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HomeMy WebLinkAbout19892-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z20026 Date JUNE 24~1991 THIS CERTIFIES that the buildin~ ADDITION Location of Propert~ 375 TUCKERS IA~NE & 50 GRISWOLD ST. SOUTHOLD House No. Street Hamlet County Tax Map No, 1000 Section 59 Block 11 Lot 07 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 20, 1991 pursuant to which Building Permit No. 19892Z dated MAY 28~ 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. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A GEORGE & KATHERINE FISHER '~'~ '/J ~ Building Inspector Rev. 1/81 I~OB.~ NO. 8 TOWN OF SOUTHGLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~- 19892 Z Permission is hereby granted to: ...~....k.~.~. ................................................. ......... ~ ......... ~...~ ............ .~......~. .......... ,o ..~.~.....~....~.L.~~ ................ ~...~..~. ........ at prem,ses located at ...~...~.~....~'.~:~...~.J~['~...~.....'~...-~.......~.;~......~....:....~ County Tax Map No. 1000 Section ...... ,,(~...~,,~., ...... Block ........ L.{ .......... Lot No .......0.,..~, ............ pursuant to application dated .......... ~~..~..~ .............. , 19..~..~.., and approved by the Building Inspector. Fee $..-~....:...~.. Building Irtspector Rev, 6/30/80 Form No. 6 TO~fN OF SOUT~OLD 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 ali 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 archiuect or engineer responsible for the building. Submi~ Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-exlstzng 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 - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10o00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ew Construction.~...~. ...... Old Or Pre-existing Building.~, ........ House No. Street Hamlet ewer or Owners of Property ............................................................ ounty Tax Map No 1000, Section ...... .'~.~. .... Block ................ Lot .................. . ~bdivision ............ ~ ..... - ................. ~z±e~_ ~tap ............ Lot ............. _'reit No../. ~.~.~..~..~..Date Of Permit.....~/..~..~../.~./.Applicant....~..~-.~..~.~..~..../.~..-...... Z.~. ~alth Dept· Approval ., . /~-/~ ................. % ..... Underwriters Approval ...... Lanning Board Approval ....... ~.:~...¢ ........ ~quest for: Temporary Certificate .... ..~..... Final Certicate ........... 'e Submitted: $ ................ ~ ~'I[ . ' APPLICANT rlzLD I,,S..~ON IfD~m COM~gNT~ FOUNDATION --~ FOUNDATION (2nd) 2. ROUGH FRAME & .FLUMBING ® INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: ROUGH PLBG. 2ND [ ] INSULATION [/~I~L DATE INSPECTO~ TOWN OF SOUTIIOLD OFf:ICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. ! 1971 June 14, 1991 TEL. 765. Mr. George Fisher 375 Tuckers Lane & 50 Griswold Street Southold, N. Y. 119~I 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(~k/not on file.)$25.00 /~/ No Health Dept. Approval on file. /~/ No final ins.pection has been made. Please contact our office on this matter. Thank you for your cooperation. Dui]ding Permit t~ ~ .9 ~ 9 _g_ Z Bu.£1ding Dept. ***/~/ No Plumber Solder Certificate on file. all pcrlnits involving plumbing beinq issued after April 1,1984 ) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 'isapproved a/c .... . ........................ ~ (Building Inspector) BOARD OF HEAL'I'It 3 SETS OF PLANS ~ ...... SURVCY ................... ClIECK .................... SEPTIC F 0 R,*I .............. .......... HAIL TO: APPLICATION FOR BUILDING PERMIT , Date . ' . , . .. INSTRUCTIONS a. Th/s application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ion. · c. The work covered by tbJs application may not be c'~)mmenced before issuance of Building Permit. d. ,Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit dl 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 i1 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 qding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. : applicant agrees, to comply with all applicable laws, ordinances, building code, J~using code, and regulations, and to , nit authorized inspectors on premises and in building fQr necessary inspections~:~/.