HomeMy WebLinkAbout18121-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218482 Date OCTOBER 19, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 4615 OAKLAWN AVE. SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 70 Block 10 Lot 13
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit hereto€ore
filed in this office dated MAY 11, 1989 Pursuant to which
Building Permit No. 181212 dated MAY 17 1989
was issued, and conforms to a:11 of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is FOR EXISTING ATTACHED DECK.
The certificate is issued to WILLIAM VERME
(owner, xxxxxxxxxxxxxxxx)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PI,i7MBERS CERTIFICATION DATED N/A
ild ng Inspector
Rev. 1/81
!'08M N0. f
TOWN OF SOUTNOLD
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 81. ~ ~ Z Date 19.......
Permission is hereby granted to: , ,
.~...e..~/....
.
of premises located ot ........~~L.os........4.r°.r~~~..'.~G?~....~.:`~
County Tox Map No. 1000 Section Block Lot No.........~-~........
pursuant to opplication dated 19........, and approved by the
Building Inspector.
Fee $...~y..~~~~.'~z`~=,.•
~~DO
per' . s~,l~iv2'~..~t
Bu ng Inspector
Rev. 6/30/80
~1
~ TOWN OF SOUTDOLD
QJ (~~J BUILDING DEPART?PENT
~~.I~a~,J iJC ~ TOWN IIALL
I\ SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE... J~~
NEW CONSTRUCTION ._.....OLD OR PRE-EBISTING BUILDING. pACANT LAND....__..
Location of Property........
UOUSE NOJ~~ STREET UAMLET
Owner or Owners of Property..':'!!/~/"hI
--.....~~?r-~---:~
County Taa Map No. 1000 Section
Block LoC
Subdivision.. !
Filed Map ........Lot.'.'././.
ate of Permit
Applicant ~C?I~ C~ l~~-
IIcalth Dept. Approval Underwriters Approval... !
~y
PLanning Board Approval
Request far Temporary Certificate
Final Certificate
Fee Submitted: ~J1ivU
APPLICANT... _/l~ L,
C ~-~L
ErL~G~~- .
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3 ~Y~/
~ yo ~g~~1z $ so
~~z,~y~a as
rC°• 10/14/88
r
FORM N0, 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
- TOWN AAL.
' I 765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must be filed in typewriter OR ink and submitted to the Building
Inspector with the following; for new buildings 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 of Ae~l[h Dept. of water supply and sewerage-disposal(S-9 form).
i 3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that solder used in system contains less
than 2/10 of IZ lead'.
5. Commercial buildings industrial buildings, multiple residences and similar,
buildings and instal}ations, 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. Far existing buildings 4Prior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" land~~.uses:
1. 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 which shall
show single and separate ownership of the entire lot prior to April 9, 1957.
- If a Certificate of Occupanc is denied
Y , the Building Inspector shall state the
reasons therefor in ctriting to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent informatioq required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1_ An application 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 entire lot 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.
D. FEES:
1. CERTIFICATE OP OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Occupancy on pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20:00
5. IIpdated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $25.00 Residential
I $50.00 Commercial
rev. 10/!4 /S8
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7sS-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] RAUGH PLBG.
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REMARKS:
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BOAFD OF HEALTH
3 SETS OF PL<1NS
- FORM NO.1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORtt
TOWN HALL
EOUTHOLD, N.Y. 11071 NOTIFY
' TEL.:765~1802 CALL
~7 rc^ '
Examined 19a:'' MAIL TO:
Approved . S-.~~.~......., 19Pcrmit No~~~~~..~~. r^.,
Disapproved a/c ~ !i
i~. 3
NpY I 11989
. BLDG. DEPT.
• . • tildi - nspector)
'TOWN OF SOUTHOLD
APPLICA ION OR BUILDING PERMIT / p
Date . ~~/.'!(...vl.,~... 1517
INSTRUCTIONS
a. Tlus 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 removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code and regulations, and to
admit authorized inspectors on premises and in building for necessary ins ec ions.
' ~ (S'~ attire oi' appli~, orra , if a corpora/tion)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~G~/G,0~2
.
Name of owner of premises Glf/1,4~1~~/.>...U~.P-~'~P, , , , , ..DATE. . • •
(as on the tax roll ~
IC a lican[ is a cor oration, signature of du] authorized officer. AT
PP P ~ y 786-1802 8 AM 'ID 4 pM FOR THE
FOLLOWING INSPECTION8:
fouroDATION tvt10+o
(Name and title of corporate officer) ~ FOR POUREDCONCREIE
`a ~0 ~ f~~ 2. ROUGH • iRAMING 8 p6tNN81NG
Builder's License No. ...~l... 3. INSULATION ~y
4. FINAL - CONSTRUCTION MUST
Plumber's License No. BE GOMPLETE FOR C.O.
Au CONSTRUCTION SHAH ME^
Electrician's License No . THE REOUIREMENT$ Of tHE t
STATE CONSTRUCTION Qi ENF'
OI}tcr Trade's License No . CODES. NOT RESPONSiBLtE
O1nSIGN OR CONSTRUC71pN E,,
i. Location of land on which proposed work will be done.
House Number Street. Hamlet C~
County Tax Map No. 1000 Section b.......... Block , , , , , Lot ; , , 3, , .
r
Subdivision F.ilcd t•tap No. Lot .
(Name)
Stale existing use and occupancy of/premises and intend~ed--use and oc~c~u/pancy of proposed construction:
a. Existing use and occupancy l.d~.~Y...~/"~I~~G/1~.
/,%Q~j~ . . . . . .
b. Intended use and occupancy u~y . J.~~~, , • • • .
• ~G,~..
3. Nap re of work check w•hi~h applicable): New. [luilding Addition rUteration
~'.~c~
Re air moval Demolition ~ • • • ~ • ~ •
• • • • Other 1Vork .
4. Estimated Cost , , , , , , (Description)
Fce.....................................
5. If dwellin^, number of dwellin (to be paid on Cling this application)
. • • 6 units , , , , , , , Number of dwelling units on each door. r/, , , , , ,
If gars^c, nuntbcr of cars ..l..... • • • • • •
6. If business, commercial or mixed occupancy, specify nature and extent of each yt pe of use . 'p
7. Dimensions of existing structures, if any: Front . '~v~~'
Hci~ht ..~5...... Rear 65......... Depth .4?~9.
Number of Stories .
Dimensions o same stnjct.}~rc~~y~th alterations or additions: Front , ~S Rca • • • •
Depth .~~;:~1~ rx~o'2 .?r~.4~ I Icight b'.. .
••••••••.....NumbcrofStorics..f
Dimensions of e~nt~r~w consGntction: Front , /P? , , , , , , Rear , , ,/a2~, • • • ' ' ' ' '
Height Depth ~a; .
• • . Nm~tbcr of Stories . . /~/(~n(,&,
9. Size of lot: Front /`.Gd: Rear . ./.4.~.,~5!.. • • • " " " " "
Depth ~YS.L.~7.......... • .
10. Date of Purchase ,,.,,,~:"~~I?'~~•••••'
N c of Pnrmcr- ;vn'=r ,y4G~. /T,z.~~/1Je~
~ ~ emises are situated GO , . ' ' ' '
. P,S t~,ll~L..1.~.' .
1 1. Does °roa osedsconstructlionty' r ate an zonin law, ordinance or regulation: , , • • ~ ~ • • • ~ ' '
p y S i?Q
l3. Will lot be re,raded •::~/~y~.~~E~~ Address7.:."Q•, 7 °
P • • • • • • • • , . ,Will exS~ss fill be remov d from premises: yes ?N .
14. Name of Owner of remises .
Name of Architect ~ ~t~Sk/G1'honc No .
Name of ContractQ~:~~
~ /~~t9 .........Address y Phonr. No.. .
• , ,Address~C/.y~(/%rv,~$'y~Z/Pd.L+~. Phone No.~6,~;ao?,/,f ;
IS.Is this ro ert loci
y ' P P y ted within X00 feet of a tidal wetland? *YES....NO....
*If es Southold Town. Trustees Permit may be required.
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 description according to decd, and show street names and indicate whether
interior or corner lot.
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STATE OF \'~`V~1.~'R ' ~~'"'t't' ~ U ,3
-COU;ITYOF ttt~; at s?a
, irr
(?~amc't51f itfidii~fizl~al ytlo''contract) • ~ • ~ ' ' ' ' being duly sworn, deposes and says that he is the applicant
about named. Jfli~b~t ~ ~.'-4>':
r, f:t . ,
T"..
i Ic is the /,cdJE2
I (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 file this
-Pplication; [hat all statements contaiged in this application arc true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application Glcd therewith.
iworn to before me this
/ ~
~o,,,-~tgqapQry Public,. C , , , , , , , , ,9~~/.//v.,l.L~ , ,County
UNDA.) COOPER ~ • • ~ ~ • .
Notary Public, State of New York ( onatureofapplicant)
No. 4822663, Suffolk County
Term Expires December 31,19.._.