 6/30/80 Form No. 6 ~ TO~FN OF SOUTIIOLD BUILDING DEPARTMENT · ' TOWN ~LL ~65-1802 / : APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be f%lled 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 f~om Board of Fire Underwriters. . 4.x-~ Sworn statement from plumber certifying that the solder used in system contains 'Less than 2/10 of 1% lead. Z,. Commercial building, industrial building, multiple residences and similar buildings and~.~installations, a certificate of Code Compliance from architect or engineer~ respdq, sible for the building. 6. Submit~Pianning 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swim-ming 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. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date , ti Old Pr isti g ildi g ~ ' Construc on... ........ Or e-ex n Bu n ........ . .... .. Crescent Ave, ~i~e~ Island,N.Y. ~6390 ~tton of Property ...................................................................... House No. Street Hamlet ~r or Owners of Property...RPbert Meyer & Wife 6 2 4 ' .ty Tax Map No 1000, Section .............. Block ................ Lot ...................... ivision File~' Map Lot it No.. 22489 Z ...Date Of Permit.~%/~5/94' .Annlicant ~&S Contractin~ Inc. ' th Dept. Approval .......................... Underwriters Approval ......................... ning Board Approval · ~st for: Temporary Certificate ........... Final Certicate..~ ....... FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADD!TIO~L COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BLDG. DEPT, TOWN OF SOUTHOt-O ............. , 19 Disappr(~ved. a/c ..................................... ............ (~il~i~spector) APPLICATION FOR BUILDING'PERMIT BOARD OF HEALTH 3 SETS OF PLA~S SURVEY CIIECK ......... CALL ................... HAIL TO: iNSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, 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 sti'eets or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appl/- 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 permit 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 Occupancy shall have been granted t?y 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. ·..z.-t. :. '. ....... i. --' (Signature of applicant, or name, if a corporation) :P.o..~.~.~.2m7~.. ~.q~.¥.~.. 2-~.~ .~o..O.Y..~¢.~.?.o .... .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, e~'~ral contracto~ electrician, plumber or builder. Name of owner of premises . .'~...$.~..~..Tc:.W.. (as on the taxr~lor latest deed If a~s a corporationl signature of duly authorized officer.' Builder's License No .... I."~. ~...cq..~r..~- ....... Plumber s L~cense No ........................ : Electrician's License No ................ z ...... Other Trade's License No ...................... Location of land on which proposed work will be done .... d...~......fi~..~.: ..... House Number Street Hamlet County Tax Map No. 1000 Section ...; ............ Block .... ~. ' Lot ............. Subdivision ........ . ............... · ....... j ...... Filed Map No ............... Lot ............... (Name) . State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................... b. Intended use and occupancy ~(.~'z~ ~ · Repair ........... ,' · · Removal .............. Demolition .... '; ' 'L .......OtherX~r~...--7 ........ : . · - ' vc.,o '..*- ,' .... , · ,__ (Desc,iption) 4, ~'stimated Cost .... ¢.t , t2c~ ... ~, ' _~ (to be paid on filing this application) $. If dwelling, number of dwellingl units ............... Number of dwelling units on each floor ............... If garage ri,tuber of cars ' 6. If business, commercial or m/xed occupancy, specify nature and extent of,each type of use .................... 7. Dimensions of existing structures, if any: Front ...... Rear ...... Depth ....... Height ............... Ntufiber of Stories ........................................................ Di f hiness ~th ti dditi ./.~' mensions o s tincture w altera ons or a OhS: Front .............. Rear.../.~ ............ Depth .... ~ ..3 .~' .......... i.. Height ...... /D. '.: ........ .~.. Number of Stories .... /. ' ' 8 Di f ti tr~cti F /.4 ./0' ~..' · mensions o en re new cons on: rent ..... r ................ Height . .(~ ....... : Rear ............. Depth ............ .......... Number of Stories .... / ........................ · Si f I I ' R .................... '~ "~" ...... >. ze o et: l~ront ......... , ........... ear ...................... Depth ...................... 10. Date of Purchase ........... i ........ . ......... Name of Former Owner 11. Zone or use district in wltich premmes are mtuated .... ' ' ' ~: ....... 12. Does proposed construction viola'lc any zoning law, ordinance or regulation, ?7?, .... 13. Will lot be regraded .. ..... ' l¢"q I .... .............. Wall excess fill be removed from premises: ' Yes 14. Name of Owner of premises .'~, PB.~M~..'T. ~..~,'fer.~t~.... Address ./:~,~.~.g-4.-~f4,+~t ~,. ~.%t'. Phone No. 7.ff$'- ?.2. ~.... · Name of Architect ' Address Phone No Name of Contractor ..... I Address ..... ' Phone No ..... . ' .. I.s this property within 30.0 feet of a tidal wetland? *Yes ........ No..~<~ .... · If yes, $outhold ' · Town Trustees Permit may be required. -. i PLOT DIAGRAM Locate clearly and distinctly nll b~fldmgs, Whether existing or 'proposed, and. indicate all set-back dimensions from property Hnes. Give street and block nu'mber or description according to deed, and show street names and indicate whether interior or corner lot. ' 15. ' 'L F()~BCDAT~C~N 'fWO REQUIRED ~LL CO~ST~UCTIOh~ SMALL MEET THE REQUIREMENTS OF THE STATE OF ~EW YORK, COUNTY OF. ~Lli~.~)b~. .S.S ........ "~ ..... ~ .............. being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) ' above named. , '(Contractor, agent , cor'porate officer , etc . ) ....... ~f said owner or owners, ~d is duly authorized t0 perform or have performed the said work and to m~e and file this tpplication; that all statements contained ~ '~this application are t'rue to the best of his knowledge and belief; and that the .york w~l be perfomed in the manner set for{h in the application filed therewith. {wom to before me this ~A~ (Signature of applic~t).