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HomeMy WebLinkAbout20237-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20407 Date DECEMBER 11, 1991 THIS CERTIFIES that the building ADDITION Location of Property 1180 GRATHWOHL ROAD NEW SUFFOLK N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 117 Block 4 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 23, 1991 pursuant to which Building Permit No. 20237-Z dated OCTOBER 28, 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 DECK ADIIITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to KENNETH HOMAN {owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Bu ldin~or Rev. 1/81 lOBM 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) c 20237 c~ N_ Z Date 19.d~ Permission is hereby grouted to: ~~y~ / t0 .G~~f fr .may ..~...~r...... ,lG a~, '.~'~~~.rjt... ..G~... .....~~~f!'2. . .~~'.Y .Gn~~a~r.'~.p~~..~.. of premises Ixated at ..~.l.~Q~S,~.. f County Tox Map No. 1000 Section .....~~7........ Bfock Lot No...~ pursuant to application doted .....lB~,~i 19~.1~., and approved by the Budding Inspector. Fee S.••.~'..~'~r/~~`"'.. . ,~r~'l..r /Boil Inspector Rav. 6/30/80 4 Form No. 6 ~ ~ ~ ~ ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ti t,~~ i - TOWN HALL IF'~,y DEC 51991 ~ 76s-lsoz ~i € ; . , ' °"1`"' A`FPLICATION FOR CERTIFICATE OF OCCUPANCY ~ ~ ~ ' A. Th'i`s 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 a 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. B. For existing buildings (prior to April 9, 19s7) 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 application and a consent to inspect signed by the applicant. If a Certificate o£ 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 - $10.00 4. Updated Certificate of Occupancy - $60.00 5,. Temporary Certificate of Occupancy - Residential $915.00, Commercial $1s.00 Date ~ , , , . New Construction..... Old Or Pre-existi/ng/Buildi g., Location of Property.~.l.8sa„~-~,j~~j.(p~~JJd.. .~1:~~~,~G_ House iNlo. .Street Hamlet Onwer or Owners of Property,J~, e h' J ~Q~'j j . .Q... County Tax Map No 1000, Section...~.~.~ ,,,,,,,Block.... .....Lot.... l................. , Subdivision ....Filed Map......... "<<~~ ...Lot Permit Noc~,~,c~,~,7,~,,,Date Of Permit...~Q!'~~.1.~~.,Applicant~r'.111171~A~~lt:'~~'~,1:~?U~ F~~. ~ e2) ~ Bi.. Health Dept. Approval.. 1`;~„ ....Underwriters Approval.~~~. Planning Board Approval. „ .6,1~ ` Request for: Temporary Certificate........... Final Certic ,y „ te. ~ Fee Submitted: $ ~ . ~l-P,C~ ~30 `~q AP LICANT ~ ~ . • . Cn ~aoy6~ ' ='1tJ 1~. L... .1 ~~Jn.u ~ 1..`1L', E:N T~ II I~~v ~ ,,,;~.--yam w FOUI,DATZD?I (1st) i~l '-3 I FOUt1DATI0N (2nd) 2. I I o ',OUCH FRki~fE & I •PLUhIBING • , N~ 3. I y` ~ m IIISULATION PER N. Y. I y ? II STATE ENERGY I CODE II * 4, ~ ~ ~ FI;IAL I ~ ADDITIOPIAL COMMEPlTS: x~~ ro ' x ^v N ~ > H VJ m _H • ~ v ~i cy ~ . _ a J ~~-j ~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INS TION [ J FRAMING [ FINAL~~ REMARKS: ~ ft~ C,( ~J° ~-r=.' , DATE (L INSPECTOR 765-1802 BUILDING DEf'"T. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING ~ FfNAL REMARKS: ~ < < t ~ , DATE ~ ~ INSPECT uoar,u ot~ H a~.rH , FORM NO. 1 3 SETS ~Le1NS , , , , , SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC r•oart TOWN HALL ~OUT}IOLD, N.Y. 11971 NOTIFY ' TEL..7G5-1802 CALL .~.~`~:'.~:~.~y :amined . 1.~~,~ 19 fy/~ MAIL TO : . 9proved ~9~~ 19 Z/. Permit No. °~..~~.3-~, ~ 1~ tR~ fp1 M + ~approveda/c D B l~ U V C BLDG. DE / (Bu~ ~ng nspecto~) TOWNOF8 APPLICATION FOR BUILDING PERMIT, Date . . 19 . INSTRUCTIONS a. ~ Tiris application must be completely Called In by typewriter or in ink and submitted to the Building Inspector, with 3 s of plans, accurate plot plan to scale. Tee according to schedule. b! Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram wltich is part of this appB• son. c. The work covered by this application may not be commenced before issuance of Building Permit. t~ d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such pern'tit~ dl be kept on'the premiss-available for inspection throughout the work, ) e. No building shall be occupied or used in whole or in part for any purlh`ose whatever until a Certificate of Occupancy ill have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ nuance of a Building Permit pursuant to the ilding Zone Ordinance of the Town of Southold, Suffolk County, New Yt~rk, and other applicable Laws, Ordinances or gulations, for the construction of buildings, additions or alterations, or fq'~ removal or demolition, as herein described. e applicant agrees to comply with all applicatifa laws, ordinances, buildinkk~d code, housinn code, and regulations, and to nit authorizer~inspectots on premises and in building for necessary inspects. (Signature~oi applicant, or name, if a corporaAOn)+ ' (Mailing address of applicant) rte whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Cie-rt-e:~ra.R-.....~~ :~a.<::~? ~ . me of owner of premises ~ 2f~ n,~~, , l~o,wt a v~ . (as on the tax roll or latest deed) tpplicant is a corporation, signature of duly autfrorized officer. :..U.1 `~5~ ~ _ (Name and title of corpllorate officer) Builder's License No. 1. , . Plumber's License No . . . Electrician's License No . . Otltet Trade's License No . . Location of land an which proposed work will be done . . , , , , , , , , , , , , , House Number Strcet\ ' ' ` 1 Hamlet , ~ Q County Tax Map Na. 1000 Section ~ , Bl~rck Lot U ~ . Subdivision F~Icd Afap No. Lot . (Name) ~ State existing qse and occupancy of premises and int/e~n_ded use and occupancy of proposed construction: a. Existing use and occupancy btu :e-, • • • : t~. ..0.~'L(1~.~-~, . b. Intended use and occupancy ......~'1 e-..... ~ /..~.~e/f~: . ~ F _ .work (check which applicable): New Building , Addition Alteration x. , , . ' • . • Rcmoyal . . , Demolition Other 1Vork , . ti Estimated Cost , , ~.Jb ~ ; OC7 ,~+~,~1 , , , , . • , . (Description) dwcllin number of dwellin ql (to be paid on filing this application) g, ......nits......,..,,, • • . Number of dwcltin6 units ou each floor , , , , , If garage, number of cars • . + , 6. If business, commercial or mixedoccupancy, s ccil' ~ • ~ ~ ~ •c~• ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' " • • ~ • + • • ~ + 7. Dimensions of c P y natufc ant. extent of+RQ ~ypc of use , : , , ~ v:~ r,~ ~ ,,,,„,,,,„„~n,$IStlpg $tlllCttl(05`-If•t)ny:.Front . 