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Home My WebLink About18865-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19539 Date NOVEMBER 28~ 1990 THIS CERTIFIES that the building. DECK ADDITION Location of Propert~ 1915 CLRARVIEW AVE. House No. Street County Tax Map No. 1000 Section 070 Block 010 Subdivision Filed Map No. SOUTHOLD Hamlet Lot 027 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12~ 1990 pursuant to which Building Permit No. 18865Z dated MARCH 13, 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. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PETE & SkLLY HAEFFNER N/A JB%ildingInspector TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO_ BUILDING PERJ~IT (THIS PEP,~IT MUST BE KEPT ON THE PRF-k41SES UNTIL FULL CC)NIPLETION OF THE WORK AUTHORIZED) 18865 z ~, .... ..~.~ ........ ~...~. ................ , Permission is hereby granted to: , ~,.~.~~...£~...~,,,,~.~ ......... L.) ...~....~.....~:~..:.....LL?.~.. ..................... ~o ...~~....~..:.~.......~~..~.....~...~.....~ ....... at premises located at ...I...°)....~ ...... ~.O..~.~..u~....,:...~~.~ ......... County Tox /V~op No. 1000 Section ....... ..~.?....O.. ...... Block ......... I...O.. ....... Lot No ...... ..-~...~ ............. pursuant to application dated ~c>_~c~ J~. , 19.~..~.., and approved by the Building Inspector. Rev. 6/30/80 TO~N OF SOUT~OLD BUILDING DEPArT}lENT TO~N ~ALL $OUT~OLD~ NE~ YORK 765 - 1802 11971 APFLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OK PRE-EXISTING BUILDING ...... VACANT LAND ........ 3outhold 1915 C!ear¥iew k~e.. · Location of Property ...................................................... HOUSE NO. STREET UAMLET County Tax Hap No. Property~ ~ s~lley Haeffner lO00 Section ..... Block ....... Lot' . ........ Subdivision ....................... Filed Map ........ Lot .......... Permit No..~8.~.6~.Z....Date of Per=it 3/13/90..........Applicaa~:iro..p~.e~t. .. .-.....~as.t.:.I.%e' for Owners ~/ ~eaith Dept. Approval ..~. ............ Underwriters approva£..., ........... PlanniuE Board Approval ..~/~ ........... Request for Temporary Cer~i[icace ....... Final Cer~i[icute ..~ ............. Fee Sub~i~ted: rev. 10/1&/88 FORM NO. ~ TOWN OF $OUTIIOLD B[IILDING DEPARTMENT TOWN [L~ LT. 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANC"f INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted tn the Building Imspector with the following; for new buildings or new use: ]. Final survey of property wlth accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of 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 solder used in system contains less than 2li0 of 1~ lead. 5. Commercial buildings~ industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the 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" laud uses: Io Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company ~hich shall show single and separate ownership 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 writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informagfon required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An applicatiou for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entize 10t prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. FEES: I. 3. 4. 5. 6. CERTIFICATE OF OCCUPANC~ -- New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swiping Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. Certificate of Occupancy on pre-existing dwelling - $I00.00. Copy of Cert£ficate of Occupancy - $5.00 - over 5 years - $10.00 Vacant Land Certificate of Occupancy - $20.00 Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy -$15.00 Residential , Commercial er. I0/14/8g FOUNDATIO:! I 1st) FOUrSDATI0:~ { 2nd ~ 2. ROUGH FRAME .FLUMBI~{G iNSULATIOH PER. N. STATE ENERGY CODE ~DDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~J~MING [ ] FINAL DATE INSPECTOR _~.~/~ 'ANCY OR IS UNLAWFUL lOUT CERTIFICATE OF OCCUPANCY ]~o~osF_D C~=C.~, APPROVED DATE: ,; ~ ,1~' ,,. 765.1802 9 TO 4 PM FOR THE ,.~ "¥, FOLLOWII~ G lC'T! :)t., 5: _ " ~ 1. FOUNI ~,~ . TWO REQUIRED '- · - .~ FORRi~ I, cONCRETE " " '~ ~ ~-', 2. ROUGH . FRAMING & PLUMBING ~-.,..~,~.,,. ,,^,/. =O,ST,~cm~o, ~u.~ I -'"--~~ m: co~ .Em FOR co. I'"-~...~~LL co~s' RUCI'ION .ti.ALL MEE'I' ..' .,~ ~d. ~T_H~ R~tU RSM[t~r8 01" THE N.Y. -- A3~ ' UCl N & ENERGY J -'---- ,,,,,,., .,, ~ ~o. o.'~.~. ~?"~// -LI,~ B .DJ TOWN GF FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 /t-BOARO OF t{EALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEFTIC FORM ................ ,proved . ! 19 /.o. P,,'mit No I x ..................sapproved. . ate .................................... . ~.~.. i~~....