HomeMy WebLinkAbout19950-zNo Z20165
FORM NO. 4
TOM OF gOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date AUGUST 23, 1991
THIS CERTIFIES that the buildin~
Location of Property. 80 CLEARVIEW AVE.
House No.
County Tax Map No. 1000 Section 70
ACCESSORY SHED
SOUTHOLD
Street
Block 08 Lot 42
Hamlet
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 11~ 1991 pursuant to which
Building Permit No. 19950Z dated JUNE 17, 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 ACCESSORY STORAGE SHED
The certificate is issued to MILEVA GOBIC
(owner)
of the aforesaid building.
SUFFOLK COUN%~ DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/~
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z20164 Date
AUGUST 23, 19~1~
THIS CERTIFIES that the bu%ldinq
Location of Propert~ 80 CLEARVIEW AVE.
House No.
County Tax Map No. 1000 Section 70
DECK ADDITION
SOUTHOLD
Street Hamlet
Block 08 Lot 42
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 11, 1991 pursuant to which
Building Permit No. 19950Z dated JUNE 17, I991
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.
The certificate is issued to MILEVA GOBIC
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
/~/B~ui~ing InSpector
Rev. 1/81
I~OB, M NO. it
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)
Ne- 19950 Z Doto ..... ~.'.~..../..2. ................................. ,
Permission is hereby gra, rlt,,~d ,o:
~'.~ ........ ~ ...............................................
~...~~./....~../~.~~.;...~;.~~~ - ---- -- ........ ~,~ /
at pre ' ~ ~ m ..................................... ~..,,,~~....~ ......................
......................................................... ~ ...................... ~~~ ...........................................
County Tax Map No. 1000 Section ......... ~.....~. ....... Block ...... ~ ..........Lot No ........~......~....'.Z...~-
pursuant to application dated ........ ~./~.. ..................................... , 19..~.../.., and approved by the
Building Inspector.
Rev. 6/30/80
Form No. 6
TOI~ OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN I~LL
765-1802
BLDG. DEPT.
TOWN OF SOUTHOLD
A~?EICAT~oN ~OR CERTIF~CAT~ OF ~OCCUPANC¥
This application must be filled in by type~riter 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 gestures.
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·
Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of i% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code C~pliance from archiuect or engineer
responsible for the building.
6. Submi~ Planning Board Approval of COmpleted site plan requirements.
;. 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 ap'plicant.
:- Fees
1. Certificate of Occupancy - New dwelling $25.00~2Additions to dwelling $25.00,
Alterations to dwc£1ing $25.00, Swimming pool $ 5.00, Accessory building $25·00,
Additions to accessory building $25.00. Businesses $50.00.
2.Certificate of Occupancy on Pre-existing BuildSng - $I00.00
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
:~ Construction~.~.q~... Old Or Pre-existing Building ...... ~) ....
)cation of Property .... ~'~ ~/~'a~--~/~'-'//a ~. ~. ~.~5~ ~ ~.~'.~.~..~..,/~.
Ilouse No. Street ' .........
~er or Owners of Property "
·
nty No 000 7. n f.
, Section .... BI ck '
')division ..................
' ................. Filed Map ........... Lot ....
.................
:mit No... .... Date Of Permit. ..Applicant.. .
~lth Dept. Approval ................... ~ ...... Underwriters Approval ..............
nning Board Approval ............ , ~ .
uest for: Temporary Certificate.. Final Certicate ...........
Z ~.~/~7 · '. ............
f/~/~/ APPLICANT ''
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN ILALL
765-1802
BLDG. DEPT.
TOWN OF SOUTHOLD
APPLICATION FoR CERTIFICATE OFii~CCUPANCY
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 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 1% lead.
5. Commercial building, induptrial building, multiple residences and similar buildings
and installations, a certificate of Code C,~pliance from archiuect or engineer
responsible for the building.
6. Submi~ Planning Board Approval of completed site plan requirements.
;. For existing buildings (prior to April 9 1957) non-conforming uses, or buildings and
"pre-ex' · 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 Uuilding Inspector shall state the
reasons therefor in writing to the ap'plicant.
:- Fees
i. Certificate of Occupancy - New dwelling $25.00~2Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $ 5.00, Accessorv 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
eu O nstruction .. Old Or Pre-existing Building .... ~. '' '
}lOuse No. Street Hamlet ' '
,WeT or Ouners of Property ~./Z'~.~..
,un y TaxNo 10oo, Soetion..7. . ........ ........ otA2 .................
bdivision .
rmit NO.. of ?°rmIt..z/.z/./ z .Appli ant.. 4v. /O. ..
~lth Dept Approval '
· '' ' ' .............. Underwriters A0proval
mning Board Approval ............ ~. .
~uest for: Temporary Certificate. Final Certicate .........
APPLICANT
rOU~D~TION
FOUNDATION
(2nd)
ROUGH FRAME &
?LUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF SOUTHOLD
OFFICE OF BUILDING IN~'PECTOR
P.O. BOX 728
TOWN tIALL
SOUTItOL~), N.Y. 11971
TEL~. 765-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/_~/ An application for Certificate of Occupancy
is not on file. '~ ~
/--/ No Underwriters Certificate on file.
/~/~/ The check is(c~&_Lu~/not on file.) ~ ~ ~5~
/5/ No llealth Dept. Approval on file.
/~/ No final inspection has been made.
Building Permit tt ~ ~ _~' ~'-_~_~ Z
Buildinq Dept.
