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HomeMy WebLinkAbout18898-z . Ljr FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N. Y. CERTIFICATE OF OCCUPANCY No Z-19158 Date JUNE 2fl, 1996 THI5 CERTIFIES that the building ADDITION TO ACCESSORY Location of Property 2536 VANSTON ROAR CUTCHOGUE, N.Y, House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 5 Lot 3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 19, 1990 pursuant to which Building Permit No. 18898-Z dated MARCH 21, 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 ACCESSORY INGROUY3D SWIMMING POOL A5 APPLIED FOR. The certificate is issued to WILLIAM & ADELE MOLLER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A GGG B ilding Inspector Rev. 1/81 8osai No. s TOWN OF SOUTHOLD ®IfILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18898 ~ / Z Date 19..~~ Permission i; hereby granted to: ~-rt~.......C..........~ to ~.,~..........~a~~~~..... at premises located at ...,r?~:,3...Q ........~C`7`'°"................................................. ~""7" ~ r.~~..: - 9 : -..l. 2:. S . County Tax Map No. 1000 Section Block Lot No..........~......... pursuant to application doted ......~~7'~..~ 19.~U and approved by the Building Inspector. / ~1 D~ Fee $.~•~=d.~`.r... /uildin inspector Rev. 6/30/80 Form No. 6 M TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ;i+ , 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 Earm). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains A less than 2J10 of 19> 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: 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 o£ 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 - Residenti 1 $15.00, Commercial $15.00 Date~~~~1'... a~'~l.l~~~......... _ . New Construction.......... Old Or Pre-existi g Building. Location of Property... House No. ~ Str/eet /~Haml . Onwer or Owners of Property.~/~!/,?~.~//..~,~~GU,I:~:..w~~,`f County Tax Map No 1000, Section.. l?,1.......Block... ~ .......Lot. • Subdivision/.~.y.~.'..f.~ ....................,2...v~.~..Filed Map............Lot...................... permit No./.1~f! ~U.......Date Of Permit4~j~/~X `~~....Applicant lIealth Dept. Approval ..........................Underwriters Approval...................... f'i Planning Board Approval Request for: Temporary Certificate........... Final CerticaCe........... , Fee Submitted: - •3y~d~a' !V ~ APPLICANT Co`l:•1 vas CQ !~tj> INS~~T,tOtJ IW~k'7'~ it m OU11D_TSO^3 (1st) ~ 'Oll'.1DAT20t1 (2nd) z I ° W ?OUGH FRAi~fE & O PLUMBING - e H m 3. "3 IIISULRTI0;1 PER N. Y• j STnTE E1IERGY I ~5 CODE 4. "'IAL ~ ' ~ x~ pDDITIOPIAL CO??MEidTS: ' ~ \p\ ' , - H iJ ~ z. ~ ? \ ~ \ • r H y x °U - v - m .n H ' ~ lui'' BOARU OF HEALTH 3 SETS OF PLANS FORM N0.1 SURVEY ~ TOWN OF SOUTi-TOLD CHECK . BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL MAIL TO: Examined .:,.°~1~ 19 ~p APProved .:7 aj 19~~. Pcnni[ No./. U _.,v... ~ ~a ~ ' ~ Disapproved a/c , ; , " , s e l~i Grl~il~ ~ ~ ~ ±iq a{$ ~~tt~\`( ~ f0 F . f~l! t.k'i.~ µsrv~W • ~t ,rv. (B r inginspector) n t,~~+JF~;~~~„..,,w~.~ APPLICATI N FOR BUILDING PERMIT Date ..~f?2L' Fl . ~ 15 ~d INSTRUCTIONS a. 'Phis application must be completely "filled in by typewriter or in ink and submitted to the Building [nspector, 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 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. e. 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 Taws, ordinances, b (ding code, housin>; code, nd regulatio and to admit authorized inspectors on premises and in buildutg far necessary i ctio s. (Signature o~T app,! cant, or name, if a corporauon • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .T~.