~._' (Building Inspector) APPLICATION FOR ~UILDING PERMIT NOTIFY 'CALL ..................... MAlL TO: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Buildin= Inspector, with s of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, lclationship to adjoining premises or public street: areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli ion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this appiicatinn, the Building Inspector will issued a Building Permit to the applicant. Such permi~ ~11 be kept on the premises available for inspection throu~=hout the work. e. No building shall be occupied or used in whole or in part for any purpose ~vhatever until a Certificate of Occupancy Lll have been granted by tb.c Building Inspector, <, ;, APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ ~ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to nit authorized inspector~ on premises and in building for necessary inspections. (Signature ol~ applicant, or, name, if ~. corporauon) .~.¢ ¢ q .~.< .c<.: ~.~'. (Mailing address of applicmat) ~te whether applicant is owner, lessee, agent, architect, engineer, general contractc~r, electrician, plumber or builder. .............. "'- ..... i t ;t' ....... ~pp[icant is a corporation, signature of duly authorized officer. (~) (Name and title o£ corporate officc~ Plumber's License No. ./~/./~. Electrician's License No ........ ' ........... Other Trade's License No Location of laud on which proposed work will be done .......... , ......'. ................................. [louse Number t Street~, Hamlet County Tax Map No. 10OOScction ...~.?~~ ' ' .%~ .......... Bipck .... I ~ Lot S~bdivision ..................................... Filed Map No ............... Lo~ ............... (Name) ~' Sm~e ¢x~sting use and occupancy of pmm~ses and ~nmndcd use and occupancy of p~op~sed construction; a. . .. ~ . ' .......... ~ ........ 3. Nature of work (check which., applicable): New Building ..... ' ..... Addition .......... a~l~,~ ,,-a,~//Alterati°n.,. ..... Rep~r .............. R~moval .............. Demolition .............. Oth~,~:*., .... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............. If garage, number of ca~ ............................................................... 6. If business, corn nercial or mixed occupancy, specify nature a~d extent or each type of use ...... 2... 2~.22: .. 7. Dimensions of existing structures, if any Front... i~ Q . . Rear .. H~igh~ ............... Nunlb~r o f Sto~s ...... O.~.¢; ........................................ . Dimensions of same structure with alterations or additions: Front Rear .......... Depth ...................... tIei~t ................ Number of StoNes .................. 8. Dimensions of entire' new' construction: Front ...... C~¢.(.~ Rear' . .~' '~{d~ ......... D~pt~ ........ ~1~,[ .... tlcigl~t ............... Number of Stohes .......................................... 9. Sizeorlot:Front......t~q:~... ... ...... Rear. [P~I~ ........ Depth ..~.Z,it/¢~5'.~............ I0. Date of Purchase ........... ' .................. Name.of Former Owner .......................... ~ 1. Zone or use district in whicli premises are situated ........ .~f,:.'g~(.6~...e.3q .'~..~ · . ........ 2. Does proposed construction violate any zoning law, ordinance'or re u/atio ':' i i i i i i ~. :... i... i iiiii[[~iii 4.3' Will lot be regradedt~ ...... ~' ][.[~.,3.D.: ............. Will excess fill~be removed from premises: Yes N Name of Owner of remises ~ ga.~c[qt~v3..e~. .Address [.ql5 '~,axu(eod .fiC~.'PhoneNo ' Name of Architect '. .......................... Address .~ .... ?~..°??.(~i'. .... Phone No ....... i iii.. i. Name of Contractor .......................... Address ................... Phone No ............ i.. Ii. Is this pcopect¥ located withlu~O0 feet of a tidal wetland,* *YES .... NO .... *If yes, $outhold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fron roperty lines. Give street and block number or description according to deed, and show street names and indicate whethe ~erior or comer lot. .'~TE OF ~EW yORK, · ...... . .~. ?.~.~x~ .~...~.3. i! .5~: :~ .......... being duly sworn, deposes ~a says that he is the applicanl (Name of individual signing contract) i$ the ....... LJ~ontractor, agent, corporate officer, e[c.) .aid owner ar owners, ~d i~ duly anthorized to p~rform or have performed the said work and to m~e and file thi~ licafion; that all statement~ contained ~ this application are true to thc best of his knowledge and belief; and that the k will be perfo~ed in the m~ner set forth in file application filed tli~rcwlth. m to before mc this ....... ........ day of ............. 19. LINOA J. COOPER Notary Public, State of New Yod;/ No. 4822563, Suffolk County Term Ex~ire~ December 31.19 ./" (Signature of applican[