HomeMy WebLinkAbout18063-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22796 Date DECEMBER 16, 1993
THIS CERTIFIES that the building ADDITION TO ACCESSORY
Location of Property 1350 EDWARDS LANE PRIVATE ROAD #8 ORIENT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 18 Block 3 Lot 9.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 20, 1989 pursuant to which
Building Permit No. 18063-Z dated APRIL 21, 1989
was issued, and conforms to all of the requirements of the appheable
prov>_si.ons of the law. The occupancy for which this certificate is
issued is ACCESSORY DECK AROUND EXISTING INGROUND SWIPII~iING POOL AS
APPLIED FOR.
The certificate i.s issued to GARY SHAPIRO
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N(A
UNDERWRITERS CERTIFICATE NO. PENDING - DECEMBER 14, 1993
PLUMBERS CERTIFICATION DATED N/A
ldin Inspector
Rev. 1/81
sosa~ xa s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUtLDlNG PERMIT
(THIS PERMIT MUST 8E KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°- 8 0 6 3 Z Date a:
~ 19.4..l.
Permission is hereby granted to:
:~.~....~:3.~
t
at premises located at ....~...3.w~~....5~~.~.
r.4...~..,c~.k~!~..,~R.v!~4..~!i?....
......c,........C,a. .
County Tox Map No 1000 Section((.~~..,,.,,~~~~~ BI«k .....Q~..,.... ppLot No. ~ L....
pursuant to oppNcat~on dated ......1.N,L<t.1~Sf:....:1~ 19..1., and approved by the
Bwlding Inspector, Y
Fee aJ.:..
.
Building inspector
Rev 6/30/80
rerun nv. ~
' TOWN OF SOUTIIOLD
~'I :
!g~'` ~ # 6 ~ ; ~i BUILDING DEPARTMENT
E~ 4 TOWN HALL
EI( ~~pp ~,T.,, a 765-1802
G , .J'.4~"i i
TOWN U~ uv~ Y~
•-1 APPLICATION FOR CERTIFICATE OF OCCUPANCY
l
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 Kealth Dept. of water supply and sewerage-disposal(S-4 form),
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn stateirtent from plumber certifying that the solder used in system contains
~ less than 2/10 of lZ lead.
„ S. Commercial building, industrial building, multiple residences and similar buildings
• and installations, a certificate of Code Compliance from architect or engloeer
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 ro erl tom leted a lication and a consent ko ins ect si ned b the a licant.
F P Y P PP P 8 Y PP
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
4. Updated Certificate of Occupancy - X50.00 ,
Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ,December 16, 1993
New Construction.D~FaS..... Old Or Pre-existing Building
Locption of Property..~Q,~,,P,r,}yate.Roadt Orient, New,York~ 11957
House No, Street li:imlet
Onwer or Owners of Property...,Gary Shad iron .y
County Tax Map No 1000, Section...~l$.,......Block.. 03...........Lot... 9:?
Subdivision ....:...............................Filed Map............Lot....,...............
Permit No.,~~,Q,63~,,;,,;,Date Of Permit.. 4/2189 ~,Applicant
Health Dept. Approval ..........................Underwriters Approval......................
Planning Board Approval
Request for: Temporary Certificate.:......... Final Certicate..,XX~~
Fee Submittedi ~,,,,?5 X00
. .
,y ~3rk5 AP P ICANT ' .
C`r1 ~ 7 Q ~n
WII,LIAM H. PRICE, JR.
ATTORNEY AT LAW
PO BOX 2065
GREENPORT, NEW YORK 11944
TELEPHONE NUMBER (516) 477-1016
FAX (516) 477-0130
December 16, 1993
Southold Town Building Department
Southold Town Hall
Main Road
Southold, New York 11971
Attn: Georgia
RE: GARY SHAPIItO
NO PRIVATE ROAD, ORIENT, NEW YORK 11957
SCTM 1000-01&03-009.002
Gentlemen:
Enclosed herewith please find:
1. Two (2) applications for certificates of occupancy covering the deck and garage at the
subject premises, together with my check m the sum of $50.00 representing fee for
same; and
2. Survey dated November 27, 1993 prepared by Anthony W. Lewandowski.
Please contact the undersigned when the certificates are completed. If you have any quesfions,
please do not hesitate to contact me.
Very truly yours,
tlliam H. Price, Jr.
WHP/lmt
enclosure
828 Front Street, Greenport, New York 11944
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w ~'1 ~ WILLIAM H. PRICE, JR.
ATTORNEY AT LAW
PO BOX 2065
GREENPORT, NEW YORK 11944
' TELEPHONE NUMBER (516) 477-1016
FAX (516) 477-0130
November 12, 1993
Southold Town Building Department
Southold Town Hall
Main Road
Southold, New York 11971
RE GARY SHAPIRO
PRIVATE ROAD, ORIENT, NEW YORK
SCTM 1000-018-03-9.2
Gentlemen:
Please provide the undersigned with cppies of the following certificates of occupancy:
7,63~~ ,
1. Addition -building permlt~#7y33~z; ~ ~ ~ ~ o
2. Two-car G -budding permit #13 342; uJo ~/v
Accessory -building permit #92242; andCn 'f~~r
4.~ 71-ulldmg perms ~a
I have enclosed my check in the sum of $35.00 representing fee for same.
