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HomeMy WebLinkAbout20242-z r FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20397 Date DECEMBER 6, 1991 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 770 NORTH BAYVIEW ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 13 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 28, 1991 pursuant to which Building Permit No. 20242-Z dated OCTOBER 30, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM & MARY GOING (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED N/A B ildinq Inspector Rev. 1/81 roses xo. s 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) N 2 0 2 4 2 Z Date ....~;,?.~:.~:4~...... 3° 199.1.. Permission is hereby granted to: , .~.......-~-,-./.-.~n~.....~..y.:...,.~ w~.~~:... °~^^....S7ielA:.°~S~!~RA(....~.~.... ~•Ys(;~...c~~:.9:4~... ~,....~!~-~::,q ~ ~ 0 1.9 \u.~S1. at Premises located ot ................................................°~rM.1e!hrRra)..................................":~.. County Tox Map No. 1000 Section .....~10........ Block Lot No....~.~ pursuant to application doted ......Q.t!~ d'~'t'~.....°1'~ 9 19.....x.., and approved by the Building Inspector. Fee 5..~~.:.~.... a-~-..~-: Buiiding Inspector i2ev. 6/30/80 Form No. 6 Q ~ ~ ~ D TOWN OF SOUTlIOLD BUILDING DEPARTMENT OCT 2 TOWN HALL 765-1802 BLDG. PT. TOWN OF UTHOLD APPLICATION FOR CERTIFICATE OP 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: 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 17 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, 1957) 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 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 - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residenti/a~l~-~$15~.00, Commercial $15.00 Date ..LY~t4'?:`~e~i./..`'~..~1.~~~~............ ::ew Construction........... Old Or Pqqre~,,~-~ex~~i~~stin Building., pp p p ' location of Property....,r,,7~.....`~`-?:l:u~.~l!2~?/-~.c~_•..~~: House No .7,,/ SCreet~/'~,',`'~Y~~`. amlet Unwer or Owners of Property... YY.~~sn:'y'"~-:. f. , , y~~ f/ ~ . County Tax Map No 1000, Section .............((//.Block................Lot...................... Subdivision ....................................Filed Mnp............Lot. n~.• Permit No ................Date Of Permit............... ~i~-~;;v!~;. ~p'~ .ApplicanC. !lealtli Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval i:equest for: Temporary Certificate........... Final Certicate.~....... fee Submitted: $ 43a~ APPLIC P.o ~~6:~4 ~7 i f`1cLD I;:S:•EC;lu;J ~~Uha~ I~ ~ON~~IGNTS 1 . ti ^o' m~ _ , H ,.L FOUtJDATION (1st) _y - c FOUNDATIOtJ (2nd) m 2. `off P,OUGH FRAME & J O PLUMBING • 3. m IIJSULATIOt•! PER N. Y. y STATE ENERGY yp CODE hh.. . a =a y F I id A L N' ~ ~ ADDITIOPIAL COMMEPJTS: ~ y x a~ 3 • ~ - x .b~ M 9 ~ ~ W O N O Z ..A W M • ~ • H x_ ~ . m . ~n y ~,/-e--rz.iv ' ~hz ~~c_~ ham' tiv~~c- (cam-,..~~~~-- a~~ ~~~2~ C?~-x~~-~.