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HomeMy WebLinkAbout20914-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~RTIFICATE OF OCCUPANCY No Z-23706 Date J~NE 14~ 1995 THIS CERTIFIES that the building Location of Propert~ 1010 MAPLE LANE House No. County Tax Map No. 1000 Section 35 Subdivision ADDITION &ALTERATION GREENPORT NY Street Hamlet Block 5 Lot 27 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 20f 1992 pursuant to which Building Permit No. 20914-Z dated AUGUST 21f 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 INSTa~. A SLIDING GLASS DOOR AND AN ENCLOSED PORCH TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DONALD & JOAN BRE~ (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N341251 UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A JANUARY 31r 1995 N/A Buildin~ 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) N~N? 20914:Z Permission is hereby granted to: ~,...~ .......... ~!_~A~..~.....~ ~ .......... .~.~.........~....~....~....~..,...u....~..~.~. ,o ,..~,. ,~.' ~,....~.~....~.....~,,...,.~~,...~!..~.:.~.~?.. ~..'-.~...~_~.~~~.,....~....~.~ ................. at premises located at ..~/_.~...~..~)...... ~ ..c~....~ _ ~..~;:~. ~...~]?......¥]~..l~),~./Mb~.~.Il '. ................. County Tax Map No. 1000 Section ....~.~;~ ......... Block ..... ..C~..~ ......... Lot No....~...~ ................ pursuant to application dated .....~¥:~.~... ....... .~-....~.. ............ , 19.~...~.., and approved by the / Building Inspector. Bui~din~l Inspector ..... Rev. 6/30/80 API'LiCA'rlON FOR CEP, T[ltlCATI,; OF OCCUPAi,'CY A. This application must be filled in by typewriter OR ink and submitted to tim b.ildinB inspector ~'itb the follo~J, ng: for ne~¢ building or now 1. Fiual s~rvey of property with accurate location of all buildings, property lines, s~rce[s, and unusual natural or topographEc features. 2. Final Approval from Health Dept. of ~ater suppl7 and sewerage-disposal(S-9 form). 3. Approval of electric~[ installatiou from goard of Fire Underuriters. 4. Sworn statement from!plumber certifying that Lbo solder used in system coutaii's . less than 2/[0 of i% lead. ,~5'. Co,u, ercial building, indostrial building, multiple residence~ and similar buildings and installations,~xa certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approwtl of completed ~ite plan requirements. B. F~r existing buildings (prior to April 9, t957) non-conforming uses, or building~ and '¥re-existing" land uses: I. Accurate survey of property sbo~ing all property lises, streets, building and ~nlttsuai llatural or topographic features. 2. A properly completed app.lication and a conaent to inspect signed by the applicant. If a Certificate of Ocnupancy is dealed, the Buildiug Inspector shall state the rna~ons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to d~alling $25.00, Alterations to dwelling $25.00, S~¢imming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinz - 3. Copy of Certificate al Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Cotmercial $15.OO' Ueu Construction ........... Old Or Pre-existing Building ................. or ............................... [louse No. Street Hamlet Onwer or Owners u,f Proper~y .~¢~5c~ ~ ~O~ coo.~y 'r,~ ~=p t~omoo, secrio,..[~5~ .......~(,~k...O~ Subdivision. ~. i% .~ .Filed Map.~.gZ~ .Lot..~.¢. Permit ~o ~.~.~. ..... Dace Of rermit~?~9.i~.J ..... ApplicanC.*[3~. Health Del Approval ~ Uzdcr~riters Approw]l ?lanning Board Approval...' ..................... '~equest for: Temporary Certificate........... ~ Final Ccrticate.........,. · . Cr ....... 