HomeMy WebLinkAbout20222-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22463 Date JULY 22~ 1993
THIS CERTIFIES that the building. ALTERATION
Location of Property THE GLOAMING & STERLING ST.
House No. Street
County Tax Map No. 1000 Section 10 Block 9
Subdivision Filed Map No.
FISHERS ISLAND~ N.Y.
Hamlet
Lot 2
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 21. 1991 pursuant to which
Building Permit No. 20222-Z dated OCTOBER 21~ 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 ALTERATION TO ATTACHED GARAGE & ADDITION TO EXISTING ONE
FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to
KENNETH L. EDWARDS & WIFE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N-246824
PLUMBERS CERTIFICATION DATED
AUGUST 17~ 1992
Rev. 1/81
ng Inspector
rOR~ NO. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING i'ERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
N~ 20222 Z
Permission is hereby granted to:
....~...~..~....~..~.~ .......................
..........
.........
at premises located at ...~...~.~..~.....~....~ ....... ~::~i..~ ·
C~ O1_
County Tax Mop No. 1000 Section ....... ./..~. ........... Block ........... .~ ........ Lot No .........................
pursuant to application dated .... ~).~.~ ............ .'.'~...). ............ , 19...c[.J.., and approved by the
Building Inspector.
~'"'utldlng Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILOINC DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORR
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPAHCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
/ ' A":'PA~. -z-.~a.~.J...
Location Of Property..'-./-7...~..(r.qS.~--.~.,~..°u.'?.g.T~.e.l."?.~..~.T.· ......
HOUSE HO. STREET HANLET
Owner or Owners of Property...~. ~..~.~ ........ .~. i.
Cou~t~ ~a~ ~p So. ~000 S~c~io~ ..~.. S~ock O~ LoC
Subdivision ............ Filed Hap ..... Lot
Health Dept. Approval b(Of....~e~ .... Underwriters
Request for Temporary Certificate ....... Final Certificate ................
APPLICANT ................
rev. 10/14/88
THE NEW YORK BOARD OF FIRE UNDERWRITERS ~[~ ~
'L(,')~)(~913 BUREAU OF ELECTRICITY
8B JOHN STREET, NEW YORK, NEW YORK 1OO38
THIS CERTIFIES THAT
OnJy the electrlcat equipment ~ ~scrlbed be~w and int~duced by t~ applicant ~med on the ~bove appticatlon number in the premises of
in thelollowlng location; ~ Bt~ement ~ Ist FI. ~ 2.d FI. 0[;~ Section Bilk
t~sexatnlnedott h[][~[~ ~ ~~ 11 ~992 attdfoundtobeincotnpliattceu'iththereqtdretnentsofthisBoard.
18 6
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS:
NO Olde RCC,~COND
OF CC, COND.
C
NO OF Hi-LEG
NO. OF NEUTRAL5
OF NEUTRAL
AVE
GENERAL MANAGER
This certlfkote must not be alter'ed in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE,MUST HOT BE ALTERED IN ANY MANNER.
FORM NO. ~
TOWN OF SOUTHOLD
E~ILDING DEPARTMENT
TOWN HALL
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. "This application must be filed in typewriter OR ink and submitted to the Building
Inspector with the following; for new buildings or new use:
I. Final survey of property with accurate location of all buildlngs, property llnes,
streets, and unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrlcal installatlon from Board of Fire Underwriters.
4. Sworn statement from plmber certifying that solder used in system contains less
than 2/10 of I% lead.
5. Commercial buildings, industrial buildings, multiple residences and similar.
buildings and installations, a eertiflcate of code compliance from the 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 buildings
and "pre-existing" land uses:
I. Accurate survey of property showing all property lines, streets, buildings and
unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separate ownership of the entire lot prior to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant LandCertiflcate of Occupancy:
1. An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, 1957 shall also accompany
the application. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
I.
CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $10.00
Addition to Accessory buildings, $10.00. - Businesses $50.00.
Certificate of Occupancy on pre-existing dwelling - $100.00.
Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
Vacant Land Certificate of Occupancy - $20.00
5. Upd~tLo~-Certlflcate of Occupancy - $50.00
6. emporary Certificate of Occupancy - $15.00
FOUNDATION ( 2nd )
ROUGH FRAME &
.PLUMBING
®
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined 19°,..t
Approvbd .~...~..~..-~...-X.I.., 19~). Permit No.~. 9...~..~:.2-r'. '~
Disapproved a/c ....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
CIIECK ....................
