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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) .