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HomeMy WebLinkAbout19006-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCHPANCY No Z-19149 Date JUNE 14, 1990 THIS CERTIFIES that the buildin~ ADDITION Location of Property 1975 YOUNGS AVENUE House No. Street County Tax Map No. 1000 Section 60 Block 1 Subdivision Filed Map No. SOUTHOLD~ N.Y. Hamlet Lot 1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 2, 1990 pursuant to which Building Permit No. 19006-Z dated MAY 1t~ 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 TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A MARILYN G. LAMBERT Building ~nspect~)r Rev. 1/81 FOI~M[ NO. JJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Nfl 'i9006 Z I Date Permission is hereby granted to: /'~ ..... ~...~'~...o.Li.~£.~_.~...,.:~.... ......... ~.~ ........ ..o.....~o,. ....... /.~.~.). ..... ~ to ....~.~ ...... ~....~.~....:~ ....... ~....~......~.~~.. ~.~..,. ~ .~ ~ ~ ~..~ ............................ ...... 'l ........ ~;~ ............................................ at premises ,~ated at ...L.~..~~~.~ ...... ~[~4 ....... ~.~ ........... o ..... ~...L ........... County Tax Map No. 1000 Section ....... .~..~..~. .... Block ............ ). ........ Lot No. pursuant to application dated .....~.~..~ ....................... , 19.,..O.., and approved by the Building Inspector. Su~"F~;~r ......... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 1% lead. r 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. For existing buildings (prior to "pre-existing" land uses: 1. April 9, I957) non-conforming uses, or buildings and Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. ~ 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. ~o 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, Cgmmercial $15.00 Date .......... ?...~,. ,~'~., ..f.~ .................. New C t t' . .... ons ruc ion ...... Old Or Pre-existing Building ................. Location of Property.. ~!u~.~ ] .~....~.,..~... ~Street .......... '~' '~' . .~...~.. ~.L.~.Hamlet .......... of Property .~.. ~¥/'~t A~~' .~... Onwer or Owners ........... . ......................... . ....... County Tax Map No i000, Section. ~C~ .Block .... ~ Lot.. ..~7~.. Filed Map ."~,; Lot Subdivision ............................................................ · · . Permit No Date Of Permit Applicant . Health Dept. Approval .......................... Underwriters Approval ..................... . . . . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [. 1 FOUNDATION 2ND [ i1 INSULATION [ ] FRAMING [ ~INAL ~) ~*~ REMARKS:~ ~/]'~ ~, ~ DATE INSPECTORU~~~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION REMARKS.' , FOUNDATION Ilst) FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 242720 reputed land now or formerly george r. jennings est. , 133.29 LLI Z Ld reputed land now or for~dy david .... owen ~ paffic~a ann avereffe ~R~EY TO BE UbED SOLELY ~R THE PU~ O~ TF','E CONVEYANCE OF TITLE'OF SHOWN ; OT TO BE USED FOR R~MOVAL OR .LAYOUT OF ~NO~, HED~:' N~AP OF PROPERTY .... BLOCK.. LOT..._A_.~ ._ SH__O. WN LOCATION. SOUTHCLD, S U EFOLK COUNTY,NEW YORK GUARANTEED ONLY' TO SECURI.Ty TITLE 8.G~ C_OUN]TY .F_EDERAL SAVINGS. ~ LOAN ASSN.. GF,._Q.F~L ~_ _M_AFLY__.MAHI:J DATE 7-_8. z. 7,5_ .......... LAND SURVEYOR GARD'EN CITY PARK, N. Y. Ti ....... N. Y. S. LIC. NO. 45017 . J. NOT RESPON, SIBLE FOR, EASEMENTS AND SUB SURFACE CONDITIONS OTHER THAN SHOWN J'I ~{~}e? t~e~,¢ ~.~ ;C~,-~.~,¢ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..~ Approved. ~.~.l]-- U .... , 19q*. me~it No. [.~ ~.$.~ (Building Inspector) APPLICATION FOR BUILDING PERMIT 3 SI,iTS OF P1,ANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : CALL Date .................. , 19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and sub~'f~fed 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, rela<tionship ,to adjoining'premises or public streets or areas, and giving a detailec( description of layout of property :must be dra~n On the diagram which is part of this appli- cation. ?* ~, ~ ~. " c The work cover&t~g~Lt~ation may not be corn nenced before issuance of Building Permit. ' d. Upon approva, o{'Lh3s ~ii,,the Bmldmg Inspector will Issued ~ Bulldmg permit to the applicant. Such pemut 't ..... :~''* ~ ' ' u ' u h work ' shall be kept on the pre¢la~S &Variable for inspection thro gno t t e . . e. No building shallqb".