1010 NatmL¢ fa~e, Box 585 F_ant ~a~Zo~, Rg 11939 7eb~tta~g 1, 1994 Town og $o~hoZd The ~wLkddn~ attd repair ~o~ec~ a~ 1010 ~a~Le £a~e~ ~a~E ~aeEo~, flew ~o~ has wot been completed due to the ~ollowin. q o~ wo~£ ~o~ the ~r~t~a~ date og ~ne ~993 to ~t.ate ~uCu~t 1993. 2) C~4EcaZ 2~LL~e~ and ~wb~¢qucnt death (~¢c. o~ a~am~Lq ~e~bee receding a~ 4aid addee4~. ]) Sho~aqe o~ ~one~ to ,~nance comp~ietEo~ o~ ~o~ec~ d~e to ex~endEtu~e4 ~oe euen~ ~n Ztem. 2). Swb~eq~erttk~, we a~£ ~o~ a ~Zx ~onih exten~Eon o~ permit 209742 to aLLow u~ add~tEonai, t~m,¢ ~o~ ao~oEetEon ~onaEd £. B~¢h~ and ~oatt t~. B~ehmt 765-~L802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] I~LATION [ ~]~ F,NAL [ ] FIREPLACE & CHIMNEY DATE ~_~ I N SPECT~ BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~/~ULATION [ ] FRAMII~G [//] FINAL RE:MARKSL ~/_-~~,/~'~ OJ, OUNDA'TION (1St) OUNDAT!O~ (2nd) :0UGH FRAME & -PLUMBING ]. iNSULATION PER N. STATE E~;ERGY CODE · It Fi;~AL BOARD OF HEALTH ...... 3 SETS OF PLANS FORM NO. 1 SURVEY ......... · TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N.Y, 11971 NOTIYY TEL.: 765-1B02 CALL MAlL TO: Appro'~e~.~*...~. · · .~.., 19c~.~'fPermit No ............ Disapproved a/c .... ............................... .... (Building Inspector} APPLICATION FOR BUILDING PERMIT Date .~..Ut.f?..~.T. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, witl sets 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 stte~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap~ cation. c. The work covered by this application may not be com~nenced before issuance of Bui/ding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such pern 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 Occupan, 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 tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws~ Ordinances. Regulations, for the construction of buildings, additions or alterations, or for removaI or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) Slate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner o f premises . .~. p?¢.A-..(_..~.../-:: .,.. ¢./~..~..[!t. ./~....'~.JT..~..¢ .~..A('...fi.. ~:..El.,r~. ~ .~. .................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly autliorized officer. (Name and title of corpc.rate officer) ALL CONTRACTOR*S MUST BE S[/FFOLK. COUNTY LICENSED Builder's License No ..... /..~.'.-. ~..~l.$-7.Z .~'. ~-... Plumber's License No ..... .-:~; ................ Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on wliich proposed work will be done ................................................ ltouse Number Street }tamlet County Tax Map No. I000 Section ...~ ........... Block . .~.~. ............ Lot.. ~ ~ ............ Subdivision .¢.~1~ ~ ~.~. ~l}/.~T.7~( ~.~.~. Filed Map No. ~.~. ~ff2 .... Lot .. ~ ........ (N amc 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy R~S/D~IV'T~O~a~ ~'~,V ,~,"".~ b. Intended use and occupancy 3. lqatut: oK work (check which applicable): Nc,¥ Building .......... Addition .. ?.' ...... Alteration . -./~. ..... Repair .............. Removal ............. Demolition .............. Other Work ............... 3/ j (Descriplion) Estimated Cost'~. 1~©. © O _ C) C) Fee .~.. , ~ · (to be paid on filing this application) 5. If dwelling, number of dwelling units...~.'!(~ .~ .t~... Number of dwelling units on each floor ................ If garage, number of cars .... .-~-. IM.O .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .... ~w-.. '2 '~ ?