HomeMy WebLinkAbout18200-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219586 Date DECEMBER 14, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 395 NORTH SEA DRIVE SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 054 Block 04 Lot 0.6
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. 182002 dated NNE 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 is DECK ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to CHARLES & WINIFRED MALLOY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
.
sosat< xo. s
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 ~ g LO ~ ~ Z Dote 19....9
Permission is hereby granted to:
-tr. _ ,
to ...~'~°:~^~::cF..~:...g......c{~,¢.c.~Qc.....c,Z.:.s1.t~t~s:!'an...a`u....~-?.,..k'r~:-v.....o.:.'!~4, .a<~.Qn~.
~?C,
..w~.~4Nt~.,..s~...~z~.sd...~~a?.~
at premises located at ...a~.t9.~.......~..Y'S:k!'1...~?=4.. ......r
County Tox Map No. 1000 Section .....~5...7........ Block Lot Na...... d~..........
pursuant to application doted ........~~R.....~- 19...9., and approved by the
Building Inspector,
Fee ~.~5~.. a:
Building Inspector
Rev. 6/30/80
Form No. 6 ~ ~ ,r.~m-~~
TOWN OF SOUTHOLD p"' ~ ~ ""`d?
O
BUILDING DEPARTMENT P~ ~y~ ! 111
TOWN HALL ~I ~ ~ ~ ~ ~ T.~7
Fj }
765-1802 ~,~p~
$ t3L17~.
DEPT.
APPLICATION FOR CERTIFICATE OF OCCUPANC'$~~ 7f)WIV Oh'
S`_, OU~FIOLD
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
f less than 2/10 of 17. lead.
S. 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
k. L'p~tated Certificate of Uccupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
:lew Construction...... Old 0 Date
• _ r Pre-existing Building..
Location of Property..,,~~~J ~~~~-ty~..~~~.•~R,~~""'
House No.
Street Hamlet
Onwer oc Owners of Property.,C~RtZ1..~S wl~~~'i"2.
County Tax Map No 1000, Section „
Block.....~.........Lot.......~'~.
Subdivision......... " ~ "
r~ ...........................Filed Map............Lot.............':
G~~ Z ~l®Ck. /~DlJlT1C~d
Permit No........ ...Date Of Permit...~~~~`~y
••....Applicant.........
Health De " "
Pt Approval ..........................Underwriters
Approval........
Planning Board Approval ~
:i
Request for: .Temporary Certificate.........
Final Certicate...
Fee Submitted: C~~C~
C p 2 S~~' APPLICANT L
~'lELD I~;SPE;.:iu;J ~~UAic ~ COaKMLNT° J
~ w
a m oG
1 .
H G
rOUtJDATION (1st) o ~
rOUNDATION (2pd) m ~
2.
z
o W
ROUGH FRAME & h
PLUMBING ~
3. ~
ra
IIJSULATION PER N. Y, P
STATE ENERGY
CODE
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4 . U ra
k H
FI;JAL
O
ADDITIOP]AL COMMENTS:
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765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] ~NSULAT~~I~~O~~ N
[ ]FRAMING [ INAL s~iX.1Z,~,
REMARKS: 7 ~ ~ ~
DATE) INSPECTOR ~+G~ V
E.~::.,_._. _ .
BOARD OF HEALTH
FORM NO.1 3 SETS OF PL.1NS
SURVEY .........i,/„
TOWN OFSOUTHOIr,p, CHECK;..:+.1... _
BUICD'ING:D'EPARTM~NT,' SEPTICFFORM•..... _
TOWN HALL
• SOUTHOLD, N.Y. 11071 NOTIFY
' TEL.: 765.1802 CALL
Examined ..~ti!!~'~:.~ , „ 19 MAIL' TO : 1`tEJo!•
(tea
Approved , d.H'ut . 19'.9 Permit No. ~.~?~OC~ h ~ ~_U l'r~l~
Disapproved a/c U ~ ~ ,
g JUN,~p 1989 ,II
1 ?OWN OFSOUiHOLD
• ~(Building'Inspector)
APPLICATION 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
dr 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 buIldinss, additions araltei•ations, "ot 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 far necessary i ect' ns.
(Signature of applicant, or narde, if a corporation)
39'S.NotZ-r~{ SE'r~~2wr,Srsut~otrD
(Mailing address of applicant)
State whether applicant i owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises CNATZI^~'r..' W IN~~R~-p , t . ,
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) '
Builder's License No. ~,.C~~R.It~
Plumber's License No .
Electrician's License No . .
Outer Trade's License No . .
Location of land on which proposed work will be done. '
395 ~oR;r K .S~A.'~R~vk Sou-cKa~.s~ ~ .
Eiouse Number Street ..d......Hamlet •
County Tax Map No. 1000 Section Blpck 4,,,..,..,,, Lo[....~
Subdivision F.ilcd t<tap No. Lot . "
~(Namc)
State existing use and occupancy of premises and intended use and occupancy o~cdconstniction: _ "
a. Existing use and occupancy ~ ...~~~11+-~...~~ , ` ,
b. Intended use and 5~~~-~• p . • . ` e 1 • • ~ . .
occupancy .
