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HomeMy WebLinkAbout21641-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22572 Date SEPTEMBER 8~ 1993 THIS CERTIFIES that the buildin~ Location of Property 605 LONGVIEW LANE House No. County Tax Map No. 1000 Section 88 Subdivision ADDITION SOUTHOLD~ NEW YORK Street Hamlet Block 5 Lot 7 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26~ 1993 pursuant to which Building Permit No. 21641-Z dated SEPTEMBER 2, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING & OUTDOOR SHOWER "AS BUILT" The certificate is issued to RALPH E. & ~ATHLEEN BERGL (owners) of the aforesaid building. 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 SOUTHOLD BUILDING DEPARTMENT TOWN ~ SOUTHOLD, N.Y. N_O BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNT1L FULL COMPLETION OF THE WORK AUTHORIZED) 21641 Z Permission is hereby granted to: ~.~.~....~=F..,..~.~.~,..~:..~~- ~,~ ~, ~ ~ ~..~.~.,.~...~.~..~ ....................... ~ .............. ~.o~......~.,....~.~....~......: ..... . ,o ....... ~~~ ............ .~ ......... ~ ....... ~.~ ........ ~,,,...~ ...... ~ ......... ~~......~,~ ......... ~ ...... ~ ........ ~ .... ...~.~ .......... ~/~ ............ ~ ......... ~a....~.: ............................... ........................................................ ~...~~ .......... ~ .............................................. County Tax Map No. 1000 Section.......~..~' ............ Block ............ ~::~.'~....... Let No ...... ~..?, .............. pursuant to application dated ............... .~..//~...~ .......................... 19.....~..... and approved bythe Building Inspector. Fee $.......2.....~..."....(~.. ..... /~/Bui~lng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~65-1802 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 ail 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 ail 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 i. 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, Conm~ercial $15.00 t e .................... New Construction ..... ' ...... Old Or Pre-existing Building... ~ ..(PPP~.~ outdoor shower) Location of Property..b~.~p~g.¥fx~.¥.~..aq.q,.~.u.$bp%.~ ..................................... House No. Street Hamlet Onwer or Owners of Property..~P~.~,.~.~&b~.~g% .......... County Tax Map No 1000, Section....88... .......Block.....~..........Lot .... 7.. ............. .. Subdivision........ ................... .. . . . ... .Filed Map ........ ... .Lot ..................... . Permit No .... ~9~ ....... Date Of Permit ................ Applicant ............................. Health Dept. Approval ..... ~/~ ............. Underwriters Approval ..... Planning Board Approval .... N/~ ................ PROPER-T SERVIC~ Request for: Temporary Certificate ........... Final Certicat~...~ ..... ~m~.~*~l~,~. ~_ ~ ' '~ /// P.O. ~x~7, Cu~ue, NY 11~5 Fee Submitted: $ .............................. ~~:/~,~ ~' ~ ~ ~-~ ~/~/~/_ ............ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... /x~j3 SETS OF' PLANS . -/'SURVEY .......... NOel FY ~ CALL ................... MAIL TO: Date ...A.n~..s.~..2.5. ..... , 19.9.5 INSTRUCTIONS · a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 seis 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. 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 is?ued 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 Buitding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and ot~se~ ap. pOcable Laws, Ordinances or Regulations, for the construction of buildings, additions or alteratio/ns, for remov~o;r jflCn,~lition, as herein d. e4cribed. The applicant agrees to comply with all applicable laws, ordinance~bt ~.kle,/~~ ~Tand to admit authorized inspectors on premises and in building for necessary ~ ~g~ "'~ra'ti~n) PROPER-T SERVICES ~ame, trion) P.O. flex ~17, Cutct~o~ue, NY 11935 ..... Ph~n~: (516) 734-580~ (Mailing address of applicant). Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ' Ag. ent Name or owner of premises ..... .R.a. 1. p.h..