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HomeMy WebLinkAbout20436-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20695 Date MAY 4, 1992 THIS CERTIFIES that the building ALTERATION Location of Property 11900 SOUNDVIEW AVENUE SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 6 Lot 17 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 12, 1992 pursuant to which Building Permit No. 20436-Z dated FEBRUARY 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 ALTERATIONS IN CELLAR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARY STRICKLAND (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-232832 - APRIL 21, 1992 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 "Rag NO. f 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) N2 2 0 4 3 6 Z Date 199' Permission is hereby granted t ..%............k. : 57 71 to Gf~ ........C Fk ? at premises located at ll.... 0..... G , ?z..E..................i. County Tax Map No. 1000 Section Block Lot No......... . ~LZ...... pursuant to application dated L~ 19./.-and approved by the Building Inspector. Fee 3..wlb... yl. 9..^. Bui Inspector Rev. 6/30/80 p~uuJLhli Form No. 6 TOWN OF SOUTHOLD JII p" BUILDTOWNING r MAY I I II 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: 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, JCommercial $15.00 Date p l .7 New Construction........... Old Or Pre-existing Building../............... Location of Property .....1,1 ~ D© . kgV.QY1 e.~Y.. ~ b?q.~ House No. Street Hamlet Onwer or Owners of Property.......` S71Z~.~ G~/l~./ County Tax Map No 1000, Section.... 5. :.....Block ......Lot..... 7 Subdivision ....................................Filed Map............ Lot...................... Permit No...°~~ 3~?.....Date Of Permit... 1.~ .7?! Applicant.... 6 .../90?-d........ To pv"-VLj Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate....... Fee Submitted: a C~,>u•~3M ~ dZa~~ 9S • • APPLICANT ?a 7 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001071 BUREAU OF ELECTRICITY F- 83 JOHN STREET, NEW YORK, NEW YORK 10038 Date AP°.I1. 21,1992 ApplicationNo.onfite 76545092/92 N 232832 THIS CERTIFIES THAT only the electrical equipment as deecrBed below and introduced by the applicant "mad on the *be" oppfieetion number in theprarnLee of .r,-.Y STP.IC6T.Ai1D, 119C1? 50?INDVIE AVENUE, SOI;THOLD, N.Y. in the following location; 0 Basement ? W FY. ? 2nd FT. Section Block Lot troy examined on APR IT 15 , i ;9 2 andfound to be in compliance with the requirement, of this Board. RxtIME R%TURES RANOES INO DMS OVENS DISHWASHERS EXHAUST PANS I OUTlE1S AQES S1 "C"ES INCA SCEM T1U011E5CEM OTNEn AMT. R. W. ANT. K. W. AMT, K.W. AMT. K. W. MIT. n. F. 3 7 3 DRYERS FURNACE MOTORS WTIME ANUANCE RatOEK SF[WLRIC'K TIME room tlNt YNN N"Un tAt%Tt-0OTIET DUMMIES 71 WATT AMT. LW. pl M. F. GAS M. P. AMT. NO. A W. O. AMT. AMP. AMT. Met TRAFK. AMT. N. r. p R1 MT. 6 - SERVICE DISCONNECT NO. OF S E R V 1 C E MEM H, LEG Na aT NEUNAa of i FUIURAI "I. "P. TM L 1 / ]W 1 / Tv 130 3w 130 M' NO. GIER%COfA. w CC i oG T NO a MAW 1 t OTtIN AWARAIM. f i i G & 5 CONTRACTOR LIC.A578-E EO% 215 SOUTHOLD, NY, 11971 GMNM MANAM 11 /V Per Y This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 6 I H a [a7 Z H i C w S O r F d H a x w s ~S,LN3Wi-i00 'IUtdOI.LIQQV w. '1VI:Z3. . a I OGOO II XDH3NS 31VIG H I x •N kl3d NOLLV'If1StI: w c N ~ •F w a I DNISHn'Id' 3' 3[•IVIf3 HDf10t o Z co Lvallm C M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [/-]-FIN7l REMARKS:- DATE -INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ROU H PLBG. [ ]FOUNDATION 2ND [ NSULATION [ FRAMING [ ] FINAL REMARKS: DATE C 7/ INSPECTOR 3. Nature of work (check which applicable): New Building Addition Alteration . . Repair Removal Demolition . . . . . . . . . . . . . . Other Work 9~ § nJ19escription) 4. Estimated Cost 3 y.O.iJi U . . . . . . . Fee (to be paid on filing this application) 5. If dwelling, 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 . . Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories . Dimensions of same structure with alterations or additions: Front Rear . Depth Height Number of Stories . 8. Dimensions of entire new construction: Front . • . . • ' • • • Rear Depth Height Number of Stories . 9. Size of lot: Front Rear . Depth . . . . . . 10. Date of Purchase Name of Fortner Owner 1. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises W. OAX t O. Address Phone No. Name of Architect Address Phone No................ Name of Contractor ~o,Ij , , ,pl?~ Address . . . . . . Phone No. .7 r;S . (pt"7 15. Is this property within 300 feet of a tidal wetland? Yes . . . No . . . . *If yes, Southold Town 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. f~ pD7TEA L-10tS nrt~ pAkn •+-7 1-ouVYte~~tt 1M suom NouflklisNOO NO NOIS30 t~} 80~ 3181SNOdS38 ION 'S3(10-) N A9N3N3 IR NOi.L) 1luiSNoo 31vis ' V n^ ~ffSerntrn T ~eXbg b~a+~rE~ WN 3111. 30 S1N31N3U1n03U 3H-k 8C 4 t viz 133114 11VMS NOtjondisNOJ "9'!1r' d'fON'£~0 803 3iJ~BS~fFtSJt?•.) ~a~.t r O isil7ltt NO113flulSMC9k - I§" IJ 'V o g DNISA'n-ld 19 9fg19"oVHJ - F99f;Oi; 6 6 gt ; 34IA40NO4? 73Ht3=00:,1'0u pILCD d,.:.kt't'fe::•? L7~~,l~t.LON UNDfRWRIT RfQ~ RfORTIFjDgTF ;TATE OF NEW Y-( .I F(6 S.S f 'OUNTY OF " • • • r• • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. 'e is the Nfevl................................................................. (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 tplication; 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. ,vom to before me this ay of ..Urt Dar 4 19gZ otary Public, . . , e?~~ unty • . ......T~cor~....... County • `1t6BEeTJR. No. 4725089,1 Suffolk Co Term Ex9utes may 31,1 (Signature of applicant) BOARD OF HEALTH FORM NO. 1 3 SETS OF --PLANS TOWN OFSOUTHOLD SURVEY FEB 21992 BUILDING DEPARTMENT CIIECK . TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ttocALL-..?6.5. 6057.• a __e Examined P~... 19° TO: MAIL Approved ..-/.~.U , 191Permit No....~~j' P ' _ . Disapproved a/c .................'L . O. din n ector) APPLICATION FOR BUILDING PERMIT Date v......, 19 f y INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ats 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 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 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 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, and regulations, and to mil authorized inspectors on premises I and in building for necessary inspec ' ns. C~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) state whether applicant is owner, lleessec, agent, architect, engineer, general contractor, electrician, plumber or builder. I ................../ZC .vI dame of owner of premises .M .I . . (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. M y (Name and title of corporatel!offcer)9 t @l Builder's License No. ~ a' U Plumber's License No. Electrician's License No. ("CCUPANCY Ju" Lo Other Trade's License No. Location of land on which proposed I,work will be done . St>un!D House Number Street / Hamlet County Tax Map No. 1000 Section {....5rr Block 6 Lot....!.!............ Subdivision j 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 . VN~...!~,y/~,,eZ 1 6N; ti" b. Intended use and occupancy ;.AvMnq-? . , , l la~SE/~RL r r2 S~jb~i ~1~