¢.._ (Signature of applicant, or n~a~e, if a 9orp~ration) . · ...... (Mailing address of applicant) engineer, general contractor, electrician, plumber or builder. te whether applicant i~essee, agent, architect, /;.- 'r ,ne of owner of premises - t9 ~E (as on the tr¢ roll or latest deed) pplicant is a corporation, signature of duly authorized officer. ,' (Name and title of corporate officer) Builder's License No /..~'~ ~0Yl-/[5' / ? O ~(_.) ~'~.~ Plumber's License No ......................... Electrician's License No ' Other Trade's License No ...................... Location of land on which proposed work will be doue ........ louse Number Street Hamlet ubdivision ..................................... Filed Map No ............... Lot ............... (Name) tare existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ............... ~. x ...... , Intended use and occupancy ~ ~q E' o~.~,~)~a 3. Nature o.f work (check which apilicable): New Building .......... Addition .......... Alterat. io? .... ....... Repair ............. Removal .......... Demolition .......... Other 'Wor~3~ ,~ .i'~.. I ¥ (D scr ption 4. Estimated Cost .......... ! ./. (to be paid on filing this application) 5. Ifdwelhng, number old,veiling uhits ............. Number of dwellinz un ts on each floor ..... · If garage, number of cars ..... ! ........................ .~.. ., ............... If business, commercial or mixed Occupancy. specify natu, re and extent of e ' . ........ 7. Dimensions of existing structures '-' - ~.t ,, J ' ach type of use ........ . / ,,,uany: Vront ...... V..~..... ~,,.,, ~, , ,-, ¥ · ......... tacptn....~7..h ........ Heig ~t . ........... Number of Stet/es . [, . . . Dimensions of same stru,,* ..... '~ , · ' ............................ ,, , ~,--,~ wan alterations or additions. Fro-~ ~ ' ............ taepm ..................... t Heh,h* ......... lqear .................. 8. Dimension~nfantl ........ [. 't' ............. ;~ ........... Number of Stories ....... ., . - ..... ,ow construetmn- Front .-~..'9 ~ · ',, r ........... _.. ' .... ~tear . . ~ ...... t~eg~t · · · N'--i ~- / ........... Depth . C. .......... ,,mo.~rot5t.ones . ! .. . .... 9. S,,iz~ oral,et: Front ..... ',' .~...~..~.....'hear' 'i' ' ' CtZ ....... /-":.''"'/LX~ .............. 10. t~are ott't rchase /O ~r'! 14- ........ · ...... Depth l./. ..... ~/.,.j.t...,..~m.. . . · ........... . .... , , · · . . ,. ..:.. .NameofForner O, ncr ...... .~t~..//k/ ~ ~ ! I.~Zone or use d,stnct m wluch premises are s~tuated 7~'t.c~..q[~ e- tOv-'rt ~_, t F.. ............... ~ 2. ~ocs proposed construction VlOlnt.g an .... ~-., , ' ' ' ;.' .......... ~- ' .... ' '"~':?-"-" ' '~'e-~ ...... , .............. 3. Will lot be regraded ..... -,~(ff~ ,,u.,,g mw, oroma.n, ce or regulation: ..... :./~.'./j ...... .,. ........ 4. u u,,-.,wner Orprem~ses .. t.~.£ .u...rT.. t-..,~'.rt.r/,~dress . ~9,0..~,.d.g' ..~..~..~... Phone No. ,: .7~. ~. %~, Nam~ ~er, o · ' ' ' '~h' ';! ' '~','~-,',:_t~_' Wdl excess fill be removed from premises: Yes Name of Architect NZ sam: ~:tfsCo cat] .......................... Address .... · Phone No ........... 5. nrtora °r'"~'~r' '~"~' '~' ~j~./~..t:.. ('~.J~..(~.Address .............. ' .... ............... Phone No ........... p p rt:y w±t:hin 300 foal: of a t:±dal wetla~'d'?' ~Yes ........ No ......... ' .... ~t£ yes, Sour:hold Tonka Trust:ecs Perra±t may be required. i PLOT DIAGRAM Locate clearly and distinctly all buildings ,whether e, xisting or proposed, and, indicate all set-back m .... ~,,,,, ,roperty lines. Give street and block nufilber or oescription according to deed, and show street names and ~terior or comer lot. .... being duly sworn, deposes and says~mt he is the applicant (Name of individual signing cc ntract) . ve named. s the .......................... '(Contractor ................................................. , agent, corporate officer, etc.) aid OWner or owners, and is duly autl'orized to perform or have performed the said work and to make and file this i~at/on; that all statements co~ rained in this application are : will be performed in the manner set fgrth in the application true to the best of his knowledge and belief; and that the filed therewith. m to before/ne this .......... · ..... dayof... ........ · fy Public, . ' . i . / / f, .................. ...~'~-.,~Countv .,.,~. -t'~ ~ ~OYCE M. WILKIN$ i ' .'. ..... ' Not~y Pu~ Sml, of N~ ¥o~ ..................................