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HomeMy WebLinkAbout19271-z I`\ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Sauthold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20049 Date JULY 3, 1991 THIS CERTIFIES that the building REPAIRS Location of Property 4900 PARADISE POINT ROAD 3OUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 81 Block 3 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 1990 pursuant to which Building Permit No. 19271-Z dated JULY 26 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 2 EXISTING PORCHES & REFLACE SLATE WALKS WITH CCA AS APPLIED FOR. The certificate is issued to GASTON CRIBLEZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N1A Bui ding Inspector Rev. 1/81 B'eD8ffi Het. e TOiNN OF SAUTHOLD aU11.D1PlG ®1:PARTAAENT TOWN HALL SO!lTHOt.D, N. V. ~UIi:DlNG PE[tAAIT {THIS PERMIT MUST SE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTWORIZED) N ~ ~ ~ Z ~ ~ ~ Date 19.~~..~. Permission is hereby granted to: . a o~wRuG~iT.i7: 1~........... ~..a.. y.. mar/ o at premises located at ...>,'7~...,~~.1~0..... .....1~.... .....4~!../ . ...............•a............................•.......a..........................................................................••.....,............a..........• - Caunty Tax Map No. 1000 ~Seetion black Lot No......~ pursuant to application dated 19.~~., and approved by ti,e Building Inspector. fee ~d ..ec....rr uil ~ g ~ r?,Spec ~ r Red. 6/30/80 Form No. 6 ~ff,-,.~(r~ tl ~ TOWN OF SOUTHOLD ~'"1 ~~p0 ~O ~ ~ BUILDING DEPARTMENT ~jo. t ( 17~ TOWN HALL ~~9~ 765-1802 BLCG. GEt~'Y~.~~~~~"~APP~ICATION FOR CERTIFICATE OF OCCUPANCY ' TOWN OF SOU7FiU1~D 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-4 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 si,Ye-plan_rpquiremPnr_s. ' B. For existing buildings (prior to Agril 9, 1457) 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.OD, 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 Building.....~.~~~~ Location of Property... ~91t::~~!r71~..~f~.I.~'% zC~; F-%7....... s~?:.1 ~F~o!-PJ, . House No.~? Street Hamlet Onwer or Owners of Property...L-7 f1:S.'T.FC~....~P~: ~ L~~:~ County Tax Map No 1000, Section..... j ....Block...... .~.....Lot......,.~.~........ Subdivision ....................................Fil/edqq Map............/L~ot..................,... Permit No.. ~95~.~~.~,..Date Of Permit..7~?Z~.,C.I~.Applicant...(?.0.~.~~.//~t~'1~acL!!~~.... Health Dept. Approval.....A/.~ ..................Underwriters Approval......f:.~........... . Planning Board Approval... ~t Request for: Temporary Certificate........... Final Certicate..~~..6.41 , Fee Submitted: $ . t<~: 4:`: ~ ~ c C~~r,. `I ,2 0 4 APPLIC ~ e o ~~ou~ ~~Lt7 -J. is ;i ~~'JniG I~ i. v:`Si9LNT.°. ~O 4q ` m v 1 . I H _ .j FOUtJDATION (1st) ` I FOUNDATIOEI (2nd) 2. I z 0 P,OUGH FRAME & PLUMBING y H m 3. ~ IIISULATIOPI PER N. 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[ ] NDATION 2ND [ ] IN CATION [7 ~ G NAL REMARKS: '~U~L'n~~,G-, ~~,tlLWl,t l ~1.r~ ~ c 7"~ ~ u. ~ DATE ~q~ INSPECTOR GDC , ~ _ ~ Ek, sT~ N~ s`7 ELK OCCUPANCY OR r ~h~$,-,~~ F,~ ~`r~~ ~ ~ USE IS UNLAWFUL r5 ~ p WITHOUT CERTIFICATE 6 ~ ~ OF OCCUPANCY ~ ~ ~R ~ ti $ CC A P e A ~ c.~ _ ~~yCa'~~ ~ x Co T'O P `T~ C C ^K~ 1/~-J Cr _ I _ , L=..._-~._i~ _ _ ~ k ~~n Z rJ f.7 W IiL ~ ~ 4f L A ~il~ ~ ~ ~ W ~ I``I _ w, ~ ~ . - - _ _ - _ _ --1 - ~ - - _ 3 5 AS NOIE6 Lj x C C F L u S t ~ W I'1' t-+ G~ ? p ix' ' pA1E:~6.P. K 11~1L N~OflFY-~'e OE AT C~° c"at. k ~c i U ~ C C 1 n) G- d' ~ ~ ~ p ~ GS t~ ~.~eo29~~arM rnE ta14~-K~ FQl10WIN6 MSPECTIONS: ~ G/'~L 1. FOUNDATIDN - 7YY0 REQUIRED ~ FOR ~OUR>tD Cf:11~C11ETE /~~fN+ s. Rt111Ca11 - atAl~ a ~uMSING e. INSUU~rIDN a. FINAL - coMSrm~cnoN ealsr ~ oo FoR ao. ALL ~ s~ MEFr i dF SL~`i t~ w ~ ~K ` 7Nt R~IMiI{R di ~ M.r. saw eoNSrRI~IION a ENERCv CODES. NOr RESPO.E FOR DESIGN OR CONSTIIUCTION ERRORS ~ ~ _ i G~~. ~~s ©uS~r ~ ~ ~~o I ~ ~ co ~ x ~ 1, ` ~ 'rt Cn D ~ S7 C ~K.1 N c c, e--+ c: R G'i ~ ~ ~ ~ 'i ~ ~ 'Y t ~J Cr- ~ v E~ t rt ~.1 L~ t~ p E ~K 1 a5rr Q.C. `4 ~ ~ is N Cr- ` C.K. l I ~ ?x~ "Tv i tt~~ (~l~/'~`, ~ ~ BOARD OF HEALTH . t 1 ~ u \-J_~'-2~1~ +i 3 SETS OF PL.1NS . u FORMN0.1 SURVEY 2 O!~ 'c~ TOWN OFSOUTHOLD CHOCK BUILDING DEPARTMENT SEPTIC FORM . TOWN HALL BLDG. DEPT. $OUTHOLD. N. Y. 11D71 NOT FY ; TOWN OFSOtlTHOLO TEL.:765~1II02 ~ CALL 7lr'--~~ Examincd...r.~`Z{~.......,19~ ~ MAIL T0: Qc~ ..IJIl~l.6.d,c1~.