HomeMy WebLinkAbout20707-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20783 Date JUNE 11~ 1992
THIS CERTIFIES that the building. ADDIT%ON
Location of Property 1845 THE STRAND & 115 GREENWAY EAST MARION~ NY
House No. Street Hamlet
County Tax Map No. 1000 Section 30 Block 2 Lot 57
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 10, 1992 pursuant to which
Building Permit No. 20707-Z dated JUNE 11~ 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING & PARTIAL
DECK ADDITION AROUND INGROUND SWIM~4ING POOL AS APPLIED FOR.
The certificate is issued to PETER & DOLORES WALSH
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
/ ~uilding Inspector
I~OB~ NO. 0
TOWN OF SOUTHOLD
BUILDIHG DEPARTMEHT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
N-°N? 20707Z
Date ............... .~.~././.. ............................... ,
/
Permission is herebygranted to:
..........................
.... Z..f.~ ~./~...
at premises Io~oted at ........ ~ ~ ..............................................................
.................................................... ...........................................
cou.~ Tox Mop No. ~0o0 ~.on ..... .~..~ ........... Block .....~..~ .......... Lot No........~..~.. ...........
pur~uont to opplicotion dot~,~:l .............../~.~..~.. ............................ , 19.~..~ ond opprov~l by the
Building Inspector.
Building Inspector
Rev. 6/30/80
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).
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:
i. 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.
· Fees
i. 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 - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated C ' ·
ertzflcate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date June I1, 1992
ew Construction ........... Old Or Pre-existing Building ................
ocation of Property ...... 1845 x~l~ STRAND EAST 14/LRION, N.Y.
Ilouse No. Street Hamlet
Iwer or Owners of Property DOLORES WALSM
30 2 57
~unty Tax Map No i000, Section .............. Block ................ Lot ......................
· bdivision .................................... Filed Map .......... Lot ......................
=mit No .............. Date Or'Permit.. DOLO W
'' Appli
alth Dept. Approval .......................... Underwriters Approw~l. .
arming Board Approval ........................
quest for: Temporary Certificate ........... Final Ccrticate ...........
~ Submitted: $ .... 25.00
' ........................
c0 Opg3 .................
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 11, 1992
TO WHOM IT MAY CONCERN:
Property listed under Suffolk County Tax Map #1000-30-2-57 is
situated at 1845 The Strand and 115 The Sreenwa¥, East Marion,
N.Y. The property has a "coal bin" on it that does not require
a permit from Southold Town.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Gary J. Fish,
Building Inspector
GJF:gar
Examined ..... ~..~././ ........ ,~. ~ ~ 9~ ~ 0~--
........ ~/.//. .... 19 ~L.. Permit No.
Approved
Disapproved a/e .....................................
ORM NO. 1
OF SOUTHOLD
'G DEPARTMENT
>WN HALL
)LD, N.Y. 11971'
.: 765-1802
.- . (B~,Ming Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTII .........
3 SETS OF PLANS ..........
SURV£Y ...................
CIIECK ....................
SEPTIC FORH ..............
CALL ...................
HAIL TO:
· I INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
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 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.
¢. The work covered by this 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
shall be kept on the premises available for inspection throughout the w6rk.
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 MADE to the Building Department for the issuance of a Building Permit pumuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the constn~ction of buildings, additions or alterations, or for removal or demolition, as herein described.
I'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit author/zed inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~ (as on the tax roll or latest deed; DD' : ~ '~'"
FEE: ~ ~ BY: ~* ~
If applicant is a corporation, signature of duly authorized officer. NOTI~ BUiLDiNG DEPART~EN~ AT
765-1802 9 AM ~ 4 PM FOR THE
. (Name and title of co.orate officer)
OCCUPANCY
OF OCCUPA? CY
El '' ' L' N
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2, ROUGH - FRAMING & PLUMBING
3. INSU~LAT. ION .
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
h
Ot er Trade s L cense No ......................
~ CODES. NOT RESPONSIBLE FOR
Location of land on which proposed work will be' done .......... DESIGN OR CONSTRUCTION ERRORS
..... ............................................................
House Number Street Hamlet
County Tax Map No. 1000 Section ,1~3..~.9 ............ Block . .o~ .............. Lot....~.7. ............
Subdivision..~?...0. ~..."Q..~..~.C.~.. I~ .~.0..~,~. 1~./~..~-.~. .3'Filed Map No...(o..,q-iq .~ ....... Lot..~.,..~ ...........
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..
b. Intended use and occupancy
3. Nature of work (check which aEplicable): New Building .......... Addition ........ Alteration' . .........
Repair Removal Demolitioh
............................... : · ·.: Other Work ...............
-~g i ~ (Description)
4. Estimated Cost../.4rTS:~. .... ! ...... ...... ............. Fee~.~,.~ ~.~..... ......................
[ (to be'paid on filing this application)
5. If dwelling, number of dwelhng tarots ......... Number of dwelling units on each floor.
Ifg .......
arage, number of cars I ...............
c~ [fy h typ .........
6. If business, commercial or mixe occupancy, spec nature and extent of eac e of use ....................
7. Dimensions of existing structure~ if any: Front Rear
He ght Number of Stories ............................. Depth ...............
Dimensions of same structure wiih alterations or additions: Front ................. Rear ..................
Depth .................... !. · Height ............ Nomber of
.......... Stories ......................
8. Dimensionsofentirenewconstrgction: Front ' Rear
Height Number of Stories .............................. Depth ...... ..........
9 Size of l~i: ............. I ........................................................
· Front .......... . .......... Rear ....... Depth
10. DateofPurchase ''"'""..'..~ ...%....,.......' Name of' .................................... Former Owner
1 I. Zone or use district in which. Premises. , are situated .....................................................
12. Does proposed constructton vxollte any zoning law, ordinance or regulation: ................................
lot be regraded . ·
13. Will ......... ? .................. Will excess fill be removed from premises: Yes No
14 Name of Owner of premises ' Address
· ' ' ' I' ' .................................. Phone No ................
Name of Architect .
........................... Address ................... Phone No ................
Name of Contractor. '
....... ~ ............... Address ..... ., ......... ;... Phone No ................
15. Is this property within ~0'0 feet of a tidal wetland? Yes ........ No ......... · If yes, Southold T~wn Trustees Permit may be required.
· ... PLOT DIAGRAM'
Locate clearly and distinctly all >uildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block r umber or description according to deed, and show street names and indicate whether
interior or corner lot.
~TATE OF NEW YORK,
?OUNTY OF .................
· ' being duly swor deposes and ys that he is ti e applic nt
(Name of individual signingI contract)
bo e named
le is tho : ~ . i .....
i (Contractor, agent, corporate officer, etc.)
.f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in this application are true to the best o£his knowledge and belief; and that the
?ork will be performed ~n t e manner selt forth in the application filed therewith.
worn to before me this
Z
:otary
Public
................. ~... County
i LINDA J~ COOPER .........
Nota~. Public, Stete of New York
No. 14822563, Suffolk County ~').2.-. (Signature of applicant)
Tbrrn E,xpires December 31, 19,
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