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Home My WebLink About19630-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19726 Date FEB. 13, 1991 THIS CERTIFIES that the buildin~ FOUNDATION Location of Property 1235 FACTORY AVE. House No. Street County Tax Map No. 1000 Section 122 Block 02 Subdivision Filed Map No. MATTITUCK Hamlet Lot 18 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 23~ 1991 pursuant to which Building Permit No. 19630Z dated JAN. 24, 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 PARTIAL CELLAR AND FOUNDATION UNDER EXISTING ONE FAFLILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED LOUIS & RUTH STOKES ~/u~ild~ingInspector Rev. 1/81 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~ 196~0 Z Permission is hereby granted to: . ~ ,// ...... ....... at prom ses I~at~ at ...... ~...~~... ~ ~ ' ................ / ./~.~ ~ ............................ ~~~ .......................................................................... C~n~ Tox ~ap ~o. I000 S~ction ...... ~..~.~Bl~k ........... ~... lot ~o ....... ~ ......... Building Insp~tor. Fee $..~...~ Rev. 6/30/80 Form No. 6 BLDG. DEFL j TOWN OF S~O~._j~J.(.~J,~,('L ........... APPLICATION FOR CERTIFICATE 0F OCCUPANCY TOWI~ OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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, Additio'ns 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 $15.00, Commercial $15.00 Date..~.~..~. '~/..~./~.. ......................... ~:ew Construction ........... Old Or Pre-existing Building ................. ~ ~ oeation or Pro ertv...Z. . ......... ~ O' Street Hamlet ....... :i County Tax Map No 1000, Section...Z.~...J~.....Bloc~....~.. ......... Lot...Z.~. ............. aubd~v~s~on ....................... Filed Map Permit No ................ Date Of Permit .............. Applicant ............................ 'lealth Dept Approval .......................... Underwriters Approval ....................... ~lanning Board Approval ........................ request for: Temporary Certificate ........... Final Certicate ........... 'Ce Submitted: $. ¢~ ~.~f'?~ APPLICANT :i~LD z,,S,~xO~ I[DATE C0~fl£~%E FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITION[L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION xST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ~~INAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION F~~OUNDATION 1ST ~ ] ~ouNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL DATE INSPECTOR BUILDING~ DEPT. INSPECTION [] N/ ION :I,$T PLB i. I NSPEG"'TOR J/~ ~ ~.~ ~U~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHQL.fl. LXL¥o 1.tq7 L , / TEL. 765-1802 Exau,,m:d../~...~. .... . Disapproved a/c ......................... n~ l~cc~or) APPLICATION FOE BUILDING PERMIT IlO^RD OF HEALTH .... 3 SETS oF PLa.s ..... CIIEcK . ~EPT~C );~ ............... 1 CALL ................ INSTRUCTIONs a. Tiffs application must be Completely filled in by typewriter or in ink and submitted to th~ Building I~p~tar, wilt sets of plans, accurate plot plan to scale, l;ee ~rC~ord'ing to schedule. b. Plot pl~ showing location of lot and of bulldogs on premises, relationship to adjoining premises or public strm or areas, and giv~g a det~led description of layout of property must be drawn on the diagram which is pa~ of t~s ap~ cation. . C. The Wor~ covered by t~s application may not be Commenced before issuance of BulldOg Pe~it. ~. Upon approval of this application, the Building InspeCtor shall be kept on the premises available for ~spcction issued a Building Pc~it to the app~c~t. Such peru throu~out the Work. ~. No buildhg shall be occupied or used in whole or in part for any purpose whatever until a Ceaificate of Occupmm ~hall have been granted by ~e Bulldog Inspector. . APPLICATION IS HEREBY MADE to the BulldOg Dep~ment for the issu~ce of a B~Iding Pe~it pu~uant to t~ Building Zone Ordinance of the Town of Southold. Suffolk County, New York, ~d other applicable Regulations, fo~ the construction of bu~d~gz, addition~ or alterations, or for iemoval or demolition, as here~ deschbe( The applicant agrees to COmply with all applica~e laws, ordinances, bu~d~g code, housing code, and regulations, ~d admit authorized ~specto~ on premises and ~ build~g for necessa~ inspections. (Signature of~pI[ch~t~ (Matting address of appEcat) State w~dther applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder L2':' ;': 2;;2; ;;" Z;: 2' ........... - ......... s . ,~.