HomeMy WebLinkAbout20743-zFORM NO. 4
TOW~N OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z~22143
Date FEBRUARY 16, 1993
ACCESSORY BUILDING
THIS CERTIFIES that the building
Location of Property 305 SANDY BEACH ROAD, GREENPORT~ NY
House No. Street Hamle~
County Tax Map No. 1000 Section 43 Block 4 Lot 3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 17, 1992 pursuant to which
Building Permit No. 20743-Z dated JUNE 19¢ 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 ACCESSORY BUILDING (WITH FENCE) AS APPLIED FOR.
The certificate is issued to
GEORGE HOLEVAS & wIFE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N/A
pLUMBERS CERTIFICATION DATED N/A
VIA
~"Bl~lding Inspector
Rev. 1/81
FO~ NO. ~
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)
Date &
................ ........................... ,
Permission is hereby granted to: . ,
...... ~:~..~.~ ...~..~../.~/..~ ......................
..:...~ :........:....~:~ /......17..~::;~...~
,o ...... :.::~r.::.:,.: .......... :: ............ 5::.::.:::.~........::.:~..: ...........................
..... ~:: ......... .~:::: ........ :.: ....... 4d:4::.....::~ ..................... : ..............................
~,,,,,,,,,~,,,,, .................... ......... ,~.,~....:~.. ........ ......................... , ...............................
..................................................................... ~::::: .........................................................
County Tax Map No. 1000 Section ..... .~../..~.. ............ Block .......~....~L ........ Lot No ........ ..~..~. .........
pursuant to application dated ............... .~././.2 ............................ , 19..~.~..., and approved by the
Building Inspector.
Fee $ ........................
Building Insl:~Ctor
Rev. 6130180
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANC
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:
I. 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 smd 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 p~lan requirements.
B. For existing buildings (prior to April 9, 1957) non-confor~in~ 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.
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 - $I0.00
4.Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .3[~... ~
.., House No. Street ' H~et
Onwer or Owners of ~ronertv.
County Tax Map No i000, Section .............. Block .............. Lot ....................
Subdivision . ,
.................................... Filed Map ............ Lot ......................
Permit No.. ..Date Of Permit · · Applicant... %. . .........
.
Health Dept. Approval ..................... Underwriters Approval ....................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate..~.. ....
Fee Submitted: g. ~,00 ' , r
............................
' ' ............
FOUNDATZON ( q ~ t_~_)
FOUNDATION (2nd
ROUGH FRAME &
.PLUMBING
ZI~SULATION ~ER N.Y. ..
STATE ENERGY
CODE
F~;~AL
ADDITIONAL COMMENTS:
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieezorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
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
NOVEI~BER 2, 1992
GEORGE EOLEVAS
22-17 19th STREET
LONG ISLAI~
HY 11105
RE: PREHISES @ 305 SANDy, BEACH ROAD
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is ~/not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits i~volving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 20743-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
JOB
SHEET NO OF
Locate clearly and distinctly all buildings, whetlxer existing or proposect, ancl, in~licate all set-t>ac~ aunensions Irom
property lines. Give street and block numCer or description according to deed, and show street names and indicate whether
interior or corner lot. .>,v h4~.,;~,'~, ~.~. ~ I.
...~'~ .~ ~. [
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST, [ ] ROUGH PLB6.~
[ .] FOUNDATION 2ND [ ] .INS..~ATION
[ ] FRAMING [P~FINAL ·
REMARKS:
Examined.. '~/5 ...... ' 19 '~' '2'''
^pproved .... ...... 19/.CCPermit
Disapproved a/c ...... . ...............................
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
_ .~ . (~,hilding Inspector) .
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .........
3 SETS OF PLA;~S ..........
SURV£Y ...................
CIIECK .......
c^LL ;;; ................
HAIL
· J 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
ar 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.
~/. Upon approval of this application, the Building Inspector will issued a Building Permit to the applinant. 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
%gulations, for the construction of buildings, additions or alterations, or for rem~gval or~d~molition, as herein described.'
?he applicant agrees to comply with all applicable laws, ordinances, bflflding co.~, hgujrf~ code, and regulations, and t9
--- '~' '~~' /'~"~'Z2'. .... /' ' : "~ .............................
