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HomeMy WebLinkAbout19646-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19775 Date MARCH 6~ 1991 THIS CERTIFIES that the building Location of Propert 440 PARK AVE. E. House No. Street County Tax Map No. 1000 Section 123 Block 08 Lot Subdivision Filed Map No. Lot No. ALTERATION MATTITUCE Hamlet 28.3 conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 26r 1991 pursuant to which Building Permit No. 19646Z dated JAN. 31t 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 ALTER & REPLACE WINDOWS AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ANTHONY & BRENDA RELIES ~r~g~Inspector 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~- 19646 Z Pen~ission is hereby granted tO: ..... .~~~ ............. ~.~ ~ ...... ..... ~ ....~.~.~...~.:~..,.../..~.~..~..~ ........ ........................ ~ ~~~ ................... .~.~. ~ ~"~"'~'"'-~ ........... ~..~....~..~ ...... .x. .... ot p~ ~ ot ..~=....L~r.~:r..::~....~ ....... ~.~.~.. ..~ ........................ ~ ................... ~ .................... , ........................................................................... ........... ~.....~ ........ ~~ ........................................... ~ ................... ~ Tox M~ No I ~ ~ ~ p . 00o ~.~. ...J ...... .~ ........ ~l~k .... m .............. ~ No..~ Buildi~ I~sp~tor. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 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: 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. 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. :. 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 $15.00, Commercial $15.00 Date ................... · .515/91 .................. :aw Construction ........ ... Old Or Pre-existing Building .... ~ ............ ocation of P ..... ~, 2890 Bungalow Lane ............... .. . Matti.uaok ........... House No. Street Hamlet )nwer Owners of Property .A.n.t.h.o..n.y .&. Brenda Helies . . . . .1.2.3 .0.8 028-003 :ounty Tax Map No 1000, Section .......... . Block ............. . Lot ................ :ubdivision Filed Map Lot ......... 'ermit No.~4~.Z ....... Date Of Permit.~P~/~l ....... Applicant~q~¥..~.¥A%~$-O~ ....... lealth Dept. Approval ..........N/A. .......... . . .. . Underwriters Approval ...,..,N/A.- ....... . ..... . . .. 'lanning Board Approval N/A. 'equest for: Temporary Certificate ........... Final Certicate ..... · . ........................ ,// ee Submitted: $.. 25.00 ..,~' %'~ ~ , ~ i ,-'d'[/z.'.-~ ,'7 , ............ CO ~,, ~77 $- AFPLICANT -- FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING e INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITION[L COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL $OUTIIOLD, N.Y. 11971 TEL. 765-1802 FEBRUARY 12, 1991 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the foil. owing reasons. ~x_--/ An application for Certificate of Occupancy i~ not on file. /5/ No Underwriters Certificate on file. /_~ The check is(~not on file.) $25.00 /5/ No Health Dept. Approval on file. /~/ Nu final inspection has been made. Please contact Thank you for your cooperation. Dui]ding Permit t~ I 9 6 4 6 Building Dept. ***/~/ No Plumber Solder ( our office on this matter. ALlllR ANIllONY & BRENDA ~LIE$ Certificate on file. all permits involving plumbing being issued after April 1,1984 ) © © k( . 3. Nature of wot check which applicable): New Building ..... Addition .......... Alteration .. Repair ........ Removal ............ Demolition .............. Other ',York..X. .......... 4. Estimate'dCost. $2,300.00 Install New windows. (Description) ............................. /. Fee .................................... 5. If d~velling, number of d~velling units .... .N/.A... (to be paid on filing this application) If garage, hum bet of cars ....... ' .... Number of dwelling units on each floor ....... ' .... 6 If busin · ess, commercial or mixed occupancy specify natstre and extent of eat t eof u ........... ' 7 Dimensions of existing structures if any FrOnt N/A t 13 yp se ' Hei,.ht ' · '. -... ........ ~ear ........... ~ Depth ~ ................ Number of Stories ~ ' ............ Dimensions of same structure with alterations ............................................ or additions: Front ........... Depth . . ............. Rear . . ~,. ',' ................... flelght ........ .., .... ' ............... 8..wfi .mensmns of entire new construction: Front .S.a.r~ ......... ,~.. rqumocr of 5tones ................... nmght ............... Number of Stories .......... Kear ............... Depth ............ ' ' 9. Size of lot: Front ...................... Rear ...................... Depth .......... ,0. ofr57d ;St; I I. ;.; }.' ~.~,::2,'. ..... · ...... ; ......... Name of Former Owner .............. ' ........ 12. ~' ,,.[ ,, ,vmc, premises are situated .... ' ........... woes proposed Construction violate any zoning law, ordinance or regulation: . [qp ...................... ~ i 13. Will lot be reeraded N~A .... i ......................... Wdl excess Ii11 De remove ' ' ' ' Nme of Owner of premisesNr. & Nfs Anthong Hel4~ ~ e~.~.~_ .-.,, .. from premises: Yes 14. :d, Nc Name of Architect ................... ~x~uress .-e..o.~.~u.X .n.~.4{ .tS.q.' P rune No.6~ly.-.2.3?r.6.87..5... ......................... Address~/eston Mass 02193 . Phone No ............... Name of Contractor S. 1;OB.l.e.y' .4:..F. 1. 5..s.s..J.r.:. Address .N..a.t.t.l.t..u.c.k ........ Phone No. ¢9.8..-~ 790 15.Is this property located withln306' feet of a tidal wetland.* ~YES.N~.XN~}.''2~'' · If yes, $outhold 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 comer lot. -% STAT£ OF NEW YOI~', , COUNTY OF · .~..~..~.~X.~ ..... S.S ................. · ' .': .... '. ...... v .... : ......... being duly sworn, deposes and says that he is the applicant (Name of ~'~'mdual stgnmg contract) above named. lie is the ................. ("e¢3 ¥ ,r'cte~. ' ' ontractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe.rform 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 Work will be performed in the manner set forth ' Sworn to before me this / fl tn the application filed therewith. .................. , ..day .... .q.'. -- . .. ........ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL / Examined . .'~,.~ .~j., 19'.1./. HAIL D sapproved a/c ............ / (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH SURVEY ........... SEPTIC FORM ................ TO: Date 1/26./9. 1 19 a. Tlus apphcaUon must be com, pletely filled ~n 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 o[ lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed descr?tion of layout of property must be drawn on the diagram which is part of tiffs appl/- cation. ¢. The work covered by this application may not be commenced before issuance of Building Permit. d. ~pon approval of this applicaltion, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be l~ept on the premises avai/abl~ for inspection throughout the work. ed No building shall be occupied or' used in whole or in part for any purpose whatever until a Certificate of Occupancy shal't 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 egulaUons, for the construction oflbuildings, a.d. ditions or alterations, or for 3emoval or demolition, as herein described. The applicant agrees to comply wit~ all applicafile laws. ordinances, building code, housing code, and regulations, and to admit authorized inspectom on premises and in building for necessary inspections. 565 Old Main Rd Mattituck N Y (Mailing address of applicant) State whether applicant is owner, l~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder. ql~p e r.o, 1 Contrag. tor Anthbnv & Brenda Helios ' of of owner Name premises I z. ...... (as on the tax roll or latest deed) If applicant is a corporation, signatureI of duly authorized officer. (Name and title of corporale officer) Bu lder s Lmense No. Plumber's License No ....... Electrician's License No ...... Other Trade's License No ...... Location of land on which proposed ............... /vo g'- work will be done. 2~,~ ~,,gal~w Lau~ Mattituck, N.Y. 11952 House Number i Street, ' ............... County Tax Map No. 1000Sectioni..................123 Block ......08... ......... Lot 028 90.3, Subdivision .......... ............................ Eiled Map No ......... Lot D (Ni ) ......... 2. State existing use and occupancy o[ premises and intended use and occtlpancy of proposed construction: a. Existing use and occupancy Summer Home b. Intended Use and occupancy· ·