~.k': A^.r.`? , M 2S.:. L,/e C 4 /.t}~n... /!!I cr L att . (as on the tax roll or latest deed) It appjli~ nt is a corporatio t, signature of dul authorized officer. (Name and title of corporate officer) Builder's License No. ,~:~-?Q`$'~~~.~......... Plurnber's License No . , Electrician's License No . . Otltcr Trade's License No . . L Location of land on which proposed work will be done. ~'GL~'c:(-~a~~. .~S3CU .................?.~a~?sTo~...~~~?!~:~.........Grr•~c~o~c.,c ~ !louse Number Street I{amlet County Tax t,lap No. 1000 Section Block ...\,.1 Lot . t..J Subdivision Filed (\lal> No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~'~"~~f v • • • • • • • • • ~ • • • r • ~9 kn , ! Er t'- j PLO ~ . b. Intended use and occupancy ..............::...l,;.v....:..._.:.:............ .e ~ ,i 3: Nature of work (check which applicable): New [3uilding Addition .Uteration....... p I Dcrnoli[ion Other work ..~~:!"`.r.'O c air Rcmovq (Description) i~ do Fee 4. Estimated Cost Q (to be paid on filing this application) 5. If dwelling, number of dwelling units Number oC chvelling units on each floor . ICgaragc,numbcrofcars ..•..,I 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing stnrchrres,'if any: Front Rear Depth . Ilcight .....NumbyrofStorics Dimensions of samtstnrcture witl} alterations or additions: Front Rear . Depth ~ Ilcight Number oC Stories . ~~yy. , 8. Dimensions d1C~{t~e~n¢w Gonstrn~tion: Front ..~.N . /?<!f,~?.. Rear Depth . flcight ...............NumbFrofStories........................................................ 9. Size of lot: Front........... Rear Dcptlt l0. Date of Purchase .................Nameof Donner Owner l 1. Zone or use district in which premises are situated . 12. Does proposed construction violaCe any zoning law, ordinance or regulation : . 13. will lot be regraded P!~? Will excess till be removed from premises: Yes No l4. Name oC Owner of premises W/et/;¢~, fyloLt~Q ..Address J~A'~S.T ~ R~ " ..Phone No.~.~~ 7~~~'... . Narne of Architect h ' Address ...~T~Gu~ .Phone No... . Narne of Contractor C.L~~~'~~'..L.~y.r!~.~:~'~~~!~iVddress~X. ~/~+?.~.f-r.~.~'t~.'.KCF'ho-~n-e~~Nyyo~~7.~~: ~-~.71~~.:.. . IS.Is this property lor.ated within 300 feet of a tidal wetland~`~..NO.... *If yes, Southold Town'Trustees Permit may be required. PLOT DIAGRAb4 Locate clearly and distinctly all Uuildings, 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. ~T~i9-~N'~, ,7~ ,ALA-~ w L~ S'~. eQV<j~ c , I~ STATE OP NE\V YORK, Si S ' COUNTY OF . ..............................I', being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Ile is the ~ (Contractor, agent, corporate officer, etcJ of said owner or owners, and is duly, authorized to pcrfonn or have performed the said work and to make and Gle this application; that :dl statements contained in this application are 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. Sworn to before me this i . ..........~./~........day of~.'/...l~....~l,a-!-~i.~..., 19 ~lU Notary Public, ..../~'~~N/..... I/1'' :../~ie. U~-.... County NELEN K OE VOE _ _ _ " " ° . N0?ARYPUBUC.SUteoftdew~wk (Signs ureofapplicant) No. ~7078'/S, Su0olk Coua41 Term Expires March 30,18_.' . ~ Q ~ ~ a ~ C) ~ i„' -•~a . ~ ~ . 4 ~ ii ~ . ~ is ~ ~ ~ v ~5 t t p J t a~ 'f ~z~ ~ItF~.]~1 ~;l/k~~~~d f 1:C~ +.~Z.S~ k - qqyy (4~ y° ~ ~ ~ ' ~ a ~ "1f . ~ h . 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