- ~ iG~ - 7~~- ~ 3o- ~ X i~~~ c~G~ ~i ~ e3 D BOARD OF HEALTH FORMN0.1 'eP SETS O~.PL1:7S `~..fr,,, 2 8~ TOWN OF SOUTHOLD SURVEY . . BUILDING DEPARTMENT OtIEC>; -~I::1•G•C•5_ • • • • • • , TOWN HALL SEPTIC l"Oli:l . BlDF8 EP7: SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OTI F'f ; ~ol~(~~~ CALL Examined.Q~%1,d~-~,,~0 X991 ,f CIAIL TO: Approved .Q~'~. , , 30 19 q ~ .Permit No. a.7 ~ ~ . . Disapproved a/c _ . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 INSTI,ZUCTIONS 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 tr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. ,c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ]tall be kept ott 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 bfADE 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 Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Clte 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 inspectiS~~~ _ ~ , (Signature of appliclg>bt, or nam a corporation) ~ (C;~C -mac! . . (Mailing address of applicant) 7:j~ c- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber r builder. ~tYfe,2/i/ ~~pp y /b \ame of owner of premises ..~r~.''":?~, ~ ~ G~'L4t,~: ,G~ C~.•. . (as on pj~fe tax roll or latest deEfi) if applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . . Pluntbcr's License No . . Electrician's License No . Otlicr Trade's License No . . Location of land on which proposed work will be done . . . ~o i~2~--fit, ~ •......~~~:.~..J~. house 'umber G~..... Hamlet County Tax Map No. 1000 Section .....Q ~ Q Block , , , , , , , , Lot . Subdivision Filed Map No. Lot , . (Name) State existing use and occupancy of premises and in [ended use and occupancy of proposed construction: a. Existing use and occupancy ...~;4i[,- ;~,~i, , , , , , , . b. Intended use and occupancy ....~.f.- , , , , • , • • , , • . • i4s.T-Y rv.:F ~J~. •i r . • . . V1 •zroil i'i5 a-.'~i~ski~h ~'t . . , `r. e; P r r ~ . 5f 3. A`ature of work (check whichapplicable): New Building ~ { . Addition . Alteration Repair Removal Demolition €•ii~Qth k . 4. Estimated Cost ~~,0 0 • ~'•~~scitipAion) . .t . Fee... ~ 5. _If dwelling (to be p id or~f~kIy;x'k}tsf~pp~.jc~tion) ! a, num er o dwellin' if ara e number of cars S units . Number of dwelling units on each floor , , g s, 6. If business, commercial or mixled occupancy, specify nature and extent of each t ~ • • • Ype of use . g Nutes,ifany:Front Rear Depth Dimensions of amei tructurtti~nber of Stories . . . . . . • , , , , , , • • • • ° with alterations or additions: Front • ~ • ~ • • • ' Rear.................. epth Height ......................Number of Stories . 8, Dimensions of entire new conskniction: Front ~ Rear , Height ~ ........Depth (d ~ . Number of Stories , : . 9: Size of lot: Front Rear , , , , i .95.E Depth 10, Date of Purchase .GC~-~, ,iqq, • , , ; , , , • ,Name of Former Owner , 1 1, Zone or use district in which prianises are situated , , , , , , , , , ~ • 12, Does proposed construction violate any zoning law, ordinance or regulatiorr!... ,-a1.rq-~, , , , , , , , , , , , , • • • 13, Will lot be regraded ' , , , , , Will excess flIj be removed from premises: ~~~Yes No P 14, Name of"Owner of remises ~:d:.