HomeMy WebLinkAbout18997-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219117 Date JUNE 7, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 450 BRIGANTINE DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 079 Block 04 Lot 42
SEC. ONE
Subdivision HARBOR LIGHTS Filed Map No. 4362 Lot No. 23
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 26 1990 pursuant to which
Building Permit No. 189972 dated MAY 8, 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 ADD SCREENED PORCH AND DECK WITH STEPS TO EXISTING ONE FAMILY
DWELLING.
The certificate is issued to VINCENT & JOAN HEFFERNAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
Bu'
din~or
Rev. 1/81
aoset xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEP7 ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
18997
N ~ Z Date 19.R.:C!
. V
Permission is hereby granted to:
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of premises located qt ....................l~.l'r.:............ d:"'.::~:'.':..,.::`.~!~:?r-a.......
County Tax Map No. 1000 Sectio ......a~...lock ......5?.~......... lot No...~.Z............
pursuant to application doted ..~4t.L.1r4.....~.!.4 19./~..~?., and approved by the
building inspector. 000
Fee S.•.-.` 8...•:•
Building Inspector
Rev. 6/30/80
Form No. 6 D
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/,~~''_s~'~'~~ TOWN OF SOUTHOLD
p"~ BUILDING DEPARTMENT
TOWN HALL
765-1802 BIDG.DEPZ
TOWN OF,SOUTHOt0
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
3 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.
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 ~ f lZ~
New Construction.~4'~.~-~:. Old Or Pre-existing Building.... ~ze:°.rr.'.....
Location of Property.. ~ S
c~ ~:E :~.:::'s.:/~2! U!~....... ~~Gt/So2. LCratr ~ 5:
House No. Street Hamlet
Onwer or Owners of Property..., ~JfNCc~N i :J.q~f,S,.] ...~:~.~SF•cJ'~:`td2t~
County Tax Map No 1000, Section....?.~.....Block.....`.{..........Lot.......-/.. Z
Subdivision.cC.~~.cc.~~
...............................Filed Map............Lot..............._......
Permit No. f .C~..I: d ~
:..Dante? Odf Permit..yJa~P.~ So ....Applicant. U
glealth Dept. Approval.....I :t.f.~:~ ..............Underwriters Approval....l~:~'........_.....
Planning Board Approval....~`~~~
Request for: TemporaryC~er^tificate........... Final Certicate...~.....
Fee Submitted: $....t~.S-~.r.:~~ ~ [I ,
~a-t, ~~1~~(v ~/..1 /,fit
0 Z' l ~/l ~ APPLICA~
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?1c:LD I;:SPEC;iU;J ~~UATc ~ COMMENTS
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IIJSULATIOP7 PER N. Y. ~
STATE ENERGY
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~vF~.alxC TEL. 7G5-1802
o OGy TOWN OF SOUTIIOLD
ti '~a,,; ~ ~'c OPrICE OF BUILDING INSPECTOR
~ .i?s
~ ` ~.'ss rn P.O. BOX 728 i
` ~ ~ TOWN HALL
,~ol ~ ~a~~ SOUTHOLp, N.Y. 11971
June 5, 1990
Bob Grigonis
Box 4406
Southold, N.Y. 11971
RE: VINCENT 6 JOAN HEFFERNEN
To Dlhom This May Concern,
We are unable to complete your Certificate
of Occupancy because of the following reasons.
. An application for Certificate of Occupancy
is not on file. (ENCLOSED)
/y/ ~No Underwriters Certificate on file.
T}ie check is (~ZdE~&$>~ffi7fnot on file. ) $25.00
No !]calth Dept. l.pproval on Eile.
No final ins.pccCion has been made.
P 1C:a ~C contact our office on this matter.
Thank you for your cooperation.
Bui]di.ng Permit i! ~ 8 9 9 7 2
Building Dept.
/ No Plumber Solder Certificate on file.
( all permits involving plumbing being
i:,sucd aft-cr rtpril 1,19£34 )
• _ . . ~..:.._~...w~„:mY
K...~., ....x,,..
BOARD OF HEALTH
3 SETS OF PL.\YS
FORIA NO.1 SURVEY
TOWN OF SOUTHOLD CIIECR '.~~-I.7 .
BUILDING DF.PARTMElVT SEPTIC FORM
TOWN HALL
$OUT}iOLD. N.Y. 11971 NOTIFY; 7! .
TEL.: 765~1II02 CALL ! (q
Examined-•.y?~°~-~..., 19q~ PiAIL T0:
Approved . 1'?:~ .0.'6'1., 194. Permit No. l ~ 9rJ 7. .
Disapproved aJc r G' €
~D ~~c a~~
E~,~~;~
. ~ APR 2 61990
~d.~
(Building Ins ector ~ ~ " "
P ) r f -,t, s>:
APPLICATION FOR BUILDING PERPi11T ~ ~ ~
Date 15
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 to scale. Fee according to schedule.
b. Plot plan showin; location of !ot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and diving 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 throu~ttout the work.
e. Ho 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
Re=ulations, for the construction of buildings, additions ar alterations, or for iemoval or demolition, as herein described.