3• Ret air of worl. (checl. which a'pplicable): New Uuilding '
p • • • • • • Retrieval ' ' • ' ' ' ' ' • • Addition rUtcration_ / .
NS'ffal,L. WOC'aD fl~ • • • • • ' • . • • Demolition Other Work .
IWST E(Z `FlOi i}tIZ~ (Description)
4, Estimated Cost . C~II"
Fee.....................................
_ (to be paid on filing this application)
5. IC dwelling, number of dwellin '
eara_e number of cars , • g units Number of dwelling units on cash floor , ~ , , , , , , , , •
If ,
6. If business, commercial or mixed occupancy, specif nature and extent of eact ty e of use . • • ~ •
7. H n^h tsio's•Zo~ cOxi~~ing structures, if any: Front ~Q•n,'=, , , , Rcar ~8~: QP, , , • Depth ~~US; r • •
• . Number of Stories . , ,l, ,
Dimensions of same~tructure tuiith ~Ici~~ions or add ns: Front ~ • • • • • • • " " " "
Depth ......-..{,_.i r:.......... Rear
' Dimensions
of entire new construction: Front . • ' ' ' ' ' • • • • Number of Stories , . . . . .
Height •I. NurpberofStories. Rear.,.%",,,,,,,,,,,pcpth.,;;';,,,,,••.•
9. Size of lot: Front...1~C"?.^,47
10. Date of Purchase Rcar...1dQ;'•t,.?,,,,,,,,,, Depth ...,~Q;$rs'e.•,•••••~~~
Name ofFormcrO+vner
11. Zone or use district in which premises arc situated • ~ ~ ~ • ' '
12. Does proposed construction violate any zoning law, ordinance or rcgulatian: • ~ • ~ ~ • • • ~ • • • • • ~ • ' ' '
13. Will lot be regraded . ,Will excess fill be removed from premises: Ye No
14. Name of Owner of premises W~~,hAA4L0y, • Address M,OJ~~ty St:r~ 'Dl4UE ,Phone No. ?:~S` ~•94.~ ,
Name of Architect ,Address . ~ • • ~ '
Name of Contract ~ ••••••••••••PhoncNo
* y ..........................Address ...................Phone No.....
15.Is this property located within 300 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 umber or description according to deed, and show street names and indicate whether
interior or comer lot.
I
.
S ~ W 'Z' `t ~'T C~•t C tom`
- •
" .
•
ST,1TE OF \E1V YORK,
~OUNTY OF S•$
• • • • • • • • • ~ • ~ ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' off" • • • • • • • • • . • • • , being duly sworn, deposes and says that he is the applicant
(Name of individual si nin % contract)
:bovc named.
M
1C IS tI1C
. , - I ' • (Contractota„nscrit; corpo`ratc'officcr; etc.)
f said owner or owners, and is duly autltorizcd to perform or have erformed the laid work and to mane and file this
~plication; that all statements contained in this application arc true to the best o'(his knowledge and bclicf;and that the
ork will be performed in dte manner sdt forth in pie application filed thcro+vi[It.
'•vom to before me this ~ q
• oZ ..."~.~...~day 'oft/. 19 ~4•
Mary Public, /YK-~?^! r1 - ,
. ~4.. , Coupty- ~.r.d •
'p~) ,
HEI.ENKOENOE ~~'6~~
~N~o~4707878 S
dk~ (Si;na ure oCapplicant)
Term EMWroc Memh 30,111 _
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APPRDYED A5 NOTED ~`o
DATE:
FEE: BY ~ /
NOTIFY t3UiLDING DEPARTMENT ~iT ~ ~.K~LE ~~0i1
765-1$02 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS. , -
t. FOUNDATION TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH -FRAMING & PLUMBING
3. INSULATION
4. FIND,L - CONSTRUCTION MUST OCCUPANCY OR
BE COMPLETE FOR C.Q.
ALl CONSTRUCTION SHALL MEET USE IS U~~AWFUE
THE REQUIREMENTS OF 7HE N.V. WITHOUT CERTIFICATE
~ STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR OF OCCUPAWCY
DESIGN OR CONSTRUCTION ERRORS
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APPPrOVED a ...~.;..>V e~ pf
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,.;':.;..~x3~?°:~~:::.::... gar.: ~ . y ~ .
\•Z~ ~~?~;r;{;;:: GUARANTEED 70i 8- 189801„ ,
\ A. ti~491NTER•000NTYTITLE GUARANTY6MORTGACEf.O.
~C ~'~a ~ ~ MAP OF LA1iD LOCATED AT2~~~~
~~~,11.~~,?``yyf 4i `
: r~ , ' S O U T H O L D ~ .''ry;=',~~n~,},
`J~ ~ YCWN OP fOU7 HO LP~~4~ OOUNTY tlF YU~IOLK'
J \iAr NRVLYFD FGR ~ .1~1{tr~
~~~'Iti'yy GN,417LE9 , E, MALLOY ~,;,a~:''~
~ PATRICIA M.. OLIVERI
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