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HomeMy WebLinkAbout19047-z t FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24756 Date DECEMBER 5, 1996 THIS CERTIFIES that the building ALTERATION Location of Property 250 SOUND BEACH DR. MATTITUCR, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 99 Block 1 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 24, 1990 pursuant to which Building Permit No. 19047-Z dated MAY 24, 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 ie ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CHRISTINE RIVERA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inapec r Rev. 1/81 roans xo. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. flU1LDiNG PERMIT ' (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~ N - i ~ ~ Z Dote .'~~..'..e` 190 Permission is hereby granted t ~i v E R R Y at premises located at ......°~..r~~......... County Tax Map No. 1000 Section Block Lot No. f:~ pursuont to application doted 19........, and approved by the Building Inspector. E p0 Fee 3.~~....... B ing t for a~~ r Rev. 6/30/80 ~~~~ao97 Ferro ~o. 5 TOWN OF SOCTHOLD !~~~y BUILDING DEPARTML•NT TOWN HALL 765-1802 APPLICATION FOR CERTIFIC.-^,TL' 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(5-0 form). 3. Approval of electrical installation `rpm 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, 1°Si) 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. Lf a Certificate of Occupancy is denied, the Building Inspector shall state the reasons ti~erefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling 525.00, Additions to dwelling 525.00, Alterations to dwelling $25.00, Swimming pool 525.00, Accessory building 525.00, Additions to accessory building $25.00. Businesses 550.00. 2. Certificate of Occupancy on Pre-existing Building - 5100.00 3. Copy of Certificate of Occupancy - .25C G. Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential 515.0/0, Commercial 515.00 Date ~'Z,~•~l ~ l° tew Construction........... 01d Or Pre-existin Buildi ~rA 'efr/y g g............ .ocation of Pro ert °2`Sn ~~~1"'~~ P Y House No. Street Hamlet tnwer or Owners of Prooerty..~~!!'.JSy~ne i/,dtr/z/f- ~ z .ounty Tax Map No 1000, Section....... ...B1ock....~ ........Lot G / subdivision/ ....Filed Map............Lot..~6................. :'ermit No. ( 1.~.Z.~......Date Of permitSl'`Y/j0 ~dn.sh~•*.e- ~J.,~®,c,~. .......Applicant !ealth Deot. Approval ..........................Underwriters Aovrovai......................... Tanning Board tlooroval equest for: Temporary Certificate........... Final Cerdcate...~... ~ee Submitted: S..C~S' Vd c 1 z 1~~~ z~.~sox 7~c~` ~d ~ 7 BUILDING DEPT. iNS~ECTION [ ] FOUNDATION iST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] 1 ULATION [ ]FRAMING [ FINAL [ ] FIREPLACE ~ CHIMNEY ~ REMARKS: ~ ~ C~.~- DATE /a INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] iNSULATfON [ ~FRAMINtA [ ]FINAL r REMARKS: , . (~IM.,r~r~:,~.f'~i I I DATE ~ INSPECTOR V / • i ~cs~~ 2 ~ CgLlr' T NS i'EGT2QtJ Iln~#T~ it Co~t;•t t. uT.S O m 1 H H ~h OUIID_TIOY (1st) ~ `y~~~0.1 h~ ~ ~ m 'OUIJDATI0,7 S 2nd) ~ ~ ~ p _tO :OUCH FRkifE & •PLUt4BIVG w fI O Q ~ c ~ . • pppp H U ! L~ [j1 3 . °7 N IIISULATIOJI PER N. Y. STnTE EIIERGY CODE 'Y r r.:IAL ~ ~ ~ ~1 . ( r~~ ADDITIOPIAL C01~!ME1dTS: x ' - ~ . ~ - - ~ ' x H a ~ O \ W } b m .b • : t t ~ a~. - ~ k ~ . ' BOARD OF HEALTH 3 SETS OF PLANS FORMN0.1 SURVEY TOWN OF SOUTHOLD CNECK .il~~ . BUILDING DEPARTMENT SEPTIC FORM TOWN HALL $OUTHOLD, N.Y. 11971 NOTIFY o TEL.: 765-1802 CALL ~~-t C~ MAIL TO Examined 19 ~s APProvcd 19 ~4Pcrmit No./. 7". . Disa roveda c ~ s.,>.a --...p,, ; ~ t(i L5',~~~.~~~-'j~ ~ , ~--~..l.