HomeMy WebLinkAbout22207-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF O~uumAN~Y
No Z-23117
Date JULY 27, 1994
THIS CERTIFIES that the building
Location of Property 1535 BAY AVENUE
House No.
County Tax Map No. 1000 Section 31
Subdivision
ADDITION & ALTERATION
EAST MARION, N.Y.
Block 9
Filed Map No.
Street Hamlet
Lot 8.2
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 8, 1994 ~ursuant to which
Building Permit No. 22207-Z dated JULY 27, 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 C~LLAR & BLOCK FOUNDATIONS, ALTERATIONS TO FRONT SCREENED
PORCH~ ATTIC ROOF, ROOF & SCREENING ADDITION OVER REAR RAISED PATIO
TO EXISTING ONE FAMILY SEASONAL DWELLING "AS BUILT"
The certificate is issued to ~uKT M. NERBER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
H-041810 - J~/LY 19, 1994
N/A
FORM 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)
No 22207 Z
Date JlJ~¥ 27, 19...?..4....
Permission Is hereby granted to:
KURT H. IJgRBgR
! 19 ~,/OODS AVI~ITOK
NALVgRI~ , N.Y. 11565-1041
to .......... c..~..N...s.~.u..c.~...c.~L..~..~..~.L.9.c..K....F..9...~....~%.z..9.N..s..~...~.I.9~s....T~9...F...R.~.~ ............................
SCI~ENED PORCH,ATTIC ROOF, & ROOF & SCREENING OVER R~dR RAISED
PATIO TO EXISTING Olq~ FAMILY SEASONAL DWELLING "AS BUILY"
ALSO FOR 4' CHAIN LINK FENCE
KBRT M. WgRBER
at premises I~ated at .......... !?.?...~Z..f.~.....~....:....~.~.s.~..~B.I..O..R,...~I:. ...............................................
Co~ntClax Map No. ] 000 Section ........... .3..{ .......... Block ......... ~. ............... Lot No ......... ~.,.~ ..............
pursuant lo application dated ......... ...J~....Y.....8.: ................................... ] g......9.,4. ....... and approved bythe
Building Inspector.
Fee $ 75.00 (foundation)
......... ~'.'0~'"(~dditlon & alteration)
35.00 (fence) ~"~'~'"'~"~i~g [~ ~e'~ _ ( ,,,,,~ ~;~;' '
Rev. 6/30/80
Must have smoke detectors in bedroom area
Form No. 6
~.,.~ TONN OF SOU~O~D
TOWN ~LL
765-1802
me
APPLICATION FOR CERTIFICATE OF OCCUPANCYj
This application must be filled in by typewriter OR ink and submitted to ~he 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.
Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
Approval of electrical installation from Board of Fire Underwriters.
Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
Commercial building, industrial building, multiple residences and similar buildings
and installationg, 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 (prier to April 9, 1957) non-conforming uses, or buildings and
Upre-existing" land uses:
~k~_Accurate_sur~ey o~.propertI sho~ng ~11 p_rpp~y ..~_i~q~p.~_~s~,~bu~ildi__ n~__a~d
unusual natural or topographic features.
2. A properly completed_~p, plication and a consent to insp~g~_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
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 Buildin~ -
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary ~ertificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...~.~ fO .~v.. ~../. f ?..~. ...............
New Construction ........... Old Or Pre-existing Building .... ~ ...........
House No. Street Hamlet
Onwer or Owners of Property...~Z. ~'
County Tax Map No 1000, Section...'~.I ....... Block ..... .~. ......... Lot ..... .~.,.~ ...........
Subdivision .................................... Filed Map ............ Lot ...............
Permit No. ~ ~.~..~....Date Of Permit.VJ~/.~.~. ..... Applicant.~.. ~ ~~... .......
Health Dept. Approval.' ......................... Underwriters Approval ........................ .
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $. ~.~ ~ ....................
. ....
Town Hall, 53095 Main Road
P, O, Box 1179
Southold, NewYork 11971
Fax (516) 765~1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 29, 1994
Mr. & Mrs. Kurt M. Werber
119 Woods Avenue
Malverne, N.Y. 11565-1041
Re: Premises @ 1535 Bay Ave. East Marion,
Pre Existing CO Inspection
surf. Co. Tax Map #1000-31-9-8.2
Dear Mr. & Mrs. Werber:
After review of our files, we do not have any records of
building permits on this property. You are required to have a
building permit for cellar and block foundations, alterations to
front screened porch and attic (roof) and for roof and screening
over rear raised patio, fence also requires a permit.
