HomeMy WebLinkAbout18467-z N
I FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24064 Date DECEMBER 6, 1995
THIS CERTIFIES that the building ADDITIONS
Location of Property 360 LARSVIEW TERRACE EAST MARION NY
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Hlock 9 Lot 12
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AIIGUST 24, 1989 pursuant to which
Building Permit No. 18467-Z dated SEPTEMBER 12, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
iaeued is A DSCR AND ADDITION TO AN BBISTING ONS FAMILY DWELLING AS
APPLIED FOR.
The certificate is iaeued to WALTER & LINSLL GAIPA
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING DECEMBER 4, 1995
PLUMBERS CERTIFICATION DATED N/A
Building Inape or
Rev. 1/61
l08M NO.f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ° 18 4 6 7 z Date ....~:.~Q.. z........., ~ 9.g:9
Permission is hereby granted to:
4:.. '
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to a.....~.~-.s.~: ~....~,.~td4~.'v:~... ~...,~~-:.~.1.:~...
/ f p.........
cY premises located at ....T~i .W.CR..... ~.K.h4en~..........41.1~-a.~:.... ~:.a..~r....:...'..A~4:?.`.r1........
Caunty Tox Map No. 1000 Secti 3. Block Lot No......~.
pursuant to application dated !:sru.V•.......~.`.`..........., 19R.~.., and approved by the
Building Inspector.
Fee s..~~l.:...
..r~.Cf.°ti.
wilding Inspector
Rev. d/30/80
Form No. 6 J~`1`~~ / `1
~ TOWN OF SOUTHOLD 1..~ ( t c~
BUILDING DEPARTMENT
TOWN "MALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OF, 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/IO of le 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 tc 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 525.00,
Alterations to dwelling $25.00, Swimming paol $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 - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential 515.00, Commercial $15.00
y~~ J~ ~
Date /1/~!~C~%./. 1~~
New Construction....... l,, Old Or Pre-e isf~,ing Buildin
JJr'~ .
Location of Property.:`:~.........:.~~14~'1/12+N ~~~Qi-~.. Q/
House No'JJJ~~f////'',1J~9 /J St/r/e~~eyt yy~ Hamlet
Onwer or Owners of Property... Y: :(X,.~~I.~G!~~cf.. IJ.~Z.~:t"
County Tax Map No 1000, Section... ~.......Block...../~........Lot...`
Subdivision........~7 ......................Q....Filed Map........ ./~JLot././~-'' ,,,~ppy..~~~............
Permit No.../~~~ .Date Of Permit... (~~~~.~....Applica , .~41~,. V~~
Health Dept. Approval ..........................Underwriters Approval.........................
?fanning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: 5 ~~~~~~~(fOsJ.,Gc.
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BUILDING DEPT.
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BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [INSULATION
[ v]~FRAMING [ ]FINAL
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REMARKS:
DATE lO 1 INSPECTOR
8 7 765-1802
BUILDING DEPT.
INSPECTION
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[~UNDATION 2ND [ ]INSULATION
[ FRAMING INAL
REMARKS: 1~' CC ~ SS
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3 SETS OF PLANS t!~:-•.
FORM NO. 1 SURVEY ~ .
TOWN OF SOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971 `f 77 /did
TEL.: 765-1802 CALL
t~ MAIL T0:
Examined I?:, 19 8 `j
Approved~E~.~~!".~. 19~ Permit No..l. g.? ~O.?.~'.
Disapproved a/c .
.
(Building Inspector)
APPLICATION FOR BUILDING PERMIT ~
Date %'t-, 1~~
INSTRUCTIONS
a. This application must be completely filled 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 stree+
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl
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 permi
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in pazt for any purpose whatever until a Certificate of Occupant
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describes
The applicant agrees to comply with all applicable laws, ordinances, buildinpydode, housing c de, and regulations, and t
admit authorized inspectors on premises and in building for necessary inspec ps.
(Signature of applicant, 6r name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or buiIdei
...................:vLr!~:---....................................................................
Ji
Name of owner of premises (~~i.^!L! Z` . [/tti4 fit., .....Lll7:~~':
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Biri]der's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
1. Location of land on which proposed work will be done . .
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot .
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occu ant ~.4 iu ~ r'?'.:. ~Xsi;:}~, A '1 fro'; ' . . . . . .
..........K>....
b. Intended use and occupancy j ;1D~IG.~!• (I,~/.~lF'.1~?rV .
3. Nature of work (check which applicable): New Building Addition Alteration ,
Repair Removal Demolition Other Work ~~~C~`.C.:/::';;
(Description)
4. Estimated Cost : I G)v' .~:i.~........... Fee . .
` (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 cars
6. If business, commercial or mixed occupancy, specify nature anal extent of each ty~e of use
7. Dimensions of existing structures, if any: Front p <,~1.~ '
Rear ..~v~; De th
Height !.....Number of Stories ~l1tl .
Dimensions'of same structure with alterations or additions: Front ~.f; ~ , , , , , , . , , , , Rear ~:s:.......... .
~ Grp%c'"- T J
Depth ~t.4r......... Height ........5............ Number of Stories L:..~.i .
8. Dimensions of entire new construction: Front , . 7 , Rear Depth .
Height Number of Stories {'l./',~~.'.................. .
9. Size of lot: Front ...........Ju'........ Rear ....Ifi..~........ ~ Depth r'. ~ ~ .
10. Date of Purchase . .........Naive of Former Owner ...t"r`i?~r~n!? ~v/yi,.(--
11. Zone or use district in tvhich premises are situated ".:~:4'............ .
12. Does proposed construction violate any zoning law, ordinance or regulation: , ,`~t,C), , , , , , , , , , , , , , , , , , , , ,
13. Will lot be regraded s~'.`:3 Wi13 excess fill be removed from remises: Yes Nc
14. Name of Owner of premises 'U?e. ~';%:.~P S!h5?.~.4T Ff~ 'Address;:" !)s~?: !Y?. icaf4: /'~R~~'Phdne No .~1; ~J-?', , , . ,
Name of Architect . ....................Address ...................Phone Na.'.''` f!~:'~... .
Name of Contractor s.~
'Y.:,~'..~ Address , .Phone No............... .
15. Is this property located within 300 feet of a tigidal wetland? *Yes No J~..'
*lf yes, Southold Town Trustees PermitPLO~ DIAGKAMed.
Locate cleazly 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 OF NE\V Y S.
COGNTX OF ~L?J . ,
........~V. ~S. j~`C f'.... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the .............................~£~t1/l-P.~..................,.........................
(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 this
application; that all 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~e this n cQ
of .......day of .....'~/.(„`.t . S f-., 19 .O,/
Notary Public, . ~~Q......... County •
CWRH S» OtE1N
Nont~rP
~o,lMwYak
S~folkC~ly (Signature of applicant)
Commksbn Expirea Oacembor 8,18
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