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Home My WebLink About21760-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22854 Date JD. NUARY 28, 1994 THIS CERTIFIES that the buildin~ Location of Property 340 GLENWOOD ROAD House No. County Tax Map No. 1000 Section Subdivision ADDITION CUTCHOGUE~ N.Y. Street Hamlet Block 6 Lot 5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 21~ 1993 pursuant to which Building Permit No. 21760-Z dated NOVEMBER 4, 1994 was issued, and conforms to aL1 of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is INST~T~.ATION OF WINDOWS IN EXIBTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. MELISSA SPIRe (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Da,e...../~ ............................................. 2~.760 Z Permission Is here,by granted to: ..~,...~.:./.~...............' . ...~~....,.~.~ ......... ~ ............ ,o ................. CotlnlyTax Map No. 1000 Section ...... ./.~..¢2. ......... Block ........ ~. .............. Lot No....~ ................. pursuant to application dated ........... ./...~./.."~'-./.. .............................. 19...?~,, ...... and approved bythe Building InspectoL Fee ~...Z .,~.,z~.. Rev. 6/30/80 TOWN 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 buildin inspector with the following: for new building or new use: 1. Final survey of property with accurate Iocation of all buildings, property lines, rStreets, and unusual natural or topographic features. 2. Final Approval from.Health Dept. of water supply and sewerage-disposal(Si9 fo ~r~). 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 6f 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, buiiding and unusual natural or topographic features. 2.. A properly completed.application and a con~ent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Bui%ding Inspector shall state the reasons therefor in writing to thelapplicant. 1. Cgrtificate 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 Building.. Location of Property..~.~{'~. ~-/~t7 %~9~ ~O/7-~ House No.. Street Hamlet Onwer o~ Owners of Property ..... ~ - County Tax Map No 1000, Section..fZ~..~ .... Block ..... ~. ......... Lot..~. ................. Su v on ................ e Map ......... ~...Lot .................... Permit No.~.~/~...Date Of Pemit.../..~ .... A lican~ · .. pp Health Dept. Approval.. ;~q X~ ................. Underwriters Approval t~ I ~ .... ~a~ ~oa~ A~p~ov~ .................. ........... Fee Submitted: ~ ' ..... . ........ ffOrLIL NO. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~! NOV 2 ' . ' APPLICATION FOR CERTIFICATE OF ,OCCUPANCY '' ' i, A~~ ·Thi a · , , · ,,~ , · ~ , 1 Fin~l~,s~rvey of property wi~h accur~e ~oca~p~'of~,Rtl builHin~s~ mr66~tv mtr2ets, 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 fcom Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than ~/10 6f 1% lead. , 5. Co~ercial building, industrial building, mqltiple 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 April 9, 1957) non-conforming uses, or buildings 'and ?pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, buiiding 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, th~'Bui%ding Inspector shall state the reasons therefor in writing to the applicant. C. , Fees 1. C~rtificahe of Occupancy - New dwelling $25.00, Additions to dwelling $25,.00, Alterations to dwelling $25.00, SwiPing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I00.00 3. Copy of Cert%ficate of Occupancy - $5.00 over 5 years - $10.00 .~ 4., Updated Certificate of Occupancy -,$50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Co~ercial $15.00 New Construction ..........., ~ Old Or Pre-existing Buildiqg.~.~ [.[...... ~ ......~ .~ Location of Property...~.i.~ .............. ~~ .... ~.... House No. Street Hamlet .... Onwer or Owners of Proporty County Tax Map No 1000, Section .... · ~ ..... .. Block ............ .Lot ....... .. . ......... . ................. ...................... P~rmi= No ...... Date O[ Pe~it..' .............. Appli an~ .............. u~.~t, u~u:. ~..~o~.Z ...... ~ 1.~ ............... u~:~ ~o~.Z... ~.~& ................ 91arming Board Approv~l ........................ ~equest [or: Temporary CertiE~eaCe ..... . ..... Final Cer-t~eaCe ...... ~.. /...~.'~ ~.~ ~~/.~d .... ......... ?'.~D i~;S?ECTiON FOU._~N DA_.T I O__N ( 1 s t ) · FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING' INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~ii? OCT2i 11993 I~,~ Examined ll/.~ .... ' .......,i97..~ Approved ! I . ........ Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 _ . ./ ino I~pector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTtl ......... 