~' ~i ..... 7. Dimensions of existing structures, if any: Front . .5'~l f~.~l ...... Rear . . . .q.~ (.6). ~'.... Depth ...... ~ ........ Height . /.b. '. Q i'. ...... Number of Stories ... ~A/~-. ................................................ Dimensions of same structure with alterations or additions: Front .. ,5j.¥..M..~ ........ Rear .. ?.A-..~..~. ......... Depth . . .51~P4...~. ............. tteight. . . ~'/~PS~. ............ Number of Stories . . ~'./t,. P.t.~. ............. 8. Dimensions of entire new construction: Front . . . ~..' ......... Rear . . {~. '. ......... Depth . .~. ~. .......... Height ............... Number of Stories ~ 9. Size oflot: Front ...]Pfl.,.°9 ............. Rear....~.~..-.t{7 .......... Depth /.3. t...~.3.~/.~.'~.:.~?. ..... 10. Date of Purchase .... ./y~ .& x/'... ] .~? ........... Name of Former Owner .-7~A- ./?(.~?...~P.~.~./-~. ......... I 1. Zone or use district in which premises are situated ..................................................... 1 2. Does proposed construction violate any zoning law, ordinance or regulation: . ./~.Q ........................... 13. Will lot be regraded ..... ~0 ....... ;~ ............ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .D.°q'6.t-.0...~..~.°.4.e,/..Fe'.~..t(./l~ddress/°./q .~??.~..'5.~.'v.~,..~-.ff~.~.%/Phone No. ~?,?.x g.z!~. ..... Name of Architect ........................... Address ................... Phone No.. 7. ............ Name of Contractor . .~.~c.tvd(. ;~T),A, ~. ~.5 ........... Address Oq~(~.q. ..h'LA-..~.JZo..c. ff-. ,Phone No..&.~ g'- g'5"?...~.... 15. Is this property located within 300 feet of a tidal wetland? *Yes ~... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAG RAM '4. 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. STATE OF N~4;~'OI~ / ]/ o o courcrY OF. .kLTtT ........ ~ .f~-~ .... .~...~-/. [ .~ ................. being (Name of individual signing contract/ above named. duly sworn, deposes and says that he is the applicant He is the ......................' ...... ~ .................................................. (,[contractor, ~gent, corporate officer, etc.) of said owner or owners, and is duly anthon'~4o pe4q-6rm 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 me this ,- ~t~*~. ~ o~ . .:...-?.--~,.~ ~,~,r~.2-~ ~ al$I~801i .................. ~ ................ ~~~_ ~ In 8~ ~ I~ (Si~ature of applicant I t~.O ,.' SI I 32.8 sTORY I HOUSE FRAME .59.1,, \ .\ SU~Y FOR AT ~AS~ MARION DATE: SUFFO~ COUNTY~ NEW ~RK NO, c~ffrr o~ ~u~E l~,lgS~ ~.¢ ~o...o ~ ~ I AND ~ND SURVEYOR N,Y.S. UCENSE N0.12845 ~ ~ HOWARD W. YOUNG, LAND SURVEYOR N~L~L(W),~ICTA~K{~TIeCE~OLS(~)~N~RE~ ~) N.Y.S. LICENSE N0.4589~ .... DIN,NG RM. BRCA~/,FAS T JTJ--) 9e ~ 9e ?e x 9'~ KIT. 90 ~ jOo L~NG F~. BEC) t:IJ~, BED t~e x 17e I:~'~r 104 x I0° Ilex 12 .,--,.: .,7" .'~ x, ,,' ~Df(oi~OSF__ B LAY,pdT C~ RAr_~ I.~NG FRM, BED ? ¢ SURVEY FOR JA~ES IDLER LOT 60, "CLEAVES POINT- SECTION $ ' Dec. is, AT £AST MAR/ON DATE: MAY 2~t, ~WN OF SOUTHOLO SCAL[, / "~ ~0' SUFFOLK COUNTY~ NEW ~RK NO. 83 ~[ ~N ~ WHOM THE SU~E.Y 15 HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUC T ANO ~ H~S eE~LF m THE TITLE C~P~Y eOV~N- . ' ., R A~E~. RIVER~AD~ NEW ~RK suaolwslo~ ~AP ~o tN r~ OFF~CE OF THE C~E~K OF ~F~L~ ~ ~;~1 ALDEN W.~UNG~ PROFESSIONAL ENGINEER ~ I HOWARDW. YOUNG, LAND SURVEYOR N~ L~ ~L(W},~IC TANK(ST)eCES~OL${~ ~N ~RE~ ) N.Y.S. LICENSE N0.45893 ALTERATION DONALD AND JOAH BREHM 1010 Maple Lane, P. O. Box 5B5 East Marion, N. Y, 11939-0585 IA/F_