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HomeMy WebLinkAbout19361-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22659 Date OCTOBER 15, 1993 THIS CERTIFIES that the building ADDITION Location of Property 510 CLARK ROAD SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 135 Block 2 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 28, 1990 pursuant to which Building Permit No. 19361-Z dated AUGUST 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 DECK ADDITION & ALTERATIONS TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to MICHAEL E. STEINMULLER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A r ~ ~ Bu ldin Inspector Rev. 1/81 roses xo. s MOWN OF SOAITHOLD BUILDING DEPARTMENT TOWN IiAl.l. SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Na • 7J ~ • Z Date o/`~~./ 19.9a i s Permission is hereby granted to• d~~ ~ ...~........e-,.u. ems' . ~E~~~ located nt a~.f ;7,~~? iii at prem ses • 4 County Tax Map No. 1000 Section ......l.-j.~..... Black Lot No f pursuant to application dated 19.,C~.Q., and approved by the Building Inspector. i ~ 4d Fee ~y~/~;~ i i1dln nspector F Rev. 6/30/80 ! Form No. 6 - ~~..y r..', i I ~ r TOWN OF SOUTIIOLD ~~~l~r~~~f ~ BUILDING DEPARTMENT TOWN HALL ;;;'a ~t;~k 7 ~i`'';; 765-1802 ' APPLICATION FOR CERTIFICATE OF OCCUPANCY A, This application must be filled in by typewriter OP, 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 17> 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: L. 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. 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, Cogqmmercial $15.00 Date ..~.~?...7~.~1.~~ ew Construction...~'..~..... Old Or Pre-existing Buil//ding....:~.•• n c r j~ ocation of Property..... rD ....................~(~lz ~°~.......:-d2::~.~. ~ House No, Street / Hamlet ewer or Owners of Property....~./,~kalc;/,,..~t....~!.~/,~iJ~;tu.~(~T~--- . aunty Tax Map No 1000, Section..~:~~,:d,b,.Block...~.~: GQ....Lot....p.~~.~.b ibdivision// Filed Map............~L/ot................ . rmit No.C..(,~'.I.`P./.....Date Of Permit.,~~/~6,,,,Applicant...'./.~.L.'~~„~~~;~~!1?~~~~~ alth Dept. Approval ..........................Underwriters Approval.......................,, anning Board Approval quest for: Temporaryy Certificate.....,..... Final Certicate.,~,,,;,, Submitted; Q~C~yc9~ /a ~ ~ ~r 5 \ APPLICANT 4 t fi : . Asa u~~mi,', ••%~~xz~F~~u r1c:LD I;:S.EC:-~;i ~~ll:.:.. I~ ~J.Ki4LNT°. ~ ro m 1. H \ ' _ _ FOUNDAION I1st) 1 FOUNDATION (2nd) 2. I o P.OUGH FRAi~iE & .PLUMBING H ra 3. ~ H IIJSULATI021 PER N. Y. STATE ENERGY CODE • _ ~ y 4 . 3 ~ ' FI;lAL 1 ~ ADDITIOIIAL COMMENTS: ~.p ro • x ~ \ • H H ~ O s, i ~ m a r~ - - - v 1'i O m ~v H ` ~ BOARD OF HEgLTH 3 SETS OF PLANS FORMNO.1 ~ SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORPt TOWN HALL $OUTHOLD, N.Y. 11971 NOTIFY 'a TEL.:765-1802 CALL 3.I......,19~D MAIL TO . Examined . , , Approved ~;~r'~. 19~.. Permit No..~~3C?.(..~ ~,,r n 4~~>~ . Disapproved a/c (s~~~" - ( d e~ e "J ( uildin~ nspec[or) , j i=:~ ~ ~ ~ , 'irfl APPLICATION F R BUILDING PERMI ~~.ti j~~Date~.r'~~~~~Cl,.; ..15~I1~ tt ~jp INSTRUCTIONS ~ t)0' ~~Fj. TOWN OF SUUIHOL~) , a. Tltis 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 of lot and of buildings on premises, relationship to ad}aining premises or public streets or areas, and giving a detailed description 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 occupied 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 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 removal or demolition, as herein described. The applicant agrees to-comply'`with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors an.Eremises and in building for necessary inspections. t`~~r . (Sign lure of applicant, or name, if a corporation) , (Mailing address of applicant) State whether applicant is owner, ]essee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ....f~ W.rtt Z Name of owner of premises ~ 01` tc'UWIU~I~~' 7'~I l.....t~ ...y....~~'.. . - : (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ W . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done,;-(~ .