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC FORH .............. NOTIFY: CALL ................... HAIL TO: Date/~/~/./~ ....... 19... INSTRUCTIONS 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 6. 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. c. 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 Bullding 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. .. ~.. ~d.0.t e~.O..m s ~37...tm~.~.~ ....... -- gSign~ture of applicant or name, ifa corporation) .... 69. £~o~ ~. . .N. .Y. . .I. ~.~. ~ ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name ~ of premises ~] .~.~.6..-~'~. $ ~ .................................................... // )///.// (as on the tax roll or latest deed) If ~plicanff. iy/c/~/~a~o~n/~jgoatj~re of duly auth~orized officer. [ ~ (Name and title of corporate officer) ........ ~ --' ,. -. [ '-. :~ ~ .~--¢- - ~.~ -_ -...~ -' ~: '~._ _' - . ~__ .- - . ._~a-z=z-~-'L~ _ ._:~__~-~-~,_~..~__-~-'~-'~- ~'~'~- Builder's License No....'~.~..~..6a....~...J~ ....... Plumber's License No ......................... Electric. ian's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. G.h .......... , ...... ............. .......................... House Number Street County Tax Map No. 1000 Section ...[..~0.......... Block .... ~O Subdivision..~' ~ .~.. (N~am~)~. ............. .Filed Map No. Hamlet ............ Lot. ~7. ............... '~.3. ~. Lot .~. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.. -'/.~--~. m% ).~ .h~l.~J{ j'.~ ......................................... b. Intended use and occupancy .I .~7...'.{~. \'} ~. :~...1~...! ..~. .... WU.!% .,, '...' ......... 3. Nature of work (check which aCplicable): New Building .......... ~Addition .......... Alteration Repmr .............. Rem;oval .............. Demolition .............. Other Work..- .............. 4. Estimated Cost .(OT ..~... ! (Description) 'i .......................... Fee ...................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwellingI units ...'.1. .......... Number of dwelling units on each floor. · If garage, num bet of cars ................ 6. If business, commercial or mi ~ · ' ................. _ xefl occupancy, specffy~ature and extent of each type of use . ./L/.~. ...... 7. Dimensions of existing structures, if any:' Front..~J.[..~'. ........ Rear .............. Depth .......... ' .... eight ............... Number of Stories ....................................................... Dimensions of same structure with alterations or additions: Front .1~./.}~. .......... Rear ............ ~D.epth ....'.. ;.... .......... i" Height ...................... Number of Stories ........... 8. ~lme/~mons orentlre new const~.ction: Front .~.[~/~,. ........ Rear ............... Depth ........... height ............... Number of Stories .................................. '. ~". 9. Sizeoflot: Front 53.\.'~. ] . t, ...... ' ............ 10. uate or rurenase ~ ,~ ~,- ~ ~ ................. ........ ~ ......... ' ......... l'qame si r rmer uwner ................... I1. Zone or use district in winch pr~mises are situated. (~. ~ ~ .................... i ....... 12. Does proposed construction violate any zoning law, ordinance or regulation' . ......... 13. Will lot be regraded ~1o1 ! .......... ' ' ' ';; ................. .... ~ ~,--k~ ~ '~' '2 .............. Will e~cess I111 De removea ~rom nremises' ~ g ~ j withi. ~ r==~ o~ a cm~az wecAano? *Yes ........ ~Ir yes, Southoid ~own Trustees Permit may be required. " ....~'~ ..... '". ] PLOT DIAGRAM Locate deafly and distinctly all! buildings, .whether existing 'or proposed, an& indicate all set-back dimensions f~om property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. 2 ~OUGH .- [,~AM~NG ~ PLUMBING ALL COF1STRUCT~ON SHALL MEET T~-~ ~EQUIREMENTS OF THE N.Y, STATE CONSTRU~ION & ENERGY CODES, NOT RESPONSIBLE FOR gESIGN OR CONSTRUCTION ERRORS STA'TE OF NEW YORK, C~td-kqTY OF .............. S S ~ ' (Name of individual signin~ contract) ~ ...... being duly sworn, deposes and says that he i~ the applicant above named. ile ,s the ..................... ! '~r~t'r;~t~, ;~;~t: ~;;~;;a't; ;'f~i~;;,'e't&.')' ' ': ........................ ~f said owner or owners, ~d is duly huthorize~ to oerfom ~. h.~....¢~.a ~h. ~ · - - · .. ....... . ............... am wor~ aha to m~e and file this ~ppncation; that all statements contained ~ this application are true to the best of his knowled e and be ' · . ~ork will be perfo~ed m the m~ner sbt forth in the application filed therewith, g lief, and that the ;worn to before me this J ....... ~ [ .............. day of .,. ' qota~ Public, ........... . ........ County · Notaw ~bl;o, $mm of N~ ' · ~ m ~res ~em~r 31. 1~/