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Home My WebLink About21001-z~ORN NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP/~CY No Z-21076 Date OCTOBER 9, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 4025 OAFdSAWN AVE. EXT. SOUTHOLD~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 10 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 2, 1992 ..pursuant to which Building Permit No. 21001-Z dated OCTOBER 6~ 1992 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 REPLACE EXISTING SECOND FLOOR DECK & INSTALL SLIDING DOOR AND WINDOWS ~ APPLIED FOR. The certificate is issued to FREDERICK STAPON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO, PLUMBERS CERTIFICATION DATED /~ui~' In~p~ct~O'r ! Rev. 1/81 TOWN OF SOUTHOLD 8UII,.DING DEPART/,AEHT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°_NY 31001Z Date Permission is hereby granted to: s ~ ~ .... _-~-'~_ ,~J ....~-, ~ //'/ -/ ' J_. / ~ ~ / // //1/ // // ~/ ,/~...~....,~r,,~. ...... ~.~,~......~,5~.,~....,~.....~_.~ ......................... at p,~mi~, fo~ot~f at ......~..~..,2..~.~.. ~~.,:..'. ......................................... ..................................................... ................................................................. Count,,, T,,~ ,~op No. 1000 ~ec,o,', ....... ~ ......... Bto¢~ ./..~.. ............ Lo~ No....~... ............... ;~ur~uant to app,~otion ~ot~ ...... ./.~/......~.... ............................... , ~9..,~..~, and opp;ove~ by the Building Inspector. ~ee S..~-~...~ Re~ 6/30/80 Form No. 6 " ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN BALL 765-1802 ': APPLICATION FOR CERTIFICATE OF OCCUPANCY A.. This application must he filled in by typewriter OR ink and submitted to the huilding 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 f~om 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 b~ilding, multiple residences an~~ 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: 1. -Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed applicJtion an~'~ 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, Cer. tificate 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 C rtzfzcate of Occupancy - Residential $15.00, Commercial $15.OO ' .... Hbuse No. Street ''~ ............ ~''~''~' )usry Tax Map No 1000, Section ........... Block ............. Lot .................. bdiviaion ' " ' Filed Map Lot ~ith Dept. Approval ..................... Underwriters Approval ..... ,... mning Board Approval .................. uest fo~: Temporary Certificate ........... Fin~~. ' OUGH FRAME & .FLUMBING NSULATIO~ PER N. Y. STATE ENERGY CODE FI;;AL ~DDITIO~IAL COMMENTS: · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1~ Examined ~. ........... , 1 .i i Approved . .~..~..~,~ .... l~.~.Permit No. Disapproved a/c ................................... i.;! BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECR .................... SEPTIC FORH .............. (~ildin~r6sp'ect or) APPLICATION FOR BUILDING PERMIT Date ..... L ............ 19 INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to sc.hedule. 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 tiffs 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 sl~all 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 alteration~r removal or demolition, as herein described. The applicant agrees to comply with all applicable laws ordinances,~uildin~ code housing ~5~de and~regulations, and to admit authorized inspectors on premises and in building for necessary in e'~jons/] -- //~ ' ¥ --' ration) .... ..... (Mailing address of applicant) State whether appli~an~.,ii oWner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premii~i .'. )'.~, .~...~...l~, 5 ,~, .<..~. ~ ~.t~. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .... ~', .............. , ......... ; ~ .' ............... (Name and title of cO,orate officer) Bmlder s Lzcense ~No..= ............. Plum~ds ~i~e~Nb~ ,./, ¢'~ 'f":~ .............. Other Trade's License No .......'/~' .......... · Location of land on which proposed work will be'done ........ HouSe Number Street Hamlet /o oc- County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ...................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premise~.~nd intended use and occupancy of praposed construction: b. Intended use and oEcm~ancv ~ /--~l ~.~ . (= ~f { I ~ ~ ;~ ~ ................... , .......... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration . ..~. ...... Repair .............. RemovalI .............. Demolition .............. Other Work .~. ~..~--~[" .~,..r~.. '.~..~.. ~ (IJescription) 4. Estimated Cost ....... .~. · · Fee ~ (to be paid on filing this application) $. If dwelling, number of dwelling uniis ............... Number of dwelling units on each floor ................ · Ifgarage, numberofcars .[ ...... i .............................. · ........ 6. If business, commercial or mixed o~cupancy specify nature and extent'of each type'~f'use · ~'Z'"..... '' '~'' '' ..... i ..... ..... 7 Dimensions of existing structures if any: Front Rear Depth Height ............... Number of Stories ........................................................ Dimensions of same structure With ~,lterations or additions: Front i ................ Rear .................. Depth .................... Height ..................... Number of Stories .......... ~ . ' . 8. Dimensions of entire new construciion: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ............................................... . . .. 9, Size of lot: Front ...... .t ..... i . Rear ' ~e'r Owner' _Depth ..~.)...,._, ............. I0. Date of Purch,ase .... q..~! ....... ' ......... Name of Fo ..... 11. Zone or use district in wliich premises are situated ........................ ' ' ' ' 12. Does proposed construction viqlatt,~ any zoning law, ordinance or regulation .................. 13 ...... ~ .................. Will excess fill be removed from premises: Yes Will lot be regraded ~ . . · ' .' .......... Name of Contractor ' Address Phone No 15. Is thf.~ property wJ-~hln 300 feet of a tidal wet3_and? ~Yes ........ No..~c~.. .... ~If yes, Scut:hold To~n Trusl:ees Portal, t: may be requ±red. .. I PLOT DIAGRAM Locate clearly and distinctly all braidings, whether existing or proposed, and, indicate ail set-back dimensions fromt property lines. Give street and block ngmber or description according to deed, and show street names and indicate whether; interior or corner lot. STATE OF NEW YORK, i THE REQUIREMENTS OF TflB N.Y. COUNTY. OF ................. iS'S STATE CONSTRUC~,0N 8i; ENERGY ~ .~..~ CODES, NOT FOR ............ .... ~ ' ' ' ' ' '~ ¢[ & I ' ' '.being duly sworn,de~g~l~r~eW~llS$~a~ht ~ (Name of individual signing cohtract) . APP/RO D AS FEE: 765-1~2 9 AM ~ 4 PM FOR THE FOLLOWING 1, FOUNDATION T~r~O FOR POURED CONCRET[: 2. ROUGH, FRAMING 3. INSU~TION 4. FINAL CONSTRUCTION 8E COMPLETE FOR C.O. A~ CONST~ON 8HA~ above named. He is the .............. ~ ~ .~ ~ . (Contractor, agent, corporate~ officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements, confained~ in this application are true to the best of his knowledge and belief; and that the work will be performed m the manner set forth in the application filed therewith. Sworn to before me this .......... · ". · ., .... Y...day of., t--~..~ ....... 19 .~.~ Notary Public, State of New York Qualified in Suffolk County Commission Expires May 22, 19 ~