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HomeMy WebLinkAbout18506-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219588 Date DECEMBER 14, 1990 THIS CERTIFIES that the building ALTERATION Location of Property 1065 KIMOGENOR POINT RD. NEW SUFFOLK House No. Street Hamlet County Tax Map No. 1000 Section 116 Block 06 Lot 24 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 7, 1989 pursuant to which Building Permit No. 185062 dated SEPT. 15, 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 REPLACE AND REPAIR EXISTING DECK OF DWELLING The certificate is issued to AUDREY W. WATSON (KIMOGENOR PT CO) {owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED N/A ~~L/ Building Inspector Rev. 1/81 l08M IPQ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COIvtPLETION OF THE WORK AUTHORIZED) NQ ~8J0~ Z Date l...l'.:~ 19. Permission is h eby granted to• ...~b,~..~.~r'~. ~.,s~~~.^ ro J~S~~G...... ...'.lZt~/./.¢..GIZr..~.«~e~~~/•~ry~...G~~'ftr......4[d~....~~~%...~.~.f.'S-h~°- . !.1 ~ . . . . . . . c . ~ ~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,~pp. of premises located at ....:101?. ....,r`G&".?.:?.? ArG.........t County Tax Map No. 1000 Section .......ll~~....... Block ..........tom...... Lot No.......'.a.~..,~" pursuant to application dated ..~j..7 19~, and approved by the Building Inspector. Od Fee S•`•~~~''~(X/.~'. cam'', ,a.!~. :.":~f~ ~uildi Inspector Rev. 6/30/80 _ Form No. 6 f ' TOWN OF SOUTHOLD ~ K`=„_r BUILDING DEPARTMENT ~ ~EC ~ 4 ~ 4 TOWN HALL 765-1802 ~ y~~~ eicr~` TOV~N OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANC~~~ 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 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. 5. 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.OQ, Swimming pool $25.00, Accessory building $25.00, • Additions to accessory Uu ilding $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 Date 'few Construction........... Old Or Pre-existing Building Location of Property......~°~~f...J~JR?A.C^~.Cb~6`.E.'...r~.r.h.t1 House No. Street Hamlet lnwer or Owners of Property County Tax Map No 1000, Section....f~~......B1ock......C~........Lot. Subdivision ....................................Fi/lpedc~Map............Lot...................... i'ermit No.. ~`~~C'lrl~~....Date Of Permit.../l-T/.9.1...Applicant !Iealth Dept. Approval ..........................Underwriters Approval.. Planning Board Approval Request for: Temporary Certificate........... Final Certicate........... Fee Submitted: $ a~.a.o ~ C p z ~ ~ ~ / ~ /ye ~.APPL1cANT r"LcL~ ~ 'I iJnTL j~ ~i:.`f'•i L,V i.: • c 1. d ~ I ~ 1 - H FOUtIDRTI0;1 (1st) FOUIIDATI017 (2nd) _ 2. z 0 ?OUCH FRAi•lE & ~PLUMBI~UG ~ Cn\ H 3. ~ m n IIISULATIOi7 PER N. Y. STnTE E;fEROY CODE r ,G o 4 . ~.r ~ f FI;1AL I • ~ . ~ ~ p ADDITIOPJAL C06?hfEtdTS: t ~l tr ' ~ ~ b~ H } H H O m a r- ~-7 • v m v H ~ ~~s.z~~ BUILDING DEPT. INSPECTION (]FOUNDATION iST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] iNSU TION [ ]FRAMING / iNAL REMARKS: ,7 DATE ~ ~ INSPECTO 0 " V tS ~ ~ BOARD OF HEALTH •a.K.: - 3 SETS OF PLANS • S~ ~ ~ ~FORMNO.1 SURVEY T ~ TOWN OF SOUTHOLD CHECK - • ~ (r; • • BUILDING DEPARTMENT SEPTIC FORDS BLDG. DEPT. TOWN HALL TOUVNOFSDUTMOLD._ &OUTHOLD, N.Y. 71971 NOTIFY jS ~ TEL.: 765-1802 CALL - - • • • -D• • r • • • gg-- ~ MAIL T0: /iefiuc~s ,d,cuca.,cu Examined . 7.. 19 ~ o ~71~x. ' Approved ..1.~~5......., I9~PennitNo. ~~`fdG U i~Q3f Disapproved a/c . t .~.~.j ~ dl (Building Insp ctor) APPLICATION FOR BUILDING PERMtT Date 19.. 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 perm 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 Occupan~ 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 ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the~~§~~tr'~c ~i~~bu~r7~dings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to gi y with all applicable laws, ordinances, building code, housing code, and regulations, and admit authon'~e~' ~ ~ ' ir`f~`pecT'ors do premises,and in building for necessary inspections. /s_"1~s. . pfy rpro ,q-, s . ~ (Signature of aprp~licant, or n1am/e, if a corp~o/ra/ti/on) ;_'Sliu?3~ 37~~~,.t.r, , h7`ev~n .lv/"r.. ~~l!?