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HomeMy WebLinkAbout20732-z r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22670 Date OCTOBER 20, 1993 THIS CERTIFIES that the building ADDITION Location of Property 340 SOUND RD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 35 Block 1 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 16, 1992 -----Pursuant to which Building Permit No. 20732-Z dated JUNE 18, 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 CEMENT BLOCK FOUNDATION UNDER EXISTING ONE FAMILY DWELLING & INSTALLATION OF HEATING SYSTEM AS APPLIED FOR. The certificate is issued to MICHAEL J. VERITY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-029315 - JUNE 15, 1992 PLUMBERS CERTIFICATION DATED N/A v Building Inspector Rev. 1/81 FORK NO. A 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! 20732Z Date 19. . r Permission is hereby granted to: , ~~y .i ~~.......2......................... €F,~~ , o /V . .......112K to cp . ` at premises located at 3f~Q.~-........./~ ..:~.1.~..~"' . County Tax Map No. 1000 Section A5.P.-.......... Block .......®1....... Lot No. pursuant to application dated .................SP ~ 19.47 and approved by the Building Inspector. Fee $ uildIng Inspector Rev. 6/30/80 Form No. 6 eo (Brp q24 TOWN OF SOUTHOLD BUILDING DEPARTMENT fl tai TOWN HALL dg d 2 z 765-1802 ~TC~UUIU(dr''.f%}~" }r-' 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. 8. 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 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 - $100.00 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 - Residential $15.00, /Commercial $15.00 Date /v.o2CJ / few Construction....... Old Or Pre-existing Building.... .ocation of Property? 4.410.... ~'GU N!a A . 1............ aREE t//Lb2T House No. ~//S'treet Hamlet >nwcr or owners of Property..../.l/e-X, L (O~Q/Ty :ounty Tax Map No 1000, Section... 3 ......Block...... L.........Lot..... subdivision .Filled Map............yLoot.........../....... ..........Date Of Permit.. Applicant.. ermit No. o -132- r~0 / G,/,4 c- 4- ae y.. ealth Dept. Approval ..........................Underwriters Approval......................... lanning Board Approval equest for: Temporary Certificate........... Final Certicate..l..../..... ee Submitted: $ Lu c< 6q7~ ~o Z.o~a(p70 - APPL CANT n a G µ p rC x m k N W A P v x A N m P ~n ~ R 0 r.~ ~ v 1~ " N ~ k'^ P m t rA D y> 0 O N 3 Q £ W m R Ti G ~ ~ :U C m G a i oo O 9 T a @. III O en -vr •w rs m p p ~ ~ U1 ~ 0o g .0 cr a x = ~ "o' a a { c 'I C c O cJ ca r-v A M` ~ A ~ tFl Z r' ~ ~ a3~ m n ~ -i A7 .3ZO g IVO O ° n t7 Rv~ ,po - c~cP `y& 'z' m j m s - ID ~ 8 ~ n w 's M £ P ZE n a A e y » p N r< X ? o A l i c £ $ N M1 v yin 3 z ~I rA i m o a P? env a m ;u 0 s z rn i a au r-m 1 m o o p as >a n m @~ N 0. C3 k 0 T A ° am "y c «a O{m P z o m Am -n 6) ^I7 A0 z 10 a f ifl - M ~ n $g a «c ~ m o ~A C 2 ~ ~ R p K. a >v x ',1 f R s a• w ~ ~ Dm ~ S R N~ 0 ;m P W > c z= m ;r- z t P rZJ m - = A s "e v b Rf~ x m f~ a W l-C o oN. F y N 'sl N mN~ £ O , a Y D ~ N M a m C ~y 3 ~ D " CS m ~ cF ; N ..t N ~ s N x D rp I.s v N ~tWRIRt1Itt61iPW _ ~,~4gltttritil/H~%UtW'(fN1[mM _ tHd4N[!l011d~IlKYNl4pi(CYU@N! %~Ntl1NNltlp(~119'dPIP 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ qi INAL REMARKS: / cet' DATE 3 INSPECTOR ,-~073 2,, M-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 41K DATE 9 3 3 INSPECTOR WEILE iLAIN S, V 1 M 47777 , 4 D' GV BOILER 4t (SERIES 2) GAS CONTROL SUPPLEMENT FOR NATURAL OR PROPANE GAS-FIRED =x'' BOILERS { a g f a TO THEUs ERA Gas Conttoi Supplernne fa,tt%ltekuaedx a iifi ~ rvfo ~ea~ Y ~ r x. ~ TO THE IWNS, . 1}ea 4 Cti w W ~ t ~a ,~up~~pe ~ d ~t¢ a ~si1 tY~p at Part Number 550-141-699/0393DCP ALD";l:;S _ .IJ:i ~~J„: Uiti1L`NT -y 7OU11DATI ON ( 1st) ^I f FOUNDATION (2nd) - - C 2. ROUGH FRAME & I o O -PLUMBING is. ti H 3. m r m H INSULATION PER N. Y. STATE ENERGY CODE I c © FINAL JI, o-Z ADDITIONAL COMMENTS: x to ro O W x m a • r _ H O m -a _ H BOARD OF HEALTH FORM NO. t J SETS OF PUNS TOWN OF SOUTHOLD SURVEY JUN 1,BUILDING DEPARTMENT CHECK < TOWN HALL SEPTIC FORM LI L,„ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:aT' FY ; L- CALL Examined , . 