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Home My WebLink About21328-zFORM NO. 4 TOM OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22426 Date JUNE 30¢ 1993 THIS CERTIFIES that the buildin~ Location of Propert¥. 2390 KERWIN BLI~D. House No. County Tax Map No. 1000 Section 53 NEW DWELLING GREENPORT~ N.Y. Street Hamlet Block 4 Lot 44.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6, 1993 ~ursuant to which Building Permit No. 2132B-Z dated APRIL 9, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR The certificate is issued to POSILLICO CONSTRUCTION CO. INC. (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 93-SO-18 - JUNE 17,.1993 UNDERWRITERS CERTIFICATE NO. PENDING - JLrNE 28, 1993 PLUMBERS CERTIFICATION DATED JUNE 23~ 1993 - VANETTEN PLUMB. & HEATING Rev. 1/81 //Bu=ding Inspector FOn~W NO. 0 T~N DF SOU'fi'tOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~°. 21328~Z Permission is hereby granted to: ....... ~..J. .......... ...~....~ ~., , . ....... ...~/...~..~..~.,....~...//..~/ , it..~ '....o~.. ed at ...... ~,.~.....~...~....~~.....~...~-~/~ ~./~-~'~'~ ~ ....................... County Tox Map No, 1000 Section .~....~... ........... Block .....~... ............. Lot No.....~'...../~./....~.... pursuant to application dated ..~ ......... .~. ..................... , 19..~.....v~ and approved by the Building Inspector. Fee $.. ~....~'..~.: .~....~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ~APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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). Approval of electrical installation from Board of Fire Underwriters. 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-~onforming uses, or buildings and Vpre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildimg 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, Swin~ning 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 ...~.~.W~.~...~. New Construction .... .Y.. .... Old Or Pre-existing Building ................. Location of Property ............... ; .............................. House No. Street Hamlet Onwer or Owners of Property .... ~0~¢~, .~.~T~0~..~'. ~.I~% .................... County Tax Map No 1000, Section...~'..........O0 Block ...... ~ ....... . Lot...~ ......... ........................ ...................... .... Health Dept. Approval ......... ..~./ ............. Underwriters Approval ......................... Planning Board Approval Request for: Tomporary Certificate ........... F~nal CertScate ........... 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. - /~ [~OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS:; ~ DATE 765-1802 BUILDING DEPT. INSPECTION [ F~OUNDATION 1ST [ ] ROUGH PLBG. [ .J FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL · REMARKS. ~~"~~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING /. [ ] FINAL REM~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [,~NAL ~OUNDA~ION ( 1 st) ,'OUNDATIO:! (2nd) ~OUGH FRAME & .PLUMBING FI;;AL ADDITIONA'L COMMENTS: TOV/N OF $OUTHOLD OFFICE OF BU[LDIHG INSPECTOR P.O. BOX 1179 T~)WN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATioN Building Permit No. ~/3~ O~¢ner' tp±ease prmn t)-- -- ~' ~ I certify tha~ the solder Used in the Water supply system COntains less than 2/10 of 1%' lead. P mber s signature)-- -- S. worn t~ bbfore me this 19q HOtary Public, /~3/~/ County Notary Publi~--- ~ No. 30-4878354 3. Nature of work (check which applicable): New Buildin~ ....~. .... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work .............. , (Degcfiption) 4. Estimated Cost ...... (to be paid on filing this application) 5. If dwelling, number of dwelling units , .... ~..t~. ~.~... Number of dwelling units on each neet... L~..~.~ ..... · If garage, number of cars .... ]'Fq. c2 ............................................................... 6. If business,.commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height .... . ......PXf ....... Nmnber of Stories ............. '; ? . 8. Dimensionsofentirenewconstruction: Front .. ~. .... i'... Rear...f'.O. ?.5. . De th ~Fo I~"P ''' Height .~.Q..F'.~ ...... Nuln_berofStories...~7//4/.O. ....... .......... Depth ...<~.:~'-~'~'.../{/. ....... 9. Size oflot: Frdnt ........ ~.~../;.-.7'7... Rear ....... '..