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Home My WebLink About20121-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPARCY No Z-22450 Date JULY 8, 1993 THIS CERTIFIES that the building REPAIRS Location of Property 8440 MAIN ROAD House No. Street County Tax Map No. 1000 Section 31 Block 7 subdivision Filed Map No. EAST MARION~ N.Y. Lot Hamle b 3 Lot No. conforms substantially to the Application for Building Permit h~retofore filed in this office dated AUGUST 29~ 1991 .pursuant to which Building Permit No. 20121-Z dated SEPTEMBER 5, 1991 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 STRUCTURAL REPAIRS TO FRONT PORCH ROOF~ & UNDER KITCHEN AREA OF EXISTING ONE F~TT~ DWELLING AS APPLIED FOR The certificate is issued to JOHN D. WNI~AD (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 FOUM' NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALt. $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 201 21 Z Permission is hereby granted to:^ ...~.~.~...-]..~ .................................................... . ........ ................ et premises located at .....¥~.~..'1:.¥~.. ..... r.~.~.....~..~.......-e~....~....~.....J[[..~L~J~, ............... County Tax Map No. 1000 Section ...... .~...~.~ ....... Block ...... .~...~ ........ Lot No.....~...~. ............ pursuant to application dated ,4~.~...~... ........ , 19.~.~., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 . APPLICATION FOR CERTIFICATE OF OCCUPANCY ~his 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~o£ I% 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" la~d 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. 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, Commercial $15.00 Date ..;. .. /.~ ............ New Construction ........ '... Old Or Pre-existing Building ...... ..~...' ...... Location' of Prop err y...~.Z~.c/.O .................. ~-~fz Lf ~/Y :..?.~..~ ~..~/.-.~. ..... ?~..~.~.~....~..~f/~. ¢ p./~../../?: ..~. .......... House No. Street Hamlet Onwer Owners of Property ~/~.~/'~ %~ ~j~/ County Tax Map No 1000, Section...~?.~/. .... Block ................ Lot ........... · Subdivision .................................. . . Filed Map ......................... Permit No. ~..~)../..c~../ ..Date Of Permit..~.. '~.C ./.~.~/Applicant ~,~$..~...~.~.~%<.~_c.~ .~. Health Dept. Approval ....................... Underwriters Approval .......... Planning Board. Approval .................... . . .. Request for: Temporary Certificste ........... Final Certicate ........... Fee Submitted: $ ........................ .......................................... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS, FOUNDATION (lst) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: BLDG. DEPT. TOWN OF SOUTHOLD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1g03 Examined .~..ff .-~...o-~rL .~...,~, 19 .~.1. Approved~~..~.."~., 19~!. Permit No..~..~. ] .~'. ! ~ Disapproved a/c .... . ........................ ..._.f~ ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... ~ SEtS o~.~L.~s .. . .. ......... c~cK ~'~. ,g~.o.-. ........... SEPTIC FORH .............. CALL ................... HAIL TO: · .~-~:'~ t. ............ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets 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- cation. c. The work covered by this applicatloh may not be c~mmenced before issuance of Building Permit. d. 'Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ,hail 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· l'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, o~'name, if a corporation) .. ,Go ,~ . . ?/ . . . .~e.~ o ~ ~. ~, .... .,,6& , '.u'. . . //.~ (Mailing address of applicant) State whether ,app[ican,t, is. owner les,s~e, a. gqnt, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~ ... d~.o/ t ¢. .d~ ........................................... (as on the t,w,x roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... /. ~...~..~'.~,...~.Z .... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... : ............................................ · .............. ............. .... Iv, .Y., ...... }louse Number Street Hamlet County Tax Map No. 1000 Section ...... 3 ./ ........ Block ....... O. ~7. ...... Lot....~.. ~3 ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b.a' Existing use and occupancy .... 'k~/~G~" '/' ctv~ r,:. .... ~'~'~'~f/~/'''~t~'a'///"'~'¢'"*;~*~?*~i"z'?~":';~'~:~ ......... Intended use and occupancy ....,,fz'. ~r/G. ,.__..~, .<Dtr. Gtd~././~,v%~,C~ , ,; , .; ; : 3. Nature of ,wor~check which applicable): New Building .......... Addition ....... !. ~.. Alteration .......... Repair . .p- ............ Removal ......... Demolition ........ Other~ . Witl~Og~,~ ~.~, .;:,..' ........ . . ~. ~ (Description) 4. Estimated Cost ..... ~.~'."~..O..O.~ fi..O. Fee ! (to be paid bn 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 mixer[ occupancy, specify nature and extent of each type of use ..................... i f i ~ if F . 7. Dimens OhS o ex sting structure , any: rent ............... Rear ......... Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wiih alterations or additions: Front ................. Rear .................. Depth .................... i - Height ....................... Number of Stories ...................... 8. HDimensi°ns°fentirenewc°nstructi°n:' , Front .......................Rear ...................... Depth eight ............... Number of Stories ........................................................ 9. Size of lot: Front ....... ; · · · i .......... Rear ............... Depth ....... 10. Date of Purchase · .---/- .,,-.~ ........ ......... a e of Former Owner . v414ti/d,,~; . ¢.&.¢~ ... 1 1. Zone or use district in which premises are situated.. 12. Does proposed construction violdte any zoning law ordinance or regulation: ........ 13. Willlot be regraded · ' .......... ' .............. ....... ~ ...... ; ...... ,.. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .t.,~.!/* m..(o.~.~.¥.o./~,~,~ ~. Address . *..f'o ~.-/g, ,/04t. ...... Phone No ........... Name of Architect ~ . Addre~. . ........... . .... ~ .......... ~ .................. Phone No ................ N. am?,o.f Contracto?..~?/.c,~/6',C..~O~pO,.eql,'3.. Address . .~2~o ~. ....... Phone No..~'.6~,..C...,o~. ?.~ 15. ~s cn~s property within 300 feet 6f a tidal wetland? *Yes ........ No ......... · If yes, Southold T6wn Trustees Permit may be required. PLOT DIAGRAM' Locate clearly and distinctly all ~u!ldings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or descriptioh according to deed, and show street names and indicate whe[her interior or corner lot. iTATE OF NEW YORK, ~OUNTY OF S.S (Name of individual signin~ contract) bore named. APP,ROVED AS NOTED NOTIFY 8UILOING DEPARTMENT AT 765-1802 9 AM TO ~ PM FOR THE , FOLLOWING INSPECTIONS. 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH o FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSI'RUCTION MUST E)E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS 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 le is the i (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly ~uthorized to perform or have performed th~ said work and to make and file this pplication; that all statements containbd hq this application are true to the best of his knowledge and belief; and that the ,'ork will be performed in the manner s~t forth in the application filed therewith. .worn to before me this ............. ....... day of..i ....... County ·//' ~ ~ ~JOY~E M. WILKIN. ~ ~.~. No. 498~'246~, Suffolk CouqJ~,_ (Signature o~ applicant) Term Expires June 12, CERTIFIED TO: MILDRED ESTATE Of HOi$1NGTOO~IESERUD BAleBARA TITLE INSURANCE SURVEY OF PROPER T Y AT EAST MARION TOWN OF SOUTHOLD 1000 - 31 07 Scale 1" = 30' Oct. 25, 1990 Prepared in ac..c, ordance with the .n~..~. um. etandard$ for title eurveye aa eatabffehed b,y the L~A.L,S, . and a~p~oved and adopted. for eu~h uae, Dy The ~ew York State Lane Title Aaao~iatle~ AREA = 25,820 sq. ft. ~K$. L/C. NO. 49618 ~EYOR$, P.C. MAIN-i~rO-AD