HomeMy WebLinkAbout18824-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18855
Date MARCH 2, 1990
THIS CERTIFIES that the building.
Location of Property 235 HOLDEN AVENUE
House No.
County Tax Map No. 1000 Section 110
Subdivision
ADDITION
CUTCHOGUE~ NEW YORK
Street Hamlet
Block 2 Lot 3
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 31, 1990 pursuant to which
Building Permit No. 18824-Z dated FEBRUARY 28~ 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 DW~LT.INGAS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
GEORGE & MI/RIEL SCHWAB
Rev. 1/81
TO~N OF SOUTHOLD
BUILDING DEFARTMEHT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NO- 18824 Z
Permission is hereby grante~d to: /~ ,t ,,~ ,~
.L~./...~....-..~.~...~..,.~, ............
..... .~..~...~/.~ ....... .~..~. ...............
....................
at pretrnises Iocat,~ at ..~ .~,...~~4~.~.....~ ..........................................................
County Tax /v~ap No. 1000 Section .... ~...,~:...O.. ........ Block ........... ~ .... Lot No ....... .5 .............
pursuant to application dated ......... ././~.~/~,, .................................. , 19..~...~...,
and
Building Inspector.
approved by the
Rev. 6/30/80
TO~N 02' SO~TrrOL~
SOUTDOLD, ~tE~ YORK
APPLICATION FOR CERTIFICATE OF OCCUPANC~
DATE ....
NEW CONSTRUCTION -~..OLD OK PRE-EXI,~TIt{G BL!'~]ING ...... VACANT LAND
~ "
Couuty Tax Map No. lO00 Secciou .~.~O... Block ......
. Lot:' . .....
S~h~o.. ~% .............. ~o~ ~p%.~ .... Lot.~.
Pcrmi= No ........... Date of Permit .......... Applicant ...................
Health Dept. Approval .................. Underwriters Approval ..............
Plammimg Board Approval ................
Request for Temporary Certificate ....... Final
Fee Submitted:
FORM ~O. 6
TOWN OF $OUTIIOLD
BUILDING DE ~A~.T~'~NT
TO~ I~LL
765- 1802
AFPLICATION F0K CEKTIFICATE OF OCCUFANC~ INSTRUCTIONS
This application must be filed in type~rrlter OR ink and submltEed to the Buildin~
Inspector with the followinb; for new buildings or new use:
l.' Final survey of property with accurate location of all buildings, property lines,
streets, aud unusual natural or topographic features.
2. Final approval of ~ealth Dept. of water supply and sewerage-dlsposal(S-9
3. Approval of electrical installation from Board of Fire Under~rriters.
4. Swor~ statement from plumber certifying that solder used in system contains lesS'
than 2/]0 of IZ lead.
5. Commercial buildings, industrial buildings, multiple resldeoces and similar.'
buildings a~d inscallatioms, a certificate of code compliance from the Architect
or Engineer responsible for the building.
6. Submit PlanniuE Board Approval of completed site plan requirements.
For exlscinE buildings (Prior to April 9, 1957] non-conforming uses, or buildlugs
and "pre-existin~" land uses:
]o Accurate survey of property showing all propert~ lines, streets, buildings and
unusual natural or topographic features.
2. A properl~ completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title compan~ ~hich shall
show single and separate o~r~ership of the entire lot prior to April 9, 1957.
· If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in ~ritinE to the applicanc.
3. Da~e of any housin~ code or safety inspection of buildings or premises, or other
]. An application for vacant land Certificate of Occupancy shall be submittedm
and a certified abstract of title issued by a title company showing single and
separate o~r~ership of ,the entire lbt prior to April 9, 1957 shall also
the appllcaZlon. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in ~iting Co the applicant.
FEES:
I.
3.
4.
5.
6.
CERTIFICATE OF OCCUPANCY -- New D~elling $25.00, Additions to D~elling $25.00,
Alteration to Dwelling $25.00, Swiunming Fool, $25.00. Accessory building
Addition to Accessory buildings, $25.00 - Businesses $50.00.
Certificate of Occupancy on pre-existing dwelling -
Copy of Certificate of Occupancy - $5.00 - over 5 ~ears - $I0.00
Vacant Land Certificate of Occupancy - $20.00
Updated Certificate of Occupancy - $50.00
Temporary Certificate of Ocanpancy -$ ~5.00 Residential
Commercial
er. IC~/
·OUND~,T.ON
FOU~DATIO~;
2.
(2nd)
ROUGH FRAME &
.PLUMBING
INSULATION PER N.
STATE E]IERGY
CODE
FilIAL
ADDITIO~L CO.~4MEL~TS:
FORM NO, 1
FOWN OF SOUTHOLD
JILDING DEPARTMENT
TOWN HALL
;OUTHOLD, N.Y. 11971
BOA~,D OF NEAL'rlt.~- ..... · ..
3 SETS OF PLANSu.~<~ ..........
SURVEY
SEPTIC FORM
~ ._~ -' TEL.: 7GS.1B02
Examined ............
