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HomeMy WebLinkAbout19286-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19264 Date AUGUST 3~ 1990 THIS CERTIFIES that the buildin~ Location of Property 475 DONNA DRIVE House No. County Tax Map No. 1000 Section 115 Subdivision REPAIR STEPS Street MATTITUCK~ NEW YORK Hamlet Block 16 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 26~ 1990 pursuant to which Building Permit No. 19286-Z dated JULY 31~ 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 REPLACE REAR STOOP AND STEPS AS APPLIED FOR. The certificate is issued to JAMES S. ATKINS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED , N/A /Building Inspector Rev. 1/81 FOBM NO. ~ TO~N 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_ ~9'2-~ " 8~:~ Z Dote ................. .~..~ ~.~,~ Permission is hereby granted to: /~ , __ ~ , ./~Z~....~.~....~.~..~ ........... e ,o~~...~.....~....~....~....~ .............................. .~~.~.....~...~.~..~ ............................................................................. ~,.~,~;...~..~.~..%_~..~ .~ ......... ~~~ ...................... co~ ro~ u~p so. ~0o0 s~t~o~ ........../l.~ ........ m~k ........ l.h ....... tot uo ..... .~..~ ........... Building Inspector, Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP~ A. This application'must be filled in by typewriter OR ink an~ g inspector with the following: 1. for new building or new use: 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. r 5. Commercial building, industrial building, multiple residences and similar buildings i ' and nstallatlons, 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 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, 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 $15.00 · ............ Date ...... .%. New Construction .... ~ ...... Old Or Pre-existing Buildig$ .......... '.ocatioa of Property.. :Z . ............... .. i ..... House No. Street Hamlet ' ' Onwer or Owners of Property .... ....~ ......, ...................... i //S' 0©4 County Tax Map No 1000, Sect on .............. Block... / ~ .... Lot. ' ' Subdi&sion. ~ /4~c~ C,za~,e F--f7'o o 423-~ ' · ~'~' ............................ Filed Map ............ Lot ........ ~ ........ Permit No ................ Date Of Permit ................ Applicant ............................. ~{ealth Dept Approval Underwriters Approval Planning Board Approval ' '" Request for: .Temporary Certificate ........... Final Certicate ........... ~c ~O/~'S - · ... . ............... FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: · Nature'ofwork (check which applicable). New Building ......... · Addition .......... Irt:ration ........... ~r 'r. Ri ' ' :pax .............. moral .............. Demolition .............. Swimming pool_ .......... ennzs Court ......... Accessory Building. .Fen~e.~ .... ~ .... ,_ ' ' Estimate Cost.. O..O..,,.0.0: .................... Fee 57..O... ;'PT.. '. (to be paid on filing this application} If dwelling, number ofdwelling units ............ - -. Number of dwelling units on each floor ................ . If Berate. number of cars ........... . ..................... . . If business, commercial or mixed occupancy, specify nature and extent of each type of use ...................... Dimensions of existing structures if any: Front Rear Depth Heieht ' ' ' ' ................ ................ Number of Stories .................. Dimensions of same stru.~t0?i~i,~,iil~ alterations or additions: Front ............ i. R~ar . .. Depth ........ :'.'....::...'li..Height ............... NumberofStories ........... :.~'i~. °' Dimensions of entire n~ew cgnstmction: Front .... Rear Dep .............. Height ......... · · ,., ...... Number of Stones... ; ..... Si fl F zeoot: font .... ~ .... :--:: ..... ~.7 Rear.. .................... D:.p~h ........ D of P ha ........ ate urc se ....... Name of Former Owner ..... . Zone or use district in which premises are situated Does proposed construction violate any zoning law, ordinance or regulation: ................................ . Will lot be regraded ............................ Will excess fill be removed from premises: . Yes .... No.. Name of Owner of premises Address ............... Phone No Name of Architect .......................... · Address ................... Phone No ................. Name of Contractor · ........................