1.9~Z- , hiA TO Approved 4/' .Ii , , 19/.LppPermit No~7$A-? , Disapproved a/c ...VV ( ilding Inspector) APPLICATION FOR BUILDING PERMIT cy Dat , 19 /.-2., 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. c. 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 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 alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. - _ J?.'. . (Signature of app ' nt, or ee,f corporation) . ,C°X . 7A.. r'reFF~ur?ae r A9 Y (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0.IA-?.l J L P- . ' ' .APPROVED'AS NOTED' ' ' ' ' Name of owner of premises .../~C• • 4AT ~i PsE3.P, lI: ~3G (as on the ax roll or latest dpi . dv BY If applicant is a corporation, signature of duly authorized officer. NOTIFY BUILDING 'DEPART y 765-1602 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) OCCUPANCY OR 1. FOR POURED - TWO REQUIRED USE I UNLAWFUL 2. ROUGH - FRAMING CONCRETE Builder's License No . WITHOUT CERTIFICATE 3. INSULATION Plumber's License No. OF OCCUPANCY 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. Electrician's License No. ALL CONSTRUCTION SHALL (MEET " " " " " THE REQUIREMENTS OF THE N.Y. Other Trade's License No. STATE CONSTRUCTION & ENERGY " " " " ' CODES. NOT RESPONSIBLE FOR j es.~ / RS Location of land on which proposed work will be done. ©D C" House Number Street Hamlet County Tax Map No. 1000 Section 5 Block Lot 7........ . 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 .....OPJ4E L f~w E LL /X) 6- . . b. Intended use and occupancy V 1 t . . i 3. Nature of work check which ap licable): New Building Addition Altera i4n Repair applicable): . . Demolition Other Work C-90A- ...it V lb 4. Estimated Cost ...C ©p~ ~DescnPtion) Fee...................................... (to be paid on filing this application) 5. If dwellindg, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy; specify nature and extent of each type of use . . Height mslons of existing g structureNum¢ ,ifany:Front Rear Depth............... of Stories , , , , , , , , , , . . . . Dimensions of same structure with alterations or additions: Front Rear . $ Diniensionns,of entire new construction: Height .._.j. , , , , , , , , , Number of Stories . Depth . . . . . . Front ..lr.~..a, , . Rear /57 .......Depth .?O•~F Height C i WN G Num Ijer of Stories 9. Size of lot: Front ..qO z Rear ....7 p C D P th . ! S........... 1 1. Zone or use district in which pre /9~ ' ' • • 1 ame of Vorn]er Owner MoL L y ~l,y~p pD w~~p 12. Does ro osed construction violate are situated 4y •F(. , , , 0. Date or PP rchase to any zoning law, ordinance or regulation: MO . 13. Will lot be regraded . Alo , . , .f~ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . ..I,e~ljaCL , T . Y4!/Tllddress 9oSoauO4o,stl Phone No.. .7-,9Q/, d 6ok6 G~¢de`iv~b¢ Name of Architect . . . . . Address hone No...... . Name of Contractor . 'a 15. Is this property within 3........ " " ' •Address ...................Phone Nir% QO feet of a tidal wetland? *Yes No *If yes, Southold TPwn Trustees Permit may be required. PLOT DIAGRAM 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. „3 ~ arm e I.t7 tz' PCia) JZ STATE OF NEW YORK~y. 1 COUNTY ' • ' F • r.~•"k S•S T . • • • • • being duly sworn deposes and says that he is the applicant (Name.of individual signing contract) :hove named.. le is the . cnv, P.(,N..... . (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 of his knowledge and belief; and that the /ork will be performed in the manner set forth in the application filed therewith. worn to before me this ,0`$u day 19 . lotary Public, County ROBERT 1. NNOTA4RY BIJ Of KY. ~ (Sig ture of applicant) Term GpimiTty 81,18