HomeMy WebLinkAbout20773-zFOR~ NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20974 Date
AUGUST 27~ 1992
THIS CERTIFIES that the buildln~ ALTERATION
Location of Property i555 BAYVIEW AVENUE GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 52 Block 5 Lot 11.1
Subdivision Filed Map .No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 26, 1992 pursuant 'to which
Building Permit No. 20773-Z dated JUNE 29~ 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 ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to ALLAN GOODMAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COdVIPLETION OF THE WORK AUTHORIZED)
N_ON.° 2077~Z
Permission is hereby granted to:
,o ......................................................................................................................... ~J'd~.~ .........
et premises located at ...... ./...~.....~.....'~... ........ ..~..~..~.~..?/
~..
~~~ ..~...:[.~ ['.....~Z'~[~ ..... "~".
~ ...... ~.~ .......
co~ To~ ~op ~o. ~000 Se~o~ ..... ~ ........ e~k ...... .~ ........... ~ot
gui[ding Inspector.
Re~ 6/30/80
Form No. fo
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~PLICATION FOR CERTIFICATE OF OCCUPANCY "
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 ail buildings, property lines,
streets, and unusual natural or topographic features.
2. 'Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 ~).
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, indus.trial building, multiple residences and similar buddings
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 bulldogs and
~ "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building ad
unusual natural or topographic features. " ..,
' 2. A properly completed application and a consent to inspect signed by the applicant.
f 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 b~ilding $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
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction .... ~ ...... Old ?r Pre-existing B~ild~ ...... ~ .......
' House No.. ~treet Ha~et
Onwer or Owners of Property ............... . ..........................................
County Tax Map No 1000, Section...~.~.~ .... Block ..... ~.~.. ...... Lot .... /Z.Z ............
Subdivision ' '
.................................... Filed Map ............ Lot ......................
De ·
~eaith pt. Approval...g. lD...~ ............. Underwr~tera Approval .... ~.1~-~ ............
Planning Board Approval ' '! '"
Request for: Temporary Certificate ..........
FOU~DATION
FOUNDATION
2.
(2nd)
ROUGH FRAME &
-PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
Ye
FI;IAL
ADDITIO~;~L COMMENTS:
/%.
/'%
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ N~i~SU~TION /~~_.~.
[ ~~MING [ ]FINAL
FORM NO. 1
TOWN OF SOUTHOLD
BUILDINO DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971 '
TEL.: 765-1802
Examined . , .. ., 19
....
· .,Ppro,. d i..
Disapproved a/c ...... ""': ';
................................
APPLICATION F(5~ BUILDING PERMIT
BOARD OF HE^LTII
3 SETS OF PLANS ..........
S URV,Ey ,. ......... o ........
CIICCK
=====================
t: OT I F'!
CALL
' ' INSTRUCTIONs
a'. Tiffs application must be completely filled in b~; typewriter 6r in ink and submitted to the Building Inspector, with 3
ts-of~ pl3ns' acbura~e plot plan to scale.~ 'Fee accordin- .
b. Plot plan showing location of lot and of builh~s?edule . .
' ' ~,s~ un premises, relatmnship to adjoining premises or public streets
areas, and gtvmg a det~led description of layout of property must be dra~vn on the diagram which is pa~ of this appli-
dom
~. The work covered by t~s application may not be cbmmenced before ~ssuance of Building Permit.
d. Upon approvM of this application, the Building Inspector will issued a Building P~it to the appficant. Such pe~it
~1 be kept on the premises avaflabl~ for inspec~on throughout tile work. ~
e. No building shal~ be occupied or fised in whole or in part for any purpose whatever until a Certificate of Occup~cy
HI have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the BulldOg Depa~ment for the issuance of a Building Pe~ii pursuant to the
ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable ~ws, Ord~ces or
gulations, for the construction of bufld~gs, additions or alterations, or for removal or demolition, as here~ desc~bed.
e applicant agrees to comply wiU] aH ~ppHcable la~vs, ordinances, building code, housing code, and regulations, and to
nit autho~zed ~specto~ on premises and ~ build~g for necessa~ inspections.
-.
(Signature of appliia~}: ;; name: ir ~ co;~;;~}i%'.) ....
.... ....
(Mailing address of applicant)
te whether applicant is owner, lessee, agent, architect, engineer, general COntractor, electrician, plumber or builder.
