HomeMy WebLinkAbout18241-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218318 Date AUGUST 29, 1989
THIS CERTIFIES that the building RE-CONSTRUCT DECK ADDITION
Location of Property 300 RABBIT LANE EAST MARION
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 18 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 19, 1989 pursuant to which
Building Permit No. 182412 dated JUNE 21 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 RE-CONSTRUCT DECK ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to_ MELCHIOR MOOR
(owner, )
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ui ding Inspector
Rev. 1/81
gosai 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 18 2 4 Z Date 3.1 19
Permission is hereby granted to:
.
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at premises located at !.Qs:~Q...............................9!ra........~.A1.1..4Nh...............
.....1...
County Tox Map No. 1000 Section .......5?~.~......... Block ........I..~i......q.. Lot No....~..J
pursuant to application doted ........~..~c~:4ll....~...9 19.R~.., and approved by the
Building Inspector.
Fee 5...~~
B ng Inspector
Rev. 6/30/80
TOG1N Op SOUTIIOLD ~ ~/~~~f~
BUILDING DEPARTl1Et7T
TOHt7 BALL
SOUTIIOLD, NGN YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIppt7CY '
DATE..~~IO[ Uq...
NEN COSSTRUCTION _ •
• • - ..~OiL~D OR PRE-E%ISTZt7G BUILDING.... _ _ VACAt7T LAt7D.. .
Locat ~ '
ion of Property„ • - • • _ - • • • ~QN'~J
HOUSE NO. ......__.,_~U~ / ~~I_ITiN
STREET DAMLET
Rvncr or Ovncrs of Property,,,,-- 1 5~~~.X1_ `
County Taz Map No_ 1000 Section LJI '•-l `'`'7•--•-••••-••
• Block Lot'
Subdivision. _ •
' Filed Map .Lot.
Permit t7o. 1~~~~~ pq
..Date of PcrmiC .;ql{~~.I DI
•APPlicaot
IIcalth Dept. Approval
" Undetvritcrs Approval.
PlanninC Board APProval „
Requc~[ for Temporary Certificate
Final Certificate
Fcc Submitted: _ •
~•~~~l~~l~ 1-Y
nrrLlcnrrT. - -,~%~~-P!~ .
°y' IO/14 /88
~ ~ FORM NO- 6
' TOWN OF SOUTliOLD
IIDILDING DEPARTTfENT
TOWN NALL
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must be filed in typewriter OR ink and submitted to Che Building
Inspector with the folllowing; for new buildings or ?ew 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_Neal[h Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation From IIoard of Pire Underwriters.
4_ Sworn statement frogs plumber certifying that solder used in system contains less
than 2/10 of 1X lea¢_
S. Commercial buildings, industrial buildings, multiple residences and similar,
buildings and insta~latiovs, a certificate of code compliance from the Architect
or Engineer responsible For the building.
6. Submit Planning Boa;d Approval of completed site plan requirements.
B• For existing buildings'i(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, buildings and
unusual natural or topographic features.
_ 2. A yroperly 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 separra[e ownership of [he entire lot prior to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing [o the applicant.
3. Date of any housing fiode or safety inspection of buildings or premises, or other
pertinent informatioiS required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy: -
l. Av application for vacant land Certificate of Occupancy shall be submitted,
and a certified abst;act of title issued by a title company showing single and
separate ownership o~ the entire lot prior [o April 9, 1957 shall also accompany
[he application. If la Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D- FEES:
1. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dve,lling $25.00, Swimoing Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00-
2. Certificate of Occcupancy on pre-existing dwelling - $100.00.
3. Copy of Certificatte of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50.00
6- Temporary Certificate of Occupancy - $/,5.00 Residential
i
$50.00 Commercial '
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B0.1aD OF HE,ILTH
FORM1i (V0.1 3 SETS 0~ PL.IYS
SURVEY _
TOWN OF SOUTHOLD CEIECK .ttk:~ y.,• .(a~l~ • • • •
. BUILDING DEPARTMENT SEPTIC Foar1 V • . • •
TOWN HALL
• EOUTHOLD, N.Y. 11071 NOTIFY
.~1 ~ TEL.:7G5~1802 CALL
L•:clmincd.. 19g~ I•fAIL T0: "R_aN,
~ ii~~ 1'
Approved ~ ~ 19 Permit No. ~ ~°.sZ. i`"~ ~ ~ ~ ~
•
Disapproved a/c pp~~ n °t~~
J~IV ~7'C~~~J i i 4.
• 647 _'SOUTt904I1
YOW~d t .
(Buil mo Inspector)
APPLICATION FOR BUILDING PERM17
Date IJ..:~.~ 15Q~
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
ar areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
=anon.
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
3uilding 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.
iite applicant agrees to comply with all applicable laws. ordinances, building code, houstn~ cod and regulations, and to
=dmit aut(orized inspectors on premises and in building for necessary inspe to s.
(Sign re of applicant, or nam f a corporatton) ~ •
(Mailing address of applicant)
State ~yhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
• .,a~.Gu.!-~!~ .
....4 °~1, 4...
.
name dj q~v,~ncr of, p;~mises f.L ('f.~/d~L:. ~Q~?D'.
:
~ ~ (as on the tax roll or latest deed)
Capplicant is'S corporation, signature of du]y authorized officer.
J-
.
(Name and tit]e of corporate ~o/fficer) `
Builder's Licansc No...~,4a y , rr f , , , , , ,
Plumbcr's'I,iccnseNv: .,.,(y(,~I(/~,,,,,,,,,,,,,,
4 ,•4
Electrician's Lnse No. ~
Outer Trade's License No.
