HomeMy WebLinkAbout18527-z t
FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19341 Date SEPTEMBER 6, 1990
THIS CERTIFIES that the building ADDITION TO ACCESSORY
Location of Property 330 YOUNGS AVENUE SOUTHOLD, NEW YORR
House No. Street Hamlet
County Tax Map No. 1000 Section 64 Block 1 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 15, 1989 pursuant to which
Building Permit No. 18527-Z dated SEPTEMBER 20, 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 ADDITION TO ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to STANLEY ANDERSON
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
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Building Inspector
Rev. 1/81
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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)
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N _ Z Date ...5:~~~:n...1~..
a.,.... 19
Permission is hereby granted to:
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~O~~Cti QR.......Q:~:.:.....~iS.~~rS~1f::S1...7~^.:
n.
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ct premises located at ....a~s
.~?...~~.5.... ..:.......~~rCX?~.."."
County Tax Map No. 1000 Section ~..~..t... Block gLot No.....~.~...........
pursuant to application dated ~.y~......., 19 and approved by the
Building Inspector. UU
Fee 5..°,Tl.../.~•.~...
Bu ing Inspector
Rev. 6/30/80
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Form No. 6 Pd-,t~,3710
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-1 ? TOWN OF SOUTHOLD
~C~ ?Ii BUILDING DEPARTMENT
' 4 j TOWN HALL
y 765-1802
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APPLICATION FOR.CERTIFICATE OF OCCUPANCY
.1. 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:
L. 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 LZ 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 huilding $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
Updated Certificate of Uccupancy - $50.00 ,
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
:.cw Construction..........2.,-.,Old Or Pre-existing Building
Location aE Property...~:'s-1 ....................~D.11a1.G~..AY ~,.........:.~tV:~A~.~.._N :~,[t
House No. Street Hamlet
Onwer or Owners of Property...~~.,~~`.~.. W.t:1~A4~ZSatJ.
County Tax Map No 1000, Section ..............Block................Lot......................
Subdivision ..............................p./. .../Filged Map............Lot.............:........
Pezmit No, /~5z7~,,,Date Of Permit..lJ.~'O` B./.....Applicant~Sl~JvEi}..5~`~~.-.ice°~
Health Dept, Approval ..........................Underwriters Approval....................,.
'
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: $
PLZCANT ~
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~ ~ 765-1802
BUILDING DEPT.
tNSPECTlON
[ ]FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
FRAMING [ FINAL
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DATE INSPECTOR
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REMARKS:~.~...
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BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. r SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y. 11971 NOCALL a~~ = ~c~.3-.Q.9`5D.
TEL.: 765-1802
MAIL T0:
Exami ~p 19 ~ 9 '
0 t ~ ~ ~.U V~
ApprovAC~:k~~yrt.~o.,19~~.PermitNo.1.$.~.a~ n
Disapproved a/c ~ ~ Dh7o?
~j laLY,G..r
0..A-BLl/
TOlhrni rs=_~' .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
F
Date . ~~{s 19
INSTRUCTION S
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 stre~=
or areas, end giving a detailed description of layout of property must be drawn on the diagrsm which is part of this app
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 Petmit to the applicant. Such peer
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 construction of buildings, additions or alterations, or for removal or demolition, as herein describe
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 in pections.
(Signatt[re of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buiIde
.......~~?.~.~4Z-........
................'.n.......................................
Name of owner of premises ~.WS~}~:~:{.. ~..y-~nS~E2Sonl
(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 MUScT BCE SUFFOLK COUNTY LICENSED
Builder's License No. : N.-~- .
Pluntbcr's Licensc No . .
Electrician's License No . .
Otlrcr Trades License No . .
I. Location of land on which proposed work will be done. ~ l/r~] ~S AVE , SOU i
t'(pl,S~r [til,t~,
...~30 ~fOUY~1CoS. , t'~~C.~...............S4~r~-~~ ~a rt 4'~ :`~.i.... .
House Numbcr Street Hamlet
County Tax lvtap No. 1000 Section ...~~0.~.......... Block Lot
Subdivision Filed \1ap No. Lot..............
(Natne)
State existing use and occupancynof premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . ° (.~S4P€rU~'.f . , ~T~ , , CgAn!?fit: , ~n1,t~lu~. ~ s. U~?.p, Fo tI guru Pw S STn
b. Intended use and occupancy ~~`>\t'?ka~~..w1~:1:1.. Cor1r?14,CeE.. FaeZ Usk _'r'o SZ-oR~ ~N"Ilov%~
3. Nature of work (check which applicable): New Building ...C...... Addition t'• • • • • Alteration .
Repair Removal Demolition - Other ~5'ork
(Description)
4. Estimated Cost Q ~ Fee ....~q 1. t .
` (to be paid on fi]ing this application)
5. If dwelling, number of dwelling unit , Number of dwelling units on each floor .
If garage,numbcrofcars
6. IC business, commercial or mixed occupancy, specify nature and extent of each type of use . .
7. Dimensions o~~xisting structures, if any: Front Rear Depth .
Hcigttt Number of Stories ~ O
Ductcnsions o re with alterations or addi ions: Front J. ~ Rear ~r~....... .
Depth . Height ~ y S, , . Number of Stories .
Depth ~
8. Dimensions of entizre new construction: Front ~ Rear .....`:~.y. 3 , .
Height 2... ~'wttber of Stories ......2 .
9. Size of iot: Front , q Rear , . l.Y.~c! 3`~. Depth /VC,zrif Z~G.3: sort !(0.4
10. Date of Purchase..... ~lZS.~."?.q Name of Former Owner t~l~K'~h~?6R..:~ XSK,C-~
1 1. Zone or use district in which premises are situated . 265LLZ~kn a~ .
12. Does proposed construction violate any zoning law, ordinance or regulation: N ~ .
13. ~yill lot be regraded~r?4'a4tt~PN. ~~!D~ti~ .~!?Ep. , wi]I excess fill be removed from premises: Yes Nc_
14. Name of Owner of.premises :...NCEY . ~+~~'u4N.. Address? o: 3o K_'3.710. S°``"""' Phone No.Sr!~r; .'I 4S: !t
Name of Architect ~C.~w`(.. 4-,V riAfiB~:~........ Address ~~?EtN Peer, WAY , ,Phone No .
Name of Contractor ...S~~F..(.4~+~!~:+':'?< <ay?~~S)Address ....:..............Phone No.............. .
15. Is this property located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustees Permit may be regu~ired.
PLOfi DIAG1tAh1
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 description according to deed, and show street names and indicate wheme~
anterior or corner lot.
Scl:,_ ~TT~Ct-i~~D PLtattiJS
iTATE OF KE~V YORE, S.S
~O1iN7'Y OF
. being duly' sworn, deposes and says that he is the applicant
(Name of individual signing contract)
Dove named.
icisthe
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and fife this
~plication; that all statements contained in this application are true to the best of iris knowledge and belief; and that the
ork will be performed in the manner set forth in fhe application filed therewith.
worn to before me this 9
~.5~.. day of . 19 8/,
otar}' Public, ,7f,•, , (L(;~ 1!~. , County ~j
HELEN K DE YOE ~,-ylC~-::S ~ . ~^.~{.n-:2u~ .
8._._1 (Signature of applicant)
~~TOlb
B Su~pulktbwdl 1
Tam Exprei IMrch 30.1