SEPTIC FORH ..............
NOTIP¥:
CALL ...................
HAIL TO:
-.. INSTRUCTIONS
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-
zation.
c. The work covered by this application may not be cbmmenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. 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 bare been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
3uilding 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to
~dmit authorized inspectors on premises and in building for necessary i~.~~ .4..~ .........
(Signature of applicant, or name, if a corporation)
..... :. o..~ .......... e?.$ ..........
(Mailing ~ddress of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pinmber or builder.
Name of owner of premises .k~.~.t~..q .~./x...L~.. k3cot~ ds . ~ . .t:~..L 7.% .................................
(as on the t.a~x roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Bu'lder s License No...f..~. ~..~..-". ~. ! .......
Plumber's License No.. ~.~.'~ .c(. _ ID
Elcctncmn s L~cense No...~.~, .cl.?/....~ .........
Otber Trade's License No ......................
Location of land on which proposed work will be done ..................................................
Ilouse Number Street Hamlet
County Tax Map No. 1000 Section ........ ].0 ........ Block .. · .~ ........... Lot... ~.~ .............
Subdivision ..................................... Filed Map No .......... EOt '; ~ ~'-.~ ~' ~?:-. ......
(Name) ......
State existing use and occupancy of premises and intended use and occupancy of proposed cons't'i'uction:
a. Existing use and occupancy ....... ~.~ ......
b Intended use and ' ' ' ' '
· occupancy ....................................................................
,9.
10.
12.
property lines. Give street and block hun~ber
interior or corner lot.
.!
3. Nature of work (check which afiplicable): New Building .......... Addition ~ Alteration
Repair ..... ~ ...... Removal .............. Demolition
i .... ' ............. Other Work ...............
,,,._~/--,~.0. 0 O~ (Description)
4 Estimated Cost
(to be paid on filing this application)
5. If dwelling, number of dwelling ~nits .......... Number of dwelling units on each floor.
· If business, commercial or mixed occupancy, specify nat,ure and extent of each type of use ........................
6. If garage, number of cars ..... , ........................................ ; .....................
7. Di'mension?.of existing structure~ if any: Front....t..~.~.. . Ra~r ~ ~ ~ ' rt,,ih "3~LI '
He ght ,.50. . Num:ho~- ,,r ~,,,,4~ ~"uo e) ..................... t, ...... ~e .........
Dunenstons of statue structure wi'th alterations or additions' Front .~.3 / ' ' ,~ ' ' ' Li '5 't ..........
- , ............... mear . l ..~ ...........
Depth ...~.1.$: .............. i. · Height ...I.~ ................. Number of Stories ....~.q %...
8 D'mension ofentir tru tion: F
R ' D pth
· i s e new cons c ront ............... ear ............. e ..............
Height Number of Stories
Size of lot: Front ..
Date of Purchase j lc~'5~= 'i ........... Rear ...................... Depth .....................
......... ~ ................. Name of Former Owner ...........................
Zone or use district in which premises are situated .~ .Iq ~.
Does proposed construction violate any zoning law ........ ; ...............................
, ordinance or regulation: ................. ~ ...............
13. Will lot be regraded .1~..d> ..... i ................... Will excess fill be removed from premises: Yes
14. Name of Owner of premises ... ~ ................ Address ................... Phone No ................
Name of Architect .....
..... i ................ Address ................... Phone No ................
Name of Contractor ......... i ................ Address ................... ~'aone No ................
15. Is this property within 300 feet of a tidal wetland? *Yes ....... Q ......
· If yes, Southdld Tiown Trustees Permit may be requirgd. '
.. PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail set-back dimensions from
or descriptioh according to deed, and show street names and indicate whether
;%'~TE OF NEW ~p,R. K1. S S
:OUNTY OF.."~)..q .~.'~. ........ 'i
................. q .................. being duly sworn, deposes and says that he is the applicant
(Name of individual signihg contract)
bore named.
le is the [ '
~ (Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly huthorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in 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 ~ this... _... ~ '
......... : 19 /.
'otary Public /Z..(..~. _--~.. (:~ ~
,/~ .......................... ,47. / County
' Hliilry Public e-,tatel of New Y~)rk ' '"~'* ~ · · · ; ..........
Ne. 4eo6559 (Signature of applicant)
OUtlilfilcl if~ Sulf~lk County
Term Expires ~/31/9~-'""
I
tTg.09~
ct rive
S 2° O0'40"W 184..79'
.,STERLING STREET'