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HomeMy WebLinkAbout19475-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCOPANCY No Z-24491 Date JULY 11, 1996 THIS CERTIFIES that the building RENOVATION Location of Property 350 LAKESIDE DRIVE SOUTfiOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 90 Block 3 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 19, 1990 pursuant to which Building Permit No. 19475-Z dated OCTOBER 22, 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 RENOVATE EBISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ANNA M. ECO (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buil in nepect Rev. 1/81 1 rosaa xo. a TOWN OF SOUTH06D BUILDING DEPARTMENT TOWN HALL SOUTIiOLD, N. Y. BUILDING PERMIT fTHiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDI N~ 1947,? Z Date ....©.S~':.~t-......?-z t9.90 Permission is hereby grants t rgaC,,O~Q,~ ~~~....~i~Lt~R~C~3r+.~....~4>...~A.xri.~.X.~....J..mtt~.f~.`.4.~.~+i!.~~....Als~r at premises locate at .:3.~~....~~ ....................~n%~:`:.41.1.!'~...........Q~la:!:LrlE::'~:~ County Tax Map No. 1000 Section .C.~.©.n9. Block .......Q...a~..... LoY No....... ~.4............ pursuant to application dated .fl.~!..~'~°`~......~.9 19~a., and approved by the Building Inspector. Fee 5.~..... B g Inspector Rev. 6/30/80 ~S ~ ~ ~ Farm No. 6 TOWN OF SOUTtIOLD ~ BUILDING DEPARTMENT @ JUN l 111986 TOWN HALL , ~ 765-1802 BLDG. DEPT. ~~a._.--,-,•----..--.~._-.-. TOWN OFSOUTHOL' APpLZCATION FOR CERTIFICATE OF OCCUPANCY 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-O form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying thst the solder used in system contains less than 2f 10 0£ 17. lead. S. 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 groperty 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. asa.f.y-sate of Occupancy - New dwelling $25.00 A~~+-. a_ 1^' Ofl, lterations t~~ o cTwe]:ring-$Z'-':~g pool $25.00, Accessory bu Z5.00, Additions POPS, Businesses $50.00. • 2. Certificate of Occupancy on Pre-Ming Euilding - $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 .Y?.~ New'Construction... Old rOr Pre-existing Building Location of Property.........~.9.~.... C(~t~.E ~ E.... House No. ~jStreet~~^^~~, ~••Hamlet Onwcr or Owners of Property......... ~ u ~W County Tax Map No 1000, Section ..............Block................Lot...................... Subdivision((~~..nn.......,//........ ..................Filed Map..........~~((..Lot...MM.~~.................. Permit No.fdl: ~Q;t; 7y.,,,Date Of Permit.,l0~2~Q0 Applicant.L~~~~,./yl;,,~C~,,,,,,,,, stealth Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate,........., Pee Submitted: ' C~ SiS ~ .AP .CANT....... c^n-2 ~t/~( 4 1c:LD ICS:'EC:'OtJ {{lli,:E ~ COMMENTS ~ ' m .o 1. ~ - J - v~ FOUtJDATION (1st) ° J~ ~ p N m FO,UNDATIOtJ (2nd) 2. z~ o P.OUGH FRAME It PLUMBING y H AA 3. m IIJSULATION PER N. Y. y STATE ENERGY CODE x _ r M 4 . .j FI;JAL 1p~ ~G £ ~fl ADDITIOPIAL COMMENTS: ama r ' 9 m • x M 9 • N ' ~ y M O ~ 2 S m a \ • r H YG S O m ^e H BOA2D OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY . . TOWN OFSOUTHOLD CNEGK BUILDING DEPARTMENT SEPTIC F02P1 TOWN NALL ' . &OUTHQI.D. L~LY~ bt2I1 P.aT ~ FY ; TEL.:7G5.1II02 CALL , ,l9 d MAIL TO• Examined . 22 c1, , ~b•. ~.-1`~r~-tom: 7~b7:'{S Approved t?.~~ .?-Z., 199°. Pctmit No. ~ q.~.~5~~.. ~ ..:e~~...~~ `l.... . Disapproved a/c -.~i9,y ~4` Q c~~~~~,.: ~ oar ~ s ~ (Building Inspector) t3l.Ot~. Oe~t: ' APPLICATION FOR BUILDING PERMIT TOWN qF 5''!"~'r'•[ i~ Date ..:..1.~~ Icr~. INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with . sets of plans, accurate plot plan to scale. Fee accorr}ing to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appb 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 Buildino Permit to the applicant. Such permi ~ 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 Occupant;. shall have been granted 6y 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 o: 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 cod's, and regulations, and tc admit authorized inspectors on premises and in building for necessary inspections. ~ .G. •(Signature,o~ applicant, ormame, If a corporation) (Mailing address of applicant) State whethernapplicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. same of owner of premises .....