- · Address ................... Phone No ...... .... .. ,.Is this property loa~ted within 300 feet of a tidal wetland? ~YES .... NO .... mil yes, $outhold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly,all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~perty lines. Give street and block number or description according to deed, and show street names and indicate whether :riot or corner lot. ' APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT ' 7~5-1e02 9 AM TO 4 PM FOR THE ~OLLOWIN~ INSPECTIONS. 1. ~OUNDAT{O~ ~O REOUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING ~ PLUMBIN~ 3. INSU~TION 4. FINAL CONSTRUCTIO~ MUST BE COMPLETE FO~ ~ CONSTrUCtION SHALL STA~ CONS~ON ~ ~ERGY co=~$. Nm .~s~aa~ FO. ',TE OF NE~--Y'OR~,~''~_ [ / / S $ .... .5..: .=5.. , (Name of individual signing contract) ..... we named. being doly sworn, deposes and says that he is the applicant ·" (Contr;cto'r .................................................... ' · agent, corporate officer, etc.) ;aid owner or owners, and is duly authorized to pe,rform or have performed thc said work and to make and file this lication: that all statements contained in this application are true to the best of his knowledge and belief; and that the. k wdl be perforated in tile manner set forth in thc application filed therewith. ~m to before me this (Signature of applicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Ex=,mined . ...~.., 19 .~.~) Approved ...'~ ~-t~.. ~11 19 5R Pe~it J.~ ~ ~,~ Il .... Disapproved a/c ..................................... BLDG, DEPT. (Building Inspector) TOWN OF SOUTHOL_D ' _ APPLICATION FOR BUILDING PERMIT i · INSTRUCTIONS a. Tiffs application must be completely fiiled in by tTpe~vfiter or in ' ' J ' mk and submitted to the B. uilding lhspector, with 3 sets of plans, accurate plot plan t~cale. Fee according to schedul0. ' b. Plot pl~ showing location of lot and of bullrings on premises, relationship td adjoining premises or public streets or area% and givNg a detfiled description of lhyout of property must be drawn on th~ diagram which is pa~ of tNs app~- Ca~o~. c. The work covered by t~s application may not be commenced before issuance o~ Budding Permit d. Upon approval of tiffs application, the Building Inspector w~l issued a Building pemit to the app~c~t. Such pemit shall be kept on the premises available for ~spection throu~out the work. o. No bulldog shall be occupied or used in whole or in part for aOy purpose whatever until a Ce~ificate of Occup~cy shall,have been granted by ~e BulldOg Inspector. I APPLICATION IS HEREBY MADE to the Build~g Dep~ment for the issuance 0fa B~lding Pemlt pursuant to tke 3uildlng Zone Ordinance of the Town of S0'uthold, Suffolk County, New York, ~d Other applicable ~ws. Ord~ces or Regulations. for the construction of bufld~gs, additions or alterations, or for iemoval~ or demolition, as here~ desc~bed. the applicant agrees to ?o~ply,with allqfi~plicab~e laws, ordinances ' ' · :dmit authohzed ~spectom 0n pr~mise~ and ' bu' dln. ~..~.~. ~ufld~g~e, hquszn% code, and regulations, and to ,tote whether ap~l.iscnt [s owne~, lessee' agent, ~chitect ~..i~ .... 5d~ :ame or owner o[~[e¢ises~. ~. ~ ,, v ~ -, ' (as on the tax roll or latest de (Name and title of co.orate officer) Builder's License No Plumber's License No ......................... Electrician's License No ....................... Olher Trade's License No ...................... Location of land on which proposed work will be done; II Nub reel Hamlet .............. (Name) ........ , .......... State existing use and occupancy of prqm~ and intended use and Occupancy i ,- of proposed construction: A. Existing use and occupancy ........................ ..... ~ ~ e~g ~ ~ ....... . B. Intended use and occupancy ...... ~ ...................... BOARiD OF HEALTH ... SURVEY ....... %. .. S~PTiI C FORM NOTIFY: CA~L ....... :'" Nfl4' 4000~ 182, 00' 182.00' G~ Nor,e: · -' MONII,,M£NT SUBDIVISION MAP FILED IN THE OFFICE OF THE ~LKRK OF SUFFOLK COUNTY ON J~N. 28, 1965 AS FILE NO. 4256.. ,~ . rs~ wc~"O~ or w~s ~ c~ss~oo~~ n~/o~ ~o~ ~r~ o~r~s~ Fno~ .Y 0 U N,G~&,~t~YO U N G 400 OSTRANDER SURVEY FOR: , BEN MENDOZZA LOT 69 "DEEP HOLE:~CR,E[K ESTA ES AT OF ' SUFFOLK SCALE: I": 40' ' :, 10 ,1,:,10, 975