~o~ ./---..2~. ....' ..... ' .... : ........ ~ ....... I0. Date of Purchase .... fi'.,/oq. 4/2~...'.' .... . ........'. Name of'F'or~e'r'(~wner . D-(~t~/~-~..pfc.¥.~.~.~_/,~ ~. 1 I. Zone or use district in which premises are situated...~. &a/.~<,/..Y?~.~.. ................................... 12. D°es pr°posed construction violate any zoning law, ordinance or regulation: .../(..O ........................... 13. !V, ill lot ?e..regraded . ./.~.-4. zg. ........ ~' ........ Will excess fill be removed from premises: Yes 14. r~amemownerofore~nises ..,' o-~.5~.7,o. ¢9,'0~- ~aa B/ 7~a,~ ~,t,,acv~r, ,_~3 o ~ -, ..... . .... · ........... ress ~d ' '".Jo ....... FKr.~.BPhone No ....... ~. { ...... marne oI Architect /~t'g~..v~,u ./zom.~.x. z; · - '~ ". ..... ~ "'.2 ......... Address ;,~g..r~ .Ont:.aA ~ .,4.51~,.. Phone No.(Z../2)..~.~...-.-.-~/././ .... N. am.e,o.f Contractor g?.a..~..z4...!c. ?. (_.qq?/.; ........Address ~.4 ./~'q.'gYY.-~.¥ .-4.a.'~;... Phort0.No..,~,9.~ J.O.d'.~'~... 1.5. .is gnxs property m. tnzn 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 corner lot. rATE OF NEW YORK, S.S 9UNTY OF ................ , , ,~<~.r/tO,..~.. ~.d9~44.~.4~. o. i .................... being duly sworn, 'deposes and says that he is the applicant (Name of individual signing contract) ,eve named. /. 4Pc . /TT.. .,, : is the . ././'/.C.g~. ......... (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~rk wilt be performed in the manner set forth in the application filcd therewith. 'om to before me this . , try Pubhc . ~d~ ........ County ... . It~CO '' -r ..... \ . ~o~or}' ~'ub~/c, Sro e of Now Yor~ · No. 30-4878354 . · Qualified in Nas$ou Counfy . C~m~:*ion ~o~e~ No~. 2< ~ /. (Signature of applicant) Examined ' ................ ,19 .. ' Disapproved a/c ~ ............... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEAL"fll 3 SETS OF sugv£¥ ...~¢' ........ ..' ...... HAZL TO: -- (Building Inspector) Date ......... ..... , 9.73 INSTRUCTIONS , a. This application'must be completely filled in by typewriter or' ' · · · . ~etsl~f ~.an.s, a. ccur. atcp. lot plan to scalei Fee according to schedule, mmk and submzttcd to the Budding Inspector, with 3 ,tqo[ plan snowing location of l~?t and of buildings on premises, relationshi to ad' ' ' ,, ' 3r ~reas, and g~vmg a detailed description of lawut ,~e ...... , ......... P .!ommo premises or public atreets :ation.; ' i ~ .... v.~w.~ mu~ ce arawn on the dmgram which is part of this appli- ¢., The work cover6d by this applic&tion may not be Commenced before issuance ~f Building Permit. d. Upon approval of this applicatio'n, , the Building Inspector will issued a Building Permit to the applicant. Such permit ;hall be,kept on the premises available for inspection throughout the w6rk. e. No building shall be occupied elf used in whole or in part for any purpose whatever until a Certificate of Occupancy ;hall 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 3uilding Zone Ordinance of the Town bf 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.' ['he applicant agrees to comply with all applicable laws, ordinances, bui/ding code, housing code, and regulations, and to .dmit authorized inspectom on premises and in building for necessary inactions. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) irate whether applicant is owner, lesse~e, agent, architect, engineer, general contractor, electrician, plumber or builder. qame of owner of premises ' ' ' (as on the tax roll or latest deed) ........... f applicant is a corporation, signature ob duly auth~orize~ officer. (N title f offi ) '" · amc and o corporate cer B ,lder s L~eense No... . .... . ......~ · ' Plumber's License No .... Elcctrlcfian's License No . Other Trade's License No. ' Location of land on which proposed Work will be'done. Ho N b ................. use um er [ Street ....... · .............. ,~ Hamlet Co!.mtY Tax Map No. 1000 Section A(4. , ................ Block ~ .~¢/3/~ S ................ Lot ......... ............ ~) · · Filed Map No. Lot (Nam .... , ........... State existing use and occupancy of pbem~ses and intended use anti occupancy of proposed construction: a. Existing Use and occupancy ~...~.C..~..14]~. b. Intended use and occupancy ..................... r ,J > -I [ ,,/ 4. (1'~ ! \ \ \