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Home My WebLink About18670-z R FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18993 Date APRIL 25, 1990 THIS CERTIFIES that the building ADDITION Location of Property 625 SOUTHERN BLVD. EAST MARION N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 21 Block 3 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 20, 1989 pursuant to which Building Permit No. 18670-Z dated NOVEMBER 27, 1989 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 AS APPLIED FOR. The certificate is issued to BETH & THOMAS WILSON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NJA UNDERWRITERS CERTIFICATE NO. N/A " PLUMBERS CERTIFICATION DATED N/A i1 ing I spector Rev. 1/81 ana:~ xo. a 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 o 18 G 7 0 Z Date ...1.~~ 19. Permission is hereby granted to: . ....a,~...... of premis s located at ....lu...2.~~.......~.~i.>-.!~..... .,c County Tax Map No. 1000 Section Block Lot No........~...,/........ pursuant to application dated ......lf..~l..~"+~ 19..~ and approved by the Building Inspector. ~ Fee $.r~~..11.. i'~ GrW~r.~..,.~.. r..Y....... ..~~~.~.r uildi Inspectal~' Rev. 6/30/80 t ~ Form No. 6 , ~ TOWN OF SOUTHOLD ~ APR 2 ~ I9~1 ' ~ ; E ~'s BUILDTOWNDHALLTMENT / p / ~ i ~ ~~hL~~;' i / P ! ~~JJ~~" ~,,,.a_„__..., 765-1802 BLOG.~pEF'T: YOVdN~,~OUTt,ltSEC!,_, APPLICATION POR 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 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 ly 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: 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 - $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 - Residential $15.00, Commercial $15.00 I(~ Date r New Construction. C:... Old Or Pre-existing Building . Location of Property....G a.5 .................J~. ~.v./'~~':~N ~!(Y~ ~t`~Sl~, l7?18;2!~4.'~ . House No. Street Hamlet p ~ Onwer or Owners of Property., ~ i/yj~?5,. ~.f''`~.... ~/.l-.~~~..T~ County Tax MaAg No 1000, SectPion....~.J.......Block....~...........Lot....:z-9 Subdivision.~!Q~1Q~txGi~...t.~~~.~C........//....FiledppMaplE~.,.56~ t. .Lot.... ~ Permit No~~67~..~r.-...,Date,,AAOf Permit..l~(.~.~~~.1...Applicant.&?~':~`7.--/~".QQ~~J'O~l~:j..~?LIsQ~ Health Dept. Approval.... N~r!n./. ...........Underwriters Approval...t'~:~r, Planning Board Approval....,,1~! r~........... Request for: Temporary Certificate........... Final Certicate....~..... ®a Fee Submitted: ~./Df.~' L O ~ ~ ff9~ ~ APPLICANT / ,+dC~alt.~?!,q Ofl'iCli ()l~ IiUILDiNG iidSPCCTOR _:f "~~~;~'l~L ' [',o. ISO}i 728 ~ti`y'. :l,y+~y,;~ "COWiJ (FALL ~ , ``~~:cc'~'`.<•~ SO(I1'1IOLS), iV.Y. 1 1971 ~f/~! al~a April 5, 1990 BETH S THOMAS WILSON 625 SOUTHERN BLVD. EAST MARION, N.X. 11939 To 41hom This May Concern, 67e are unable r_o complete your Certificate ' of occupancy becau~c,of the following reason. ~ e•' 1_-?! nn :inplication :or Ce~tificatc of Occupancy is not on file. (ENCLOSED) / )!o tlndcr•::riters CcrL-ificnto on file. /i!/ 'i'1~e cliec}; .i~ (cg,XR~~$d€~~not o:i file.) $25.00 t:n ;Ir.11th P,ept. Approval on file. l:c~ final inspection has bee:1 made. P]e.i:;e contact our office on this matter. Thank you for your cooperation. 3uilda.nr, Permit 1 8 6 7 0 Z Builclinc[ Ucpt. fin i'lumbcr Solder Certificate on file. ( all permit:: involving plumbing being iarvecl after April 1,19II9 ) I i~LD i::~. n . ~~;in: ~ 1~ ~va:4LNT~ n 1 f ~ II ~ r'OUiJDATI0:1 (1st) ~ a - ti =OUtJDATIO;J (2nd) m~ I o ~ ~OUGH FRAifE & .PLUMBING ti y 3. ~ m n I1ISULATIOPI PER N. Y. • • STATE EPIERGY I ' CODE II x ~ o v/ m ~ , ~ ~ ` F I;1 AL ` ~cQ • o ADDITIOPJAL COMMEIITS: x`~ m r,~ • x H . •v • H O H • m } • r\ • - / = ~y. c*f H BOARD OF HEM\LTH 3 SETS O~PL~INS FORM NO. 1 SURVEY • . TOWN OFSOUTHOLD CHECK .~~:«r~ BUlLD1NG DEPARTMENT SEPTIC r•ofzrf ' TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY TEL.:7G5.1802 CALL AIL T Q~ ~ ~ ~ q y~ ~ Examined ~~y.7......., 19 !~Cl, ~.Jv-~-'-e-~ I ' ~ Approved f 2r.7 I~JV'7. Permit No.. 6, ~~-~-'@- ~{~.~a~~ Disapproved a/c ~~'y j~ 'r-r,:,.~. ,r, ~(Bui mg Inspector) 7glN~ ~F _ OFpT APPLICATIO FOR BUILDING PERMIT SOUTI' 0 Date ..~r . 15~a INSTRUCTIONS a. Tliis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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. 