Please co~tact our office on this matter.
Thank you for your cooperation.
No Plumber Sol¢ler Certificate on file.
( all permits involving plumbing being
.issued after April 1,1984 )
, I
'2O
C~LJA,~,/>..I'-ITI~Ixr) TO TI'Il;' Cl-II{/k~O TITt...I;''
__~.....v.___~__..__~..M ...............
h
7~'0 ,,
0¢
m(
BOARD OF HEALTI1 .........
FOnMNO.~ ./-3 SETS OF ?LA~I'S ..........
TOWN OF SOUTHOLD /-SURVEY ...................
BUILDING DEPARTMENT /CHECK .....
...........
i,_. <' ~ TOWN HALL SEPTIC
..... SOUTHOL
[.... ,'; D, N.Y. 11971
~a,nine~l ...... 19 ~ ! ~ CALL) ...........
~_..;'~. ,~ ~ "- ~ ~'v~'r~ To: ......
~sapproved a/c ................................
(B u Hdir~f.~'Inspcc tor)
APPLICATION FOR BUILDING PERMIT ' ~/.~ ' fl
· Date .............. 19 ,
INSTRUCTIONS
a~ This application must be completely filled in by Wpewriter erin ink and submitted to the Building Inspector, with 3
; of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and o£ buildings on premises, relationship to adjoining premises or pubBc streets
areas, and giving a detailed description of layout of property must be drawn on the diagram ~vhich is part of this appli-
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 wi/I issued a Building Permit to the appticant Such permit
~I 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
I 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
ding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
ulations, for the construction of buUdings, additions or alterations, or for removal or demolition, as herein described.
applicant agrees, to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
it authorized inspdctors on premises and in building for necessary inspections.
(Sionature of applicant, or name, if a corporation)
(Mailing address of applicant) ' ' '/
e whether applicant is owner, lessee, agent, architect, engineer; general contractor, electrician, plumber or builder. .
.................... ....................................... . ........................
eofo,vn rofpremises ..............
( e t~.t roll or latest deed)
plicant is a corporation, signature of duly authorized officer. ,'
........................................... °cc'u 'mcv OR
(Name and title of corporate officer)
US£ !$ UNMWFUL
Builder's ,License No. . ................
:7, IcctricJan's License No ....................... OFOCCUPANCY
3ther Trade's License No .................
)cation o£ land on which proposed work will be done.
' m ........................................
.........
· ' · ...... '.: .............. ,. ~ ~,.e. .~.5.~ e-~..~, x3
)use Number Street ............ /' · ...........
Hamlet
unty Tax Map No. 1000 Section .... 7.~ Block ~., .~.~..
)division ...... Filed Map No.
(Name) .............. Lot ...............
t¢ existing use and occupancy of premises and intended use and occupancy of proposed construction:
occupancy ......... ..
3. ot ~ c eck a cable: New Bud ng .... on ,\
.... · mOva .. .. Additi ........
. teratl
mn .............. k o~.. . 'D
~ .............. emoht Other'Wor
'
4. Estimated Cost. . ' nption~
..................... .., . Fee
5. If dwelling, number of dwelling ~nits .. (to be paid on filing this application)
. lfgarage,,,umberofcars . i .... j':'' j... Numberofdwcllingun,tsooeachfloor ..............
5. If business, commercial or mixe,~ occupancy, specify ,,attire :,~d exten~ ol'ca~ type or
7. Dimensions of existing Stmcture~ if any. Fro t
'.? .......... :... ............. .............
D~nensio ~s of same stmc ~ Wqn mterations or additions: Fro A .....
Depth ............. ................ ~qear ......
....... i · Height .... . ........
Nnmber of Stories ..
8. Dimensions of entire ne~v constn etlon: Front ............... Rear ............ th ........... ....
He ~t ... .. Num~erofStofies D~p
9. Size of lot: Front ......... . , ,, '
0. Date of Pure rose ~ ...... Rear ............ Deuth
I. Zo~ e or use district ..... ~_ . . , ...... NameofFo.nerOwoer .... ''
2. uoes proposed Construction violate any zoning law, or~in;nc; or re;n a~ o ~' ~0' ' ' '
3, Will lot be regraded ....... '.
4. Nme of Owner of pre~iseo M[~' '~5~'R;;' '.' Will ex.si fill~E~c~m~d, frq~ premises: - Yes No
name of Arctntect .. ' 'm~'S't~(~. ..... Address 55.{
of Contractor .......... ~ ............... Address ................... Phone No ............
5. I~ rhS~i~roperty w~rh~n 30;0 ~eer of a ~dai wetland? ~Yes ........ No ........ ''''
yes, Souchold To~n Trustees Permit may be requSred. "
~ PLOT DIAG~
. Locate clearly ~d distlnctly ~I b~ildhgs, whether existing or proposed, and. indicate all set-back d~ensions from
:ope~y lines Give street ~d h~- m,~ [
. ' .... ~ number or deschptioh accord~g to deed, and show street nines and indicate whether
TE OF N[
7'O
being duly sworn, deposes and says that he is tile applicant
]NTY OF "l ~ -
(Name of individual signing coi, tract)
e named.
the ................. CO r¢_C .
id OWner or owners, and is duly authbrized to perform or have perfonoed the said work and to make and file this
cation; that all statements contained i8 this application are true to the best ofhis knowledge and belief;and that the
will be perforated in the manner set fo:rib in the applicatiou filed therewith.
a to before me/his d
_ : (Signa~re of applicant)