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HomeMy WebLinkAbout20473-zFOR~ NO. g TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20587 Date MARCH 12~ 1992 THIS CERTIFIES that the building ALTERATION TO ACCESSORY Location of Property 375 MAPLE AVENUE SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 75 Block 2 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 11, 1992 pursuant to which Building Permit No. 20473-Z dated MARCH 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 ALTERATION TO EXISTING STORAGE SHED FOR A NON-HABITABLE DRESSING ROOM (CABANA) AS BUILT. The certificate is issued to JAMES G. & MARY K. BREWER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - MARCH 11, 1992 PLUMBERS CERTIFICATION DATED MARCH 11~ 1992 - JAMES G. BREWER / Bu~z~ing Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT CTHtS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~I? 20473 Permission is hereby granted to: ~.....'~.,....~..~.~ ......... : ........................ ....... ~.~;~..,..:~.~ ............... !; .... , ~ ~......~....~..-~~~;~..~..~~-..~,~' at premises located ot ....~....~....~...~~:$..~~.,.//~ ...................................... County Tax Mop No. 1000 Section ........ ..<~..~... ..... Block .......... ~ ...... Lot No ......~....7.~...~(.. .... / pursuant to application dated ...~../..~ .......................................... , 19..~....~., and approved by the Built'lng Inspector. Rev. 6/30/80 Form No. 6 *' , TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN IIALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY '~' I'his application must be filled in by typewriter OR ink and submitted to the building lllspector with the following: for new building or new use: ~. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. '~. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). ~.A.' Approval of electrical installation from Board of Fire Underwriters. ~, Sworn statement from plumber certify~ing that ~h~ solder used in system contains less than 2/10 of 1% lead. ' · '%. Commercial building, industrial building, multiple residences and similar buildings ~, and installations, a certificate of Code Compliance from architect or engineer responsible for the building. % ~, Submit Planning Board Approval of completed site plan requirements. %' ~'~r 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. ~. 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. 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. Certificate of Occupancy on Pre-existing Building - $i00.00 Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date · .ew CCh~struction ........... Old Or Pre-existing Building .........· House No. Street Hamlet _____ ¢-. O,,w~r ,~t Owners of Prope=ty...-J.d~Y~.~. .... count>, 1000, Bectinn...Z... ..... ......... .......... '.;ubdiv ~ :;ion ................... Filed Map Lot ?erml~ Mo.v. 20473-Z ...Date Of Permit. z3/l .... Applicant.I 'J~S BREWER Hen 1 tl~ {)ept Approval · ' ......................... Underwriters Approval .............. ?lanai:,,% Board Approval ................ for: Temporary Certificate ........... Final Certic~te .... ~ ttted: $ .... CO ~ ~ ~.~? ............... ;" TOWN OF SOUTtIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ~~ ~p ase przn t'~ --/ I certify that the solder used contains less than 2/10 of 1% lead. in the water supply system Sworn to before me this ~l4~ day of kk&&.'¢la.._ ,. I/Otary Public, ~ %% ~ County FORM NO. 1 TOWN OF SOUTHOLD BUILD]N(3 DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined . .~...~/./. , I~..~-. TEL.: 765-1802 Disapproved a/c ..................................... AP,,PROVED AS NOTED .~ .~ ii NOTIFY ,~,UILDING DEPARTI~I~J~T' AT . (B~l~din-~spcctor) FOLLOWING INSPECTIONS: APP.L?CAT. I'"ON FOR aU LDING PERM I' 1,FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMUII~G 3, INSULATION ' INSTRUCTIONS BOAaD OF HEAL'rtl ......... '<C SE-rS oF ~.~.,5~' .......... ~g~U R V E Y %'11EC~ .................... SEPTIC FORfl .............. ,,0, I CALL ,. ................. H^IL TO: Location of land on which proposed work will be d'gne ........... ~ "~'-- ,~,, 61¢~L,~. t/~¢~, '" , ............................... IIouse Number Street Hamlet ................... / County Tax Map No. I000 Section .... ~. ~ .~ ...... Block .................. Lot .............. Subdivision Filed Map No. (Name) .............. Lot ............... State existing usc and occupancy of premises and int?