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HomeMy WebLinkAbout21861-zFORM NO. z~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Bouthold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22821 Date JANUARY 5~ 1994 THIS CERTIFIES that the building Location of Property 1350 EDWARDS LANE House No. County Tax Map No. 1000 Section 18 Subdivision ACCESSORY Street Block 3 Filed Map No. ORIENT~ N.Y. Hamlet Lot 9.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 20, 1993 pursuant to which Building Permit No. 21861-Z dated JANUARY 3~ 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 ACCESSORY DECK ADJACENT TO TENNIS COURT "AB BUILT" The certificate is issued to GARY SHAPIRO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM TOWN OF BOUTHOLD BUILDING DEPARTMENT 1'OWN HALL SOU';HOLD, N.Y. 21861 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ............................................. .... .E..~.'..Z.,.. ~~......~ ................................. ..~~.....~..../,../.~ .............. to .~_~..~.....~ ......... ~.....~,:~..~..~ ....... ~,.~, ........ ~:.,.~.~.../..~.. .,~.,~..,,J ........ ~... ........ ~ ......... ~.~ ......... ~ .......... ~.~,..~,..,.~.<~. ....... ,,,~,.,,, ~,,~,,,,,~ .......... /~,,~.,,,.,,, ~ ,~:,, ~, z~,,../.,~,~ ................................... atprem~ses~ocated at .............. lJ..~ ....... ..~'..~.~.~....i~: ............................................... ................................... ~,..~,,,~,,,,,,,~,y,,,,,., ................................................. CounlyTax Map No. 1000 Section .../...~'.. ...............Block .......... ~,.~., ......... Lot No ........ ~..,-'..~., ........... pursuant to application dated ............................................ 19 ............. and approved by the Building Inspector. Rev, 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHE~T TOWN I~LL 765-~802 · APPLICATION FOR.CERTiFICATE OF OCCUPANCY This application'must be filled in by typewriter OR lnk'and submitted to the building inspector with the following: for new building or new use: 1. Fib.al survey of property Mith accurate location of all buildings, property lines, streets, and unusual natural or topographio features. Final Approval from Health Dept.' of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwrite~s. 4. Sworn state~ent from plumber certifying that the solder used in ~ystem contaima less than 2/10 of 1% lead. r 5. Commercial building, indus.trial building, multiple residences and similar buildings an,~ installations, a oertifica~e of Cod~ Compliance fromBarchitect or enginoe~ responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming use~, or buildings and "pre-e~istin~" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. '" 2. A properly completed applicatioR and a consent to lnspec~ signed by' the I~ a Certificat~ o~ Occupancy is denied, the Building Inspector shall state the reasons therefor ~n writing to the applicant. C. Fees 1. C~:rtifieate of Occupancy - New dwelling $~§.00, Additions to dwelling $25.00. Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Ad~itions to accessory building $25.00. Businesses $50,00. 2. Certificate of Occupancy o~ Pre-existing Building - $100.00 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 New Construction~Q~..qQ%~l~ Or Pro-exis~ing Building ................. House No. Btree~ Hamlet On,er or Owners of ................................................. County Ya, No 000, $ection... ....... lock...?A .......... ..... ........ Bubdi~ision .... ; ............................... Filed Map ............ Lot ............. ; ........ Pe£mlt Mo ..... i, ..... ¢~.;.Date Of ~ormit ................ Applicant ............................. Health Ocpt. Approval .......................... Underwriters Approval ........................ ,! 'Planning Board Approval ........................ Request for: Temporary Certificate .......... Final Cercicate...v~, ..... Fee Submitted ~ streers~ and unusual natural or topographio features. 2, 'F~nal Approval from ~ealth Dept.' of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation fro~ Board of Fire Underwriters. . 4. Sworn state~en~ from plumber certifying cha= the solder used in system contn{-s less than 2/10 of lZ lead. r 5. Commercial building, indu~trial building, multiple residences and s/miler buildings and £ns=alla:ions, a'certifica:e of Code Compliance from~architeot or engineer responsible for the building. , 6, Submi~ Planning Board Approval of completed site plan requirements. TOWN OF SOUTIlOLD BUILDING DEPAKTHE~ TOWN tL~LL · 765-1802 · APPLICATION FOR.CE~II~IOATF- OF OCCUPANCY Thi~ applica=io~ mug= be filled ia by =ypewri=er OR ~nk'and submi=ted inspector with the following: for new building o~ new use: 1, Final survey of proper~y ~igh accurate locagio~ of all building'~, For existing buildings (prior to April 9, 1957) non-conforming use~, er buildings and "pre-existinB" land uses: [. Accurate survey of property showing all property lines, streets, b~{fding and ,, unusual natural or ~opographi¢ features, ~. A properly completed applica~ion and a consent to inspect signed by the applicant. If a Certificate o~ Occupancy is denied, the Building Inspector shall sta~e ~he reasons therefor in writing tO the applican£. C, Fees l. Cer~ifioate of Occupancy - New dwelling $25.OO, Additio~s to dwelling $25.00, ' Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, A.d~ltlons tO accessory building $25.00. Businesses $50~00. 2, Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certifioa~e of Occupancy - $5.00 over 5 years - $~0.00 4, Updated Cer~ifica~e of Occupancy - $50,00 .~. Temporary Certifica~e of Occupancy - Residential $15,00, Co~ercia~ DaCe .. P~.q~D~A .!~..l~$~ ................... New Construe=ion. .. Or Pr~-exis~in~ Buildin~ ................. ~oc~%o~ of ?roper=y...~R.~.Private Road, Orient, New York, 11957 House NO. S=ree~ tla~e C Gary Shapiro O~wer o= Owners of Properly.... ................................................. . ~ 018 03 009.002 County ax Hap No [000~ Sec=ion, ..... ~ ........ ~lock .......... .,,... Lo~ Subdi~i~ion ' ' ' Filed Map LoC " Permit No .... ~ ...... ;~.~.Dage Of Pe~it ................ Applicant ............................. Rea%[h Dep~, Approval,, .... , ................... Uade~wci~e~s App~ova% Planning Board Approval .... ... ................. Request for: .Temporary Certificate.; ......... Final Certica:e...~..... Fee Submit~ed~ THE NEW YORK BOARD OF FIRE UNDERWRITERS [ 0 01.0 9 3 BUREAU OF ELECTRICITY [-- 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CE~IFIES THAT Lot RXTUI~ RXTURES RANGES OVENS ~SH WASHERS EXHAUST FANS UNIT HE&TERS MULTI-OUTlET SYSTEMS NO. OF F~ET DIMMERS 12-96-93-1 R V I C E NO. OF HI-LEG DOROSE[ ~LB¢. INC. CU?CROGUB, NY, 11935 LIC.12941-~ ll _..~.*~" This ceflifica~ mud flQt be ~ in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. WILLIAM H. PRICE, JR. ATTORNEY AT LAW PO BOX 2065 GREENPORT, NEW YORK 11944 TELEPHONE NUMBER: (516) 477-1016 FAX: (516) 477-0130 December 17, 1993 Southold Town Building Department Southold Town Hall Main Road Southold, New York 11971 Attn: Georgia RE: GARY SHAPIRO SCTM 1000-018-03-9.2 Gentlemen: 1993 Enclosed herewith please find: 1. Application for Building Permit; 2. Application for Certificate of Occupancy; and 3. My check in the sum of $60.00 representing $35.00 for building permit and $25.00 for certificate of occupancy. Pete Andrade is to contact Mr. Fish to make arrangements for completion of deck/platform and inspection(s). Please contact this office when the certificate of occupancy has been completed. If you have any questions, please do not hesitate to contact me. William H. Price, Jr. WHP/lmt enclosure 828 Front Street, Greenport, New York 11944 FORM NO. 1 TOWN OF SOUTHOLD 0FC )_' 0 (~:J3 BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved ..... ~.~. ...... , 19~. Permit No..~./y&/~- Disapproved a/c ..................................... Received .......... ,19... (Bffi~14ng p APPLICATION FOR BUILDING PERNiIT Date .................. , 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to thc 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 by 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 regulatiorLs, and to admit authorized inspectors on premises and in building for necessary inspections. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... (Signature of applicant,..o~r name, if acor. l?Rration) Yva_~u~.A;.t H. PR~, ~., ~. ..~A.~QA%.~.~y..~Q.~Q~ 2065 ~ail~g a~dress of applic~O ~reenpor~, ~x 11944 State whether applic~t ~ owner, lessee, agent, ~chitect, en~neer, gener~ contractor, electrici~, plumber or builder. ......... ~g~.q~gY..~9~. ~ ........................................... ~B ~ ...... (~s on the tax roll or htest E~'~, ~ _ BY: . N¢I~ BUI~ING DE~E~ AT If applicant is ~ co~oration, signature of duly authorized officer. 765-1~2 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION ~O REQUIRED FOR POURED CO~CRETE 2. ROUGH - FRAMING & PLUMBING 3. INSU~TION 4. FINAL CO~STRUCTION MUST BE COMPLAN FOR C.G. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.Y. STATE CONS~U~ION & ENERGY CODES. N~ RESPONSIBLE FOR _ D~IGNOR ~NS~U~QN ~RORS I. Location of land on which proposed work will be done. no ~ Private ~oaa, ur~enc, ~ew ~orK ........ ........ .... .................. ...................... House ~umber S[reet Hamlet County Tax Map No. I000 Section .qa,. ~ .............. Block .... .3 ............. Lot .... 9.: .2 ............ Subdivision ..................................... 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 private one-family dwelling '% b. h',tended use and occupancy ...................................... ..., ............................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .%~n. ~-x,i.s..c..o.u.r.~. (Description) 4. Estimated Cost ...................................... Fee ...................................... (to be paid on filing this application) $. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensionsofexistingstructures, ifany: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ......... , .. Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ...................... Rear ...................... Depth ...................... Date of Purchase ............................. Name of Former Owner ............................. Zone or use district ii, which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 10. !1. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. See attached survey STATE OF NEW YORK, COUNTY OF...Suff.o.],]¢ ...... S.S ........ Mil liam. Icl,. Rricm.,..Jr .................. being duly sworn, deposes and says that he is the applicant (Name of individual signi_ng contract) above named. tlc is the ...a.t..t.o.r.n.e. y ............................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ ......... t~..~ ...... dayoC Dfi.c.~qtl?fi.r. ...... ,19..93. NotaP7 Public ......... $.~f fO~k ................ County ~ (Signature of applicant)