Loading...
HomeMy WebLinkAbout21476-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22469 Date JULY 22, 1993 THIS CERTIFIES that the building ADDITION Location of Property 1725 OAK DR. & 520 WEST SHORE RD. House No. Street County Tax Map No. 1000 Section 80 Block 1 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 49 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JURE 1, 1993 pursuant to which Building Permit No. 21476 Z dated JUNE 9, 1993 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 OPEN SHOWER ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. MARJORIE H. KRUEGER (owners) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED JULY 6~ 1993 - PERFECTION PLUMB. & HEATING Rev. 1/81 /~uil~ing Inspector FORM NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ......~../~. ............................................... ~1476 Z Permission Is hereby granted to: .................... ,-~,~ ......... d..~,.,~,,,.l,,-.,,~.~.,~,.~,,~ ,.v.~/./~...~,,,~/,,~,, ~ ................... Coun~'rax Map No. ~000 Seot,on ....... ~.. ........ B,ock .............. l ........ LotNo ...... ~ .............. pursuant to application dated ...... ~.../~.. ....... i ................................ 19....~..-,,:-'-'-'-'-'-'-'~....... and approved by the Building Inspector. ~ee Rev. 6/30/80 TOWN OF SOUTHOLD Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 1II2/ 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 Healgh 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/l'0.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. B. For existing buildings (prior to "pre-existing" land uses: 1. April 9, 1957) non-conforming uses, or buildings and 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 Inspec{or 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 l-- Date ... ~Z~..~../.~. ......... New Con tru' S ction Old Or ..... //~'/"/f' ............ ........... Pre-existing Building ....... z... ....... Location of Prop erty.. 47a~.. Q~..~J.~a .... 5~.~i~0 ~R,,. ,~7'*~. . Z~ ~7 I... ~. ~' ~ . f/~ r~ House No. ~'~O Street~/~ ~- ~, Hamle~ .... · Onwer or Owners of Property ........ ~.~.[~'~..~.~~ .. . County Tax Map No 1000, Section ..... ~.~ ...... Block ..... / .......... Lot .... .¥~ .............. Subdivision .................................. Filed Map ............ Lot ........ .... Date .~/~./~3 .... ~f ~ ~ Permit Of Permit., ~ .Applicant/~z/~.~J~.f....~.~ ~.~.f~ ~.~.~..~. Health Dept. Approval ....... .r ~ ........~./~ ..... Underwriters Approval ..... ~./~ ............... Planning Board Approval ..... ~./~.''''''.'..'. Request for: Temporary Certificate ........... Final Certicate ......... Fee Submitted: $ ......................... TO~¥b[ OF SOUTIIOLD ' OFFICE OF B UILDIHG INSPECTOR P.O. BOX 1179 T'O~vN HALL SOUTHoLD, N.Y. 11971 TEL. 765-1802 Date_ ~.~ Building Permit No.~7~ Plum~ber ~ ~ , tp~ease prznt;"~------ 'I certify that the solder Used in the Water supply syshem Contains less than 2/10 of l%'lead. ~ _day of NOtary Public, -~ ,~ \o\~____.Coun ty FOUNDATION (lst) FOUNDATION (2nd) ROUGH FRAME & .?LUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Building 40--SUNY, Stony Bro6k New York 11790-2356 ~J ~.t-~ I ' ;'-' / Thomas C. Jodlng Based on ~he ~nEo~mat~on you have submitted, the ~ew ~o~k  ironmental Conservation has determined that the parcel project is: '" .. Greater than 300' from inventoried tidal wetlands. ~ Landward of a substantial man-made structure greater than 100' in length which was construcfed prior ~o 9/20/77. Landward of the 10' above mean sea level elevation contour gradual, natural slope. on a Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore~ no permit is required under the Tidal Wetlands Act (Article 25 of the E~vironmental'Conservation Law)'. Please b~ advised, however, that no construction, sedimentation or disturbance of any kind may take place seaward of the !0' 'contour or topographi~ crest without a permit. It is . your responsibility to ensure that all'necessar~ precautions 'are taken to ...... · prevent any sedimentation or other alteration or-disturbance to the ground surface or vegetation in this area as a result of your project. Such precautions may 'include providing adequate work area between the 10' contour or topographic crest and the project (i.e. a 15' to 20' wide construction area) or erection of a temporary fence, barrier, or hay bale b~rm. ' ' Please note that any additional work, or modification to the project as. described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not relieve you of th~ responsibility of obtaining any necessary permits or approvals from other agencies. Very truly your~t ..... Deputy Regional Permit Administrator :t 4 765-1802 BUILDING DEPT. INSPECTION FOUNDATION SST [ ] ROUGH PLBG. FOUNDATION 2ND [ ~NSULATION] FRAMING [,/] FINAL REMARKS: INSPECTOR~~'~-~/ Examined ~h .......... , 19 ?.,-,~ ' Approved..