~ .......~.~., T~ . (as on the tax roll ' ffapplican/is a corporation, s~gnature of duly authorized officer, or latest deed) Builder's License Na ..... 9~.~ ~ ............. Plum bet's License No ......................... Electrician's License No ....................... Other Trade5 License No ...................... Location of/and on which proposed work will be done; ..... ........... llous~ Number ~l~e~L . ·' ' ' ' .... amlet ....... County Tax Map No. I000 Section ...... . ' · ..... Block .... Subdivision .......... · .......... Lot ....~ ,, "' ~ .... ) .............. Eiled Map No. State existing IIS~ 2" * ............. Lot ......... nu occupuncy Of premises nad ~/llC~cd IISC alld oCCuPanc . · ...... , · · · ~j~/ , 'YOlproposedco · A. Exzst~ng use and occupancy ..... ..~//~, ,Strnctlo~ . d Use and occunancv.. ~ ,,~,,,, 3 N ture of york (check vhich ap'plicable) Ne Building .'fAlters ' · a ~ x ~ : w .......... Addition ....... Reps.ir' . ............. R~m6val ...... n .... ... .. Swi:mi n,, Tennis Court ..... '_'-. ~CCessory Building .......... Fence ...... 4. EstimatedCost... ~,S00 J _ '7~'-- 17~7r.~ · */ ....... I ......................... Pee ./.-,4 ............. ~ J (La be oaid on filing this application) 5 Ifd~elling numbero£dwcllingCnits Nnmberof ' · lfgaraee ' ' ............ dwctling units on each flour ............... number of cars ' 6 Ifb i corem i I i d ci£ynat ........ · usncss, erca ormxc occupancy, ape nrcandextcntofcachtypeofuse ................ 7 Di i fexi ti i if F '' · mens ons o sng structure, any: rent ............... Rear ............... Depth ...... }leieht ......... Number o f Stories ........... ' ..... Di i f , ' ......................................... mens oas o same structure wl:t I alterations or additions: Front c ..... ;" ' '. ........... I ...................... Number of Stories ........... 8. Dimensions oz entire new construction: Front ~ i ..... Height Number of Stories · ·., .......... , Rear ............... Depth ......... 9 Size of lot: F/-ont ................................................ · · .......... ~ ........... Rear Depth 10. Date of Purchase ........... i .................. Name of Former Owner ......................... IL Z°ne°rusedistrictinxvhichpre~isesareaituated.. :ii i Does proposed construction viol ........................................... 12. Ate anv '~nnln. n,.t, 12,. ' . _ ...... = ...., ordinance or regulation: ... &,/O.D. ................. Will lot be regraded ......... i .... ' ......... ~ ...... Will excess fill be removed from premises: . Ye: 14. Name of Owner of premises . .., ................. Address ................... Phone No .............. Name of Architect .. Name ........ ................. Address ..... i ............. Phone No .............. of Contractor ......... I.. ~. · ' ............. Address ................... Phone No .... ; ......... 15.1~ ~h.i~ groparty ]Loc~zt_ed w' ' zth~n 3QQ feet of a tidal wetland? '~YES .... NO .... ~If yes, South01d Townl Trustees Permit may be required. PLOT DIAGRAM IbuHdings, whether existing or proposed, and. indicate all set-hack dimen:ion: [umber or description according to deed, and show street names and ' ' ~ ....... Lndlcate ~ ...... Locat~ clearly and distinctly all property lines. Giw street and block interior or comer lot. STATE OF NE~,g.~QR~"',,~.~/l-'" 8i S COUNTY OF,.._.-e=.~...-~...%5A.. '" ......... ofindividual signi~g contract) ..... being duty sworn, deposes ~d says that he is the above nam'ed. : ~(Contrac~geet. corporate . of said owner or owners, ~d is duly iauthorized to pe.rform or have perfo~ed the said work and to m~e and file th application; that 311 statements contained in this application are true to thc best of hi, knowledge and belief; and that Work will be perfommd in the m~ner: et forth in thc application filed therewith. Sworn lo before me this ............ .... .,, No. ~7~ ~