~d use and occupanc~ of proposed construction: ..... U'~;':" .... fi; '>.Xo..:t:.D...w~/rT;:;;,:,~%,'¢~?y ...... (Name and title of corporate officer) Builder's License No .................. Plumber's License No ......................... Electrician's License No. Other Trade's License No ...................... WffHOUT CEETIFICAT:: OF b. ~ i~j~.~.~/,~c.ffipn~::'t~t it.nd of build~gs on premises, relationship ,o adjoining premises or pubhc streets ~t~]~q}~l~q~}{.B,~f layout of property must be drawn on the diagram which is pa. of this appH- ~O ).ES . NOT P,E~ -~NS a~ : ~ d ~g6~~[~g~ may not be commenced before ,ssuance of Building Permit. · q89n apprqval o t't~$.appdcation, the Buildin Ins ector wHlissu ' ' * ' n~l be ,c. , ..... ~ .... = . g P ed a Bufldm~ Pe~t to the apphcant. Such pe~lt ,~h~ ~q~P~[~{:~pechon throughout the work, e. %~¢~n~s~,~J{ ~ %c~i~)Rrl~d in whole or in p~t for any purpose whatever until a Ce~ificate of Occup~cy ~all hav~&~l~t~ding Inspector. )r¢; J~CO~4~' unamg uepmment /hr the issuance of a Building Pe~it ursua uilding o ' uthold _ p nt to the ~r~~X~a~ra~ ,Suffolk County, New York, ~d other appQcable Mws; Ord~ces or -egulati~]~i~¢ng~"c'tiSn or~UnUmgs, additions or alterations, or for removal or demolition, as here~ described. }e .~PP[~~O~'~C~ ~liqable laws, ordinan~lding code, h~ing co e, and regulations, and to amz; aurn~fi~)~p6emise~-gn-d-~ ouild~g for nece~ ,~ections. 'co,muc ,o, ........ DESIGN OR CONSTRU~ION ERRORS ' '/' ~' r~.~ .... ~ .... /~q.~ ............. ~(Mailing address of applicant) tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, e ectrician, plumber or builder2 .......... ' , . (as on the t~ roll or latest deed) ' applicant is a corporation, signature o[ duly authorized officer. 3. Nature of work (check which applicable): New Buildin~ .......... Add ' ~ ' ~t'~"'~'t'~ Repair .............. Removal,. ............. Demolition ............. ': Oiner Work ..... '. ....... ~. ~'~',-~ ~ ' (Description) 5 Ifd lli eJ~} i (to be paid on filin~ thi{application) b f I ' g Unit ' · we ng, hum ero ( w i s .......... Nulnber o we ng tin Son fac ocr .. · arage, hum er cars .... i ........... ' ' 6 Ifb si ial i' d ..... I cify atur d of ach t> f ' ' · u ness, commerc or m xe OeCll)ancy, spe n e an extent e ' e o use .... 7 Di i cfc i ti i ifa F P · mensons x s ngstmcture , ny: rent ..... R ................. Height N 'b of Sro i .......... ear .............. Depth ..... Dim sions ors (th It tic ................................................... en amestructure w a era ns or additions: Front Depth Rear .... ' ................ [. Height ................................... 8 Dimensions of entire new construction: Nn nber of Stories ' ~ ~ · Front Rear ' ' Depth · Height ......... ; ..... Number of Stories ..................... . 9. Size of lot: Front . m~- ,' ............... 10. Date of Purchase . · ............... Depth ........... - ' <' ~ : ....... ~ ........ ' ......... Name of Fenner Owner ....................... 11. ~one or use d~.t[~tm'which preinises are situated ........................................... ~2. roes p~oposed construction wo~te any ~oning ~aw, ordinance o~reg~ation: ...... i .... : ..... i.. :. i .... ii.. i 13. Will lot be regraded I fp ......... ! .................. Will excess fill be removed from premises: Yes ,N.c. 14. Name of Owner o remises ..., ............... Address ................... Phone No .............. Name of Architect ........... i ................ Address .. . Phone No ..... Name of Contractor ...i ........................... ....................... Address ................... Phone No ....... 15. Is this property within 300 feet of a tidal wetland? ......... · If yes, Southold T~ *Yes ........ No ......... wn Trustees Permit may be required. .... ! PLOT mAGRA~ Locate clearly and distinctly all ~uildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nt~mber or description, according to deed, and show street names and indicate whether inter/or or comer lot. FA,.TE OF NE~ORKDr'> t ou,~¥ o~.....3~..~-_,... ....... ~~ ~' ~'~'~'~ ~. .. being duly sxvorn, deposes dud says that he is the applicant (Name of individual signing Contract) .... ~ove named. ~ (Contribtor "' corpo~at;;ffi~e;~'d}~ ............................ , agent, . said owner or owners, ~d is duly ault mrized to perfo~ or have performed the said work and to m~e and file this plication; that all statements containe4 i ~ this application are true to the best of his knowledge'and belief; and that the )rk will be perfomed in the manner set iforth in the application filed therewith. 'om to before me this .... ....... ' "' ...... : ....