Please contact Building Department for any other
information your need.
Very truly yours,
sou Ho
Sr. Building ~p
TJFtgar
Approye~ . ..~ ]~9 ...... 1.9,~..~Permit No.~ .~.fl. ?.~.. '.
Disapproved. '. : a[~.. ~ ...................... . ~ ................
B~ARD OF ItEALTIt .... o.o..,
~,TOWN .OF SOUTHOLD.
. . ..
TOWN HALL ,,. ~, SE~,T~C ~QR,I ,,. ......
SoU'THOLD~ N.Y~
TEL.: 765-1802, V~ ~ '
H~[L
.......
.... *.
................ ......,
APPLICATION FOR BUILDING'PERMIT .
' ,.,, , t 'tO'([rt' J '"
a. Tlfis application must be completely filledJn by typewriter or in ink and subinitted 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 6uildings on premises, relationship to adjoining premises or public sfi'eets
or areas, and giving a detailed description of layout of property mint be drawn on the diagram which is part of this appli-
cation.
· c. ' The work covered by this application may nr~t be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Such permit
sh',lll be kept on the premises available for inspection throughout the work, .-
¢. No building shall be occupied oi' tised in whole Or in part for any l~urpose whatever until a Certificate of Occupancy
shall have been granted ~y the Building Inspector. . .. ..
/'APPLICATION IS HEREBY MADE to the Building Department fo~' 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 the construction ~f.buildinFas,, ~dditions or alterations, or for removal or demolition, as herein described.
The applicant agrees to coati61y '~vlth alY ~p/)lic//~ble laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on pr,,en},isesr and in building)for necessary inspel~tions.
-- YA ~'1..i ~,);,,t:~:~ )'.)~. ; ' ' (Signatur9 of applicant, er nam:, if n cor?erat.%-m)
3 t ~:.,~O:) ~))~; ,~c, }; ~o,, · (Mailing address o f applicant)
State whether engineer, generai.'contractor., electrician, plumber or bu'lider.
........... . .............. 30.~ ~Yl' :*il. ........ ' .................... . ...........................
Name of.owner o f pre.~i{e!tHT.. HO JlA
YD#!~ffil gl i~O~?~Jffi'atlOO ~'rAI8 (as on the tax roll or latest deed)
If applicant is a corpoll~n.~DJ~{~_8~¢~h~.O.I~, .,_~il00~
S~K~fII!I '~}lD)i¥1~ffilgfy ~liq~ffi~'~l omcer.
(Name and title of corporate officer)
Builder's License No '
Plumber's License No ....... . ..................
Electrician's License No .......................
Other Trade's License No .......................
Loc~tion of land on which proposed work will be'done ......................... . ....... : ..............
ltouse Number , Street Hamlet
Cou'nty Tax Map No ,000Section' ' :.~.i' ' Block ' ?. ' 8
................................ Lot...
St bdi isi ' Filed M No Lot
I v on ....................... ap ..................
(N ) ...........
State existing use and oc. cupmmy of premises and intended use and occupancy of proposed construction:
a. Existing Use and occupancy .... ' ..... ....... . ......... ~ ..' .., .,...~'.':~' ,,., ........ ....
.3. Nature of work (cheek whic~ applicable): New B
~ .............. Removal ........
ddmg ..........
.... Demolition ._...: ......
4. Estimated Cost l&o.o.r-. ['(Iz.P.a~,.~ K?,c,~cv~d..~.? IS' ~O,"" (Description)
' ~-~t c~u .......... Fee ........... ' .
5~ -~ - ,; I -- ' (to be paid on filing this application)
· ltdWeu!n~,numbefofdwellingunits.,~f~q'.,, .. ' .
" ~ ".~. '.,,g,h~.,.',.~'.~ I/x/n*. { · . .. Number of dwelling units on each floor ...
· If.~ara,._ ..~.,.~. .... .,~ars .. ,,...- ,~. . , · ..........