~~.0.. ffouse Number Street. Hamlet Block o~...... r,0~® County Tax ptap No. 1000 Section ~.7J.~.'.©~ . • • • a Lot C~Q~ . Subdivision Filed Dlap No. Lot . ~(Namej . S[a[e existing use and occupancy of premises and intended use and bcCu `_L panty of proposed construction: A. Existing use and occupancy......\~PY.S:L~ •..ir+i,t' B. Intended use and occupancy.. • • • ~6,~0, ~ • • • • R + 3. Nature of work (check which applicable): New Building Addition , • • • • Alteration • Repair R~mov~l Demolition , , .....Swimming pool . Tennis Court Accessory Building.........,Fettce .Other Work:. Q. Estimated Cost ....:~,LG~?t?`~` Fee •.~~.n . (to be paid on Gling this application] 5. If dwelling, number of dwelling units . Number of dwelling units on each floor IC garage.numbcrofcars 6. if business, commercial or mixed ,occupancy, specify nature and extent of each type of use , , 7. Dimensions of existing structures,~,iC any: Front . o? Rear , a`,~, Depth . ,~1~5(~, , , , , , , , , Hcigltt Number of Stories . m . Dimensions of same structure with alterations or additions: Front ..`JGk , , Rear . ~ktr'.~,, , , , , , , , , , Dcpih . , ~9•.!vY`!- . IIcight ..............Number of Stories , . 8. Dimensions of entire new constrtt~tion: Front ~P:^.":~:..... Rear ~4: ^^~r..... Depth SS?yw2,., , , , , , Hcigltt Number of Stories'...... . ' 9. Size of lot: Front , ,~,Q:~, ~ , , , , Rca^ ..J Q:U............ Depth . ~Pv~.:`+!~y-.~.Q`l:~s~.. 10. Date of Purchase (0,-: J ~ -tI,O , , , , , , , , , , , , , , Name of Former Owner . • ~J2er~Q~/,~....... , , 1 1. Zone or use district in which premise's are situated . . • , , , [2. Does proposed construction violate any zoning law, ordinance or regulation: r7.q . I~ , , \Vill excess fill a removed from premises: Ycs , , NoJI. 14. NameoofOwner o fpremises .~,C'1~4+f~ ,~/j(~O,~rEr2 ,Address ~/0..~'~~:k.. r~ ..Phone No..:1 ~ti~:s~~`.~~ . , . Name of Architect .Address , ..........Phone No................ . Name of Contractor ,Address . ..Phone No.. , . IS.Is this property locaaed within 300 feet of a tidal wetland? *YL~S,...N01S.. *If yes, Southold Town!Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and indicate alt 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 l ~ vFa as ~torr=a7 DATE: 3 D d v B.P, q NOTIFY BUI 1NG DEPARTM 766=1802 9 AM TO 4 PM F R THE FOLLOWING INSPECTIONS: 1. FOUNI~ATIUN - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH -FRAMING & PLUMBING ' 3. INSULATION FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQl11REMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGV CC'iDES. NOT RESPONSIBLE FOR Of:SI2"sN OR CONSTRUCTION ERRORS STATE OP N61V Y K, S.S COUNTY OF ~ K,-..... • • • • • • • Cf • ~ being duly sworn. deposes and says that he is the applicant (Name of individual signing contract) about named. He is the C~1~.11;~;1~ . (Contractor, agent, corporate officer, etc.) • of said owner or owners, and is drily authorized to perform or have performed the said work and to make and Gle this application; that all statements con,'taincd in this application are true to the best of his knowledge and belief; and that the work will be performed in the manrjer set fortlt in the application filed therewith. Sworn to before me this ~ ' ~~......daydf...... 19~~. Notary Public, , .....:':':.:r7.1.-.. CY:e : , ~ County J~ NOYARY PUBB.~ RyDEfJew Yak . j~•~~ ~aY •~-`":6~~ . T~'~1?~~^~ (Si;nature of applicant} ROAp CLARK N 2 0° 5 6~ 1011 W. ~ ~ i ~K --~-V w 00 502.85' ' z 4~ O~ N .a IIN Flo ° , ~S ~ ~ N o,,~ M 4 ~ u TT 0 baN 29 is b' ~ ~lJ ~ ~ b H 7.Y Sa ~ 8~ ~ T y' Q ~ b..-~` u oia 2 D \ 2~ ~ N A S`,] i ~T~ k j 'q ~ S I i rQ- ~ ~ ~ ~oC ~ x~' a ~ ~.1 , ~ ~ ~ w'woSN ~ ~ , o- ~ b r' ~ ~ rll ~ ~,KL u ~ ~ ~ ~ ~ ~ ~.~M •o D p,~ ~cn \7L j Kg w / 5 M ~ ll~J ~V ~ 1 S' u' YI 7~ ~ ~ 'a 7 K ~ a N o N ~ W O u ~ ~ A N °i a ~ m O W o°~~ ~ ' r g ~ 3 p. a. K 3 5~•~30lg'401AE bD pOMiNlC T. AURlCNIO a EDA AURlCNlO N/GVF m r~ ~ fi o-,~ ~ C A ~ d ~ FMSF, ti x4 ~ ~ a c. cr> O ~ Z ~ ~ ~ . y 2 SFA O C n Q Q ~ n b D ~*1 W K a rOa-. m a~.~'~ ~c n~ z -i io 1~ O C G y m "C w~~~~oh~r o ~ rte- o0o Ny?O~p w ? 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