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Home My WebLink About18202-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25929 Date: 08/28/98 THIS CERTIFIES that the building ADDITION Location of Property: 290 SMITH DRIVE NORTH SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 76 Block 2 Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 2, 1989 pursuant to which Building Permit No. 18202-Z dated JUNE 13, 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 ie DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to DOROTHY B. KLEID (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A c ildin inspector Rev. 1/81 roast sTO. s TOWN OP 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 Q g ~ ~ ~ Z Dore ...10. 19.6. Permission is hereby gra~t~ to: „ ~ .........:.r fo .C,nrC.'A.~sZf4frl~.s~......l~r~. 4~n%~,F~J `6~..,..,,~~%~ ~'.j~/r......... ~'f.~ . rr ...:ate . ~ of premises located at ........................x'13... .~`~5............................................................................ County Tox Map No. 1000 Sectio/n Block Lot No..........1.~...... pursuant to opplicatian doted 19.~, and approved by the Building~~Inspector. Fee $.o./...1~i Bu ing.l... for Rev. 6/30/80 Form No. 6 I M a. TOWN OF SOUTHOLD ~ " ~ ~l _ BUILDING DEPARTMENT TOWN HALL . 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the buildint 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 19 lead. 5. Commercial building, industrial building, multiple residences and similar buildir 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 an '-'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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25p. 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00q,~C/ommercial $15.00 Date ! 4 . New Construction........... Old Or Pre-existing Buildin Location of Property. „c~3pv.17_~..~/L_.._~~~ . House No. Street Hamlet Onwer or Owners of Property ^-~II County Tax Map No 1000, Section....!.1®,,,,,.B1ock......~.......Lot.../ ~ ' Subdivision ....................................Filed Map ............Lot....... Permit No...!~.Io~."~~,°,~-.Date Of Permit ................Applicant........................... Health Dept. Approval ..........................Underwriters Approval........................ Planning Board Approval Request for: Temporary Certificate........... Final erticate~...... Fee Submitted: - ~-~c - 35 a~~ . p APPLIC ~ 0~,2.5'~~ "II D ~ ~ Q ~ ~ Form No. 6 TOWN OF SOUTHOLD aU~ ? 6 ~ BUILDING DEPARTMENT yln TOWN HALL ,Y' 765-1802 ~~~,'p,i; ~ BLDG. DEPT. T WN FSQUfF10l.D AppLICATION FOR CERTIFICATE OF OCCUPANCY A• This application must be filled in by typewriter OR ink and submitted to the buildinf 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 buildir, 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 an "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 Buildine - $100.00 3. Copy of Certificate of Occupancy - .25~. 4. Updated Certificate of Occupancy - $50.00 S. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...~."..~~....G~.~.......... New Construction........... Old Or Pre-existing Building.. A., Location of Property..... ~ .1.. ~ ~ .....'2/ ~~~C,; ~ €,ep c~.~ House No. Street Hamlet N q Onwer or Owners of Property........G-:71r0~.~4~;..'.y.~~~ 4 ~ ...................Q.~............. County Tax Map No 1000, Section....L.s~'......Block.....~..,,,,Lot....~P..., Subdivision .Filed Map........... .Lot.. l-Y Permit No.. ~ ~,Z-C~, Z, , , , ,Date Of Permit. z ~U ; , 7)'Applicant.. C7', ,f~' , , ~ ~l Health Dept. Approval ..........................Underwriters Approval........................ Planning Board Approval Request for: Temporary Certificate........... Final Certicate...