~. ~ ~ wit 2 ~ l9gp , ; ~~ildin~ spe or) ~~,w~l~ BLDG. pEf'T. APPLICATION FOR BUILDING PERMIT TOWNUFS UTHOLp~~ Date .....'T. 15`~.1~ INSTRUCTIONS a. Tlils application must be completely fi]]ed 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 showing location of lot and of buildings on premises, relationship to adjoining 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 snail 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 ousin~ code, and regulations, and to admit authRtized inspectors on premises and in building for necessary inspect/io~s. G, ..'r.' . . (Signature of applicant, or n , if a corporauon) (Mailing a ress of applicant) ~//J~~d State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ..J~.1;~~~i.... t ~ . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly auth rued officer. ,~~l,,de~ Cho (~res~~et~°~-~..... (Name and title of co~~aarporate officeur) Builder's License No. ..~fJ.t, 73 ~ :~.Al-~ . Plumber's License No . . Electrician's License No . . - - OtherTrade's License Nc . - - - 1, Location of ?and on which oposcd work will be d~on~e~;,- I?ouse Number Street. ~ Hantlef County Tax plap No. 1000 Section ..~.7.~bI'., 6 Block Lot ' , , ~ Subdivision . Filed !`fap No. .Lot . (Name) ~ ? ' State existing use and occupancy of premises and intended use and occupancy of proposed construction: A. Existing use and occupancy.....J~~?.."::..:..:"^.-`~ B. Intended use and occupancy..../ i s 3. Nature of work (check which applicable): New Building Addition Alteration . Re air Removal Demolition ..............Swimming pool........... . 'Tennis Court......... Accessory Building..........Feilce .......Other Work............ 4. Estimated host' . ~,C!'O 0' ©d Fee , • ' (to be paid on filing this application) 5. If dwelling, nutnber of dwelling unit's Nttmbcr of dwelling units on each floor • If garage,numbcrof°C3rs ~ 6. If business, commercial or mixed 'occupancy, specify natura and extent of each type of use . 7, Dimensions of existing structures; if any: Front . Rear Depth . . Height Number of Stories . . Dimensions of sargcrs,~ructure wit~t alterations or additions: Front a`::, , Rear . . Depth t? height ......................Number of Stories . 8. Dimensions of entire new construction: Front Rear ,Depth . Hei;Jti ~yy dumber of Stories . 9. 'Size af~lol~t~~ Rear Dep h 10. Date of Purchase • • ~.9SG , ; , , , , , , , , , , • • , , .Name of Former Owner ~.~•?~l: s.~• T".~....... . . 11. Zone of use district in w l:ich prcntises are situated . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . IUO . . 13. 1Vi11 lot be regraded , Nb• . ....Will excess fill be removed from premises:/~ Yes No . • l~{. ' ila,tre o: Owner of preniiscs' ~~W!'S........... Addre'ss' / ..Phone No . . . . . . Name of Architect . ~~f:. ~ SO~y ,Address . ~l~!"'Yt p !`k Phone No. Name of Contractor ..~1hc~,hJj . ,l.,J h ;o ...Address .~dS~ 1:!~~0?'~~/. Phone No. ~.~~1.~ :7{,Z ?::'7b2, IS.Is this property located within 100 feet of a tidal wetland? *YL~S....NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM ' Locate cleazIy 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. STATE Oh NEW,YOR ' ~ .S COUNTY OF ..:~N.~ ..fit.-~r. ~ 5;~ ! ~er...~:. ~ ~ ~ , being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) - above named. I • Hcistltc (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 61e 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 performed in the manner set forth in the application filed therewith. Swom to before me this qq ......~G~~~............day of 19 ~,Q Notary Public, ~kU.Vt~'~. ~,:~1'~• • ..'N~S~44~lCounty ~ • . ; • • . • JANEY A CINO • NOTARY FU9LIC ST f ' TEOFNE'NYORIi ~ • • NO. 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