' 6:, If business, cdmmercial ar mi'~oa'~.,,'..'~.~.~. .... (;" ; ...........................................
..... -- '"'~ ....... v--'-y, s ~ec;uy na,t~re aha extent of,each type of t se ,, ~.~ ...........
t. ~unenmonsol existingstmctures if any, Front .I ~,~r ., Rear .~),FE .,, De~th
?g~t .,..t;.ea.~ .... m~o~s~o~,.~.16.a~" ... . ' .... " ...........
~tmenmons of shine structure' with alterations or ~d":': ..... ;' ' ' ~'2 'all .................... z ..........
D~'~- ~u, ~,~ I ~19~-o-~, eronr · · mO ~. Rear
.... Hel~t ..... ~,~,~. ....... *..NumberofStores . .'. .i ........
8. Dimensions of entire new codstmction. Vrnnt ' '
'~'g"' · · ·, ' , ...... Ngmber of Sto~es...I.(... '.,. . ~ ...............
9. 2~?o(17 Front .... g.a.~r ........ , .... ~...~b~ b~": ...... ~ ;~"~6;'~ ...........
I0. ~ate OIl'urchase .m-/7- 76 . ' ............. P ......... '~ ..........
~ .- ,. . ' ~ ...... '1 ................... .. Name of Fomer Owner
11. aone or use amtnct m which premises are situated ~ ......... ' ........... ~: .......
Does proposed construction violate one zomn~ la ~-a;-~-~ ~, ,~ ~ ' .......
~'13. -, ~ g, .... ,.--~ ~--~g~atlon ......
Will lot be .....,~a ~c ~ ~ ,~,.~ ~ ..... n .....................
"14 ,.~,,. ~. ~wner ot premises ~X .1~: WVB.~}~ .... Address [.la N00Pi.~g ~[~... P~ono
Name ... ~ '. ......
of Architect '
Name of Contractor,, ' '~" ....' .......... Address ..... ~ ........... Phone No. ~ ...... ,.: ....
. c" , ........... ~.... O~dre~s ........ . ...... ~.. Phone No..~ ......
15.' Is n~s property wiChir 300 feat: of a tiaa& wetland? *Yes ....... ~ '''
· ~f yes,' Southol, To~n Trustees Piermi~ may bo required. '
Locate clearly ~d distinctl
y,
prope~y ~nes. Give street ~d bloc
inte~or or corner lot.
· P!~?T DIA~ . . . ' '
11 buildings, Wheth~r existing or Proposed, and, indicat~ all set-back dimensio
¢ · ~ . ns rom
. APPROVED AS NOTED
NOTIFY 8UILDING DEPARTMENT AT
'.765-1802 9 AM TO 4 PM FOR,~E
FOLLOWING INSPECTIONSl
~, FOUNDATION - TWO REOU,IRED
*' 'FOR POURED C~CR~E,
2, ROUGH; ~MING & ~M~NG
3. INSUliN
4. FINAL -' CONaTRU~ION MUST'
BE ~OM~ ~'~O.
ALL CONISTON eHA~ MI~
THE REOUIRBMEN~ OF ~l N.Y.
8TATi ~ffiWl~ i B.ReY
CODES. NOT flE8fONelILI fON
'DES~ON Off OoNsnluGlION ~;:
STATE OF NEW YORK,
cOUNTy. O~ ................ ~.s .
(Name of individual signing contract)
above named.
being duly sworn, depose.s and says that he is the applicant
' [{e is the . .' . . . '¢SO/t//~'~/~_ " . ,
' . .. '5; , ' , i ~; , ' ICqn!ract°r,~gent, corporate'officer;etcO'I ........ '7' '""'f'! ....
. ~i sam ow.ncr or owners, and is duly~ at tli0rized to perform or have performed the saki wok
~pplicafion, that all statements contained in t {q'onnllo-']- ....... r and to make and file this
. vo.~......, ...... ; ;- -rr.,*aupn are ~rue to the qest of his knowledge and be ief; and that the
· . ,,. wm De permrmeo in the manner!set forth ia the application ,flied therewith.' '
. ~wom to before me this
,! . ' ~ I... ~. ~4r/~..
'i'°tary Public, ..... ~, ,~,., ~~
' Notary Publ o Sate of NawYo~
E~,,qY AVEN[J£