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HomeMy WebLinkAbout18828-zFORM NO. 4 TOW/~ OF SOUTHOLD BUILDING DEPkRTMF~NT Office of the Building Inspector Town Hall Southeld, N.Y. CERTIFICATE OF OCCUPANCY No Z19029 Date MAY 8, 1990 THIS CERTIFIES that the buildin~ Location of Property 3280 WUNNEWqZTA ROAD House No. County Tax Map No. 1000 Section 111 Subdivision ACCESSORY POOL Block Filed Map No. Street Lot 30 Lot No. Ham]et conforms substantially to the Application for Building Permit heretofore filed in this office dated FEB. 21, 1990 pursuant to which Building Permit No. 18828Z dated M-ARCH 1, 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 ACCESSORY INGROUND POOL WITH DECK AND FENCE. The certificate is issued to LINDA DE ROSE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING SLIP MAY 7~ 1990 N/A ~~~ ~u '~din~Ins e r -//l~ ' ' g p cto Rev. 1/81 FORM N~. · TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PEI~tlT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 18828 Z Permission is hereby gj:~3te~J ~e: /.- ..~ ~ / -- ~- ~'~ ................................... .... · ..~..~ .............................................. ~,~,,~ ,,~,=,~,,..~..a~...~ ...... ~~~~Y~~ ..................... ~unW Tax Map No. 1000 Section ..... ~ .......... Bilk ........... [~ ..... Lot No .......... ~.~ ..... pu~uont to a~lication ~at~ ............................................. , 19..~., and appr~ by t~e Building Insp~tor. ~, ,...~Z..a~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must he 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. 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 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 - $I00.00 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 ........... . .~..~,~./.~ ~ .............. .. .. New Construction ........... Old Or Pre-existing Building ................. Location of Property ......................................................................... Rouse No. Street Hamlet Onwer or Owners of Property ................................... County Tax Map No 1000, Section... JjJ ..... Block ..... !t ........ Lot ...... '~.~. Subdivision .................................... Piled Map ............ Lot ...................... Health Dept. Approval......... ........ . ..... .. . Underwriters Approval ...................... . . . Planning Board Approval ........................ / Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ....... ~. .... FOUNDATIO:~ ( ls t) FOU:~DATIO:~ (2nd) EOUGH FRAME & .PLUMBING INSULATION ?ER N. Y. STATE ENERGY CODE Fi::AL ADDITIONAL COMME1;TS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [] INSULATION ]FRAMING [ ~FINAL REMARKS~: ~~'~ / eO~ ' t '1 </03 15.2' 32,2' 19,9' 'I~0 '~ 2-~B' ~ : "0 I '" 7008, 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Mteration_.,. ..... Repair .............. Removal" .............. Demolition .............. Other Work .... ,~,~C~t r~. /,~c, r~O'Oc, 7fro S <¢ ,~r~. D~'cl~t /=t:,~c~' (Dcscriptio~ 4. Estimate'd Cost ......... ~5.-~.~. ,..~.-~. ................ Fee ................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............. If garage, hum bet of cars ..................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................. ?. Dimensions of existing structures, if any: Front.., ............ Rear ............... Depth ............ Height ............... Number of Stories ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth ................... tleight ...................... Number of Stories ..... 8 Dim,~,,o new construction: Front ............... Rear ................... Height ........ ~,~ .... Number of Stories ..................................................... 9. Size oflot: Front ...................... Rear ...................... Depth ............ : ...... 10. Date of Purchase ............................. Name of Former Owner ...: .g .~ .... ~.~.'. .... '. i ...... 11. Zone or use district in which premises are situated . ~. f~ ~ ~-~vz-r'4]c- ~',~ ~ ' :. ......... 