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21678-z
l~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23527 Date MARCH 6, 1995 THIS CERTIFIES that the building REPAIR Location of Property 1555 SHORE DRIVE GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 47 Block 2 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 13, 1993 pursuant to which Building Permit No. 21678-Z dated SEPTEMBER 24, 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 REPAIR OF EXISTING ACCESSORY DECK IN THE REAR YARD AS APPLIED FOR. The certificate is issued to MONIQUE MORRIS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A a Building Inspecto Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2 N® 21678 Z Date o1.f................................... 19....? Permisslon Is hereby granted to: to.... 1` l ~-Ifx.&!c 4T ri+~!~? Y.v„{n,s ?1... C-p ~O .lx....1..o .....SfS...s~v~ •?~y~l....Sr.~~l to ......4~.P:9/1e, .......x~ sT?~ !Jr........ cc.rss... .e yt.................7// *t 6.s.......fh° L% ~aie. .............,.~~...y................I.......... y............................................................................................. at premises located at./.."~Q,, .F...4 1P . 6'4 E-~r~~. r:.......... may S:S....... !v County Tax Map No. 1000 Section n..... 17............ Block ®.Z Lot No. a pursuant to application dated r -!Fe. F....../..,.3 19...`~~...... and approved by the Bullding Inspector. Fee 3s gip....... Building Inspector Rev. 6/30/80 Form No. 6 F 7~ OP "60UT1IOLD 41995 BUILDING DEPARTMENT !1°~ 1 IC,/h'rn~ to i ~ TOWN HALL 6LD0 765-1802 r~3WN aF SOUpT OLra ~ J «~~~P.~"~ APPLIC1,TON-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. 2t 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. 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date.V2_ . ew Construction........... 014__Or Pre-existing Building.. ocation of Property...~~? S~ w C ~y`. ~ Yea .......'i.° /Y~.... House No. Street ~f Hamlet nwer or Owners of Property. .~lG ~.[~1a75.!.;.°71/ ~e.!.!."„' .;,5.,...g ounty Tax Map No 1000, Section... f./........Block.. © ........Lot.... 2.! ubdivision.................................... Filed Map........... .Lo { ermit No. Date Of Permit. ...Applicant.,,,,,,,,,,,,,,,,,, 2alth Dept. Approval L/ ......................Underwriters Approval......................... lanning Board Approval., ~ aquest for: Temporary Certificate... 6._ . Final Certicate..:~..... ee Submitted: cCo 3 a+, APPLICA~T c~2` ~ 7e M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING FINAL REMARKS: DAT INSPECTO PIK' Ii0U11DATION (lstl ~_I 1V 1 `~J ~ c YUUNDATI011 (2nd) SOUGH FRAME & Cry -PLUMBING I lp~~ c rn y . !IlSULATIO;! PER N. Y. I STATE ENERGY II CODE I _ H cri • I y ~i FI;JAL Ilk b ADDITIONAL COMMF,NTS: m x a . r m A H BOARD OF HEALTH j,`...`... 3 SETS OF PLANS ~L~, FORM N6.1 SURVEY . . . . . . . f1~' TOWN OFSOUTHOLD CHECK y { y El) 1 3 BUILDING DEPARTMENT SEPTIC FORM 1119 TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765.1802 .27 93 TO l! M Examined 19 Approved .....9~ X 19V. Permit No.. Disapproved a/c ()ii mg lector) APPLICATION FOR BUILDING PERMIT Date 151y! INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 set's 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 issued 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspect(' 07 •!le G'L (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . ~p ~.e cn... . v. p~0 ,t DA B.P. iil GS . Name of owner of premises ~P.u~°./A;C.`it!.!p?LlGVYL9,,,,, •gY ttt{{{~~~ (as on the tax roll or laLesN BUILDING DEPARTMENT. AT If applicant is a corporation, signature of p~~ 765-1802 8 AM 110 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED.. (Name and title of corporate c, FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Builder's License No. "6 a INSULATION WHO I . FINAL - CONSTRUCTION MUST Plumber's License No. BE COMPLETE FOR C.O. ' ' ' ' ' ' ' ' ALL CONSTRUCTION SHALL MEET I#_•~ OCCUPANCY THE REQUIREMENTS OF THE N.Y. Electrician's License No. STATE CONSTRUCTION & ENERGY Other Trade's License No. ' CODES. NOT RESPONSIBLE FOR ~yt SlGN OR CONSTRUCTIOIRRORS 1. Location of land on which proposed work will be done. le .......-Sp1.4Y.Y.'....... . pxv t.....47 .Yi>,4'!vl. cs-? ~/A'~ .o. House Number Str~neet Hamlet County Tax Map No. 1000 Section ........1 Y Block Lot. . t . Lot . . Subdivision . v 3............ Filed Map No. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: n a. Existing use and occupancy /.l. _A'( 5 Cz,?a,C,'. . Vn :C 4') . b. Intended use and occupancy ; ,Pi,;, . • • • • • • 3. Nature of work (check which applicable): New Buil inl Addition Alteration Repair • . , , , , , , , . Ren'oval Demolition Other Work , , • . .y L 4. Estimated Cost .........,~°.i2l3do.'' ~v47....~....... Fee . (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor. ~ . If garage, number of cars , , , , . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use Dimensions o e xi g structures, if any: Front .4....... Rear 7 e...... Depth ..gip......... . Height ,,/?..in, Number of Stories . . Dimensions of same structure with alterations or additions: Front 7t4 n Rear . . . . Depth Height Number of Stories . 8. Dimensions of entire new construction: Front . S.a. • • • . Rear . . . . . . . . Depth . Height . . . . . . . . . Number of Stories . , , , , • ' 9. Size of lot: Front /•q: I............ Rear /.6 , . , Depth . 10. Date of Purchase , . • • • • • • • • • Name of Former yvner S G Li .~!e . premises are situated f .lr iif O tl.~ . 11. Zone or district use which 12. Does proposed constructio~~n/violate any zoning law, ordinance or regulation: . N 13. Will lot be regraded , 14!o Will excess fll be~emoved frpm premises: Yes No 14. Name of Owner of premiss a'~ , M,oyv , , , • • Address Kl"?. id("\ phone No. 6. 9z - Soa p Name of Architect 'n/k e, Address , . Phone No. Name of Contractor !t't.a l ,T,o ~rgN~,e. ? Q Address .0, j y'.~f,(~'~oF, , Phone No. 17.? 79' 15.Is this property located within 300 feet of a tidal wetland? *YES..:~.NO....' *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block) number or description according to deed, and show street names and indicate whether interior or comer l/o/a. rI ! c 1 L d / / /(ePa,~ o ( d e~~/( sn 14_c. .:I/ ®h ~~~~12'zl J ~iJ E' v 2.. l L I!,,ri r ~c a 1`-e ~1, '772 2,'k, y ~eeo~s ehatrt~,Ln~>' ~Fyef~ ~I~t ~..Y~~u x Cc I . STATE OF NEW YORK, COUNTY S.S • • • • , .4 T.7 , , , , , , , , • , being duly sworn, deposes and says that he is the applicant l' (Ifamo~Qfindividual signiing contract) above named..,,,,„ He is the h? Yac/oY (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained 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 ma this, „ day of Notary Public, county IWM N"V K KsLQL9W of Now~kMk , , , . No 4578806 ' t " ' ' I X tlmIMedinSuNdkCou (Signature of applicant) Cpmmlu 14" 8xpket Deasmber 1 !'v~['.taJA?,^:Y!??'v~".aNl~"''~r ~k.~'§+~"de va`-4s/ts •rxTro.4`wk. 'f'I'i`&e~ a'l't°ts. f~„"I'^i s4y?M'k"+t~,ASS°'t'"y aar°"}5ewy' to ,g~: 's=7`°r } /i ° ptr} a a'a ="6. r r " r F w y do rlS ',3f~~e- 4 -v,j~'~t Po d+*VA pa-I!~ `"°~~fwp s+ ad{ nM ~aa++'PAO +a pva4i t"43 ~~wa }o p aq~ing - -61 0,0 s s *da}5 ~,aao z a 9 04 Y man. w . . G -a'a I E I'h. - asnoh ~H+onj- i W ~ j hno+s i ( ~ 2 I ! ~ , n ~ ~ R ~ !y I f,,}st o ~ N 'I o. 1 o' w.t ~ryI i ' csa 71~. u x b io ` 9H/~ NO- ^d'~H9~ ` ' 'AH1~ HO- A7iA 7j~ O'b01 -317~,8~.o05"tJ , ~ ~ rj 0 f-i sale v s N hT3'F q - r y „ •l~ .y„• fib` R;I t YR i{] 1~' Ffa y wN. 'tY;,Y$ 4~3i:^~ 1-r t'i0 K~.~ 4 Y` x~jJr~ 1~ ~y s. F ~ kNr'x y9 'K' a K:. /a-i ~ rn. . y d 1K ~ id omlve , na Gh., All ` Wyfneu' ~~1•,'ti Eau - ~ ~ . pepWd•Nis suneyma?ncl6o> ts'-y ~0 aeai of ' e abeavaiidvwtoP.ri , -x c? ; OuaFenteae h+dk hereon ' oo.0 to the person lorrvholn 1ft0 na!!1 3 ' c N.'SQ 3L] E. ravrepare, ce >:hrsc~ .nberd , tal - r t: eon aa~ldd Ft,tae -ors #44e > mace -mop li?aa ems ean9 ID the assign ~ ~a adSit6iwiel Y.sui7iurle or a6,a?r~~ i 4 r n.. $ x .~o t f MAP of LAND v SU6eVCYRD lr4W DOUGLAS P ~ M0NIQuE: NOICQI W--!ol, 1 s+ovy A' y. ;va wr a Noase - a am+so i raf~e GRE€~htP~R"S -l TOWN OF 001JIT440L DI X11. o»: +2 NE S ~ If) 5ccx(c CIO M I - r ~ t M1QN1A4M~kC~' o~ No.t89,W ,,6'~¢ . ~ in LAND ~d e~a17, crck 3+ep! Note : L4+ Rw hi blYS tik4')ww v4f4w +0 } ~ . So°Q4' tQ" W. 00 0 _ " Math o& 6ree.+por# .4944&Y* s - 4w . C~utk d al4 wd 6wtk4o" at Ord. IN. w,aY ~Me x~ C 104CA I" 44i'a. SU* 4:0k Cowl o.p- ~,M•°'' ~ Clark'3 office as Map N~ ITS"$. - Z' ; ~r Hlyl+ WatiRr +++a,-k ow.~Filed ma r M 6iriara/+ts#rC4: 1A~?. 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