HomeMy WebLinkAbout22329-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26452
Date: 05/14/99
THIS CERTIFIES that the building RENOVATION
Location of Property: 74605 MAIN ROAD GREENPORT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 45 Block 4 Lot 5.1
Subdivision Filed Map No. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 25, 1994 pursuant to which
Building Permit No. 22329-Z dated SEPTEMBER 15, 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 RENOVATE EXISTING BUILDING AS APPLIED FOR.
The certificate is issued to WILHELM FRANKEN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N-326790 09/13/94
N/A
FORM NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
N£ 22329
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~,~ ................... ~ ...........................
Z
Permission Is hereby granted to:
.... ~.~..,.,,~ ....... ~z.:~ ..............
..... ../,..~:...../~.~.:.....?~ ~ ....................................
C~.~_d~o....~.... ....... ~../-....H...,.....~./.?~ ........
,o...~,.~.---....~.......~~:.....~..~.,.~'~ ~-:-': '~'~'~' _ ............. ~ .................
at premises located at .................................. ~ .....................................................................................
............................................................................... ~'...~.~.'...-. .............................................
CountyTax Map No. lO00 Sectlon,....,~,~..,. ....... ,.. Block ...... .~...~.T. .......... LotNo ....... ~-...l .....
pursuant to application dated ........ ~..~'.~..,......~.~... .................... 19....~....~...., and approved by the
Building Inspector.
Fee $, ../.,.O,,.'~,...:.~...
/~' . Building Inspector
Rev. 6/80/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Th£s application must be filled in by typewriter OR ink and submitted to the buildin
inspector with the following: for new building or new use:
1. Final survey of .property with accurate location of ali 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 build~
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 a
Vpre-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 applican
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, A~cessory building $25.00,
Additions to accessory building $25.00. Businesses $50.Q0~
2. Certificate 'of Occupancy on Pre-existing Buildin~ -~-
3. Copy of Certificate of Occupancy - ~
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 Building .....
oeation of Property.. 7 .O. . ............ ........
House No. Street Hamlet
.o..¢ ......-t ......
County Tax Map No 1000, Section ......... Block .... no ............
Subdivision .................................... Filed Map.. i ......... Lot ..................
Permit No..~..%?..~..~. .... Date Of Permit.~././~/.~. ..~. .... Applicant~././.~.~./.~..~/~/...~
Health Dept. Approval.. ~./?~. ................. Underwriters Approval..~..~..~..~. ~. ?..~. ......
Planning Board Approval ...... ~./~ ............
Request for: Temporary Certificate ....... . .... Final~Cert~icate. ~
~. ~ APPLICANT
CO~fbtEUTS ' '
;ULATION PER'~.
STATE ENERGY
CODE
FI;~AL
IDDITIOII~'L CO!¥1ENTS:
~ 765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATIONlST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[.~FINAL
[ ] FIREPLACJE~& CHIMNEY
INSPECTOR
Examined
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN tlALL
SOUTfIOLD, N.Y. 11971
TEL.: 765-'1802
Disapproved a/c .....................................
· ~,l~uffffing Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF It['ALIII
SURVEY
CIICCK ..................
SEPTIC FOR.'!
eT I F Y
CALL
INSTRUCTIONS
'This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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'ee'
o,r areas, and giving a detailed description of layout of property muJt be drawn on the diagram which is part of this appi
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 perm,
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 Occupanc
shall have been granted l?y the Building Inspector.
APPLICATION IS HEREBY MADE to the Building DepartmeJt for the issuance of a Building Permit pursuant to th
Building Zone Ordinance of the Town of Southold. Suffolk County, New York, and other applicable Laws, Ordinances o
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 tc
admit author/zed inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name. if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general ',?ontractor, electrician, plumber or builder·
¢..~.x,,~-~ , · , ~.~, ~¢ ...........
Name orowner of premises ....//-/./.4.//~Z:.~.~. .... ,z~,,/Z..~,./~..~. ,g~./~' w S//__/Z~' /~:/g~/P/Z
: (as on the tax roll or latest
If applicant is a corporation, signature of duly authorize~l~fiilERS 0ER?IHC^I'E nay='nr~-~m~ a* .v.,.~~,//~/.~_g:
· ' '. ........................ ' .................... I~ /~ ,~' ,', ,,~':
· (Name and title of corporate officer) NOIllY' 8UILOINO DEPARTMENT AT.
; ' OCCUPANCYv,,n° ',,,..
Builder's License No ...... ' FOLLOWING INSPECTIONS:
...... USE'IS UNLAWFUL ,. ~o,,,^,.o,. ~,o
FOR POOR~D
' ' "WITHOUT CERTIFICAT . ,ouo.-
· . INSULATION .
, ..... UP UISCUPANCY .' - MUST
' BE COMPLETE FOR C.O,'
OtherT adc, sLlcense. No ............ .'-..-..-. ALL CONSTRUCTION SHALL MEET
?. ./'-/. ~',--' -- -- ~ ~ _THE ,,F. IF~_QUIREMENT$ OF.&';THE N.Y.