~ Fee Submitted: ~ APPLICANT a,~;•~ TOWN OF SOUTIIOLD D q ~ppp 14 BUILDING DEPART2IENT ~L~N7fiPi I~3•~ _ TOWN HALL SOUTIIOLD, NEW YO[ZK 1 197 1 gLpG• OEP7. TOWN OF SOU7HOL0 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE..~~?F-~~.... NEW CONSTRUCTION ~ „OLD OR PRE-E/%'ISTING BUILDING......VACANT LLAND....._.. Location of Property. 9~,,,5~~ ~/I _ ~.F"'. _ ~I~p ~ou ~G~P7 ~c~ BOUSE NO. STREET , ~ ~ " " HAMLET Owner or Owners of Property. ;i-:!~?I'w ..~.x.. County Taa Map No. 1000 Section 7 Block / . Lot......... Subdivision Filed Map ........Lot........., Permit No. ~,~;Z,~~,,,Date of Permit ,~O ~ ~.~?..Applicant : 1; le /C~ Health Dept. Approval Underwriters Approval Planning Board Approval Request for Temporary Certificate Final Certificate Fee Submitted: $;~_S APPLICANT./!,(l~. ~ , _ _ reV• 10/14/88 C„`- =1ELD I;:Si`nC:-U;v ~~U6;E SOMMENT° ~ i . R H _ _ . y AI r0U17DATI0N (1st) - - - ?OUNDATIO;J (2nd) m 0 ROUGH FRAME & ~ PLUMBING ti 3. y x ro ~ i IIdSULATIOPI PER N. Y. y STATE ENERGY a_ CORE ~ ~ r a . / ~ 3 ~ ~ ~ .-J y . ~ FIiJA~ ~ ADDITIOPIAL COMMENTS: N- ~ ~ ro ~ ~ a ' G9 H \ H O m • a r H ~L'p O, ~ N ' O C*1 ^a H a ~ l Y M_ ~ N N ..s~ o ~ o ~ ~ z 3 _ Z ~ o A ii 1 4~ 'd c x Z a ~ a~ ~ ~ ~ ,-L r, "C7 Z vl 1~ ~ ~ V ~ry 1~~~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ) ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INS TION [ ]FRAMING [ FINAL REMARKS: q ~ X Flo DATE ~ ~ O INSPECTOR l~~°~ 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INS TION FRAMING ~ FINAL REIIAARKS: _ ~ti ~ iY3lo~ ~ ~ ~ ~ _ ` DATE o2 ~ ~ INSPECTOR s 1. y. - - - h ~ N t . Y - y . _ _ 0 '`ice j~ .r- ~ - _ - 'g!, •i t t F. o.'S . ~1nJ' -i v -~i a• t Jet ~'.i ~t~~ T a A.. L f •'i ~ ; 3 ~ ~ 8" 89 , a.~ t x a ~ _ SuR~ EYEO;'FOO~ . - . ~r ~ z ~ ~Iw ~ t 0 ~ t ,1_?' ~ f - yf g : M ~ ~AAY;."``t L - ~ _ -s• ~a~ ~'~OWf~I GF ~C~7?tflLff- tt ti' a ~ a ? • - _ r ~_s3 " T~y~y3.3~410o w ~on.o_ ~ r .,`S~cat~ 4~ - IJ Y y~ 1~ y '-T r a yr_ 4 t ~ ~ ~ SAC .b is ~c t. y. .v'~ ~ - ~ .~'OF'uktlen ls. ? 3 >ti. ,e. Lot 13~ ~ ~ i.F':-+~..~ ''•._i t ~ 13~~ Lot 1Z9•--11 s, t f ~ i-r ~j.. ~ - i ?F w~% c wt• W s y~ y- + IYOH p1pC ~ i' f: sue'. ~l ~.s a Y`' ,t t w - ~ SgSE y~-~~ ~ w ~.a~ ~ t 1' ~ ~+`-r y„ # ~pg~0+S1i-. '""~TCi~ ~1rW41, ,a.. ~ .;,~•~h4.._~.s~ .:.+s„Y ~ ~'-'{ti i C ~~a~Y{S~ ~Qcitiiy ~ tV ?My I++icc Gtiv••-.i `'.1 SY " ~e -s+y*: ~ .d.~G-' r.~'-~ ~ ~-e...~-S ~ a . _ 1 f~„~ t •:i~~. 4`YCt ?t; ~ MOr 4i+gt5 t`p G ~~-~i : ~i ~k~c., s1-, w~+i'~,':.,~c3'~ ~ a~-~.,~ ~ y >c `1i: Via. L~ ~ • ~O {~T j 9~q, rr ~,s{-. F,~ a ate _ ^ 1(' kr t . ~ ~'~y~~-~s~"~2.-.~..~'.,n["~h-R 1a .r Sin iii~~ I Ta+ -'M"~~ ~C~ _ ~ ~G r~ ~ ~ A ~C [ C~ GS`3% D 1 ~`f~,m /y l , ~ 1 q 7 / ~ X X C C ~ ~ ~~a in ~o~xs-e 5/ ~ ~ C C/~ `F X ~ C C ~ ~ _ ~ S' 7 ~ c. v ~ ~o~t10~-d' I . I- ~ X ~ ~o°~I I?I ~I'auh~ ~h l'~.5 e ~ X~ ~ 02 k ~ a~ S ' I c~ s-~ u ~i ~ ~Ap~ Aa NarEo ~(se Gia~~ t^a~ ~I C~~ c ~ ~s'~e~ S DATE. QP. N ~ ~ 9-~ o' FEE: ~ NOTIFY BUI INd DEPA~ 1 I 78b-1802 S.AM TO 4 PM FOR THE 1~FOUNDATIONPE~TWOREf1U1RED OCCUPANCY O FOR POURED CONCRETE 2. ROUGH - FRAMING ~ PlUM61NG USE IS U 4 FINA ~T'O CONSTRUCTION MUST I STOUT CERTIFICATE BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET I ~a THE REQUIREMENTS OF THE N.Y. q (~9~A ~Y `STATE CONSTRUCTION & ENERGY ~`e ~J "~:'~ES. NOT RESPONSIBLgE FOR ~N t~R CONSTRUCTION ERRORS BOARD OF HEALTH 3 SETS OF PL.1NS ..y FORM NO.1 SURVEY ..tl.......... TOWN OF SOUTHOLD CHECK .......1~ BUILDING DEPARTMENT SEPTIC PORDi TOWN HALL • SOUTHOLD, N.Y. 11971 NOTIFY ~ ~~0 • TEL.:765~1802 CALL Examined . S~/~`3 • • • 19 v.9 ~ MAIL TO / ,f'9 G ~ . Approved ...c?/.<.~......., 19V./.PermitNo. ~0.~~.?~ ~ ,'s ~~~f~-...`` ' Disapproved a/c/ ' ~ ~ JUN . ~ ! e 2 i i U r ~ , TOWN OF SOII HOLD (Bt ine Inspector) APPLiGATiON FOR BUILDING PERMIT Date ...................15... INSTRUCTIONS a. Tltis 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 Buildin; 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 inspections. (Signature of applicant, or name, if a corporatton) • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..Q~?C'.F~-~ Name of owner of premises ..,-.Jre'?Y:~:~h~J.. ~ ~ .