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Home My WebLink About19333-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20174 Date AUGUST 27~ 1991 THIS CERTIFIES that the building REPAIR Location of Property 275 SOUND A~E. House No. County Tax Map No. 1000 Section 67 Block 2 Subdivision Filed Map No. PECONIC, N.Y. , ......... Street Hamlet Lot 7 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16, 1990 pursuant to which Building Permit No. 19333-Z dated AUGUST 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 STRUCTURALLY REPAIR EXISTING DECK ADDITION TO ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & LINDA VARDY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~i~di~g Inspector Rev. 1/81 FOB, B~ NO. 9 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ........ ...... ~/'~ ..~.~ .... ~.~..~...~.,~.....~ ....... ~~....~ a/t ~re'm ses~l~ated at . ~/......~. ..... .%~..~ Z_/ , ~ ............................................................. ~,~.~....~,.~.~,. .......................................... County Tax Map No. 1000 Section .-..,:....~...~..... Block ......... ~ ...... Lot No ..... ~ .............. pursuant to application dated .... ~..~.~.~.. ....................................... , 19~..'~.~...., and approved by the Building Inspector. Fee $....~.'...~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDi.:G DEPARTMENT ~7%~ :gALL 765-18C2 [CATION FOR CERTIFICATE OF OCCUPANCY ,lication 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-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 architect or engineer r~sponsible 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 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 ....... ~..~. I ).. 1.92. l .......... New Construction ........... Old Or Pre-existing Building ....... .~¥....~ Location of Property ............ ~ ....... House No. Street Hamlet Onwer or Owners of Property ..................................... County Tax Map No 1000, Section...~.~ ....... Block.~ ............ Lot.~ Subdivision. ~a*~kt ~ 5~C~' ~ ~.~k~led Map,.. [(~ ..... Lot.. l~ ................. Permit No..J.~ .... Date Of Pe~it..~~...Applicant~.~U.~. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~. ....... Fee Submitted: $...%~...~.~ ................... APPLICANT FOUNDA'TION FOUNDATION (1st) (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~"... . .., 19 ~..~' Approved . .f/~. Disapproved a~ ..................................... N~[~ DEFEE 76~1802 9 AM ~ 4 PM FOR ~EApPLICATION FO~ BUILDING PERMIT FOLLOWING INSPE~ONS: 1.FOUNDAIION ~O REQUIRED FOR POURED CONCR~E 2. ROUGH - FRAMING & PLUMBING INSTRUCTIONS 3. INgULATION NOTIFY~ CALL .... MAIL T;i'~ ......... ~ .... .... ~?..4~P...$~.... .... ~k ffi[kh~appliOlJl~BltRU~tlll~:~,~_~ltely filled in by Wpewfiter or in ink and submitted to the Building Ihspector, with 'sets of B~o~~n to scale. Fee according to schedule. ~LP~$~ ~n~t and of bulldogs on premises, relationship to adjoining premises or public streetr or aI~, ~~ I~r~ffon of layout of property must be drawn on the diagram which is pa~ of t~s apph- ~ ~~~&~tion may not be commenced before issuance of BuHding Permit. . ~~~~ ...... n. the Building Inspector will issued a Building Pe~it to the appHc~t. Such pe~it shall be kept on the pre~e~flable for ~spection throu~out the work eFE . , : . - . Bna l ~. ~a~~Naspectgr' ' A~[YQ~~~o the Bulldog Depmment for the issuance of a B~lding Pemit ursuant to th Build~g~~nde 3[v~~ Southold, Suffolk County, New York, ~d other applicable LawsVOrd~ces The ~P~?~U'~l~'hlFapplicable laws, ordinances, buHdNg code, housing code, and regulations, and to admit~u~M~ffi'~f~X[~$~d ~ build~g for necessa~ inspections 4. FINAL - [;o~u~,u~ ~uo, - ~ ..... '(S~gnature o~ applicant, or name, if ALL CONSTRUCTION SHA~ ME~ .... ~porar5~n) THE REQUIREMENTS OF THE N.Z s~,~; co,s;,u~,o, · ;,E,O~ ~ .Q~ ~. .. ~OES. ~ ;ES~O,Sm~ ~O; ..... ~-~-~-~' DESIGN OR C~S~U~ON ~RORS ' (Mailing address of applic~t) State whether applicant is owner, lessee, agent, ~chitect, enDneer, general contractor, electrician, plumber or builder. . . .~ ~.~.~ ' ... ................ Name of owner ofpremises ,, '~ ~' ~ .... ~(as on the tax roll or la'st deed) .............. If applicant Is a corporation, signature o£ duly authorized officer. Builder's License No .... .0..~...X"5~..~. ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Location of land on which proposed work will be done: · .~ .......... llouse Number ' Street, ' ' ')' ' ' "t ;' .............. Hamlet " 57' ty T } 1000 S ' Coun ax Map No ection ........... BlocE ..... .... ' . .... Lot .............. Subdivision . '.. .~. . Riled Map No. (Name/ -. . ...... Lot ............ State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and occupancy .... 3. Nature of work (check which appl cable): New Building .......... Addition ........ Alters, on . .~ .~[.~.? · '- · ~' ' R~mov;. Demolition Swxmtazng, Repair ................. . ..........................., i.,. , · · · Tennis Court Adcessory Building Fence Other Work; 4 Estimated Cost ~. /) ~.0.0~ Fee . . ........................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units, on each floor ................ If garage number of cars i ........................................ 6.7. Dimensions of existing structures, lif any:If business· commercial or mixed 0ccupancY,Frori. t ] l~specify'! ~,~nature' ~ ...... and.. extent.. Rear°f. each;.~.: type, of use .Depth .... {"~ '~' ,--x :'~ 'l~ ...... ' ' Height..,.~.! . . Numb~rofStories :.777........... .............. · '' ., Dimensions of same structure witl~ alterations or additions: Front ~ , .t. ............... Depth ....'.'~./..,;Q.Q .......... ~ Height .... ,~ ./ .............. Number of Sto~fa~P. ~F!~,'~:~ .~ ...... .... · ' . - ' D th .... .t~;~ .. 8. Dnnenmonsofentrenewconstm!tmn. Front .... }[~(~.~fi.. Rear ..... ~ .... ;&,..~[~ ~! ~,,~,~ · ,'o ' ~ ' ~ ' ~ · ~ ....... .7.' 7 :'. TT~q~i He,~ht ... ~ .......... ,Numbgr of Stones .......... _. ....................... ~; 9. Sxze of lot: Front . .~.~.~ .t ................ Rear .... ,~'b ....... ~;-l~'gL~:,'];~,~',¢:';~='3? '~' ':,~'~'~' 10. Date of Purchase ...... ..... {~/ /.cl..} .7.~ ...... Name of Former, Owner'-"~'~7lT'~:"'izxu~nYr'.~m ,n~a :-~., ~ , . .- "'*' 11. Zone or use dmtnct ~n wtuc~l pre~ scs are mtuated... ~ .~.C~C~'~OJ ............. , ,e ',' '?. '~-"' ';' :"' .' .'" 12 Does proposed constructmn wolate an zonm law ordinance or regu atmn ,~e,'~*,. ~,, '~ ..... ~ :,"v~': ', ....... 13. Will lot be regraded .'MO ! ............... Wall excess fiI1 be removqd frol-n:~{~3O~s~ ' · ~.*"'Y'5~Si:;'~': ~°'' 14. Narae of Owner of premmes ,..~.~xc~. · ."~J/A."g 0~"4.-'. · ... Address~. ~,~g,.~2.~n'~ Nmne of Architect ....'7'7....C-...ii ....... {'.b~h~,~.'~} Address .~,-~7. ,~[;D.,15 ~Y', .... Phone No. [.'l,~.