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
,'amc of owner of premises . .~..6Y~....q:...G..~...~.{ .6' ...¢?..c~..'ff.~.S. ........ ' APPROVED AS NOTED ,
,;. ' (as on the tax roll or latest' ~' '~i.~ ~"~
f aplHicant is a corporation signature of duly authorized officer FEE' ~'~Zg.~O BY:
" ' Nb~:lFY BUILDING DEPARTI~IENT AT
......................................... ; . . 765-1802 9 AM TO 4, PM .FOR THE
· (Name and title of corporate officer) FOLLOWING INSPECTIONS:
I. FOUNDATION - TWO REQUIRED
Builder's License No .......................... FOR POURED cONCRETE
2. ROUGH - FRAMING & PLUMBING
Plumber's License No ......................... a INSULATION
4. FINAL CONSTRUCTION MUST
E cern?mn s License No ....................... 8E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL. MEET
Other Trade's License No ...................... THE REQUIREMENTS OF THE N.Y.
' STATE CONSTRUCTION & ENERGY
Location of land on which proposed work will be'done .......... CODES. NOT RESPONSIBLE FOR
:~ ............ DESI(,~ OR'CONSTRUCTION ~R'ROR$
}louse Number Street Hamlet
' .... .q. 3
County Tax Map No. 1000 Section ......... Block ................ Lot ...................
Subdivision .......................... Filed M N
........... ap o ............... Lot ............
(Name) ' ' ·
State existing use and occupancy of premises and intended use anti occupancy of proposed construction:
a. Existing use and occupancy ............... ~::/464bA..~g-. .~.O~..~. ~? ..... : ,' '!'" ' ..~' ....
b Intended use and occupancy ~ . ~:*,,,
N i '
3. ature of work (check which applicable): New Building ...... Addition .......... Alteration ..........
Repmr ~.... ........... .. Re oval .............. Demolition .............. Oth~xr Work ..............
4. Estimated Cost .... ~}.~q~P.( ~.~ff.¢.~.,-,. ~.~.,o~te~o'~
; ............... Fee ......................................
i ~ (to be paid on filing this aPlPlication)
5. If dwelling, number of dwellin units · · · Number of dwelling units on each floor' .-~1..~.-.
· If garage, number of cars .... i ..................................................
6. If business,.co.mmercial or mixed occupancy, specif~( natu~re and extent of ea~ch type of use .......
7. Dimensionsotexistingstructur~s, ifany. Fiont LIS ~7~...o...~. .- ',~ ~.', ~o----c. ~. .. ' .......
He oh* v,~ .. r. ' · · - ..... ~ear .x .... ~-~'... r-~. tJepm ...?,-.';1)... ' .....
° ' ''"~'~ .......... mumoerofStories ... ',,l .................... ' .....
Dimensions of same structure ~ith alterations or additions: Front ................. Rear
Depth .................. ~ · · ..
· . · He ght . .. Number of Stories .............. '..~..
8. Dimensions of entire new construction: Front . ............. Rear ............... Depth ...............
Height .. ............ .. Nm~ber of Stories i... "
9. Sizeoflot Front [l~} ........ .~'~i ...................................
~ · ..... { ........... Rear .... [.[.Z., II i Depth . {1~ ~..~..o..e:~...'.~.~
10. Date of Purchase . ~g..tL~ O"b · ' ........ ..
...... . .................. Name of Former Owner .~*c.,"l)~ . .t.~qR...~ [q:~; ' ' '
1 I. one or use dmtnct in winch pr?mines are situated .... ..~..I. R .....
12. Does proposed construction violate any zoning law, ordinance or regulation: ...~ ....
13. · ...........
Will lot be regraded ........ ~O ........ w:, ...... ~., ..... ' . . . .
Name of Contractor .......
15. Is ch:ts property w5'th±n '~ ................. Address ......
300 feet o ...... ' ....................................
, ~ a czea~ wetland? *Yes ........ /'~
· If yes, Southold To n · . · .......
i w Trustees Permzt may be required.
.... ! PLOT DIAGRAM'
Locate clearly and distinctly all ibuildings, 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 whett~er
interior or corner lot.
rATE OF NF~V-M~ORS~'~/// $.~
........ '~b"'~t~ '/~' ..................... being duly sw6rn, deposes and says that he is the applicant
(Name of individual signin~ contract)
,eve named,
.IS the ...~..~.~. ~5 5~ ~ (Contractor~%corporate officer, etc )
a~d owner or owners ~d ~s duly a~thorized to perf~ have performed t ~e said work and to m 1
phcatlon: that all ~tatements contained ~ this application are trne to the best of his knowledge and bel~; ~ that the
)rk w~l be performed in the manner se]t forth in the applicat on filed therewith·
'om to before me this ~' ~, . ~ ' - .
.... , ..... ....
Publlo, Stye ~ N~ ~ '