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Home My WebLink About20534-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20674 Date APRIL 24, 1992 THIS CERTIFIES that the buildin~ Location of Property 50 BREISTADT' COLrRT House No. County Tax Map No. 1000 Section 70 ALTERATION Street Block 9 SOUl, OLD, N.Y. Hamlet Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 3, 1992 pursuant to which Building Permit No. 20534-Z dated APRIL 9, 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 ~J~TERATION TO CHANGE EXISTING WINDOWS TO EXISTING ONE F~k~ILY DWELLING ~ APPLIED FOR. The certificate is issued to MARVIN & ANNETTE' GRUBMAN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A . . '- // Bruilding Inspector Rev. 1/81 l~Ott~ NO. ~' TOWN OF SOUTHOLD BUILDING D£PARTMENT TOWN HALL SOUTHOLD, No ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? ~05g~Z Permission is hereby granted to: o, premise,,o~a,edot...~.....~..T......~....~ ...... ~ ......... ~ .... County Tax Mop No. ~000 Sectig.~n ...,,,'Z,.~. ............ Block .....,(~.,,~, ........ Lot No...,,.~,,..~ .............. pur~ua,,t to app~¢a.on dat~ ....... ..~ ....................... , ~¢~....~. ond appro¥~ by the Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTI£OLD BUILDING DEPARTMENT TOWN I/ALL · t. This application must be filled in by ~ypewriter OR ink and submizz2d to the building inspector with the ffollowZng: for ne~ building or new use: Final survey of property with accurate location of all buildings, property &ines, 2. Final Approval from Health Dept. of wazer supply and sewerage-disposal(S-9 form). 3. Approve& of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying ~hat the solder used in system contains less than 2/i0 of ~l lead. 5. CO~ereial building, industrial bui[ding, multiple residences and similar buildings and instaZlaZions, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of compZezed s~te plan requirements, "B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and 1. Accurate survey of property sbowing all property lines, streets, building and 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, Addlc~ons to dwel1&ng $25.00, Alterations to d~eZZ~ng ~25.00, Swiping pool $25.00, Accessory building $25,00, Additions to accessory building $25.O0. Businesses $50.00. 2. CercifZcate of Occupancy on Pre-exist~ng Build&~g - $100.00 3.. Copy of Certificate of Occupancy - $5.00 over 5 years - a. Updated Certificate of Occupancy - $50.00 5. Temporary Ceruif~cate of Occupancy - ResZdent~$15.00, Co~erc~al $15.00 ... ,zaa& .................... ~', C nstrucci Old Or Pr ..ew o on ........... e-existing Building ........ Location of Property .... ~ . .. ~'{S%~ ({'% CO~ House No, Street Hamlet On=er or Owners of ,:oo,~y ~ ,~p ~o ~000, s~tio,..TZ.O ........ B~o~k .... ~ ........... zo~...e.~ ........... :iubd ivision .......................... Filed Nap ............ Lot.. . Permit No....~..'.. ,Date Of Permit. ~' .... Applicant :~,,~h D~p~. app~o~Z ~ ~+ ~,.S .................... '" ........................ Underwriters Approval. ~/~. .................. F.I,>. ............ lequest for: Temporary Certificate ........... Finn Certicate .... ~.. ........ :OUNDATIO~'! (2nd) :OUGH FRAME & ,PLUMBING INSULATION PER N. STATE ENERGY CODE '~. FI;;AL ADDITIO~IA'L COMME~;TS: ~q o~ 765-1802 BUILDING DEPT. INSPECTION REMARKS: FOUNDATION 1ST I- ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [*~RAMING [ ] FINAL BL~ ,-: :)~.PT. TEL.: 765-1802 · v~ C~' ";' dYHOI D l~×amh,cd ...... ~'19 ~). ~ Disapproved a/c .... . ............................... ~ ................................ .... (Buildin~ Inspector) APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD JILDING DEPARTMENT TOWN HALL OUTFIOLD, N.Y. 11971 -SURVEY ......... c,,~E~ ,~: :I:~3;~X :: ....:.. SEPTIC FORH .............. CALL ................... HAIL TO: Date . .~. ..... 