Location
of land
on
which
proposed work will be done .... ...... ./.~..~../4~.'t.A.~r~./~.9NSTRUCTION ENERGY
/~ //f]~/~ ·
............. .. /.. . Z ..s,G. o. E..O..S .
Ilouse Number Street Hamlet
County Tax Map No. 1000 Section ; ~/-/5,0 Block O {/:~O : ' Lot ODs, O?/
Subdivision
........ . ............................. Filed Map No ............... Lot
(Name) ...............
State exJstiug use and occupancy of premises and in tended usc and occupancy of proposed construction:
a. Existing usc and occupancy ,~' 4~'7-72./~,,eTZ_
b. Intended Use and occupancy ....................... ~ .....
· 3. Nature of work (check wh Chla--. .... ' . ,.,
, ~'~ ]cable): Ne,.*,, Building. · · .\dd ti ..... :::"":""'~F~"'7 ' ' ~
Rcp~r .. ~ ......... Re~oval ,, ' ...... qP q -fi. ~1' ~,~. ~g:tion .....
4. Estimated Cost . ~,5,~ ~o · ' ' . '~ , (Descrption)
...... ,... ........................... s~ .... '.'..~;~... .:~l
5. Ifdwelling, numberofdwdl/r~oun ts ~' "q~}his~p31icatid,) ''
Ifgarage, numberofcare ? ...4e .......... . Numberofdwellin&q~j~~r ~
. , ...................... ,=::,,~:~3~~'
6. If business, commercial or m,x?d occupancy, specify nature and extent of.each type of use ~g4g~f~ ........
7. Dimensionsofexistingstmctt, yes if any. Front
Height .. ' · .. Nt ~ - ~' ' '''.~ ........ Rear ............... Depth ......
. · ..... meet oI~tor es ~ ........
" ' ...... 'fi ..... ; ..............
D~mens~ons of same structure wah alterations or a OhS: Front
Depth ...~ i · · .... ear..
' ' .............. ;... Height ....... · ''' ...........
............ ;..NumberofStofies .. ' .'
8. Dimensions of entire new construction. Front . .ff/~ ~.
ht ' cs ' . .................... Dept .......
~ei .' ............. nut, her of Stofi h
9. aize of lot: Front ..... . '~ ...................................... ' ' '
10. DateofPurchase . · ''', ..... ; ...... lxear..~; .......... ~... Depth ................
' ''"~ .................. mameofFo~erOwner f/.~, ~.co, ..
11. Zone or use district in which D~emises -~ ~t,,~+~ . ' ...............
...... v[ ...................
12.Does proposed construction w ate any zoning law, ordi or regula io .... o ..........
14. N~e of Owner of premises . .. Address ~
, '. ' ' '~ad.~ g ..... Phone No..q?7-/a~3.
N~e of Architect ......... ~ ............. Address .. ' ..........
N~e of Contractor .~ ~c ................. Phone No ................
ts -' " ', ................. Address .~a.,~a~ qey ~hon?~ q?.gd, qff8
' ' ' ~ 7.'.'.'.C'.'. ....
~5.' ehxs properZy x~tehin 300 teee off a exda[ wec~and? e' e No...~ ..... .
~tff yes,'Soueho~d Toun Truseees Pemtc may be required.
~ PLOT DIAG~
Locate clearly ~d d~stmctly ~ll bulldogs, ~heth~r ~xisting or proposed, ~d, indicate fll set-back d~ensions from
property Hnes. Give street ~d block mmber or description accord~g to deed, and show street n~es and indicate whether
~te~or or corner lot.
,
(Signature of applicant)
Notary Public, State of NOW Yorkn.
No. 4822563, Suffolk. County
Term Expires December 31~,
;TATE OF NE~,~~:~9:~ 0''~ ~,~i¢'l ,~';¢~ ~' ' .
'7,7'75t '"~q' .... .~.'... ~,,,,~.,. ~, . 'b,~itD.~ ~ ~ , ' ;~}t ' '
................. ?. ........ '. ~ ~4~. ~0. ~ --b'e'ih'g',~lul worn, deposes and says that he is the applicant
( me. ofmd.lv]61ual s~gnmg contract)
e is th/~ '. .;;, ~ ,' .~':"
ontractor, agent, cot' )
,, i' , porate officer, etc.
' said owner or oxvners, and is duly a~tllorized to perform or have performed the said work and to make and file this
' plication; that all st tements contained in this application are true to the best o£his knowledge and belief; and that the
)rk will be performed in the manner se[t forth in the application fi ed therewith
,'om to before me this
~ff~ ' ..dayof.. ~ ' ., 19 ,?~
tary Pfiblic ........ = .......... Coun
·
~ UNDA J. COOPER
MAP OF Pi~OI:)ED. TY
SUqVEYED FO~.
G~_O~GE I~. ~ MADELINE L.
HUB,_?._
-"" "' ,.,F SOu,, ~,.,~.~ ]..!:~.
GUAP. AhIT~ED TO TH.~ SECU~i T'f TtTI
VAN TUYL~SO~t