~a,•, •~ddress ~~~',z,-~+~,e,'~''~Q• e°. ~i6 7 ~ • " " ' ....Phone No..... ~7. , : 7. ~ , Name of Architect l .................Address ?t% Name of Contractor a?; ; tiw,-~,,q,~ys~ ' ' • • • • • • • '`P~"~°: Phone No..... . • ..........Address .......'7'C' /iJZj"~v.. Phone Nos%~ ..~°~~..`J~. / 15. Is this property within 300 feet of a tidal wetland? * *If yes, Southold Town Trustees Permit may be required. No"x""~ ~~673 9or; PLOT DIAGRAM Locate clearly and distinctly all''i buildings, 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 whether interior or corner lot. ii j n • TATS OF NEW YO OUNTY OF S:S ~ ~Q.t,~, Ol?~ • • ~ ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' g ~ ~ • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si nin contract lout named. is the ~G? 4~4.v':......... . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this plication; that all statements containQd in this application are true to the best of his knowledge and belief; and that the >rk will be performed in the r~i ner seat forth in the application filed therewit}t. porn to before me this ~ .day f ©•C•Te~d~~ ('~9 q' tary Public, . , SU ~ 19~~ • yp • • G...... County / ~ ~ Q n R09ERi L SW , JR. • i . ,~OTARY pURIIC ~ ~{µy ~4 y5Q89~~ 81,x, (Signature o pplicant) i i {20 ~ I L~ ~ I-I o ~ s E ' - - I, iI'I~ ' I ,I p i I li ,li 4 fl ~ I it {3~N° H' Ir ~ II I i I 1 ~ / II,' - 51-a u , . to ~I~ _~N~' p ~i fJ6 4! I I ~ j { I I I{I 'I i~l I o VQ - --L G ~a t~wN I - OCCUPANCY OR ~ I ''~.x 15 I I I --p-~-~--~-: ~ ' I I USE IS UNLAiNFUL ~ ii " } 3 I NIITNOUT CERTIFICATE ~ I I Ili OF OCCUPANCY I ~ ~ - - f ~ _ .I arreoveo as edo~~wa ~ i , i GATE; to D 91 KP pV COOIf~' ~ 2X ~0 5 ~ ~ 17' FEE: J~ • ' KY' ~ _ . - - - I 3. NOTIFY RUILDINC~ OEPARTMEN"i F:i" ij a p ~ I ° ~ ~ L 765-1802 9 AM TO h PM FOR iliE 1 FOLLOWING INSPECTIONS. ~ ` ~ ~ 1. FOUNDATION ~ 1LVD REOUIi:ED -u._-.-•-.-~a---~----~ _ FOR POURED CONCRETE ~ ~I ~ ~I ~ 121- Q' ~ ~ I~ CJ II '2. ROUGH ~ FRAMING PLUNKING ~ ~ O V ' 3. INSULATION _ - CONSTRUCTIO _ 2 ~ _ -v- BE COMPLETE FOR CA .-r,.-.......-._.....-_-.,u__,._. -..w,~_-._ . ~ ~..4. _ _ ALLI CONSTRUC'f1pN SHALN MUST L MEFT ~ _ I i ~ ~ ' HE REQUIREMENTS OF TENEROY - - - - - - - - - - STATE CONSTRUCTION & CODES. NOT RESPONSIgLHE N V, ~ ' E FOR ;.V o-.._,_..~__F.~.~..._.__,__..~ DI.SIGN OR CONSTRUCTION KRROKS - / ~ ~ ~ ~ ~ . i -~-II-.A~c~_~ , .I ~ ~ i ~ Ns~Np~.l~T7r~~PQ~T ~ ~ a ~ ~N 3 ~ 1~ ~ u 18 ~ ' ~ ' 5 ~3~ C I. I IJ G. o ~ W Loo ~ - ~ ~ hlr. H{.'S ~ ~ - ~I' P ~.p- T- - - o f ~N ~P~ N ~ _ 'a.sN~a~• _ G. a U L N I - .I' EGA. ~ ~ ~t - LGa.V_.~ V_NV~.~sIUL= p ~ t~, ~ ~ o=P~ - ~o~ ~_~~~r_n--~~~. I,~ yo>~ o m ~ti ~ mall _ - _ . _ ~i 6 I I I i ~ t I gl~pll I I I~ I I 21-`i•II 31-a II I I I i ~ ~ h _ ~ ~ - - i y~~l _ ~ N P ~ N 'i~ ~~,I a n;;N p ° i - wo, p ~-lslvfz- Q°~ r~.p.~~6 ~ ~ ~AaE FrIDE of sT ~i ~ Y o MaT~H ~I_D ~i o li ~ 2 ~ it ~aI N~ br~~ 20 ~-o II 20 /Ils,l~-~ ~I M, 60l N6 ~j2~ ~I~'86a1' i ~,u 7YP I'es? TYp i~i~~N6 y ~i t=AS a ~ A - - 9jl - p ~I fi a Fhtp l/~ ~ ".I'3o II _ ~ ~ L I N'~ ol" ~ N J ~ 3v I G p~N o PAN,, a'PerJ ~ s , ~-a UN~ LI N E s vP P~ 1~-T A~ N~GG, ' t, es~?~ uo~p~~sl a~ a~ D~ol~'~~p7EN ~ ~ ~ A 7" I a iJ C~~P~ALL a DBG~- - - L I~. 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