12. Does proposed construction violate any zoning Iaw, ordinance or regulation: ,. :'.'.x% C( .................... ~.~ regraded ........ ~ ................. W/Il excess ti11 be removed from premises: 13. Will lot be 14. Name of Owner of premises .../)f~'~9?.&- .... .... Address . t~'~t.~7~t~'~..~(t~2 .... Phone No ............. Name of Architect .............. ...... Address ................... Phone No. Name of Contractor ~. /z~{/.~. 7 r -. .................. Address..,~.~OF27).~.~.C,/.~-... Phone No. g~. 15.Is this property located within~00 feet of a tidal wetland? *YES .... NO.~. ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and. indicate ail set-back dimensions f, property lines. Give street and block number or description according to deed, :md show street names and indicate whe~ interior or comer lot. // AP~RQVED AS NOTED DATE: ~ B-P. # ~~,~,~ FEE:'~/~ ~'~: ~/BY: NOTI~ B~l~ DE~T 765-1802 9 AM ~ ~ ~ ~R ~OLLOW~ ~S~EC~O~S: 1. FOUNDATION - ~ REQUIRED FOR POURED CONCR~E 2~ ROUGH - FRAMING & PLUMBING 3. ~NSULATION 4, EINAL CONSTRUCTION MUST CE CO~PLE~ FOR ALL CONSTRUCTION SHALL ME~ THE REQUIREMEN~ OF THE N.Y, STATE OF NEW YORK,~ STATE CONSTRU~ION & ENERGY COUNTY OF.. ~.~ ~?~.~ .... S.S COD/S. N~ RESPONSIBLE FOR ............................. ; ....... being duly sworn, deposes ~d says that he is the appli{ (Name of individual signing contract) above named. He i~ the .................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to pe.fform or trove perfo~ed the said work and to m~e and file application; that ali statements contained in this application are true to thc best of his knowledge and belief; and that Work will be perforated in the m~ner set forth in the application filed therewith. Sworn to before me this ........ 19~. ............. ¢. :... , ~ ~b~, S~ ~ ~ Y~ ~, Commission Expires December 8, 19 *. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1802 ¼/ .,ppro ed .... ........ Pe it No ....... Disapproved a/c ..................................... '"'v"vlm.~lA/ELY" APPLICATION FOR BUILDING PERMIT ~.CLOs~ .oot ~ co~ u.o~ coM.m~o~ INSTRUCTIONS BOARD OF HEALTH ............ 3 SETS OF PLANS ............ ~E~,> ~. ~ 3'~ O'~i~ ......... CHECK ............. SEPTIC FORH ............... NOTIFY CALL .................... MAIL TO: Date....7<./Z O 19~) a. This application must be completely filled in by typewriter or in ink and submitted to the Build'ng Inspector, wih 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 stre or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl 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 pen 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 Occupm 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for ~'emoval or demolition, as herein describ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspections. (Mailing address of applicant) State w. hefl3er, apL~.a~t,gs owne~', lessee, agent, architect, engineer, general contractor, electrician, plumber or build ........ ~.:. : . '. ~777..,q:.~..7~.K,. .......................................... Name Of owt~er'o~preI41ise~ ......... L/.&. D~ ....... O.e.~gZ&Z.. ................................. · (as on the tax roll or latest deed) Builder's License No ..... ~....~. ~..2-.'T Plumber's License No ......................... Electrician's License No. ~'4/.20~r'-~t).. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY Other Trade's License No ...................... Location of land on which proposed work ,viii be done....~.~..ff.~....~./.~...~',~...~.{4...7~...~..G'..~.~.-...~..~. . .?.a~7, o ...~...~..~-.~.~.-z-.~...r_2o,,to., ........ C... l.c~o.~.~ .... }louse Number Street Hamlet County Tax Map No. 1000 Section ..... //.t · - Brock ...... ii. .......... Lot ..... S.C.') ........ Subdivision ..................................... F. iled Map No ............... Lot ............. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ' ~...~.3-/. jif.. 6-4~. 2'7.~ . . . , . . . , , . !¢.. ¢-x. :.o .~. . F. ',. .7~. . " b. Intended use and occupancy .......... .r .~.cx.....C:o.. ~. ....~..O.q q.~.. ....