~J~iipied or used ~in whole or in part for any purpose whgtever until a Ce3tificate of Occupancy sh~ll have been granted by tlq~Bii~ding Inspector.' . . . ~ APPLICATION IS HEREBY MADE to the Building Department for the gslua~ce of a Building Permit pursuant to the Building Zone Ordinance of the Town Of Southold, Suffolk County, New Yqrk, ind other applicable Laws Ordinances or Regulations, for the construction of buildings, additions or alterations, or~.~o.?' removal'6f demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances build~mg codes housing code and regulations, and to admit authorized inspectors on premises and in building for necessary insp, ec~iofis. "'" ~ ~; ' % " (Si,nature of applicant, or name, if a corporation) (Mailing address of applican%) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. ..................................................................................... Name of owner of premises fi]kOY~lL/]k ~-.: ~.¢~-..~ ................................................. I (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY Builder's License No .......................... Plumber's License No ........... .~. ~ LICENSED Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .... .~. ?. .......... Block " / '~ Lot... 5'7../.'~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .' .~..~.%.% ............................................................. b. Intended use and occupancy ~f.O..~4_..qp.'.r~.. V'.CIM&. ~...~. ....................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ¢.,d~.'w:f.xw. Alteration ........ ,. Repair .............. Removal .............. Demolition ........... ... Other Work ............... i (Description): 4. Estimated Cost ...~,~ .~. ~ .............................. Fee ......... ' ........................ ' (to be ~aid on filing this application) 5. If dwelling, number of dwelling units ... I. ........... Number of dwelling uni!s on each floor .............. If garage, number of cars ............................................ : ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... ....... Depth ............... Height ............... Number of Stories ...Z, .................................... ; ............... Dimensions'of same structure with alterations or additions: Front ............ : ..... Rear .................. Depth ............. ......... Height ..................... . Number of Stories ~ .................... · 8. Dimensions of entire new construction: Front ............... Rear ........ i ....... Depth ............. i. Height ........... ,... Number of Stories ............... ; ............ i ................. e .......... 10. Date of Purchase ............ gr//.qq'/. ........... N~.~e of, F~prmer .Owner . 11. Zone or use district in which premises are situated ...... 1.~O~.. ..... 12. Does proposed construction violate any zoning law, ordinance or regulation: .za, F.~ ............................ 13. Will lot be regraded ...... : ..................... Will excess fiI1 be removed from premises Yes 14. Name of Owner of premises /VX04a[q ~(>.~&!*~.q,.~'.xC'Address l~.-t.~..~(9.~¢~s. ~.. Phone No..7.61;:¢--~?(-~...."~. Name of Architect ........................... J Address ............... r ~' .... Phone No .............. ;. Name of Contractor .......................... Address .... : .......... , .... Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .~... *If yes, Southold Town Trustees Permit maybe required. PLOW 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 corner lot. APPROVED AS NOTED oATEi ~l lt] 90 B.P. # ~ NOTIFY BUILDING 76~-1802 9 AM ~ 4 P~ FOR THE FO~OWING INSPECTIONS, 1. FOUNDATION ~O FOR POURED CONCRETE 2, ROUGH ~ FRAMING & PLU~RI~G 3. INSULATION 4. F;~n~ COnSTRUCT;ON ~UST BE COMPLETE FO~ C.O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS S'IATE OF NEW YORK, - - : 7OUNTY~...,S,(--t'~.~.[/'..., 8.8 . ....... ~. ~&~..~,.. ~e.C.~.~ ............. being duly sworn, depokes and says that he is the applicant (Name of individual signing contract) 1hove named. -re is the (Contract~gent, corporate officer, etc.) ..................... ...... ~f said owner or owners, ~d ivduly authorized to perform or have performed the smd work and to m~e ~d file this ~pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the york will be perfo~ed in the m~ner set forth ~ the application filed therewith. w~ to before me this ~otawPublic, .. da~of.