~. duly authorized officer. . .
~ ............ = ~ corpmate officer)
Plumber's License No ........ : ......
Electrician's License No .......................
Other Trade's License No .......
ocation of land on which proposed work w/Il be done ...........
....................................
ouse Number ·
Street ' · ...... .
Hamlqt .......
'u"IY Tax Map No. 1000 Section. · .0.~ Z ....... Block ~ '
,bdMsion .... ' .... ' .... Lot .... t.t.... I .........
(Name) ......... Filed Map No ......
......... Lot .............
. i p y ........
......
3. Nature of work (check Which !applicable): New BuL!ding .......... Addition .......... Alteration . ~ ....
Repair .............. Relnoval .............. Demolition ........... Other Work .............
.ff/.o.'°..o..'7 '...
4. Estimated Cost ..... .s,. · ......... Fee.
$. dwell rig, nnmber o lling units ......... ( o be pald on filing this application)
·"garage, number of cars ...~ ................ '' NumberofdwelHngunitSOneach floor ...............
6. If business, Commercial or mixied occupancy, specify nature and extent of each type of use ......... ;..-..-~..; .....
7. Dim,,ensions of existing structu~'es, if any: Front ..... /~.i( ..~ Rear
tlei~bt ............... Nulmber of Stories . *..%. '*~, ~, '* .............. Depth .............
Dimensions of same structure, ivith alterations or'additions: Front .....
Depth ....... ' .............
8 Di ............ ,... IIe it ......... ' .............. ear ..............
· m6nsions of entire new constn ct/on' Front ..... ' .......... tnnber of Stories ....................
Hezgbt ,.,_I ~'- . · ......... Rear .......... De
9 ............ ~'~-m ocr ot atones ..... · .... pth ...............
· f 1 F? ..........
lO Size o or: ont .......... i ............ Rear ....... ' .................................
......... Depth ....................
· Date of Purchase ........ I ................... Name of Former Owner ....
I I. ~o~e or use district in which premises are situated
12. ~,~? proposed construction, vi61ate any zonin,, la'"' ~'~'' ............ . ........-' ~ ~ ........... ~ ...........
13. wm lot be regraded ..... ~ 6 ~, ~ruxna~ce or regulahon: . .. ~.~ y ........ '
14; N~e oFOwner of premises ~gi~&' '~.~ ...... lVdl exf~ss~ll be minored from -remises,' .... ~ ..... ~; '
N~e of Arclutect ... ~ ~Address I~..~
Nane of Contractar ~MOlig~; L'~ ~L'~ i" Address .......... ~ .,. "~ i; ......... ~'~'~
....... '"~'~. ~ $. Ifl~dr .... ~ ~ ,. '~ )~'~ 'h %' $.one l~o..~ ..............
15. la this proparfly w~Chin ~300 feet oE a tidal wetland? *Yes ........ No .......
· ~ yes, Souchoid ~own Truseees PermSt may be required.
· ,.. PLOT DIAG~I
Locate clearly and distinctly fl build~gs, whether existing or proposed, ~d, indicate ~l'set-back d~ensions from
property ~nes. Give street ~d bloc) number or desc~pfion accord~g to deed, and show street n~es and indicate whether
inte~or or co.er lot.
7654802 9 AM TO 4 PM FOR THE ~
1. FOONDATION "- ~0 REQDIRED
, FGR, POURED CONCRETE i ~ ~ ~' ~
,
At.L CONSTRUCTIO SHALL ]ME~ , : ,
~')4~ REOUIREMENTS OF TH~ N.~
STATE CONBTRUCT~ON & ENERGY
CCO~S. NOT ~ESPONSIBLE FOR
DF~I~ OR ~ONSTRUCT ON E[ RORS
TATE OF NEW YOR[, ,
(Na~e of individual signin~ co~tract)
~ovc named. I
is the :
..... ' .................
~ (Contractor, age~ of fi ..............
pHcadon; /hat all statements contained in this application arc true to thc be~t
,rk will be performed in tl~e manner s~t forth in the application filed therewith, of his ~nowledge and belief; and that the
om to before me this
...... ....
~ ~bll~ ~te of N~ ~.,, · . .....
. C~R~L~ 'i .. .~ . ~ .........