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Home My WebLink About20532-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hull Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20819 Dute JUNE 19~ 1992 THIS CERTIFIES that the building Location of Property CRESCENT AVENUE House No. County Tax Map No. 1000 Section 9 Subdivision ADDITION FISHERS ISLAND~ N,Y. Street Hamlet Block 5 Lot 2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7, 1992 pursuant to which Building Permit No. 20532-Z dated APRIL 9, 1992 was issued, and conforms to all of the requirements of the applicable provisions of t~e law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWELLIN~AS APPLIED FOR The certificate is issued to GUNTHER STROTHE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 TO~N O~ $OUT~OL~ BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N? 2053~Z Permission is hereby granted to:.. ...£,...~.~....~....]. ........... ........_, ............. . . ...... ~~ .......... ~~..~ Co,nV Tax Mop No. ,000 S,ct,a,, ..~.....~. ..... ,,o~k ..... ~ ......... ~.ot No ........ .~. ......... pursuant to application dated .......................... , 19 and approved by the Building Inspector. Rev, 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN I/ALL 765-1802 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 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 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: l. 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. C. 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 Building - $i00.00 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 - Residen~l $15.00, ,~-- Date .~z/~../~...Commercial $15.00 · . ....... .ocation of roperty .................... .... tlouse No. Street Hamlet ..... Bounty Tax Map No lO00, Section...~.O.~ ....... Block .... .~ .......... Lot ..... ~ ............. " Permit No~O..~5~?~.....Date Of Permit '(~.¢..~2. Applicant..~_....~_..~.. ........ -~... Health Dept. Approval ..... .~. ............. · · · Uuderwriters Approval .~ ;'lanning Board Approval ~-;~ {equest for: Temporary Certificate ........... Final Certicate .... ~ ,,/ FOUNDATION ( 1 s t ) FOUNDATION ( 2nd FRAM~ & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI~IAL ADDITIONA'L COMMENTS BLDG. DEFt. TOWN OF $OUTHOLD Disapproved a/c ..................................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 BOARD OF HEALTII ......... 3 SETS OF PLANS .......... SURVEY ................... CI1ECK .................... SEUTIC FORtl .............. CALL ................... HAlL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~.~.~ [~., ..-7. ...... 19 .~.~. INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~'ts 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by ti'tis application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available for inspection throughout the work. e. JNo building shall be occupied or 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 ;uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ',egulations, 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, building code, housing code, an4 regutatigcs, and to ,dmit authorized inspectors on premises and in building for necessary,,~~inspections, ff-~ ,,~ ~,,~, ~ - -- '~ ~ '~(Si~nature of applicant, offname, if a corporation) (Mailing address of applicant) ~ ~ ~ ~'~ ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... L.. .............................. . ........................ q'ame of owner of premises ....¢,1~ RT.~'~.~--,..~. .... ST 0T¢. .......................................... (as on the ta[x roll or latest deed' f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No../.~ ~..~.~.'~..'-:. ~.~.. ...... p ,. lumber s Lmense No .... q .... :'T'. .... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................. House Number Street Hamlet CounW Map No. 1000 Section ... .......... Block ............ Lot .... .;L ............ 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 .... ~.[~I.~--L~_~....~. ~/~. l.~...~>.~.~ ~,~ ~ t/,~.~,. ....................... . . . .. b. Intended use and /~ It / t , , occupancy .................................................................. 3. Nature of work (check which applicable): New Building .......... Addition .... Alteration . .';.:' i'v~i;'::,... Repair .............. Removal i .............. Demolition .............. Other Work...' .. ~. '.~'..!.(.~... ,t~/~'- r"'~-, va i ,,,~tr' ..... ;.~..~, ~ (D~gripti,° ) 4. Estimated Cost '.~,'/?O~ t~, ~ ,~'ff/"tF~"~8,~l[ 5. If dwelling, number of dwelling unit~ ............... Number of dwelling units on each floor ................ . If garage, number of c~s ........ [ ........... S . ............................................... 6. busln ss, co e Iai or mixed cc upancy, spec na ure and extent of each type of use .............. 7. uimens~ons ct ~tmg structures, if any Front.. ~ ~, ~o * ~o~th ~q ~ .... ~ 'g~ / ~ . a~ ......................... ~, ................. e~ xt ............. Number of Stones ............. . . D~ensions of same structure with a~terations or additions: Front . ~ * Depth .~/ H .. ~ / ............. Rear...~ .................. eight .... / .......... Number of Stohes .. ~ .... 8. Dimensions of entire new construction: Front ... ~. / ................ ........ Rear ...~ ~ Depth Height . .~. ( .... : · ~. ~umber ~f Stories .~.. , . . . Sizeoflot: Front .~¢~ V~R~ '' Rear ~g~'~ ............. ~ ....... ~'2~ ............ ..... ' ' ' '. - ~ ........ ~.~ ............... ~eprn ~,~ .... ~;~°~rr~7~ic} .... ..-, ............ ' ......... Nam~ of Former Owner ~*~0,.. ~~: j r in wnicn pre nises are situated..~.~.t~ ..................................... Does proposed construction violate dny zoning law, ordinance or regulation: ... ~.~ ......................... 5i. .. v' '2' · ....... wi. o a. ro, ~me ox owner ox prem~ses~hffi~. 5~.1~ .... Address~, ~O~q. ~ ~ Phone ~o. Nme of Architect ........ ~. . Nme of Contractor ~{~,~,~J~..' Address ................... Phone No ............... . Address g~.~ ~ .[~.. ~. Phone No. tS. Is th~s property w~th~n 300 ~eet o~ a C~dai wetland? eyes ........ No.~ .... ~If yes, Southold Town]Trustees Permit may be required. PLOT DIAG~ Locate clearly and distinctly ~1 builO~gs, whether qxisting or proposed, ~d, indicate ~I set-back d~ensions from prope~y Hnes. Give street ~d block number or description accord~g to deed, and show street nines and ~dicate whether inteffor or comer lot. ~,11. 12. 13. 14. ;TATE OF NEW.yORK, t _ S S :OUNTY OF...%.~_ I, .t.~ .... · ..... . .~...~.O.1'.$... ~.., .~.t.vgzL,e'rl..~. ................. being duly sworn, deposes and says that be is the applicant (Name of individual signing coOtract) bore named. 'e is the Co ~37~v'o. C~-O v~ (Contractor agent corporate officer etc ) ........... smd owner or owners and ~s duly authprlzed to perform or have performed the said work and to make and file this ~p ication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set fo 'th in the application filed therewith. a, om to before me this ................... day of ..... otary Public .......... ~.tl ff~'l .~. .... · M~RY 8. PANKIEWICZ ·