~ . Approved ...l,/..~........, 19,~'. Permit No..If.a`1 jlj4h tl.(~a~ DG/a ~dif7N ~D,. Disapproved a/c ~ie~i az~ t{. ............................c=~.L~ / ~ y..t,/.. . (Boil g Inspector) APPLICATION FOR BIJILDING PERPJIIT ~ Date ....:7/. 19 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 ttFSCale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets oa 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 [his 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 Lativs, 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 co~de~housin~ code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspeciion~~>~; . . (Signature of appl,cant, name, if a corporat,on) r~'Y,~eF,oG,1 d?;a7...Q~l"~..~ S~~ES~h'.°.~~. . (Krlailing address of ap~icant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ...................~L[/.~ ~L3~.............................................................. ~y Vame of owner of premises .......M?.~srap! .1~~ .1~~.~~ . (as on the tax roil or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate/officer) / / • BuildcrsLicense No....L~:..G.~o'".z3,-. f7./.... Plumber's License No . Electrician's License No . . Outer Trade's License No . . Location of land on which proposed work will be done; ~p 0 house Number Street U Hamlet ~ / , ] County Tax ,11ap No. 1000 Section BI'ock . , . , ,Q~, , , , , , , , , Lot - ` Subdivision Filed A1ap No. Lot . (Name] ~ State existing use and occupancy of premises and i~n,'t7ended use and occupancy of proposed Construction: , A. Existing use and occupancy.......~5-~`.~~P~~`~.7`?~t"... . B. Intended use and occupancy.... .~Lr L~ ~.~.TU.A:L , y _x;10 ' ° , , , , ~~LfieC.{ oZ (ADD cf~ G~X r5'TNG- % d~Gryt3S _ ~i G(?LftC~~ Ck !S'f7N~ SCJJ7G~ ~/'~-G:CS w T~ ~(n'~ _ , Naturc'of work check which applicable): New t3uilding Addition X........ Alteration . ,Swimninp.ooo~. gg~~ Repair . X Removal Demolition ,a: Tennis Court Accessory Building ..........Felice .......Othe~r`~ iJoYk°i , Estimated Cost c~ (7.U''.R..~~ Fee o~ • (to be paid on filing,this,ap~licationj If dwelling, number oC dwelling units ....1 . t~?YS~i'~.. Number of dwelling units on each floor , . ~ ; -'a..... • IC garage. number of cars IC business, commercial or mixed occupancy, specify nature and extent oC each t pe of use . Dimensions of existing structures, iC any: Front , ...Jr.~...... Rear Depth , , , , , . , , Hei=lrt 1£s:........ Number of Stories ~ . . Dimensions of same structure with alterations or additions: Front r~ . ~ • Rear ...~'a. ~ . . Depth ~ g. Ficight l.~ : ..........Number of Stories , . , Dimensions of entire new constnuction: Front ...7..? Rear ....'7.. 7.' Depth , d, . . Hei;ltt f R :r........ Number of Stories . , Size of lot: Front Rear ~ S Depth 1.x,3. , . . Date of Purchase ~SFS.~ Name of Former Owner . Zone or use district in which premises arc situated ....`.~ri.~/~4FN. ~.":`}4 . . Does proposed construction violate any zoning law, ordinance or regulation: . , Hill lot be regraded 1.~6 , • , , , , , , , , , , , , , , , , ~Yill excess fill be removed from premises: .Yes NnX. Name of Owner of premises . ~ !li?L~?r.... Address~r9?~:~ 5.°N.. ~;a;rzs', .Phone No . . Name of Architect ...............Address Phone No................ . Name of Contractor~~~,~?..~~.t.6s:! is....... Address~l7~.`!u4El.°.:°.~':'t .Phone No..7.~5:.~.G.SA 1 S.Is this property looted within 300 feet of a-tidal wetland? *YES....NO.... *If yes, Southold 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 operty lines. Give street and block number or description according to deed, and show street names and indicate whether tenor or comer lot. $'G~G Ail kct-t +s r) ~ Sf`t eZ6/C5 . 'i i iATG OF NE1V YORK, g S AUNTY OF . being duly sworn, deposes and says that he is the applicant (Name oCindividual signing contract) bve named. !istltc (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~lication; that all statements contained in this application arc true to the best of Itis knowledge and belief; and that the Irk will be perl'ornrcd in the manner set forth in the application Cdcd therewith. !om to before me this ~ ~ 4 ?~L'... .n.day oaf/.... ~Li-i~1.........., 19 .~U Itary Public, , , , . , , 6~-Z,~~, ,Y[, ; ...r/C~.J,. U~~.. County / ~ NELEM K DE YOE ~<j~~ lM1ARY PU841C, Sbte d Nnr Yert No.47117818,SuBalk (Signature of applicant) Tam EKplres Much 30. ?a--.~.~ . i . -