~1~-f.e7........... . (as on the [ax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporatle ofiFJCer) Builder's~ra *Io. .S~I~sS~-.?Il..~l.~;e1~..~on~ Plumber's License No . . Electrician's License No . . Other Trade's License No . 1, Location of land on which proposed work will ybe done. , , , , ; . House Number Street. " ~ • " • " " Hamlet County Tax Map No. 1000 Section ....7~ Block ~ • , , , , , , , , , , , , , Lot ../.£>r.............. . Subdivision Filed tap No. Lot . (Nance) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy t.. 4~'19?rNt.~, . • • • ~t ~)"^•L . b. Intended use and occupancy . • • • h,~11~'1• • • .h,'I;~'.l%. • • • . 1~,~~„,~' . 3. Nature of work check which p • ( applicable): New Uuilding , , , , Addition .Utcration Re air Removal t~ • • • • • • • , . Demolition ,Other 1York .~r!1~ . 4. Estimated Cost . , ~ SQ ~ . Q U (Description) ' Fee..................................... 5. If dwelling, number of dwelling units . , u~l~ (to be paid on filing this applic//~~~ion) oara_c, number of cars ~ • Number of dwelling units an each floor.... ,N!'~, If ~ ~ . 1 ~.t:Z.t 6. If business, commercial or mixed occupancy, speci!'y nature and extent of each type of use ....N. ~ , , , , , , ~ • 7. Dimensions of existing structuFes, if any: Front , , ;'!j• s Height ..l . S, ~'~:Q...... Rear Depth ..'Llo.. Number of Stories • , ,1, , • . Dimensions of same Structure with alterations or additions: Front • • Depth s...... • ~ .Height . Rear ..x`41: , ~ztn~ . 8. Dimensions of entire new cons ruction: Front • • • ~ • ~ • • ' • ' ' ' ' ' Number of Stories Height . P: ~ , Nu ~ bcr of Stories . • ~ • ' ' ' ' ' • Rear ,7~?:'C. , ir{Lc7rv , , pcpth . , , - , , , , , , ~ • • 9. Size oflotrFront.••,•• : 10. Date ofPurchasc Rear...................... Depth..:.................... 1 1, Zone or use riffs+rict in :vhic,: ~ • ' • ' ' ' ' ' ' ' ' • • Name of Former Owner . , • , • • •F c,. rises are situated ~ ~ ~ • ~ • • ' • " " l2. Does proposed construction vidlate any zoning law, ordinance or regulation: Ny, ; ~ • • ~ • • ~ ' ' ' ' ' Will lot be regraded ..N17„ , 14. Name of Architect remises ~ ' ' ' ' ' ' • Will excess 611 be removed from premises: Yes P ................Address Phone No.. . Name of Contractor . • - ~ ~ • ~ • • ~ • ~ • • " • • • Address ...................Phone No.............. c . IS.Is this property located within •Address.. .Phone No........., yy f *If yes, Southold Town Trustees Permit may bearequiredetlaud? *YES....NO.Y.. ~ PLOT DIAGRAM Locate clearly and distinctly all~~ buildings, whether existing or proposed, and. indicate all set-back dimensions from property fines. Give street and block'number or description according to deed, and show street names and indicate whether interior or comer lot, ~ I ~ ~ P~v~uS~~ ~ i i - ~ ~ ~ ~ ~ f I \ S'TOt+~1 G~ISTIN~ ~juwptN~ i ' • I ' I~I N~ (Zwdt, L,o~ i I III ~i II 1 ST,1TE OF \E\V Y'ORIC, S `COUNTY OF FS ...........f...... . (Aamc of individual signing ' ' ' ' ' ' ' ' ' bang duly sworn, deposes and says that he is the applicant • contract) abovc,namcd, i _flc is the , II (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•tltis ~PPlication; that all statements contain4d in this application arc true to the best of his knowledge and belief; and that the •vork tvi11 be performed in the manner set forth in tltc application filed thcrcwidt. -worn to before me this .............tai.. ...day of..1. ~ 19~,~ -votary Public. (/yam County HELEN K. DE VOE ../~r_s~ vij . ~ . NOTARY PUBLIC, Stets of New Yank l-: No.4707878, Suffolk County • Term Ezpirea March 30,~i19_~1 (Signature oC applicant) i i