~l~T . ~ . (as on the tax roll or latest deed) !f applicant is a corporation, signature of duly authorized officer. ' (Name and title of corporate officer) ' ~~._G~~N,r. Builder's License No_ . Plumber's License No . . Electrician's License No . ' Otltcr Trade's License No . . 1. Location of land on which proposed work will be done' ' f/ouse Number Street. Hamlet J Block ©3....... Lot . J. ` County Tax \tap No. 1000 S¢ctio • , Subdivision • F.ilcd l,tap No . Lot . (Name) State existing use and occupancy of premises/and intended use and occupancypof proposed construction: A. Existing use and occupancy..G.~Ig'+r21R.J/....~kL?X.`~•~T't'~,.,ts~~i+~'4'~ ~~1~ . Y~ .;1ii~+~1~ ~^~atr,:~ g. Intended use and occupancy....f.~:.~.ANrk4.t!••l~.~~t7/.~i.!•r!.ltf•~°•~'•% ,-,,,t,,; i ~ ' ~x tt t ~ . v 3. Nature of work (check which applicable): New pudding Addition Alteration . Repair R~mgval Demolition ..............Swimming pool.......... . Tennis Court,...... _ ~yA~ccessory Building..........Fence .......Other Work:. 4. Estimated Cost ......~0.'~~.` Fee . ` ~ be paid on filing this application S. If dtvclling, number oC Jwclling lunits Number oC dwelling units on each floor • G • . • . • • • • • , IC garace, number of cars • • • • • • • • • . 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front . Rear Depth . Hci~ht ...........NumbcrofStorics......................................... . Dimensions of same structure with alterations or additions: Frant Rear . Depth . + FIcight ......................Number of Statics . 8. Dimensions of entire new construction: Front • Rear Depth . Hci~ht Number of Stories . 9. Size of lot: Fi•orit Rear Depth . I0. Date of Purchase .................Name of Former Owner , ! 1: Zone or use district in which premises are situated . 12. Does proposed construction vio;latc any zoning law, ordinance or regulation : . 13. Will lot be'regraded , ' ....................Will excess 611 be removed Crom premises: Ycs . ::c, 14. Name of Owner of premises L • • , , , • , . , . , , , , ,Address . ...............Phone No............... . Name of Architect .Address ...................Phone No............... . Name of Contractor ~ .....Address . .Phone No . 1S.Ls this property loc~ted•within app feet of•a tidal wetland? *Y>:5....NO.... *IE yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f: - property lines. Give street and blocl; number or description according to deed, and show street names and indicate wt:c::.. interior or corner lot. i ~R ~~ocar~ 2 ~><is'~` Lr7isoa~. ~',2oi'/ 3owzwJ S°~'~ '~O ~s.T.S~r~~ , © /`tea[ ©vsz tailit!A~ ~ ~2is:T, -"~.i~oo%t. ~'7" /.r1s.s7" S.vr~~ ~ w~ycT~Al ~ ~ZOQ~' I', ~v~R.~lA.G9~ ' O.y La~~s.j' S ~D~ ~~~o~ 3 ,Q.bour zg` ~bb~~ ' ~tPPROYED p~ NOTED DATA: ~ z r3.~: `u, ~II~~ ~ a''~. . FEp;~~cl. k3Y:-~ •4 . OCCUPANCY 0~ NpTIFY F3LIILDINCs DkPRRTMENT Ar 7s6-IROZ ~ AM Ta n. PN~ FoR ri+E USE IS UUI.A~'I~Ui~ FC)LLOWINGINSPirCTIC)NS'. V~ITHOUTCERi'IEICA7E 1. pQl1NDATK7N TWC)'REC1111RF'D ®E p(;UUPAIVCIC ~r>R ~tat~fat D coNCRFr'E 'L. R47LIGH -FRAMING tla NI_UMRING j 3. IN5t1tATiC7N q.. t-iNAt - CCJN ;TRLIC PION MLtST 13F.. C;C1MPI~ETF FC)R t; C)'~ ALI. t;C)NSTRUC'TION SFI'FI_l MEET` TfIE 67EC1UlREMFNTS Zak' THE N Y. ;,T.gTE CC)NSTRUCTICJN ~ EPJf ItC;'! CC)OES. N()T RESPC)N918t.E FCPi~ 17t:,"SIGN OR Ct7NS'TRUCTIC~N F..Rf3411t STATE OF NE1V Rl;~~~, S.S COUNTY OF r~GV „r' I~~ ` being duly sworn, deposes and says that he is the applica;; (Name of individual si~nittg contract) about named. Hcisthc' Contractor gent, corporate oCCicer, etc.) oC said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi application; that all statements cottained in this application arc true to the best of his knowledge and bclicC; and that th work wilt be perforntcd in the manncrsct forth in the application filed thcretvith. Swom to bciorc me tl is ~ ....day of 19 ~3.~ Notary Public, .4'{/tsC,(..p~• • County , , Notary f+ublic. State of New Yeitlt ~ • • ~ ~ ~ • ~ ~ ~ • No. 87880f? . , • (Signature oC applicant +nualified in~Suffnik C.ouMy ll ;Commission Expires December 8,18~(J