HomeMy WebLinkAbout21735-z F~RM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22744 Date
NOVEMBER 23~ 1993
THIS CERTIFIES that the building ADDITION TO ACCESSORY
Location of Property 250 EAGLE NEST COURT LAUREL~ NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 127 Block 9 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 22, 1993 pursuant to which
Building Permit No. 21735-Z dated OCTOBER 27~ 1993
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The oocupancy for which this certificate is
issued is DECK ADDITION TO EXISTING ACCESSORY SWIMMING POOL AS
APPLIED FOR.
The certificate is issued to
of the aforesaid building.
HOWARD & SHARON WALDMAN
(owners)
SUFFOLK COUNTY DEPARTMENT-OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
FO~M NO,3
TO9~I OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y.
N_O
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLEllON OF THE WORK AUTHORIZED)
Date, /~...~ .~'.
21735 Z ............. --' .........................................
Permission Is hereby granted to:
......
...~....~. .~......~//.. ........... . ................................
~ ~~~ ~ , .; //~'7
....... ~,._..>. .......... ,,......~ .......... ~, ......................
' Counly Tax Map No. 1000 Section ...... ./....o~....."~.. ..... Block ........... ,.~... ......... LotNo. ~
pursuant ia application dated .............................. '., 19 ................ and approved by the
Building Inspector.
0-~
/
Rev. 6~30/80
FORM NO. 4
TOWN O.F SOUTHOLD
.'BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Cerfificete O[ OccupanCy
Date ...J.ul.y. 13, 19.87
THIS CERTIFIES that the building ..... O.n..e..f.a.m..i .1.y.. d. F.e.l. 1' ~ .n.g .....................
3..0.0 E.a.g.le~ Nest Cour~t Laurel
Location of Property House No. ~ ........... Street Hamlet
County Tax Map No. 1000 Section~ ! .2.7.. ~. j,~./.Block ...'. ~ .0.9....-.-. '..L0~. ', 03
Subdivision Golden View Estates ..... Ffled Map No. 777.0 .LotNo.
conforms substantially t'o the Application for Building Permit heretofore fried in this office dated
....~ p.r.i.1...2.2.,.........1986 ,. pursuant to which Building Permit No.. ,1.4.9..2.3,Z. ............
dated May 30, 1986 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 .........
OPg f..a.m.il.y..dy.e.l. 1,.~.n~[~. 2 car garage. '
The certificate is issued to GOLDEN 'glEW E STATE S, I N.C. . ...............
..................... ......
of the aforesaid building.
Suffolk County Department of Health Approval 86- S O- 29 ~ 7~Z ! ? 1987
UNDERWRITERS CERTIFICATE NO ...- N803~95 Aprii 15 1987
PLUMBERS CERTIFICATION.DATED:
Hay ~, 1987
Rev. 1/81
/
l~Building Inspector
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, Cgrm~ercial $15.00
N nstru t~on ........... Old Or Pre ex~st Date ........ ~/~.~.~l.~.~z/~/~/ .................. .
ew Co c ' - i lng Building....~. ..........
Location of Property ..... ~...~... ................ .~..~...¥[.~[ ].~.~ ....... .~.../~M..~../. ........
·
House No. ~treet Hamlet
Onwe or Ow er of Property..
County Tax Map No 1000, Section..J~..~. ...... Block... ~. ........... Lot.~. ..................
Subdivision . . Filed Map Lot
Permit No.~/. ~.~,f.~..~.~...Date Of Permit ................ Applicant .............................
Health Dept Approval Underwriters Approval ....
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ . . .~. ~..'--'.~. ?. ..................
NORTH FORK
PHYSICAL '~ THERAPY
;
/~UG - 5 t993
PEACHTREE EXECUTIVE PARK
P.O. BOX 2442
AQUEBOGUE ® LONG ISLAND · NEW YORK · 11931-2442
FOUNDATION
FOUNDATION
2.
ROUGH
FRAME &
.PLUMBING
INSULATION
(1st)
(2nd)
PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONA~L
COM~ENTS
t
SUFFOLK GOUNI~ HEALTH DEPARTMENT
\ SINGLE FAMIL~X~WELLING ONLY .
THE S~AGE OlS~SAL AND ~'AT~R 3UPPI.Y FACILITIES FOR THiS
L~ATtON HAVE BEEN ~NSPEGI'EO EY T~S DEPARTMENT AND
FOUND TO BE SATISF&CTORY,
Chief of Wastewater Menegement Sect[on
S C DEPT. OF
HEALTH SERVICES
SURVEY FOR
GOLDEN,, VIEW ESTATES ~
LOT :5 GOLDEN VIEW ESTATES"
AT LAUREL
TOWN OF SOUTHOLD
SUFFOLK COUNT¥~ NEW YORK
YOUNG YOUNG 4OOOSTRANDERAVENUE
RIVERHEAD~ NEW YORK
ALDEN W*YOUHG~ PROFESSIONAL ENGINEER
Disapproved
a/~ ............................ ....
