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HomeMy WebLinkAbout21158-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22048 Date DECEMBER 21~ 1992 THIS CERTIFIES that the building~ ALTERATION Location of Property 4525 WUNNEWETA ROAD CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 12 Lot 7.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 18, 1992 pursuant to which Building Permit No. 21158-Z dated DECEMBER .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 ALTERATION ~PARTITIONS) IN CELLAR OF EXISTING ONE FAMILY DWELLING AS BUILT. The certificate is issued to of the aforesaid building. HENRIETTA SILVERMAN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - DECEMBER 16~ 1992. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FO~I,~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL $OUTHOLD, H. Y. N°N? BUILDIHG PERMIT (THIS PEPJ~IT MUST BE KEPT ON TH;= PP~EMISE$ UNTIL FULL COMPLETION OF THE WOP~K ^UTHORIZED) 31158 Z ~a,e ..Z .~.~.~ ............................... , ~..g...,~ Permission is hereby granted to: ~.~.../,...~./~.~.~..J....~~ .~:../.~.,.......'. .................................. . ~~ ............................................ ~~ ~~/ ,o ~~~~).;~:..~....~~..~. ~ ,, ~ _~ , ~,, ~~ ................ f..[ ........... ~.~....~~:.....~ ......... ~~ .......... .: ................ ~, ~,~, ~,~ ~, ..... ~~.~~....~ ...................................... .................................................. :.~~~ ........................................................................ co,~ ~ ~ No. ,000 s,~,,o~ ..... ~// ......... ~,~ ....... Z.~ ..... ~o~ No....2~.~ ......... ~,~ ,o o~t,o~ ~ .... ~/ ........................................ . ~.~.~ ~,~ ~o~ ~ ,~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 FOR CERTIFICATE OF OCCUPAHC 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. 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 applicJtion 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 Occupanc~dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $~3.__~ Swimming pool $25.00, Accessory building $25.00, Additions to accessory bu~'l~d-ing $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 SeDtember 11, 1992 New Construction .... .,~.... Old Or Pre-existing Building..__... . .... ,~. }louse No. Street Hamlet Onwer or Owners of Property Hemrietta Silverman County Tax Map No I000, Section. 111 ...Block. 1.2 7..~. lubdivision .....· ' Filed Map ~% Lot --- 'ermit No.~.~.~ .Date Of Permit..~~.~.Applicant. Henrietta Silbermas {ealth Dept. Approval ..... ~ ................. Underwriters Approval~~..~~... 'lanning Board Approval .... ~. ................ ~equest for: Temporary Certificate ........... Final Certicate ........... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ~- ] ROUGH PLBG. [ J FOUNDATION ;ZND [ ] INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~./~~~ ~ DATE .... INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-~802 ..... , Disapproved a/c ......... t ........................... ~PklCATIO~ FOB BUIkDI~G INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SEPTIC .... . . t:OTl FY: CALL ................... HAIL TO: Date Sept. 1~ 197g. a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 -'ts 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 ~all 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 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 dmit authorized inspectors on premises and in building for necessary inspections. .... (Signature of applicant, or nacre if a corporation) (Mailing afl/d, lCess of applicant) 'rate whether applicant is owner, lessee, ~(~en~ architect, engineer, general contractor, electrician, plumber or builder· · Marion R. King, Broekr ~ameofownerofpremises c ~'Henrietta. Si'lverman (as on the tax roll or latest deed) ."applicant is a corporation, signature of duly authorized officer. (Name and title of co.orate officer) Builder's License No. OF-4)~ ~'t~. (0~ner) Plumber's License No ......................... Electrician's License Nb. r ....... ' ...... - ......... Other Trade's License No ...................... Location of land on which proposed work will be'done~O~.W, unnewet a Rd. Nassau Pt . . gue, N[ ¥'. 1~19'~ ............ .... 4.~..5.5. 4~b:r6~teta Road, Cutchogue, NY Ilouse Number ......................... : .................................... Street Hamlet County Tax Ivlap No. 1000 Section 111 Block 12 7 -~-~-~---~-~ ,~ , Filerl~. Subdivision ...~ ................................... . ..... L (Name) ..... et State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy '....[. ~-c~Ad........L--.....f .... .(.F.~a~m.z..ly,t....f,: L;' ' ........" ' ~ ' ' .................. b. Intended use and occupancy .'... : · ... ................ 3. Nature of work (check which applicable): New Building .......... Addition .......... .,'rite ...... Repair .............. Ren]oval .............. Demolition .............. Other We r ~.~.r-;~.~ .... ~ e~ ~escription) 4. Estimated Cost ./~.O.~. .... i ..................... Fee..~...Q. ................................ · · . . (to be paid on filing this application) 5. If dwe ng, number of dwelhng umts ............... Number of dwc~lling units on each floor ................. If garage num bef-6r'ears !. . 6. Ifbusmess, com~ercia~ed occunanev .... ~¢ .......... -, - · ~ : ' ' ' 9~' ..................... ...... -~ . ~ ..-:, ~v,.*,,y ,~,m.,u u..u extent et each type of ua/e ......... ' . . Hmght ............... Num b¢~"~ories ,. ~ .... tJepm ............... D:mens,ons of same stmcture~)vi't~ alter~;;.~dditions: Front .. i ~iiiiii 'l~ear ........ 8. tamenmons et ent:re new c~bnst~ction: Front ..... ~ --~.- - .......................... ' .... 12. Does proposed c~' ',. ....... ~ ..... ~ ~, .... ,. ~, . ~ ,./ ./ ' ! ......... Will eXCesS Illl De removed.ft<rfi~ prem scs Yes Name of Archlt~e~t~-... ....... . ................ rnone No ................ 15. Is this property within 300 feet of a tidal wetland? ~Yes ........ No ......... · If yes, Southold ~own Trustees Permit may be required. PLOT D IAG POMM 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 comer lot. ' hlterations/Partit!ons in cellar. STATE OF NEW YOfi~Kf'['--~l COUNTY OF ..~....~.4 .t~3.~.... ......... ./. . /:4 . /.(/. . . . (Name of individual signing contract) 'lbove named. API~ItOVED AS ?JOTED NOTII~ BU (LDI~-~ D E pA Ri~fi~ E~ 7654802 9 AM ~ 4 PM ~R THE FOLLOWING INSPECTIONS: ~. FOUNDATION .. ~0 REQUIRED FOR POURED CONCRETE 2. ROUGH .FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUC~ON MUST 8E COMPLETE FOR ALL CONSTRUCTION SHALL 'MEET THE 'REQUIREMENT9 OF THE N,Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ........ being duly sworn, deposes and says that he is the applicant ' !lc is the ' agent corporate officer rte ) >f said owner or owners, and is duly authorized to perform or have performed the said work hnd to make and file this ~pplication; that all statements contain~ed in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner s~t forth in the application filed therewith· ;worn to before me this · · .... .~///uay et ,<h. · ./.Z"~. ' .......... ~_., 19 ,iq. . ota. p blic . . ' , · ..-~/. :'.."':w.0...---~..'.~,4C~.,DCounty ~-~ · ....