5Q. , RCar ,+Q , DO th Hufght ' , .'.;~,#4,,.. f'NU)~ r'<}f Stodoa P .i..'1. •1 i.„ Dimens ji ................q......~...,.~.. Sfltn©-StRltaUi'C Wll G~(¢rations or additiensl Frent , . , , , r~, d , i , , , , , , 1R4a1` ~ ~ H ~Qi i r ~ 1 ~ ~ t ~ r ~ , I7t1p(I'1 , . , , , , , jlnil;ht . ,Numb r of Statics , 8. Dimens f ~irtCs... . , , , .1' , . f~tru;ctioh: Front , , (p, , q~,• s i ~,r• • • Height 9S ~ Rear De t . , l 9. Size of t: • Num er o Stories ,N, ' ~ ~ . P h • • , . , r;±.~~t,~,.t• ]tear ..:.ls b Depth ..l.-?`~..•. R R t0. Date of ur '3:5?i:}:.`:'~:~':, ~•~t .Nam of Former Own r :1. Zone or use district in which pret~tises are situated , , , ' c{~,,,ryz: ' ' ' ' ' ' ' ' ' ' ' ` ' ' ' ' ' ' • • • • • • p posed co structiat violato any zoning law, ordinance or regulation: ~ ~ • • ~ ~ ~ ~ ~ ` ` ` ~ 3.,-1Vllllot be regraded No. .........•.,..,•.•.+.„~,}+.1. , 4. Name of Owner of remises , rrta.n~ ~ • • ' ' ' ' ' ' ' ' 1Vt11 excess rtil b • rm roved front premises: ,Yes No P .Address Q.0 - 8 uu ~l t 4t- :Phone No . . . . . : Name of Architect ~ ,Address 'Name of Contractor ~Kttua2oNtn,E;?? E; Est-, • iNC,.• ~{~~~•J~ • ,Phone No. , , , , , , , , , , , IS, Is, this property 1,ocaC,ed within~00• feetsof aP~ ~ ~~e L~aod?n*No .7s3FF„7,~t7,~,,, *If yes, Southold Town~Trustees Permit may be required. YES,....NO.'.'„ t PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from roperty lines. Give street and block n}tmber or description according to decd, and show street names and indicate, whether ' tterior or corner lot. r,r`" ~ ~ ~ ,c•', ~ ~ ~ , r. ' i i i I _ ' I ~ - i ~ . - - ~ ~ , ATE OF,NE\V YORK, UNTY OF S.(S ~........6`SOi~ ~ ; , a~. (Name of individual slgnji'n~ ~ ~ ~ ~ ' ' ' ' ' ' ' ' ' ' 6etng duly sworn, deposes and says that ha is the appUcant rve named. contract) , • • , . • , • . • (Contract , agent, or orate officer, etc.)............ • . ~ • • , ' • . • ` . .aid owner or owners, and Is duly authorized to p5r of rm or ha c pcrf<~rmed the said work and to make and•filo this lication; that ail statements contginpd in this application arc true to the best of his knowledge and, belief; and thaC the k wUl be performed in the manncrs4t forth In the application filed therewith. to to bcCore me this i ~ V. ~ ,I~,.~„~, .day of .4k :Cal2-r.... , 19QC. iry Public, ~%IS-t-K..¢~cc.P•,lX~~~i~1C ,.kt-!,~i~t~ . ,'~~M y , nt 1 r 1~ ~4',} y. 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I ~'-:i.L CONSTRUCTION SHRIL MEET THE REQUIREMENTS OF THE N.Y. ' ~ STATE Cr}PiSTRl/C170N $i ENERGY ~ '-s;-;: S. NOT RESPONSIBLE FOR ' ~'r al'~N t~R CONSTRUCTION ERRORS 4 ro f ` - f6 ~ ~ , _ ~ ~ _ . L 6CALE: r t..DK-- APPNOVED BV DRAWN-B+F--k111V r ' DA . Y'r - ~ _ - + f ~~]~~a. J~ t -+1i ~ :,Y.. ~iF , r - F e'~'/ R b'.e y - 'Y"a. DRAWING NDNB@i s: a- w". yN _•'r ''Y 6 _ #.~.i v ~ s~i' ~ Y~J ~ a;~: ft+_rt - n ~ 4 ~ s § ~t , "''~~'..non9m u ' :v_... y :-m.~ eiwe~rtE mofom~ non Nwn®ai - - u _ , . ~ van"~.:~"'^"P'.e'°` u f a . } ,k -u s u sF K a ' t *tLF _ ~ x~' Ztk € a~ w P kvi!v r s f~' ~ r ¢ `3' ny 4 tN yyp~,yP .a "rS t s~z ° sF ~e~+. m,t s c~ f s4'i~d s { y r. ~ - * .--I:. .Ca -~L.i * . ~ a ~ p