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Home My WebLink About21918-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF Of X:uPANCY No Z-23189 Date AUGUST 31, 1994 THIS CERTIFIES that the buildin~ Location of Property 195 GRETON COURT House No. County Tax Map No. 1000 Section 107 Subdivision ALTF~ATION MATTITUCK, NY Street Hamlet Block 2 Lot 3.11 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated F~BRUARY 16, 1994 pursuant to which Building Permit No. 21918-Z dated FEBRUAry 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 I~NOVATE Tn SECOND FLOOR OF AN EXIBTIN~ ON~ FAMILY DWELLIN~ AS APPLIED FOR "AS BUILT". The certificate is issued to DENNIS & SUSAR Hu~BA~D of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. H039540 PLUMBERS CERTIFICATION DATED N/A FEBRUARY 23, 1994 N/A //Bui ding Inspector Rev. 1/81 TOWN OFSOUTHOLD BUILDING OEPARIMENT TOWN HAU. $OUTHOLD, N.Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....... ~ 19... 21918 Z Permission is hereby granted to: ..................... ,,-.,~. .......... ! . . . . . r/~..d. .,~. .,~ .......................... ..l~......~..:.~ ....... .~..~ .............................. to . . . . . /:~. ~.~,~ ,.:~ : ............. .:.,~. . . . ............ ~ ~ ~: ~ ........ ~ ~ ......... ~ .................... ... ~ . . . ~ ~.,. . '.:. . :: ~ ~ .......... ~ ....... ~,?. . . :~ :'/. . . . ....... ~,: :/. .,:.~ :. . . . . . ~:.- ........ at prem,,,s ,o¢oted at .............. /. :. ~...:.... ........ ~..~,.~.......~.~,.'.: ............................................. ............................................................... ~.:~/...r..~..~.. ~ CounIy Tax Map No. 1000 Section ...,l~,./~. .......... ~i:i...~:'~."~'"i~'t'~:''''::'/ ........... pursuant to application dated......,,~.,~..,~.......,~.. ............................... 19.....~./,., and approved by the BuiLding Inspector. Fee $..,, ,?~...'. ~ ......... //~' BL~lldlng inspector Rev, 6/30/80 ' BLDG. DEPT. · .' '/N OF soUTHOtD _.__ Form No. 6 TO,TN 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 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 Date ........... ................. New Construction ........... \~Old Or Pre-existing~%%_~6~ ~u~%Buildi-~ ..... Location of Property. ......................................... .... .. ... ~. .. . . . House No. Street Hamlet Onwer or Owners of Property....~..~.~.t.~~ ~.~..~3......~.~..~. County Tax Map No I000, Section .... ~.-~. ..... Block ...... ~ .Lot....-~.:.!l Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept Approval Underwriters Approval ............. Planning Board Approval ........................ Request for: Temporary Certificate .... Fee Submitted: $ ...................... ....... Final Certicate ........... ~ULATIO:I PER'N. STATE ENERGY CODE COHM~T£ ADDITIONA'L COM~IEUTS: {{ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~.~ ~6(~9~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date ~'~]~U~}:"," ~'~ ~ ~;'~ AppllcationNo. onfile ~:~ :~?~' ~ ~ ~ ' "~' ' THIS CE~IFIES THAT SU~AN HUBBARD, 195 GP, ETO~ ODURT, HATTITUCK, N.Y. in t~ foltowing t~ution: ~ B~nt ~ IntEl. ~ 2nd Ft. ATTIC,uL}T .%etlon Rl~k Lot ~examin~on F ~EP.~? 17,1996 and~undtobeincompl~nce~ththeN~onalElectdcMCode. RXTUI~ OUTLETS OTHER RXTURES 1.6 t 3 FURNACE MOTORS DRYERS NEDERS RANGES OVENS DISH WASHERS EXHAUST FANS KOTORH:I.F H.P. TRACK COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT RE ALTERED IN ANY MANNER. FEB I~1~1 BLDG. DEPI: TOWN OF SOUTHOLD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765 1802 Examined .... .~./~. -.~... ..... 19 Approved....~t)/j.~.. ...... 197/~.' permit No.c~.'/.~. ~6~?.... Disapproved a/c ..................................... BOARD OF HEALTtl ..... 3 SETS OF PLANS ~ ~'.~ SURVEY ................... ,-z'TV cIIr'CK ............... SEPTIC FOR:l .............. t:OZ i FY; CALL HAIL TO: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appti- .cation. c. The work covered by tiffs 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,..~guiations, and to admit authorized inspectors on premises and in building for necessar~ insp,~ections. (Signature of applicant, or name, if a corporation) l (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House N'um her Street Hamlet County Tax Map No. lO00 Section ........ 1.~..-2 ..... Block ..... ~ ........... Lot....~..-. ! / .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of'proposed constrpction: a. Existing use and occupancy . ....... ~. ~. ?. 5/?-,~. I~r.~. Y.~ .¥. 3. Nature of work (check which applicable): New Building ........... ~kddition .. ~; ...... Alteration .......... Repair .............. Removal .............. Demolition ............ ;i' Other Work ............... ,~. (Description) 4. Estimated Cost (~1.[(30- Fee (to be plfid on filing this application) 5. If dwelling, number o£ dwelling units ....... [ ....... Number of dwelling units ~n each floor.~ ' . If garage, number o[ cars .......... .~ ............................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..... - ................ 7. Dimensions of existing structures, if any: Front.. -- Rear ...... .'-7. ......Depth . ..'7 ............ Height ....... ~ ...... Number of Stories ....... '7. ................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ....... /.%. .......... Number o£ Stor/es ...................... 8. D mensions ofent re new construction: Front .... '-¢..~'. ....... Rear . .. ,~ .,~.) ....... Depth .... .Ot7. O.' ....... Height . .~. '. ....... Number of Stories ..... ~ 9. Size orlot: Front ..... l .qt:. .............. Rear... '~.~i" ............. ~);~[t~' ',~'~'"'}-'t'd}.~ ......... 10. Date of Purchase . ..~ ~.3/... [~.~. 71 ............... Name of Former Owner ............................. l 1. Zone or use district in which premises are situated ...... ~..v~ .c...~ ~ ..................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .k3..6 ......................... 13. Will lot be r ~raded ."J.e,..~. ....... ~ ............... Will ex o~, 14. e, ~s~ fill re~m~_.~d from premises: Yes No Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .. ~o. [ .b...~4.~,.4..g.sT&'i-.e.~.... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? ~Yes ........ No...~'~7.. .... *If yes, Southold Town Trustees Permit may be required. 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. STATE OF NEW COUN'f'( OF. :...~.~.~-~..~,.\ .~ .,- o.o, , , ..... ~2~ ......... w-:-. ...... x ........ ~( .......... being duly sworn, deposes ~d says that he is the applicant (Name of indMdual signing contract) above named. ......... .... ..................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly autho~zed to perfom or have perfomed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work wdl be perfo~ed in the m~ner set forth ~ the application filed therewith. ~wom to before me th~ ............ ......t. ......... Nora,' Public(. ~. (:'~/..~. ~'-. ............................. ~ Public. Stalo o~ N~ York .- (Signature of applicant) ~o. 4879505 ~, ~ / ~ml~lon ~ires D~e~f C.,Z-O..;~ ~.t 7GS-:1.802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION ZND [ ]/~SULATION / FRAMING ~] FINAL Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYor~ 11971 Fax (516} 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD