HomeMy WebLinkAbout19357-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219767 Date MARCH 4, 1991
THIS CERTIFIES that the building ADDITION
Location of Property 500 BEACH COURT EAST MARION
House No. Street Hamlet
County Tax Map No. 1000 Section 37 Block 07 Lot 9.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUG. 27, 1990 pursuant to which
Building Permit No. 193572 dated AUGUST 30, 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 GARAGE ADDITION TO EXISTING DWELLING.
The certificate is issued to SHIRLEY & THOMAS APREA
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N174688 FEB. 19, 1991
PLUMBERS CERTIFICATION DATED N/A
. ~j
Buildin~~ector
Rev. 1/81
vos~ xo. s
TOWN OF SOUTHOLD
BUiLD1NG DEPARTMENT
TOWN HALL
SOUYHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date
Permission is hereb r nted to:
Y9
~~~~.'._,~~.......9 l~..s~.~'~i~'E 39
_
,
ro ..~...~..c .......~~~G
.
at pre ises locate at ...~~.Q........ ...t.............................................................
County Tax Map No. 1000 Section ........~7..... Biock Lot No.....~./...,1.........
pursuant to application doted ~~'~.~..7 19~1~'.., and approved by the
Building Inspector.
Da~
Fee 3•r~s?j~.'~X[..
~ icitr...................
' B ing Inspector
Rev. 6/30/80
I
Form No. 6
~~.~~c~
a~~ ~ ~ ~
TOWN OF SOUTHOLD J,
FCU ~ c ~ ~ BUILDING DEPARTMENT
v ~ TOWN HALL _
~.y 4a~,,„~.,.,~..~,Ae.=._... 765-1802
~LC~. o~Pr.
i..~..?o~J~v o~F sou~r~ao~~,,~,
APPLICATION 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-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 19< lead.
5. 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.
3., 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 inspecC signed by the applicanC.
If a Certificate of Occupancy is denied, the Building Inspector shall state Che
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00,
Alterations Co 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
S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
(,~°~-~.4'qE ~ p~ f O,KJ Date . ~ .
';ew Con ~ftruction........... Old Or Pre-existing Building..........
Location of Property..:~.p0.~;~.E~/Gf~ CUV2l ,,,.f~~,..~ij,9G.10!~,..,/( ~'~y. .
House No. Street HamleC
/ r
'lnwer or Owners of Property.:'-.~~.~~fz Le ~:.~I.~~~!?i.~"~Sj.~~~~.~
CounCy Tax Map No 1000, Section... :~.~.....Block......<..........Lot
Subdivision ..Filed Map.......... .Lot.. .6..~...........
p
i'ermit No.~ ~3c~F. .....Date Of Permit. Pf.~p~l.~....Applicant~~i!!1L: d/_$%~!i(./..
!Iealth Dept. Approval ..........................Underwriters Approval..
Planning Board Approval /
Request for: Temporary Certificat~(e........... Final Certicate.,..../.... .
Fee Submitted: ds......~.`?~~7.........
~/~~9/ APPLICANT
~3~ / 765-1862
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ l ROUGH PLBG. ,
[ ] FOUNDATION 2ND [ ]INSULATION
[~MING [ ) FiNA4
REMARKS: ~rt.~~-~
G}
DATE ~ ! ~ INSPECTOR
C~ 3~~ r~-~8o2
BUILDING DEPT.
INSPECTICJN
f.
FOUNDATION 15T ~ ] ROUGHI PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ )FINAL
REMARKS:
•4+6~i
DATE ~ ~ INSPECTOR
_ _ _
NAe
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAC,`
1.00960 BUREAU OF ELEGTRIGITY
88 JOHN STREET, NEW YORK, NEW YORK 10038
Date YF6RUARY 1.9,1991 ApplicstionNo.onftle 9297091/97. N 179688
_ THIS CERTIFIES THAT '
only the eleetrte~l puipwent v descrt6od ke/ose and tweredrseed by the appNcartt rramsd ow the a6ooe application numhsr in thapromisss of
THttMAS APRBA & 5RTRLIE, EWU OF CEl1AR LANE, FAST NAR7:(1N, N.Y.
In thefoBotsinR lontion7 ? Basement ? 1st FI. ? 2nd FL (iAR. .Sertiun 81ock Lot
uw axaminedon FEBRUARY 1.1.9.991. and found to be in complianm with the reyuirernentx of this Board.
N%~ RANOG COaKNta MGRS OVlNS 0M311 w M(NAUST F
OYTeRTS AURS SYYIiCIIlf INCANOttClNT NU01R{C7NT OTNFR AMT. K. W. AMT. K. W. AMT. R.W. MAT. R. W. AMT. N, r.
7. 9 2
DRYRRt RNMAtx MOTORS NIri1M AlN1ANf! IRlIM RRC~T TIteRCWCKS _ qLL IRAT INATAf IAULfLT,0~8Ti~R BIMMlRS
AMT. K. W. pl K r. GAS N. r. AMT. NO. A. W. G. AMT. AAV. AMT. AMrS. TRANS: AMT. N. r, tp.a lei AMT. WATTS
7 5n
SMVN7 glCdMACT N0. q S R R V 1 C E
AMT. AAV. TYrt 1 / tVI 1 / SW ] R SW S R A\V KRC.COND. Or CC. C ~ NO. Oi M41EG NO.Or NEGwAlS ~ Ml
OTNRII AMARATUS:
G.F.C.I:-1
.tro'{
ARTHUR V. .7UNGE LZC.~2143E -
P.0 90% 768
Ct1TC8(?GUE, NY, 1.1935 OeIIML
11
Per Y~ ' E
Thit nAiRcaM mwt not bo aMared in any marl~i_ Mum M tllo aNia. ef_tM Roord if incorrM._ Mtpactors nay ba idantfiad I'Y_ Mpr trRdantiab.
fOR BUILDING DlPARTM~IT. TIMB RTIfIGATE A{15T NDT11E ALTERED IM AID
r ~ ~ m CrrU,,
1. - ? "1
H V
H\„
FOUtJDATION (1st) ~ `1~P~
c
ti
FOUNDATION (2nd) ~
~ ~j>1~.,.e,e.-
z. o
P.OUGH FRAME & o
.PLUMBING
ti
H
m
3. ~
m ~
IJJSULATIOPI PER N. Y. ~ ~ y
STATE EPJERGY i T
CODE
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4. ~ y
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FZ;JAL
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ADDITIONAL COMMENTS:
• -
ro
• x
b
H
h
O
_ _
~
• r
H `O
- ~
• m
~n
H
~ a J
3. Nature of work (check which applicable): New Building Addition Alteration .
Repair Removal Demolition ..............Other 1Vork .
¢Des~riplion)
OOC~" " , ~ ~ <~~v
4. Estimated Cost......./~. 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 ...........'Z. .
6. If business, commercial or mixed occupancy, specify natu~e and extent of each type of use .
7. Dimensions of existing structures, if any: Front Rear . ,/.6Q Depth .
Height ~ Number of Stories ~ .
Dimensions'of same structure with alterations or additions: Front ~?9!?ic'. , . , , , Rear ....~~P:~? C...... .
Depth .....SAS?? c..'....... Height ...J`.:?~?. ~ .:.........Number of Stories .....1 .
" 8. Dimensions of entire new construction: Front ....'1°f.~ Rear S°. t Depth .
Height ~ .......Number of Stories .
9. Size of lot: Front ,~.$'a , Rear i::.:.3. !-F t? Depth . - .
10. Date of Purchase ..................Name of Former Owner
11. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation: ..../.VQ .
13. Will lot be regraded G?. O......... .....Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .~E KL E2~~~~/~.$, ,Address ...................Phone No. `l.'17. gr~... .
Name of Architect Address ...................Phone No.......... .
Name of Contractor ~~0.:SCH4~?~!ST~~!v..... Address~~ `/~~`~,?N Phone No.~:'!'I. `~Sl~......
15. Is this property located within 300 feet of a tidal wetland? Yes No %
*If yes, Southold Town Trustees Permit ma be required.
PLOyT' DIAGRAM r
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 corner lot.
j ~ Lam- ~ U ~ ~ JJS~ ~~i?
va ~
STATE OF NEW YORK, S.S
COUNTY OF ,
,~-~,c~-/,,D, f~,!?.~. ~.L~. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
r
He is the ...~~'V ~ZZ s}. L; . ~ a,.t, ~ GL ~ ~ .
(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 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
O~.? .......:...day of , 19 %1.
z~~,
Notary Public, [~?~-..~..~:A-. !!~f, County p/~~
NELEN R DE YOE ` ....'.L~~~~: . ~/~2p?%~yd'' _ .
NOTARY PUBLIC, Stye of NeW York • • • • •
No. 4707878,SuHolkCounty~,/ (Signature of applicant)
Term Expires March 30,19.11 " . ,
i .u
~ BOARD OF HEALTH
~ 3 SETS OF• PLANS
FORM N0. 1 SURVEY . .
AU6 2 T 1990 f' ~ ~I TOWN OF SOUTHOLD CHECK • • • • - • • -
J BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
BLDG. DEPT. SOUTHOLD, N.Y. 11971 ~ 7 ~ 7 ~ /
TOWN OF SOU HOLD I TEL.: 765.1802 C LL
M T0:
Examined•~. .4~p........, 1~
3'° ~
Approved 1~. Permit No +
+ I
Disapproved a/c q ,
y
• OL-- % ,
iZ
(Buildin Inspect
APPLICATION FOR BUILDING PERMIT
Date 19.. .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
' sets of plans, accurate plot plan to Scale. Fee according to schedule.
~ b. Plot plan showing location iof lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed descYiption 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 occup}ed 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 HEREBYl~,tADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the T~ ipwn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, far 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
p p lmses and in building for necessary in ections. _
admit authorized ins ectors on re I • • • ~p~~~~.
~ (3/i/gnature of applicant, or name, if a corporation)
I ~C7•Q•.~fJ~ ~i!/Ii1jo.~~A..~~•.•f11?~./~.9'~~.... .
li (Mailing address of applicant)
State whether applicant is_ owners, lessee, agent, architect, engineer, general contractor, electrician, plumber o uilder.
..p ....II
I,~ /
Name of owner of remises ~~H 1.~ Y VV ~x. ~"'.t~... ~~•`1~+.•~.,
(as on the tax ro~or latest deed)
If applicant is a corporation, signaljure of duly authorized officer.
........................~I;...................
(Name and title of co orate officer)
ALL CONTRACTORS MUSTI BE SUF LKf~OUN Y LICEN/SED
Builder's License No. ~:G~.. ~~j5`f^~I .
Plumber's License No. . .
I '
Electrician's License No. ! '
i
Other Trade's License No. . I'~ . .
1. Location of land on which proliposed work will be done:.~~r~~~N. ~.zu7.2$`.. . ~.y ~R t~.~r~..:.:..... .
~Q~? .1~.~R~H.. ~T.... ~ r~,~9 S . ,ll!1A~.t A :c1... 5',3 t; .
House Number i Street r~' .Hamlet
County Tax Map No. 1000 Se~tion ! Block Lot ...7•.~, .
Subdivision Filed Map No. Lot................
(Name)
2. State existing use and.occupar>,cy of premises and intended use and occupancy of proposed construction:
g p yl' ......dN~'...C"-A.:/.tO. l.~:.~'f~..~.QrH'.G'.:...:'...'.........'....`..... _
a. Existin use and occu anc
b. Intended use and occupancy ~.m. G 5..~3 P.r!. •.~f. ~
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