19... INSTRUCTIONS a. Ttzis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 p~emises or public streets ~r areas, and giving a deta/led description of layout of property must be drawn on the diagram which is part of this appLi- :atign. ¢. The work covered by this application may not be cbmmenced before issuance or' 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. No 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/vIADE 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 al/ applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in buildfl~g for necessary inspections. (Signature of a~plicant, or name, ifa corporation) ...W.¢.e~J. ,.~.. N.Y../~.q.s: .aS ................. (Mailing address of applicant) ;tare whetber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... .~.~m4...Cso.~~, ............................ : ........................ ,'amc of owner of premises .m ~0.~. 5..h.0..~..¢c..~. ~,&, .~.~,0. .............................. (as on the tax roll or latest deed) ~' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ~. Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be (lone · llouse Number Street Hamlqt ............ County Tax Map No. 1000 Section .... ~.~ ......... Block ...~ .... Lot .............. SubdMsion ..................................... Filed Map No ....... (Name) ........ Lot ................ State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy . .~..V.~.I. Ih-~ ~.~'t-(.G ~.~,.~,'~fl~'(~,l.~t~~ 3. Nature of work (check which apphcable): New Building ....... ~ ~ · 'Addition .......... Repair ..............Removal ..............Demolition' '- ......... t~/. /~' I , · ............ ~ .... , ...... · . Othe?Work . . . 4. Estimated Cos O. Oi ¢} '"" ' ' >' ' ', ......................... Fed .......... If dwelling, number ofdwellia'g units J : , (to be paid on ~ling~his application) .............. Number0f dwelling units on each,flo~r ............... . Ifgarage, numberofc~s ...~ ..................................... . .......... 6. If business, commercial or m x~ed occupancy, specify nature anti exten~ o'f each't~pe of use'/. ................. 7. Dimensions ofexistingstmctffres if any. Front : . Height .. . .... ' . · .......... .. Rear ... ' De~'tt, ~. . · · : .... l~ulmoer olStorms ....... . ..... ~- ................ ~menmons of same structure With alterations or additions: Front ' ' ' ' .... Depth ' ~ ................. Rear 8 ................... :... llmght ...... · ................. Dimensions of entire new constnction: Front '~ ............. Number of Stories Height Roar ...................... Number of StoNes ' ' '' ....... Depth Size of lot: F?ont .......... ~ ........... Rear i ....... '.. 10. Date of Purchase .. . I xr ~ ' 2 ..... Depth ~ ................. II. ' ....................... Zone or use district in which n;e nises a~- ~;~.~i~ ' ' ~ o(Eo~sr Owner ~5' ..A..I~t ....... '. .. ' . . ~.. 12. Does proposed construction v 61ate a ...... : , - 1~. " ..... x ~ -g ~umlIg ~aW ordinance or re t . wm lot be reoradea x ~ . g lation 14. N~ ' ' '. .... · ...... W~i excess fill be re oved from rem~ses ,. eofOwnerofpremmes~..O~~ ~_, ~ ., ~ .. P ' : Yes No ~e of Architect . .. [ ......... Q~res~.~?' ~' - Phone No ,, ....... ~, ,,,,~..,, ...:, .. ........... ,,~=~ ........ ,~ = ~ .~ ~/ ,,~-~ o} conrracto~g, ii~~tffU( __. ~ ...... ....;.,... ....rhone No ............... ~a~u. xTe$ '. 1.{. NO ..... ~ ' · ~ yes, Sourhold ~own Trustees Permit may be requir;~. ~ '' · ... ~ PLOT DIAG~f Locate clearly and distinctly ~li buildings, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from propeNy ~nes. Give ' street ~d block 'number or description accordNg to deed, and show street nines and indicate whether interior or comer lot. TArE OF NE~R~_. (~ S2 ovxT~.~D..~ . _ ' . . · .~ ..... , ...... (N~mo or maw,d~ mgm~=~ ~;ac~ .. being duly sworn, deposes and says that he is the applicant 2 is tim ........... . i . ' . '' .................... ;5~ ...... ~ (Contractor, agent, ~offic ) ' ' ' ............. said owner or OWners, and is duly authorized to perform or have perl0nne~ that all statements containeU in this application are true to the best of his knowledge and belief; plication; aid Work ~nd to make and file this ~rk will be perfomed in the manner se{ forth in the application filed therewith, aud that the om to before me this .... ........ x%<. .d=, . <t,o ' Qualified t. Suffolk Cou.~ [ ~/~ .............. ~mi~lon E~es D~m~r 8, ~9 ~ (SignatUre of applicant)