If you have any questions, please do not hesitate to contact me.
Vvrv truly vnnrc
WILLIAM H. PRICE, JR., ESQUIRE 2892
OFFICE ACCOUNT
828 FRONT ST
GREENPORT, NY 17944 v~
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T65-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS: ~ rte-
- ~ .
DATE ~ INSPECTOR
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL /
SOUTHOLD, N.Y 11971 NOCALI~ • • ~~•1• • •
TEL.. 765-1802 •
n~ L T0:
Examined ],1. , 19 ~-o~ ,(,(~-L,LI)/~a.~,~P
Approved 2~ 19 ~ 4 Pennrt No ~ ~ IV a •y _
'
Disapproved a/c ~ ~
• ~111~
• • BLDG. DEPT.
(Building Inspector) TOWN OF SOUTHOt-D
APPLICATION FOR BUILDING PERMIT
Date , 19.
INSTRUCTIONS
a. This application must be completely filled in by typewriter or m ink and submitted to the Building Inspector, wit
sets of plans, accurate plot plan to scale. Fee according to schedule
b. Plot plan showing locatron of lot and of buildings on premises, relationship to adloinmg premises or public strc
' or areas, and giving a detarled description of layout of property must be drawn on the diagram which is part of this ap
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 pee
shall be kept on the premises available for inspection throughout the work
e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certrficate of Occupa,
shall have been granted by the Burlding Inspector.
APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Butldmg Permit pursuant to
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance
Regulatrons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnb
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authonzed inspectors on premrses and in building for necessa inspections.
SOUTNOLD P0~}! S Ili , Q~~~ j,`'~-. .
0 ~~X J~O (Signature of applicant, or name, ~f a corporation)
SOCiTHOLE7, NY 11371 .
(Mailing address of applicant)
State wrhether applicant is owner, lessee, agent, azchrtect, engineer, general contractor, electrician, plumber or bush
Name of owner of premises 6D~z.~ ~"~t:~`J
(as on the tax roll or latest deed)
If applicant is a corporate n, signature of duly authonzed officer
.
(Name and title of corpo e officer)
ALL CONTRACTOR`S MIj,S BE SUFFOLK COUNTY LICENSED
Builder's License No 1,~ ~Sb,' H ~
Plumber's License No
Electrician's License No
Other Trade's License No
1. Location of land on which proposed work will be done
l-~~ c"l~k.A2.'~~ t:A~.c PRA R~~h Qel~=~
~
.
House Number Street Hamlet
County Tax Map No 1000 Section Block Lot
Subdivision .Filed Map No Lot .
(Name)
2 State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy I--~') RICH . ,
. - . . . .
b Intended use and occupancy 7'~tl t"r
1~
3. Nature of work (check which applicable) New Building Addition Alterat>~n .
Repazr .Removal . Demolition Other 1ti'ork ..r1~.~~''. .
y~T ` (Descnpfion )
4. Estimated Cost . ~ Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor . .
If garage, number of cars • .
6. If business, commercial or mixed occupancy, speedy nature and extent of each type of use
7. Dimensions of existing structures, >.f any Front Rear Depth .
Height .......Number of Stones .
Dunensions of same structure with alterations or additions Front Rear .
Depth Height . Number of Stones .
8. Dimensi ~iw construction Front Rear Depth .
Height Number of Stones
9 Size of lot Front ~.~2-.... Rear . ~.?.l Depth Z.~S~ .
10. Date of Purchase ~ `.'''vl.. Name of Former Owner . .
1 1 Zone or use district in which premises are situated .~'!4'~..
12 Does proposed construction violate any zoning law, ordinance or regulation .
13 Will lot be regraded !Y.~ Will excess fill be reGmoved from premrses Yes
14 Name of Owner of premises G4ey. S~A~~ Address (~`Q t=I?" ~"r?~~:'.'~- .Phone No 3~,3..3`J 3?r .
Name of Architect .....Address Rh. ~ . 4~: r ..Phone No.... .
Name of Contractor S ~ ~ .pu : .....Address .~'.~.`1 ..Phone No 2~. .
15. Is this property Located within 300 feeC of a tggidal~~ wetland? *Yes No
*If yes, Southold Town Trustees PermitPLO~ DIAG1tAM ed.
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frog
property hues Grve street and block number or description according to deed, and show street names and indicate whethe
interior or corner lot.
STATE OF NEW YORK, S S
COUNTY OF
being duly sworn, deposes and says that he is the applican
(Name of mdrndual signing contract)
above named
He is the .
. . .
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tlu
appl~catron, that all statements contained in thrs application are true to the best of his knowledge and belief, and that th
work will be performed in the manner set forth in the appl~cahon filed therewith
Sworn to before me this ~r
..~r'/-~ day of V ~ , 190/
Notary Public, .."~>t%.. ~ ~t1.a-1~~!4:~...... County
ffF~ EH K PE VOE ~
raemavrl++3l'C, state o+ t.ew York (Signature of apphcam
Fk G~fi'3'b Sa. 1eCaanti
-Tarn, Exavea Mz,tr du", t9~