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HomeMy WebLinkAbout19737-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19861 Date APRIL 19, 1991 THIS CERTIFIES that the building ADDITION Location of Property I400 HYATT ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 50 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 21, 1991 pursuant to which Building Permit No. 19737-Z dated MARCH 26, 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 2ND STORY DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to JOHN MULLADY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A n Bu' ding Inspector Rev. 1/81 FORM NO. a 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) Na 19737 Z Date...... Permission is hereby granted to: CL4X ms~~J&a a....o..ea . to ...tid....4............... . 1~ at (prre/mises located at Z 1rY ................u~l'!?~ Te ,Y..°.:......Mt County Tax Map No. 1000 Section rr~~...~~.~^ a...... Block P...I......... Lot No...... .A pursuant to application dated SL ~r Z 19.1t., and approved by the Building Inspector. Fee 5.. ...°.k ~ ~ wilding Inspector Rev. 6/30/80 a Form No. 6 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 n APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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, 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 - Residential $157.0,/.V0, Commercial $15.00 Date New Construction... Old /OLrr/,, Pre-existing Building.. Location of Property... j.[L7©...'.'. ~ 0~ el- ...........................5. . 694 House No. Street Hamlet Onwer or Owners of Property ...v County Tax Map No 1000, Section. C. s c? Block. .P1........... Lot..~? A Subdivision Filed ~.Maap............ Lot............... Permit No...~,9.?.3 7.2- Date Of Permit. J.~C.6Q.Gri.~. 22,6ipplicant.. yW~ 6a'k-:'^...... Health Dept. Approval.... Approval...' ~1~................ Planning Board Approval A ./CyAL Request for: Temporary Certificate........... Final Certicate........ Fee Submitted: $ APPLICANT ' c1ELD I1:SYE 11O,'J JIDA;c ~ COMMENTS 7OU14DATION (1st) m FOUNDATION (2nd) 2. z F ti -Z_ OUGH FRAME $ PLUMBING H 3. INSULATION PER N. Y. STATE ENERGY CODE z a 4. 7 ~y FINAL z ADDITIONAL COMMENTS: x c1 H • 9 y H O z N rh • A • r q. M y BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY CIIECR .3.U.l ' BUILDING DEPARTMENT TOWN HALL SEPTIC FORtl SOUTHOLD, N.Y. 11971 TEL.: 765-1802 MOT I FY CALL PIAIL TQ: Examined . J Sn(4't a.~a., 19~.~. 0. Approved. CXt .rl b 1~ Permit No. 9C Disapproved a/c tcQ @-~ U FWR ( Building Inspector) 1991 APPLICATION FOR BUILDING PERMIT -:c Date/ a4....... 19 BLD[A. C1i''f TOWN OF Oflifgtlg, 1 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or 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 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 shall 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 shall 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins ctions. ......~-r (Signature of applicant, or name, if a cor oration) .~.e....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..C fZ.................................................... Name of owner of premises .`a (as on the ta( roll or latest deed) ;If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No . Electrician's License No . Other Trade's License No . I. Location of land on which proposed work will be done . . 1`i.Qb U.................7S ° LA................... House Number Street Hamlet County Tax Map No. 1000 Section 5.0.......... Block .....1 Lot ....e Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . 1AC3. ~..t 1Al l.Ilfl................ . L a" tMW IIU Jss . b. Intended use and occupancy ...,8l,D'I9dra3u:.k .r e~ouc,.~i, t5t~:~siPntMO•'t i 3. Nature of work (check which applicable): New Building Addition Repair Removal Demolition Other Work . (Description) 4. Estimated Cost . ? f Wit? ..I Fee . (to be paid on filing this application) S. If dwelling, number o dwelling units Number of dwelling units on each floor If garaga number of cars 6. If business, commercial or mixed', occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures; if any: Front Rear Depth Height . Number of Stories . Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories . . . 9. Size of lot: Front Rear . . . . Depth S!~ C?-e? 10. Date of Purchase . . . . . • Name of Former Owner 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : Ale) , 13. Will lot be regraded i Will excess fill be removed from premises: Yes co 14. Name of Owner of premises . Address , , Phone No............... . Address Phone No................ Name of Contraactor......................... Address Phone No................. 15. Is thi* property within 30,0 feet of a tidal wetland? *YeS........ No......... 1 If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 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 i II II _ I ear x STATE OF N O OUNTY OF. I ~'S • • • •g • • g• • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si nin contract) above named. ~v`.•?? 4 ie is the Cki............... . (Contractor, agent, corporate officer, etc.) >f said owner or owners, and is duly al thorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the vork will be performed in the manner.- I t forth in the application filed therewith. ;worn to before me this.{_ `.S.I.....dayof..i.~I~ \•Cc V_ 19...~ dotary Publi . Y^ , County !,JJ CLA1RB L.OLj:W C 7 Nowt Pulift State bf NIOWYar t , , , , , , . No.487850b lmw in ssuffool, fir" 1~ (Signature of applicant) Qua LOP~K, tSLNNf SaUNL r MAP OH PI OH- FROPEISTY RVE`lE.LD.^ FQQ. _ : - ' <O FJpT LIGHT cF W~1' --~NOr- ' _ rCAVkLED)- TG HOCTpN';a I_Ary~ - _ _ - _ TTIL~t` r0l L~~[)Y - J Q F o OTT I L E ~a 011 9 ~Af 19 1 , 51OUTHQLD TC.?WW ph SOU 4 OF SOUTHQL.U' W.Y, 1 T . clew rc ul i I vlV-i ____1____ _ 'its ~ ~ ,'.SALES _P,S N9TER, r\ _ 50 'FOOT (9232 1 ertFQl~ I~ ~ ~ ~ J1 =~MCIN4.1M~1JT ~ ~ I I,-uaaiN~ 1A6S,FCTO_r{6uti~Fj r ~.~/~q $U F. MT" MAP DATA; IC00 60-f•8 T i I Tox r ~varr o F ~~vER ~.F,i~a ~ t~ - ~p X36.17 $ SO Wlpk IwIGFITen ~F r/ - . . _r ° FkN4Fr l0 4~. .~..OF 1W. F HYATT. _ L w ' W ~ I 17' ff~ L~ - ~ ~ 11 I ~yLY MY;r 1 ~ • O CA!VT1ION'MAF r i w , ~ p11~-1P H9; f, ~ o 5 ,~v WELL I4'. . • rt/rR•4 IF" J . yoi 61 a SD ua' . t i 1 , i I r J+ JI r ~1" ~ f~ I I N n+l'.na11 rul bu C" ~"1111IIYm CnpY ,u,n u, i, i V44, I, Sr InWCemf Imrecn =11..'1 .u tom. r s t ~J,,1CxkdT r 4, fd 4 ~ a c p A . " i_ EF ''i., 6Pl,QA1 f;t 17MI'r11G'FI"~~i. ~Fe~ tIr~N„ yy44~~..JJL 4 ~ ~f ~ FYI n~ 1 ln<:, rq r,an ma on tF,, , 1 1:mr rl m bE I, lif~,11,QAYfaC 1{.~.%+4QA1'a~ ~~I F.l~ryh Q~/1~'AI~+~l!~~ 5 r O I n . -a. r rr ~"^~NNnn / r d b b plf mY':Itutlnp IL?.J M1n: ern, ar ' r~+C.G 11, r9lY 0~'.5.k. ry ,W / ~5 I 1_I! i IuI JI ~r•~-,..~ 1,!-I-. fnY (52F6 PL~ ~ r c c V. Irb I i.l "V+! ee of lpo IanJ n.l Il F.,- \SZ LAN / Inc, boons cr ou: uP b r al6lial t4q.-1pL 1.1 nai,10I p! Opbpny:onl i I - r." - - - - OCCUPF _ - - - ~ USE IS U OCCUPANCY OR 2r.lo,- ~aI $i USE IS UNLAWFUL WITHOUT C WITHOUT OF OCCUPANCYATE OF Occ U~ql - I MAR 2 1991 cE Aq_ rnq;H 4~ i! w TOWBL 50PT. UTHOLD - - I cop P4PPROVED P AS NOTED 1'F~ _ . I I I salvo E2„ h.. I ~ - ~ DATE: S E; S ~4 s. P. p 19 'i FEE: BY, NOTIFY BUILDING 'IFV BUILDING DEPARTMENT AT I ` 1 755-1802 9 AM TI -1802 9 AM TO 4 PM FOR THE r +ro 'J 1 F I _ FOLLOWING INSPE- l7 8S.) 4 1. FOUNDATION LOWING INSPECTIONS. FOR POURED CC 'OUNDATION . TWOREOUIPED OR POURED CONCRETE TOUGH - FRAMING, & PLUMBING 1 I ! I i f I I_ 2. ROUGH - FRAOA NSULATION -j tz~ I r t -I Dig'.FJ'x,,v.c . 4. FINAL CON Cc RNAL - CONSTRUCTION MUST _ 3. INSULATION ~i ~ I 1 y (.I I I BE COMPLETE F, IF COMPLETE FOR C G CONSTRUCTION SHALL NIIEF1 4 4 1 iHi a~_ _ ALL CONSTRUCTIC i { I -'I THE REQUIREMEN REQUIREMENTS OF rHE N V STATE: CONSTRUC TF CONSTRUCTION & ENFRGY CODES. NOT RE )ES. NOT RESPONSIBLE FOR I DESIGN OR CONSTI IIGN OR CONSTRUCTION ERRORS b fly. nS A a ~CC~1y'1 '16AI~nk(S rt`/V I-;, ICA " DV'L '4x~L T II , y "_ay _ I ~Ac1c ~M~1laiay C"Y pot EDWARD f.. WILLIAMS BUILDING CONTRACTOR 150 ,><...m1~S,i-~'~• SOUTrHOLDo,NY.isir Ii