~i r':wsal.. Name of Contractor . .~...! ................ Address . .C~x',I~.,. ['~...~',B~b}.,Phon, e,No ......~ .-? 15.Is this property locatled within 300 feet of a 'txd~l wetland"?,*~gS ..... · If yes, Southold TowniTrustees Permit may be requir~,:g ,~3.:'/~ ,~ c~ i~-" PLOT DIAGRAM ',~ :~ -~0 , ?: ~,~ .~':" Locate clearly and distinctly all buildinns,, ~ whether existing or proposed, an4 f~d~c~,%:~J~,~q~-b~c~, . ? .... .~-. ~r.-.guDenm°ns from property lines. Give street and block number or description according, to deed, and shS~W~s,[.geot~es and intimate wheiher interior or comer lot. . -- ~ - tx 16e I[oI '' STATE OF COUNTY (Name of indMdua} sig~ing contracO above na~ed. H 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 du!y authorized to perform or have performed the said work and to make and file this application: that all statements con!ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner sc, forth in thc application filed therewith. Sworn to before me this · .f. ..... dayo:f .... ~ ....... , 19~.~'. ..... (Signature ~licapt; ' " BOARD OF HEALTH 3 SETS oF FORM NO. 1 SURVEY . ../ TOWN OF SOUT, :::: ....... u' u~~~' , TOWN HALL .......... TOWu OF SOLO7~f~up_, ...... ~OOTHOLD, N.Y. 1197~ NOT I FY: ' ~ .....;- - ........ TEL.: 765-1802 CALL .................... ......... , .Exa ~ ned MAIL TO' 19 · Disapproved a~ ................................... 76~1802 9 AM ~ ~ ~OR TNE APPLICATION FO~ BUILDING PERMIT ~OLLOWlNG INSPMCTIONS: 1. FOUNDATION - ~OREQUIRED Date .~ i~ .,19~ · ' FOR POURED CONCRETE ..... 2. ROUGH - FRAMING & PLUMBING INSTRUCTIONS 3. INSU~TION -.~ · F~appH~9~~tely ~H=d ~n by ~pewdter or in ~nk and submitted to thc Duilding Inspector, with "sets of~~~n to scale. Fee according to schedule. ~LLP~~ ~n~t and of bulldogs on premises, relationship to adjoining premises or public strcet~ or aT~, ~UI~~ ~r~on of ~ayout of property must be drown on the diagram which ~s pa~ of t~s app[b ~ ~P~d~i~ap~tlon may not be commenced before issuance of BuHd~ng Permit. ~.~~~~, th~ Building Inspecto~ wHJ issued a Building Pc~it ~o the appHc~t. Such pe~t shah be kept on ?~e pre~s avaHab[e for ~spccfion throu~out the work . eFE . . ..... . .... . - . A~P~b~'r~'~ '~ - · o - .... , ~, ,~,~,~,ca,., . ~~o th6 Buddm, Dep~aent for the ,ssuance of a B~Idin Pe~' ~uumn~!~,~[~ q-Own or Southold, Suffolk County, New York, md other a ic~ble Laltv pursupnt to the Ke2ulatlo~] ~ ...... pP . . s. Ordm~ees or -- .... ~- ~.~.,~fea,rl.~au~u,,a~d'hons or alterations, or for removal or demohhon, as herea described. The .~p~~ ~lY~'alrapplicable Jaws, ordinances, bufld~g code, housina code, and regulations, and to adm]t~u~~eeto~ on~re~se~d ~ build~- for necessa~, 4. FINAL - CONSTRUC~ON M~I-' ~ .~ ,, pu~,~n?~ . · ~y. '. ~..~ ...... ALL CONSTRUCTION SNALL ME~ . (Signature ot applicant, or na~,~r~t~dn) ' ' TNE ~EOUIREMENTS OF THE N.Y. · ~DES. N~ RESPONSIBLE FOR (Mailing address ofapplic~t) DESIGN OR CONSTRUC~ON ERRORS Stat= whether applicant is owner, lessee, aSent, ~chit=ct, enEineer, aeneral contractor, electrician, plumber or builder. ......... .~ ~.~ .............................................. (as on th~ t~x roll or la,est deed) ' ' If applicant is ~ corporation, signature of duly ~uthorizefl offic~r. Builder's License No ..... .~..~...~..~. ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done: OOCUP/taCy Oi WZTHOUT CERTfFfCA TE OF 000UPANOY' llouse Number ' Street ' Hamlet ......... .6':.l' .y. pN ' County Tax Ma o. 1000 Section ........... Block .... u vision . ' ..... ¢ . Riled Ma o. . (Name/ · . ...... Lot ............ State e" · x sting use and occupancy o£ premises and h~tendcd use and occupancy of proposed construction: ... , / , q I 1. Nature of work (check which applicable): New Building .......... Addition.....--... Alteration ...... ,.~.,'. · ~ ' R~mova i Demolition Swimming pool Repair ............................................... '...' ' · ·" Tennis Court ......... Acdessory Building Fence Other Work' ~ Fee ' ;. Estimated Cost ......... ~ ...................................................... · · 5 If dwelling numberofdwcllinguniis Numbcrofdwcllingunits , , ............... on each floor .............. . If garage, number of cars ....... i ............................................................... 6. If business, commercial or mixed o4cupancy, specify nature and extent of each type of use ...... ; .......... 7. Dimensions ofexisting structures, ifany:Front'~!~['. · . --~ ........ Rear .:.;.'. ......... Depth.:~./.~y..'''... Hmght . .5 / ......... Numbe~ of Stones . .: ............................................... Dimensions of same structure with alterations or additions: Front , ,/. ,cQ, ,, Rear , ~ ........... Depth ....-7. ( .q:~.t ) ........... Height .... ~/' ' i ..... Number of Stories ~ ................ a. Dimensions of ant re new constmc¢on: Front ..... ].[,. ~:~)[ ii Rear .... '...' ........ Depth · .~. )~,~i .... Height ,~. { Number of Stories ~ ' ' 9. S:zeoflot: Front ...~.{ ............... Rear....J.l~D ............... Depth, .~,~0 ........... 1. Zone or use district in which prefni:ses are situated... ~-,~S. ]-C~'~ i OJ .............. 2 ' ' ~ ' ordinance or regulation' Docs proposed constructmn wolata any zomng law ........ '3, Will lot be regraded .... 'I~,[~... i .............. Willexcessfillberemovedfro,rnffir/~mises;~.;~Y_e{.-.-~o.. ,4. Name of Owner of premises ~,~q..~;(~ ~./'...,. Address ,'~!III1~...~7.< ~X~'-'-'-'-'-'-'-'-~}~~e $o.(,51O~'' Name of Architect ...'...'-7'~T.. .... i ......(.b,~Y~l'~ Address ~qb4,(~. ~,,~h .S2-1-, .,... Phone No. [.%W;.')- Name of Contractor ... ,--;wv;... .... i ......:' ....... ( Address .. (~",I $~.d~t. · ['~.~,1}~1. Phone No ...... f ',,' 'F? ..... 15.Is this property locatdd within 300 feet of aItid~l wetland*- ~YES .... ~u.~.. ~If yes, $outhold Town Trustees Permit may be required. i PLOT DIAGRAM Locate clearly and distinctly all b~ildings, whether existing or proposed, and~ indicate all set-back..din~l, ensjons, f~r,om property lines. Give street and block number or description according to deed, and show street names ann maicate wnemer STATE OF NEW YORK. '.S COUNTY OF ................. ....... (~ ...... "'[vi(~ ' ' ' [' '~ ................... being duly sworn, deposes and says that he is the applicant · '' amc of md ual ssgml~ contract) above named. I He is the ...................... i ..................... . .......................................... i .'. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file this application; that all state,neats contained in this applic;uion are true to the best of his knowledge and belief; and that the Work will be performed in the mannai set.forth in the application qled therewith. Sworn to before me this ;.;;:;3.:..i..,.._;> . .... 0 bl ...~...2'I r ............... County I~t ~Jst~ ~ .......... .