' The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and rcoulattons, and to
admit authorized inspectors on premises and in building for necessary inspections.
. ~(Signaturepplicant, o ame, rf a corporairon)
• - (Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, aenerai contractor, electrician, plumber or builder.
.............~~ul.4d.?~/~
I a`"'__, of
Name of owner of premises ...Uf:o,c~a? i ~°'!t ..~~.;-~FC~!'!~}
(as on the tax roll or latest deed) -
If applicanC is a corporation, signature of duly authorized officer.
• ~ ~ . ~ ~ ~ ~ (Name and title of corporate officer) '
Builder's Liccnsc No. ...f.'iJ.:.lQa.'~.: = N..I.....
Plumber's Liccnsc No .
Electrician's License No . .
Otlicr Trade's License No .
1. Location oC land on which proposed work tvill be done:
House Number ~ ~ Street. Hanrlct • ~ ~ ~ ~ ~ ~ ~ ~ "
County Tax \fap No. 1000 Section ...G.~°J.........: Block Lot ...`.'C 2~.. , , , .
Subdivision Filed <,Iap No. Lot .
(Nvuej
• State existing use and occupancy oC premises and intended use and occupancy of proposed construction: - ~ - "3
a. Existing use and occupancy .......~r~fldts.N% ~ sr s.:;~~..tt:~
b. Intended , ~ ..~y>(1 is i~'.'~'°r
1lttdi]'a~. GJfl95i F`F ..5!til~`!h1
use and occupancy ' ~t~.4-:- 4A-11~ i , . , , , .
,....1a+~ .t~ Ilrttf(SM1t~1~'i H9t a12"t'Fi E~''~4df Ni'W~•
3. Nature oC work (cheek which app~icableT: New Ouilding , . Addition . ,X • . • • • • ~Utctauon
Repair „ „ RFmoval Demolition ...Swi;~nin; pool............
Tennis Court•...'.. Accessory IIuilding.........,Fence .......Other lJork..
oa
4. Estimated Cost .......~.7.5,•~(?F? Fcc
(to be paid on filing this application)
5, If dwclting, number of dtvclling units ,f°........ Number oC dwclting units on each floor
Ifgaragc.numbcroCcars
.
6, IC business, commercial or mixed pceupancy, specify nature and extent of each type of use .
7, Dimensions of existing structuresj if any: Front . Rear .5~........ Depth ...;~a,'
Hei~ltt 1 g ~ Number of Stories . .
Dimensions of same structure with alterations or additions• Front ....`a s~- : Rcar . , , , , : , , , , ,
Depth .....:4w••1:.......... . Ilcight Nuntbcr of Stones .....1 •
S. Dimensions of entire new constntction: Front ~r~ Rc r . , . l r'-'.... Dupth , (3'
I-Ieigltt t Numt;'er of Stories ..~`Di
:GG. S.r;z,~r~ ...1~: f S'$r t~KC,
m~~
9. Sizcofloi:Front........g~.. Rcar .......R~?~........... Depth ..,f.~,~?.',
10. Date of Purchase 15.3 .Name of Former Owner • .
l 1. Zone or use district in wlticlt premises arc situated , : ~.t,~~.tPlxw S'f+~c . . .
l~, Does proposed construction violate any zoning law, ordinance or regulation: ...N..°. • . . .
l3. \Vill lot be re;raded , .r.~ C2 , , , , . , , , , \Vill excess GIl be removed from premises: Yes , No
l4, Name of Owner of premises ~.o,~~ga,~?~.a+s: ~N?'Address ~tE~t'Tt?~? .q>({tp:t• .Phone No..~t?~-.b`Y~~ ,
Name of Architect ~A2q#a,T , 9?r?~~:
; ,Address ..tYt?•iN. ~ ...Phone No..7~5~ .s~f~~. .
Name of Contractor ~.~a,(aft~~,.j ' , , ,Address ..01-P. Ncra~. JZoQ,.. .Phone No. ?.65 .a°'-~.£o....
IS.,Is this property located with in .100 feet of a tidal wetland? =YES....XO,X,.
*If yes, Southold TownlTrustees Permit may he required.
PLOT DIAGRAM
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 comer lot.
STATE OF NE1V R S S
COUNTY~OF ,
,6 ~ ~o.C,l6~
(Aamc oC individual si n ~ • ~ ~ ' ' ' ' • being duty sworn, deposes and says that he is the applicant
• ' pg contract)
above named.
Heistltc
Contrast ,agent, corporate oCficcr, etc.) ~ ~ ~
of said owner or owners, and is duly au ~ perform or have performed the said work and to makr. and Gle this
application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
work will be pcrforntcd in the manner, set forth in the application filud therewith.
Swom to bciore mu t1his •
G°~~~~ .dayof.... f! 1~~
Votary Public,~Y~`~; - ~ _ ~
GLAtITEL.b County
Notary Pudtfa State of New Yetk ~~jC~ ~
No. 4878606 • . • .
Qualifbdln8ufFdl~Countyr • . • Si;narure oCapplicanq
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