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Home My WebLink About19537-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19556 Date DECEMBER 4, 1990 THIS CERTIFIES that the buildin~ Location of Propert~ 75 House No. County Tax Map No. 1000 Section D~LTERATION CEDAR POINT DR. E. SOUTHOLD Street Hamlet 90 Block 03 Lot 08 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 26, 1990 pursuant to which Buildinq Permit No. 19537Z dated NOV. 26~ 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 CLOSE IN EXISTING PORCH OF A ONE FAMILY DWELLING. The certificate is issued to EP~NEST H. P;kPPAS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH kPPROVAL N/A UNDERWRITERS CERTIFICATE NO. N161063 NOV. 15, 1990 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Inspector FORM NO. · TOWel OF SOIJTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ~rHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 19537 Z Permission is hereby granted to: ............ ............. Co~.~ Tox Mop No. ~000 S*c,ion .......... .~..~ ..... B,o~k .......... ~ ...... Lot.o ......... ..~... ......... pursuant to application dated ............................................ ./~..~.....~... , 19.~.., °nd opproved by the Building Inspector. Rev. 6/30/80 BUILDING DEPARTMENT TOWN HALL 765-1802 ! - APPLICATION FOR CERTIFICATE OF OCCUPANCY '~ · · %. This application'must he 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 streets, aud unusual natural or topographic features. Z. Final Approval from Health Dept.' of water supply and sewerage-disposal(S-9 form). 3. Approval Of ~lectrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains ~ less than 2/10 of IZ lead. 5. Commercial building, indus.trial 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, 19~) 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. ,,o 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 om Pre-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated C~rtificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.~, Commercial $15.00 Date ::ew Construction .... ~ ...... Old Or Pre-existing Building ..... ~ ........., House No. ,~ .... ' ........................ .. o~c Hamlet Onwcr or Owners of Property... ~J~? // -~.~/~ -'~ - ' County Tax No 1000, Section ........... Block ................ Lot ...................... SubdiVision .................................... Filed Map ............ Lot ...... .... 7 ...Date Of Permit.~ ....... Applicant ............................. [lealth Dept. Approval.....~/~ .................. Underwriters Approval ...................... ,, Planning BOard Approval ..................... Request for: .Temporary Certificate ........... Final Certicate.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y, 11971 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY · . . SEPTIC FORM ................ TEL.: 765-1802 Examined ./. .............. , 19 ~/ ^pproved ............ Permit No../. Disapproved a/c ................................... APPLICATION'FOR BUILDING PERMIT NOTIFY; CALL ..................... MAIL TO: Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Iflspector, 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 streetz or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pan of this appli- cation. c. The work covered by ttds 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 aoy 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 ~:emoval or demolition, as herein described. The applicant agrees to comply with all applicable la,ws, ordinances, building.gode, housing coagulations, and to (Mailing address of applicant) ;L' i2Z ........... .... ................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. e and title o corporate cer Builder's License No ........ '~ ........ " Plumber s Ltcense No ....................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location ofland on which proposed work~at, illbcdone: .~...~. ~'- ~_...~... ~"/~i.t..~ l[ouse Num bet Street Hamlet County Tax M~p No. lO00 Section Block Lot ' Subdivision ..................................... EHcd Map No ............... Lot ...... (Name) 2. State existing use and occupancy of premises and ~ntendcd use and OcQ~cy of proposed constrnction: B, Intended use and occupancy.-~-/ 3. Nature of work (check which applicable): New Building .......... Addition .. · -'- · Repot .............. R moval .............. Oamo,ition ............ Tennis Court ......... Accessory Building .......... Fence ... .. (to be paid on filing this~ $. If dwelling, number of dwelling units ............... Number of dwelling units on each floor. . If garage, number of cars.. .................................................................... . 6. If business, commercial or mixed occupancy, spccify..l~.ture and extent of each tYR.~ of use .----- . ...,. ........ 7. Dimensions of existing structures, if any: Front.., .~..'.'.~.. ....... Rear .... .7.$~ ................ Depth ' ' .'~..~' Heieht_ ...... ........ . Number of Stories ................................................ ....... Dimensions of same structure with alterations or additions: Front . ..~t~'oa= Rear ..... Depth ...................... Height ...................... Number of Stories ............ 8. Dimensionsofentire new constn, ction: Front....,~.....4f~.. ..... Rear .............. 'l~e';t~ i~i . i ...... Height Number of Stories .. ·. ' 9. Size of lot: Front ...................... Rear ...................... Depth .................. ... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....................... ... 14 Name of Owner of premises Address Phone No ............. Name of Architect ..................... ... . . . Address ................... Phone No ................. Name of Contractor ' Address Phone No · · ...-.-...' 15.Is this property located within 300 feet of a tidal wetland? *¥~S .... NO .... · 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 comer lot. STATE OF NEW YORK, S.S COUNTY OF ................. " (Na~e of ind;,'idu~l signing contract) above named. being duly sworn, deposes and says that he is the applicant I% is the ....................................................................................... '.'. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in tiffs application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in thc application filed therewith. Sworn to before me this .............. ..... day of .... ............ _---, HELEN tL DE VOE NOTARY PUBLIC, State o~ New York (Signature of applicant~ Ne. 4707878. Suffolk Countl~, Term Expire~ Msich 30,