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Home My WebLink About19596-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19744 Date FEBRUARY 21~ 1991 THIS CERTIFIES that the buildin~ Location of Propert~ 190 PVT. RD. #7 House No. County Tax Map No. 1000 Section 038 Subdivision ACCESSORY EAST MARION Street Hamlet Block 01 Lot 25 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 18, 1990 pursuant to which Building Permit No. i9596Z dated DEC. 20~ 1990 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 PERMIT AMENDED TO INCLUDE AN ACCESSORY SHED. 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 WILLIAM & BARBARA GUNTHER Rev. 1/81 Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19745 Date FEBRUARY 21~ 1991 THIS CERTIFIES that the building Location of Property 190 PVT. RD. #7 House No. County Tax Map No. Subdivision ADDITION EAST MARION Street 1000 Section 38 Block 01 Lot Filed Map No. Lot No. 25 Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 18~ 1990 pursuant to which Building Permit No. 19596Z dated DEC. 20~ 1990 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 HOUSE TRAILER. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED WILLIAM & BARBARA GUNTHER N/A N/A ~uilding Inspector 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 Tile WORK AUTHORIZED) NO_ 19596 Z Permission is hereby granted to: ....... ~..~..~... ' ...... ..1~..~..~....~.~.~ ........................................... _ ..... .~.~.~_...~.:~.:....j..!..~..~.~ ..... . ,o ..~.:~...~.....~.~.'.....~....~o.........~....~ ..... ...... .................................... , ........................ at premises located at ...1..~.0.......~...~.....~......"4~.~ ....... ,...~..I.~ ,..-...~.. .¥........~.~ ................. County Tax Map No. 1000 Section ......(~.....'~-...?. ....... Block ...... ..C~....} ......... Lot No.....~....~..~.. ........... pursuant to application dated .....~,~~.....)...~) ............. , 19..~.~.., and approved by the Building Inspector. ~. 6/3o/~o ~ C 0 o · BLDG, DE~. TOWN O~ Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building -inspector ~ith the following: for new building o~ 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 frog"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 ~nd installations, a certificate of Code Compliance from architect or engineer responsible for the boilding. 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, Additiohs 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 pf 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 ate .... .................... :ew Construction ........... Or Pre-existing Building ............ PRIVATE RD. #7 EAST MARION, N.Y. .ocation of Property ..... !~9 ....... House No. Street Hamlet Inwer or Owners of Property ......... WILLIAM & BARBARA GUNTHER Ounty Tax ,000, Section ..... ...... ...... ........ ............... ubdivision ...................... Filed .............. Map ............ Lot ...................... ~rmit No.~.f~ ....... Date Of Permit..~..=.~.~?.~.~..Applicamt ............................. ~alth Dept. Approval .......................... Underwriters Approval ......................... [arming Board Approval ........................ ~q~est for: Temporary Certificate ........... Final Certicate ........... 'e Submitted: ',i',,ii FEB20t991 Form No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filleB in by typewriter OR ink and submitted to the building .inspector ~ith the following: for new building or new use~ 1. Final survey of property with accurate location of ail 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). ~. 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 god 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 ail 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. Co 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 pf 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 ...... 190 PRIVAT~ RD. ~7 Location of Property - · House No. Street Hamlet WILLIAM & BARBARA GUNTI/ER )nwer or Owmers cf Property ............... · 38 I 25 :ounty Tax Map No 1000, Section .............. Block ................ Lot ...................... :ubdivision .................... Filed Map ............ Lot ................. ormit No If£Z ^ p icant ........... ....... Date Of Permit ..................... ealth Dept. Approval.... ............ . ....... . . Underwriters Approval ...................... .. . lanning Board Approval ................... · · .. · equest for: Temporary Certificate ........... Final Ccrtieate ........... ee Submitted: · 25.00 '-/ sz ' ' FOUNDATION (2nd) 2. ROUGH FRAME & .FLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7GS-'~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION FRAMING 2ND [ ] INSULATION [~FINAL REMARKS= ? DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD ~ [ 8m BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N,Y, 11971 TEL,: 765-1803 Examined 19 ?.o. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT B0^RO OF HEALra ......... ~3 SETS or PLa~S .......... ~SURVEY ................... ~CIIECK .................... SEPTIC FORH .......... .... c^[[ }~Z.~.: ..... &~A ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets 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 inspec~tions. , . ...... .... (Signature of applicant, or name, if a corporation) ~. ~..~.~... ~z..~... C.~. &~./~¢ ........ (Mailing address of appticafit) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... .................................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..'~.' '?...fi-5...~?../'/.D./,~..~,~ ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ...... //..c ..... .......... .................. House Number Hamlet County Tax Map No. 1000 Section '~.~. .............. Blbck ..... ./ ............ Lot .... .~,4.~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. [~.f--7,~/c/')cid~[~'(- ..... b. Intended use and occupancy ' " 3. Nature of work (check which applicable): New Building ...... Addition ........ Alterahon- . .. Repro .............. Removal ........... Demolition ........... Other Work. ~.~?~.. ''' ' ' ' Estimated Cost ..... c~.w .~.~.: t ......................... Fee ....................................... i (to be paid on filing this application) If dwelling, number of dwellinglunits .............. Number of dwelling units on each floor ................ · If garage, number of cars If business commercial .................................................. ~ .............. , occupancy, specify nature and extent of each type of use ............... Dimensions of existing Front ' Rear Depth any: .......... : ................................. Height ............... Stories ........................................................ Dimensions of same structure additions: Front Rear Depth ............ ' .... '' 't~ .................. Number of Stories ...................... 8. Dimensions of entire new cons ction: Height ............... Number of Stories 9. Size of lot: Front .. I 10 Date of Purchase ~ 11. Zone or use district in which pr~mmes are situated. ........ Rear ............... Depth ............... .................. Depth ...................... 1 2 Does proposed construction violate any zoning law .......................................... · regulation' 1 3. Will lot be regraded ......... , ................... Will ~ fill be removed from premises: Yes No 14 Name of Owner of premises i Address Phone No Name of Architect .......... i ................. Address Phone No. Name of Contractor ~ Address Phone No 15. Is this property within 200 feet of a tidal wetland? *Yes. .. No ......... *If yes, Southold %own Trustees Permit may be required. ". i PLOT DIAGRAM Locate clearly and distinctly allI buildings, whether existing or proposed, set-back dimensions from property lines. Give street and bock ~umber or descnphon according to deed, and show street names and indicate whether interior or corner lot. I STATE OF NEW YORK, COUNTY OF S.S (Name of individual signi above named. He is the ..................... ................... being duly sworn, deposes and says that he is the applicant ag contract) (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dui authorized 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 work will be performed in the manner!set forth in the application filed therewith. Sworn to before me this ................. ; .... day of~.. ................... ,19 ~.d. Notary Public ...... ~ .'r~-eq4q-~... NOTARypUf31.1CiStateolNew ,:~.,' ,/ ...... y. · . .... . ~. 47078~.q, ~01k ~'/ / ~ (Signature of applicant)