APPLICATION FOR BUILDING PERMIT
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 ..................
CllECK ...................
SEPTIC FORH
CALL
HAIL TO:
. INS'rRUCT]ONS
" a. This 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 igsued 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspe~ii~s. , , .~..~
· . ......
-- (Si°nature of ap~y!~cant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is ~ lessee, agent, architect, engineer, general contracto~,.'?!_~e ician, plumber or builder.
' ' :, ,:. 4,2 '
Name of owner of premises . . . :(?. ............ ( .....?'..t2%-9' ...............
(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 L~cense No ......................... "
Electrician's License No.
Other Trade's License No .....................
1. Location of land on which proposed work will be done ................................. ; ................
............................ ~..e. ....... /4~'-
House Number c5/ . Street Hamlet
Couhty Tax Map No. '1000 Section ..../.~..7. ......... Block ..... ~ .?. .... J... Lot .... ~.. ~ ..........
Subdivision ~°cP/~5~',~ 'e'~-~ 7Z'~2z..~'..j'. Filed Map No. 777~ Lot '~
(Name} ·
2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction:
a, Existing use and occupancy ....... .,~..~.5'/.~. ?.,<%/..~. ~g.'. ..............................................
b. Intended use and occupancy .... .,~..~.~../<....~..~..~.(4'...-~.0... ~..~..'~..dZ..,.'.. ..............................
,~ "
· 3. Nature of work (check which !apPlicable): New Building . ~ ........ Addition ....... Alteration ....... ?..
Repair Removal
Demolition · Other Work
i . ~'/..T..~-' .o.~../.y] (Description)
4. Estimated Cost ........... i ..... F
i (to be paid on filing this application)
5. If dwelling, number of dwellin~ units .......... ..... Number of dwelling units on each floor .....
· Ifgarage, numberofcars .. 4 ......... ' ...........
6. If business, commercial or mi.x~d occupancy, specify nature and extent of each type of use ..........
7. Dimensions of existing structu es, if any: Front ............ Rear ............... Depth ..... ' .... ' .....
Height ............... Nu[n . ............. ' .... ' .....................
bet of Stories ..... ~~'
Dimensions of shme structure With alterations or additions: Front Rear
Depth ' [ Height ...................................
· Number of Stories
· Dimensions of entire new construction: Front : Rear
Height Nurnber of Stories .............. ' .............. Depth ...............
~ Size of lot: Front ' ~ ' ~ ' Rear
i Depth
I0 Date of Purchase ......................
.......... ' ................ Name of Former Owner ....
11 Zo di i tin hihp~ i it ted .
· ueoruse strc w c r msesares ua
12 D espropos dc ' ' 'la ~i glaw .... ' .........................................
· o e onstruct~on VlO', .~.~. any zo B , ordinance or rcgulatiou: ............................
13. Will lot be regraded ...... ~ v T · · · :o'z 9; ;,'/~ ...... Wdl excess fi~ll be removed from premises: Yes No
14. Name of Owner of premises .,f/ff.~,~.~:~ff,/'~ .~. Address ~.o7> ~.~.(.(~qcfl/.~?.f.C.f. Phone No q~.~.-.~-/6,~ .
i ~b~" .,,, '' · o. ........... ;.
Name of Architect ......... ~ ...... o ........... ~;z. h'ess ................... Phone No ......
Name of Contractor ......... , .~ .%.17.*. .......... Address .... ' . . Phone No
Is this property within ~00 feet of a tidal wetland? ~Yes ........ No...~ ....
· If yes, Southold Town Trustees Permit may be required. '
PLOT DIAGRAM
Locate clearly and distinctly all ibuildings, Whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block humber or description according to deed, and show street names and indicate whether
interior or corner lot.
15.
STATE OF NEW YORK,
COUNI' y OF ......... fS.F
(Name of individual mgmng icontract)
above named. . , .
NO'~'~FY ~d~t.,,D!NG DEPABTI~.~ AT
'?~&-'~fi2 9 A~ TO 4 PM FOR THE
F()L~,.OW~NG tNSPECT~ONS:
~, FOUNDATION '[~NO ~EQUiRED
FO~ POURED CONCRETE
2., ~:~OtJG'H - FRAMING & PLUM~ING
3. b~S~t.ATIOk~ '
4, FINAL CONgTRLICTIoN MU~T
~E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
'THE ~EQBiREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CCDES, NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
.... being duly sworn, depose5 and says that he is the applicant
els the . . '
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly a~thorized to perform or have performed the said work hnd to make and file this
application; that all statements containe in this'application are true tO the best of his knowledge and belief; and that the
work will be performed in the manner sc 'forth. in the application filed therewith·
Sworn to before me this
......... '.dayof ./, ~ .......,19 ~. ~
..ore, Pub,c, .......... Co.n'- . -
:.: ' " · . f . . . : ........
/ , .. , . ', . ~&c/A/'~,~(~Z~T ' (Signature of applicant) .