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 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 iemoval or demolition, as herein described. Tlie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit au±horized inspectors qn premises and in building for necessary inspee ~ s. ~~~s~~~~-~"'"="'-_' J,r'.. v~ . . (Signature of applicant, or name, if a corporation) 5~ Je~7I~~~sr/ psi ~~J~/t«~~ . (Mailing address of applicant) ?t/d/• IP°~d State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name ofo~ggera.ftpremises,<::..'.:~~f~/%~.:~..i.'~~~~T?•t~t..f... 'G.!.'. ,,,,,,;iya ~ ~ ~ ~ - ~ , (as on the tax roll or latest deed) if applicants a ctl~t~p~it~(igii; signafure of duly authorized officer. . dt. ;tit e.~ti . (Name and title of corporate officer) Builder's License No. ~ W Y12~........... . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Lofcation of land on which proposed work will~be,d/one . . House Number Street. _ Hamlet ~^y County Tax Map No. 1000 Section - • • • • • Block Lot .4 ' ~nt Filed 1\Ia No. . , ` Subdivision . l7.Q~~i. (~J..4'.G.v'.... /.~/9.~ ~f.. p S~~ ~ ~ Lot . (Name) State existing use and occupancy of premises and intended use and accupancy of proposed construction: a. Existing use and occupancy ~~i/~/.%'~r, .....~~G~~~~!f; . ,.,..,,,a., b. Intended use and occupancy - Re air , , • • • ( pPlicable): New Building , . Addition Alteration . 3. Natpure of work check ~4'h~Rcmoval Demolition Other 1Vork . ~i o (Ddscription) 4. Estimated Cost ..:~~?~c~~.' /.a Fee . 5. If dwellin number of dwelling+ (to be paid on filing this application) g, units Number of dwelling units on each ?oor . Ifgara;c.numbcrofcars 6. If business, commercial or mixgd occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front . Rear Depth . Height ...............Nur}tberofStorics....................................................... Dimensions of same structure with alterations or additions: Front Rear . Depth .Height ......................Number of Stories . • Dimensions ofr~entire new const~n:ction: Front Rear Depth . Hcigltt ~ f ~ Number of Stories : 9. Size of 1 n Rear . Depth . , • , 10. Date of Purchase , • Name of Former Owner 11. Zone or use district in which.pmises are situated . . . , , , , , 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . 13. \Vill lot be regraded Nill excess fill be removed from premises: Yes T*l< 14. Name of Owner of premises ....................Address ...................Phone No.............. . Name of Architect . .............Address ...................Phone No.. Name of Contractor . .Address ..Phone No.. - . IS.Is this property looted with in~00 feet of a tidal wetland? *YL~S....NO' *If yes, Southold Towp Trustees Permit may be required. • I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or descriptipn according to deed, and show street names and indicate whethe: interior or corner lot. s o•. m M ~ , ' ~ AP RO EO AS NOTE PATE ~ 7'~ ~?r B.P. # ~~67® ~ NOTIFY UIL ING DEPA E T AT ty 765-1802 9~ AM TO 4 PM FOR THE ~ FOLLOWING INSPECTIONS: ~ s ~ Q 1. FOUNDATION • TWO REQUIRED y ash ~ ly FOR POUNED CONCRETE ~ _y~/ ~ ~ ~ 2. ROUGH -FRAMING & PLUMBING 3. INSULATION r-I 4. FINAL - CONSTRUCTION MUSt BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~f ~p 70~ STATE CONSTRUCTION 6 ENERQY p~nGKl' Pr~.rrvT Rcl CODES. NOT RESPONSIBLE FOR _ _ _Y- _ p~SIGN_ORCONSTRUCTIONERRORS I ~v INek'l1J_ II ~'rJvlt, d'~g,~~ STATE OP NE1V Yr~K,~ I S.S COUNTY OF I/L....... . • • • • • • • • • • • • • e~v,• • • ~•1~ • • • being duly sworn, deposes and says that he is the applicant (Name of individual singing contract) above named. fie, is the.......-~,,........~ (Contractor, agent, corporate of(iccr, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tltis application; that all statements contpincd in this applic~[ion are tn:c to the best of his knowledge and belief; and that the work will be performed in the manner se[ forth in the application filed therewith. i Sworn to before me this ............~~~.....day ofi.. v . , ]9 `~9 Notary Public,.. .County CLAIRE L. OLEW . . 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