Location of land on which proposed work will be done. , , , , ,
house Number Street. • • " • • • • • • • • • • ,
2 HamIM
County Tax Map No. 1000 Section a-1 I• • • • • • • • • Block ~ ~ 7
Lot...
Subdivision F.ilcd Atap No. .
~(N~ntcj ~ Lot
State existing use and occupancy of premises and intended use and occupancy of proposed constntctio -
a. Existing use and occupancy
b. Intended use and occupancy • ~''~~,o.
3. A'aturc oCwork (thee • nick (,applicable): Ncw Uuild' '
Repair Rerhoval , mg • • • • Addition ,Utcration
~ ~-7 ' ' ' • • • • • Demolition .Other SVork .
4. Estimated Cost .........~6:./. . • • ' . ? . • • • • • • (Description) •
i Fee
5. If dwelling, number of dtvcllins units C~~ (to be paid on filing this application)
If garage, number of cars ~ ~ " " " Number of dwelling units on each floor .,r(~6~/~
6. Ifbusincss,cornmercialormix ~~~t
Q P Y, spccil'y at Ire and extent of each ty c of use .•f~G%?~~ • ~ • • • "
7. Dimensions of existing structur~cs, iC any: Front .
Height ..ri.~,~ , . Number of Stories , Q,' • Rcar . ,.,~p,~, , , , , , , Depth . j y, • • ~ • • • • •
Di F ensions of~s~mc structure ~yith alteration " ' " " " • • • • • • • • • ~ • •
Dc th . ~ s or additions: Front .gyp!, , , , , , , , Rcar ,a2CJ,?• • • • • • • • ' '
• • • • • • • . Height • Number of Sto
Dimensions oC enlijc new construction: Front , , , ~d~.... , • • ~ ncs , • • • • • • '
Hei.ht Rear G"~.~<~!.. , Depth . ~i .
9. Size of lot: Front ' Nwnber of Stories , , , , , • , • • • .
. r~~~ Rear • '
10. Date of Purchase ~'r........... . •S.f~„'.Cf•`~....... Depth .9~g• ' .
} ..................Na cofP rrOw cr
11. Zone or use district In which p; f:miscs arc situated , , , ' ' ' '
12. Does proposed construction ~•IO tc any zoning law, ordina~is/~~o!I! ~y .
13. Will lot be re_rraded , ~d [/~!1~yE
. • • • • ~ •
' ' • ' • • • • • • • • tiVill excess fill b • removed from premises: Yes • No
14. Name of Owner of premises . /1~~,1~.~iJa~ rJ~~': ' '
Name of Architect Address ~(~,~`,,fyg'/~• , ,Phone No. .
Name of Contractor e~/~(A~,~~I• • ' ' ' ' ' • • • Address . P nr, No... • ~ • , , • • ~ • • • • •
IS.Is this property located within •'•Addressir/,F,~j~~, o ~¢%r.~~;j~::;
300 feet of a tidal wetland? *YES.S~NO....
*If yes, Southold Town'I Trustees Permit may be required.
PLOT DIAGRAIti1
Locate clearly and distinctly all I'ibuiidings, whether existing or proposed, and. indicate all set-back dimersions from
property Lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
~ v II
~ O ~ ~ Q
~ , ~~~b ~ I e~Qi~~'~~ ~ APPROVED AS NOTED
, ~~-9 ~V~~ bATE~~~i B.P.H 9a'~I
~ ~ V1 \I~'+~ FEE S~.•
=_._BY~ ~a~~_.
~ NOTIfY Bl11LDING C:EPARTMEN7 A1'
ii 7Ei5 t 802 !3 AM TU 4 PM FOR THE
~9 U FOI.I (lbNING; iNSpECTiUNS.
I7. FUl1N0ATION TWO REQUIRED
~ O( FOR POURED CONCRETE
~ ~ ~ 2 ROUGH -FRAMING & PLUMBING
0 ~ ~c- ~ ' ~ 3. INSULATICIN '
' b 4 FiN<+~ STRl1CTION MUST
~l I'i ~ f1E CO FOR C.C.
~ ~ ;i A 1(~~ON SMALL MEET
~ Q ~.1 ~E REQUIREMENTS OF THE N.Y,
3 ~ V ' ~ li STATE CONSTRUCTION & ENERGY
`1 ~ ~ I 5 ~r CODES. NCT RESPONSIBLE FOR
\ U DESIGN OR GON6TRUCTIpN ERRORS
ppHG~ pR
~y
T,~TG of xen~ 'oRr;, i ~N1.aw~V~'
ouxTY of ss, ,a c~Ea~~~~~pjE
w=
' /~,I C ' ' ' ' • • • • • • • • • being duly sworn, deposes an~~ays that he is tfic applicant
(lame of individual si nin~• contract)
-ovc named.
is the /.4t~~~ I
(Contractor, agent, corporate officer, ctc.)• • • • • ~ •
Bald otvncr or owners, and is duly au',thorized to perform or have performed the said work and to make and file this
olication: that all statements contained in this application arc true to the best oChis knowledge and belief; and that the
rk wdl he performed in the manner set'~forth in the application filed therewith.
om to before /me [his
...day of . . f ..~-Kn•,-.,~. 19
a~i Public, ~ Cqunty
No erLyl
Publ~icHState o
New Vork • • • • •
No. 52.8125860, Suffolk Count (Si^ • tore oC applicant)
7orm Expiros October X31, 19~ _ _ _