Disapprove ate ....................................
APPLICATION FOR BUILDING PERMIT
NOTIFY: ~ ~.'
/] ,",~, LZ O~ ~,'a~''''-
CALL ~.~V. . .v:-~ .............
tlouse Numbcr St rcct Ham [et
·
County Tax Map No. 1000 Section ........... · ck .. ... . Lot
Subdivision ...................... cd Map No. . . Lot
(Nmne)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
'% Existing use and occupan% .......... '' ' -- ·
· Intended use occupa--J -
OCCUPANCy OR
[/SE I$ UNLAWFUL
/ qTHOUT CERTIFICATE
OOCUPANCy
Other Tradc's License No ....................
Electrician's License No
Plumber% License No
INSTRUCTIONS
a. 'llds application must be completely filled in by typewriter or in ink and submitted to the Building t~'l~ector, svith
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 premise~ or publ/c stree,
,or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par[ of th/s appl
cation·
· c. The work covered by th/s application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Pe~nit to the applicant. Such perm
shall be kept on the premises available for iaspection ,tl~o.~out the work. ,
e. No building shall be occupie~ 'or u~d in whole oi: ~n'Part for a.ny~purpose w,.tt~iever until,a.Cer~ific.~t~: of,Qccupanc
shah have been granted by the Building Inspector.,
APPLICATION IS HEREBY MADE to the Building Department for the isSuanc'd~a B'~lding Permit pursuant to th
Buildino'"'Zone Ordinance of the Town of Southold, Suffolk County, New York, an/other appIicable Lam. Ordin:mces o
Regulations, for the co~,~t~ctio, n of buildLngs, a~ditions or alterations, or for ~er~val 9,1' d,,emolitiol~, as he.in describe,,
The applicant agr~ees ~d~.~0{'nply wi~ all .apo icabie laws, ordinances, budding c~e, ho~s~ code,~nd regulations, and t,
admit aurH6I-izcd'.i.g~.Ili~s ~l,n'~'If/-emise~ ~i~d 'ih building for necessary inspectionS.. ' "[.////~, / / ..~/
· r~:-.~,, . , . (Signath'r~/o~ .hp~licgnt, or n~me,
State whether a~p~i'~i J~ ~wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
............. ; . : . :v ).". .'.?X% .................. ., ..... , ...................
¢ ~;~ ~ :,,.: (as on the tax roll or latest deed)
If applicant is a c~ral~'Si~ature 6f duly authorized officer.
........litil .........
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration
Rep~r .............. Rl~moval .............. Demolition ........ ~ .)-SS}t ~ng P o°~ -~[~_h ......
Tennis Court ....... ~ Accessory Building .......... Fence
....... Other Work: ..... ~.~.,...~
~ '/ . Fe
4. Estimated Cost . ~...-G'-~.. ............................. e ................................... '
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If parsee number of cars ...........................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....................
7 Dimensions of existing structures ir any: Front . . . Rear ....... Depth .
Height Number of Stories ............
Dimensions of same structure with alterations or additions: Front Rear ............. ·
Depth Height .... . Number of Stories ..........
$ Dimensions of entire new construction: Front Rear ...... Depth . . .
Height Number of Stories '
9 Size of lot: Front Rear Depth . ..
:O. Date of Purch~e ............................. Name of Former Owner ............................
i 1 Zone or use district in which premises are situs*ed ..........................
[2. Does proposed Construction violate any zoning Iaw, ordinance or regulation: ...............................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes .... No
14 Name of Owner of premises .... ' .... Address Phone No .....
Name of Architect ........... Address ................... Phone No ................
Name of Contractor ................. ' ........ Address ................ Phane No ......
IS.Is this property located within f00 feet ~}'a tidal wetlaod? *¥ES...;NO.-::''
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly alt buildings, whether existing or proposed, and. indicate all set-back dimensions from
property Lines. Give street and block number or description accord.lng to deed, and show street nmmes and indicate whether
interior or comer lot.
APDRO~D ~S I~OTED .. '/
NOTIFY [IUIL~D~IG OEPAR"i'*~'~CT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING ~NSPECTIONS:
~. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH . FRAMING & PLUMBING
3. INSULATION
4, FINAL CONSTRUCTION MUST
BE COMPLETE FOR C,O.
ALL CONSTRUCTION SHALL MEET
THE REOUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES, NOT RESPONSIBLE FOR
OF, SIGN OR CONSTRUCTION ERRORS
STAT
COUNTY OF ...... _. .w~..t~..,O.h ..... S.S
................................................. being duly swam, deposes and says that he is the applicon:
(Name of individual signing contract)
above na~ed.
He is the ........................................... : .......................................... :.
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thi
application: that all state~nents contained in this application are true to the best of his knowledge and belief; and that
Work will be performed in the manner set forth in the application filed therewith. '
...... day of ...... 19 .~
Notary Public ....... fi. ...... County ~: -, //
No. 4707~78, ,5a~l~ Coast/f/ (SignatUre of applicmat
Ten~ Expires Match ~, 1~.