~ .[~..~[!~1:.... _ ' ~ • . • - ~ (Mailing address of a~icant) State whether applicant is owner;?let;see, dgent, architect, engineer, general contractor, electrician, plumber or builde ..........Tt~fl~` A" Name of ownerWfm~s ::1:'res$4r:~~!:...~`.~.°.'PSr-Yl.'a....... . r%1p31M3 ; LtCdt ;,KSt'~ 3',• (as on the tax roil or latest deed) If applicant is~~ o>~~~nT s~gn~ture of duly authorised officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder'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 Z-..t~..........`. Subdivision Filed hlap No. Lot.............. (Name) 2. State existing use and occupancy of premisesa~n~d i~nt1ended use and occupancy of proposed construction: a. Existing use and occupancy ~~`~'G°~~/` , , . b. Intended use and occupancy ~ ~~v~ 3. Nature of work (check which a Iicable :New Buildin PP ) Repair . , , , ,x • . , , , , , Removal , g ' ' ' ' ' ' ' • • • Addition • Alteration , , • • • • • - • Demolition Other lV qrk, 4. Estimated Cost P~ © o a (Description) y r . Fee 5. 7f dwelling, number of dwelling units ~ lto be paid on filing this application) If garage, number of cars , , , , ' ' ' ' ' ' • • • Number of dwelling units on each floor . 6. If business, commercial or mixed occu ane • • • • ~ • ' ' ' ' ' ' ' ' ' ' ' 7. Dimensions of existing structures, if a y_ F7pnpeciJ~ Lure and extReaof each ty e of use , - ~ • Height 2.Q,! . , , ....Number of Stories .....,1~.. , ~ ~'6' ' ' . • • • Depth Q _ . Dimensions of same structure with alterations or additions: Front . ~6; ; • ~ • ~ ~ ~ • ' ' ' ' ' ' ' Depth 5!Q. ~ - • • . ..Height ZS?,', • • • • • • • • , , , ,Number of Stories Rear . , . 8. Dimensions of entire nets construction: Front , , , , Height ~ . G Rear............... Depth ..Number of Stories . 9. Size of lot: Front ' ' ' 10. Date of Purchase Rear........... Depth 1 I. Zone or use district in which premises are situated , • Name of Former Owner , ~ ~ ~ ' ' ' ' 12. Does proposed construction viol to any zoning law, ordinance or regu]ation: • ~G7 • 13. 1Villlotberegraded „/j~d• 14. Name of Owner of premises r Gj„~%,r, • ' ' ' ' • Will excess fill be removed from premises: 'Yes Name of Architect n... Address//. ;t•rnJ mh.~r!?,Rd, p}tone No.. 7.3/- 66~3~ Address ,-~'J.. • • • ,Phone No. . Name of Contractor , • , , , 15. Is this p y •••••••••Address pro err located within 300 feet of a tadal wetland?•*yeS~ "Phone No. *If yes, Southold Town Trustees Permit ma be re u~ired. gg •X.. No PLOT DIAGtcAM Locate cleazly and distinctly all bui]dings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or'de~ription according to deed, and show street names and indicate whether interior or corner lot. Sr;°~ Sv I" Ue~ AP D NS NOTED _ ~ . DATE: - Q.P. 8 7~vrQ ,6 -FEE: a . NOTI UI DE~PA, 766-t8(I2 8 AM lU 4 PM THE FOLLOWING INSFECTtONS: t. FOUNDAT1pN - TbVOREQWREO FOR POURED CONCRETE 2. ROUGN _ FRAMING ~ PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPI.ETc FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCttpry i ENERGY CODES. NOf RESPONSB~E FOR UESIGN OR CONSTRUCTION ERRORS STATE OF NER' YORK, COGNTY OF S.S (Name of individual sip ' ' ' ' ' • • • • • being duly sworn, deposes and says that he is the applicant ~bot•e named. oning contract) ileisthe (Contractor agen ,corporate officer, etc.) of said owner or owners, and is duly authorized to perfo~r 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 me this ...............:~........da of... Y 19~y rotary Public, ....a`a?/G~x,~. a~. ,QL•U • ~ • • • • County ~ HELEN K DE VOE . 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