~:..aD, cl...K.a.t.h.1..e.e.n..]3..e.~g.]:. .................................... (as on the tax roll or latest deed) ~PPR0V£D ~[$ [JI)llJD If applicant is a corporation, signature of duly authorized officer. DATE: ~B.R # ,~/~ ~/ .............................................. (Name and title of corporate officer) 765-1802 g AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I. FOIJND~;rloN - TWO REQUIRED FOR POUBED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INS ULATIO~ ~ FINAL -* .CO,'4ST[{UCTIO~,I MUST R,E COMPLETE FOR C,O~ ALL CONSTRUCTION SHALL, MEET THE REQUIREMENTS OF THE 1. Location of land on which proposed work will be'done ................ STATE CONSTRUCTION & ENERGY · .6. 9.5 ................ ~..o.ng..¥~.eE .~..a.n.e ......................... .s.~.g~?~:[~. c.'9~.sL~.u.C.T!gt~.q~q .~:' ltouse Number Street Hamlet County Tax Map No. 1000 Section 88 . Block 5 Lot .... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .S.±ngle-.~a..m~y. ...... ........................ res±den?e , .... ,. ................. b Intended use and occupancy Same ' 3. Nature of work (check which i . apphcable): New Building .......... Addition .......... Alteration ..... ~ .... Repair .............. Removal .............. Demolition .............. Other Work ]).e.c.l~. 8~. 4. Estimated Cost .. ~ ......... Fee ..... 15.7.5... : (to be paid on filing this application) 5. If dwelhng, number of dwelling units ..... 0~.e ....... Number of dwelling units on each floor ....... . ......... If garage number of cars ' 6. If business, commercial or m~xedl occupancy , specify nature and extent of each type of use ..................... 7. Dimensions of existing stmcture4, ifany: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wi~h alterations or additions: Front ................. Rear .................. Depth .................... t · Height .................. 8. Dimensions of entire new constraction: Front (see below) .... Number of Stories .......... ~ .. ............... Rear .............. Depth ...JiJjj'jjj .... Height ........... a ~,.~ ~Num~er of Stories ...................... 9. Size of lot Front ..... ; ...... Rear Depth ............... 10. Date of Purchase ..................... Name of Former Owner ....................... 1 I. Zone or use district in which premises are situated R~4© 1 2. ocs proposed constructkqn wol~te any zoning law, ordinance or regulation: ...N.o. ........................... 14.13' NW. ila~l leOtofb;~ng;;doefdp ;~.i~s°. (r ~le.' '15~1.c/W) .....:: ~.d~lels:XCe~s ~ill be remTved ~o~t~;em~;~: .. Y~s.. .....Ne Name of Architect .......... i ........... Address ................... Phone No ................ Name of Contractor · · ' Address Phone No 15. Is this property within 3~0 feet of a tidal wetland? *Yes~ ....... No...X ..... · If yes, Southold T~wn Trustees Permit may be requi~ed. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propos'ed, and. indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. Owners: Ralph E. and ~athleen Bergl 381 I.U. Willets Rd Roslyn Height~, NY 11577 ApplicatiOn is for existing deck and ~outdoor shower, as built, before purchase by current o~ner. Overall dimensions of deck are 18'-5" x ~6'-4,,, and shower 3'-7" x 6'- dated 12/5/8~. .0"; locations as shown on attached survey by V~ Tuyl STATE OF NEW YORK, SiS COUNTY OF ............... Jam~es E. Fitzgerald. Jr. (Name of individual signin ;contract) above named. Agent He is the ....................... being duly sworn, deposes and says that he is the applicant of said owner or owners, and is duly application; that all statements contaiped in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... 2.6. t..h ............ day of. i..4,u, g.ll.s.~ .......... , 1995. ....... County · ' , 8USANJ~AG¥~' f C//l' ~ Publio, State et New Yod~ c. - ~- .. -- N0.489BT~i . I ''/ / · .? · .o ..... ~mll'n4 In 8uff0~ O0~nly __~.~ licant) (Contractor, agent, corporate officer, etc.) authorized to perform or have performed tbs said work and to make and file this ! zt ...... s~O,O / /