~ ....... 19~. Permit No..~.../(.~. ?..~. Disapproved a/c ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1802 ~BOARD OF HEALTH /3 SETS OF PLANS ../SURVEY jCIIECK ................... SEPTIC FORH ............. r'~'~.~.//~.z "?4 HAIL TO: . (B~ildi~Aspector) ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .............. 19¢.~. 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 st?eets 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 cheil 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 Ordinanqe~of,.~¢,.T.o~v~g.o~' S, outhold -Suffolk County New York, and other ap licable Laws Ordinances or Re~ulahons, for the co~s'truett~5~5 ~' l~aild~gs, addmons or alteratmns, or for removal or demolition, as herein described. The applicant agrees..to.c~o~pi~itb~,.alL, applicable; laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premis'es and in bqilding for necessaiT~i..nspectiqns. (Sxgna~r~ of apphcant, or name, ii a corporatmn) ...(?.~..r.. ~a~. ,0~, ~.~ .o.~a,:.o,,. ¥, .t./. ~?/.... (Mailino address of applicant)t State whether applicant is owner, lessee/agent, architect, engineer, generai contractor, electrician, plumber or builder. o..~. ~..~,~' ' Name of owner of premises .. ~.,..~U ~ ~. 6 ]~ ...................................... (as on the tax roll or latest deed) If applicant is a corporation/signature Of duly authorized officer. · ' (Name ~nd title of c;.~r..~.~ ;~ficer) Builder's License No Plumber s Lmense No ................... . . Electrician's License No ....... .~./~ ........... Other Trade's License No ..... .~./~ 1. Location of land on which propdsed work will be done ................................. : ................ .... · -f..~ ~,.& .............. ¢~ .~. t~,,, ........ '...¢~ .~.~( ~l~.~. % .,~, )4 ,. II¢...>./,, ............ · House Nun ber . Street . Hamlet ounty Tax i000 Section ,,.: .... ....... Block ..... / ' Lot ...... ......... Subdivision Filed Map No ............... Lot (Name) 2; State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E×isting ,se and occ,pancy .. ~.~ . .l~. t ~. . l b. Intended use. and occupancy ....~./~1V & ~./~.. hPvli ) ' ' Additi ' -3. Nature of work (check which cable: New Building ......... on .......... Alteration .... ~ ..... 4. Estimated Co~t ........... ~.:... ,..~. escr on . I ' " (to be paid on filing this application S.Lf dwemng, n.,mbeLofdwellin~ units ..... : ./. ....... Number of dwelling units on each floor ~ ). . ngara, ge, numoerorcars .. ~. ~.busln.ess, co~nmercial or mi.xed occupancy, specify nature and exte~t'ofle'a~'*~,;,;,'2c',;~'~ ....... ,i) 2'i ......... t. ulmenmons ol existing structures if any' ti'rant . ,-, -.'r .............. /. ¢'a .......... ' Height ...... Nu-d 7~ -] ....... ~ ..... ;' 't'_ ~ear .............. Depth ..... .. · ~D,menmons of same structure with a terations or additions' FronT' ........... A ..................... pth ........ · .... , ..... 11. Zone or use district in which prlemises are situated ............... .............................. ~ ...... 12. Does proposed construction violate any zoning law, ordinar{ce or regulation. ~a/g) ........... ' . .. l'~ame of Architect ......... q ~./,.4 ........... Address ................... Phone No ........ :.~.. Name of Contractor ......... ,/!//. ~ ........... Address.· ............ .... Phone No ....... 'i ~.. 15.' I.s this property within ¢0O feet of a tidal wetland? *Yes ........ " .... · *If yes, Southold ~own Trustees Permit may be'required~ . i~o ......... · .-. i' PLOT DIAGRAM Locate clearly and distinctly alli buildings, Whether existing or proposed, and. indicate all set-back dimensions faom property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. APPA~/ED AS NOTED ,..# NOTIFY BUILDING OEPART~ AT 765-1802. 9 AM ~ 4 PM ~OR THE FOLLOWING INSPECTIONS: 1. FOUNDATION ~0 REQUIRED FOR POURED CONCRETE. 2. ROUGH - FRAMING & PLUMBING ', 3.~ INSU~TION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR'C,O. ALL CONSTRUCTION SHALL ME~ ~E REQUIREMENTS OF THE N,Y, ~ATE CONSTRU~ION & ENERGY ~ES. N~ RESPONSIBLE FOR }rATE OF NEW VaRI~ -ouN'r( OF... :: .... . ) N ...... . being duly sworn, deposes ~d says that he is the applicant (ame of individual mgnmg contract) ~bovenamed.. . .................................. ' .... agent corporate officer etc ) .......... f said owner or owners, ~d is duly aluthorized to perfom or have perfo~ed the said work and to m~e and file this pplication; that all statements contained M tiffs'application are true to the best of his knowledge and belief; and that the 'ork will be perfomed in the ~am~er s~t forth in the application filed therewith ' worn to before me this / ~ [ ' . . '~ ,~ , , . ............. ~o. 472~89, ~ffo~ ~.n~ ,/ . -' ~ ~ ~X -- ' q ...................... ,..pi~M,,3l,!~ , · , . ' ~Signature ofapplic~t).