HomeMy WebLinkAbout18244-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218989 Date APRIL 25, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 1530 BOISSEAU AVE. SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 55 Block 06 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 16, 1989 pursuant to which
Building Permit No. 182442 dated JUNE 22, 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 RITA G. DELANEY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
/ ~_L.?
wildilding Inspector
Rev. 1/81
?[V?i~ NAB 8
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)
Z Dore ....111'~...:Z::.' 19.A..jC
N°- X8244
Permission is hereby granted t .
....mow
c..~ _ .
of premises located at r;J 30......rtwD.~/.~A.A't~GCrf•A..er......~r
............................................~~?K..~~...................................................................................
County Tox Map No. 1000 Section Block .......>f!.......... Lot Na.....~~........
pursuant to opplicotion dated ....f! 19. j..., and approved .by the
Building Inspector.
Od
Fee
c~-~ . ..l.~fl....
Buil g Inspect
i/~
Rev. 6/30/80
.
~(r~:}'~~, Form No. 6
TOWN OF SOUTHOLD
2,3 , j ` '',p BUILDING DEPARTMENT
J!y TOWN HALL
BLDG. DLNT. ~i9 765-1802
TOWPI OF SOUTHOLD y ~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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 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.
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
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
New Construction........... OlQd Or Pre-existing Building. ~I/
Location of Property.LS.~O...UpL~S.~AGI $p f;1.T/T.O.~..~....11~'v
House No. Street Hamlet
Onwer or Owners of Property..}~.~r'~, C7.~~ L ~ NF_;/
County Tax Map No 1000, Section......:
S.S....Block......0 L.......Lot.......:~1............
Subdivision ....................................Filed Map............Lot......................
Permit No. /.$,•Z.~f,~,~...Date Of Permit.~j~d'.~g./r......Applicant.~lt!~...~-~.:F.~i9~£'~,,,,,,,,,
Health Dept. Approval ..........................Underwriters Approval
i
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate.~........ ;
Fee Submitted: $.,r~,~.:a.Q
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7?65-1802
BUILDING DEPT.
INSPECTI®N
[ ]FOUNDATION iST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] SULATION
[ ]FRAMING. [ FINAL
REMARKS:
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D ~ BO.1RD OF HEALTH
3 SETS OF PL.1NS
r~ FORMN0.1 $URV6Y
TOWN OF SOUTHOLD CHECK
,Rlf~a BUILDING DEPARTMENT SEPTIC r-oRM
~Li~.~ratt. ~ TOWN HALL
~P.~i't1~"t~1~.XN~.~,.i~ii.~gYbflt'~91.IP.7i ~ o
.~,.,_...,s,.„,m„,.„.,._..: .,OUTHOLD, N.Y. 11971 NOTIFY r~
p TEL,: 705-1802 CALL /6S, , ;3a,~.3
Examined „ 19 4 ~ pp tee/ MAIL T 0 : • •
.\pproved ...6./.2.2......, 19~/~. Permit No.~/J,a,~'/~,y j"~ •
Disapproved a/c .
( ildin Spector)
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
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 Bui]ding Inspector will issued a Building Petmit 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 par[ 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.
Tile applicant agrees to com~,~lppl~~~~ }y~~~ plicalile laws, ordinances, buddin code, housing code, and regulations, and to
admit authorized inspeldrF~r@:PtlSe~s~and in bui~ ing for necessary inspections.
•XB.~r-;-•-~^^^' (Signature of applicant, or name, if a cor oration
~~..,..~-'fftA~~U ;;Y~s4£hf4alC? x~lrs'~»s P )
~A yaR349 MA ~ i i,~t e;r°
~ HOB t4t"~ # C1t' (53rs l3o~ss~c,~,as~,Sou7-hold~n/fw.yoreK /!9 y/
' e;,k1.'lk~";2i`~ri'~; ^11rSf.PP,.t .y~p.a
E'~5~1 ~t~~ yl.,nti~~,'~ ,Y (Mailing address of applicant)
State whether app
t~~
c~ant~iyCc~?"~1~,hl~s , fa~~~rr„~arehitect, engineer, general contractor, electrician, plumber or builder.
t9WN'~E12 (itMlA~,l.l~4 ~ ~?ikN1AB
. . . [.Jy. ..R.f ye+~.... e~. jF i.. .
tPTIiV\!JM ~ . .
Name of owner otpremises .~il~~~ •t 1.~+t~<ti>~,. •
T~J'`KM ,y,SAN8 Mi,) t,~IbiYir: 4~.r,~ ~ .
,~1'N~M~~It+tJ~Si :}s„ (as on the tax roll or latest deed)
(f applicant is a cot~i~~~n,~tg~alt!~tll~ly~hti~"horiied officer.
Y 7~,~pyll1C;14r'~id3 1"C't?°'
.........Name ,~drr~~pp~~yq(1tY9\iFt7 F'-~:~'.°.~
( a'r;tl'tit]e of corporate offic/er)
Builder's License No. C~-....... •
Plumber's License No . .
Electrician's License No . .
Outer Trade's License No . .
Location of land-on which proposed work will be done. , , , . ,
/53o SOISSEI~Iu- AJ~ /5~0 ,~olssF!a-v,,34?F........~oct;`F~ol~
Clouse Number Street. • . . • Hamlet
County TaxAtapNo.1000$CC[IO? ......b?s3........: Block Lot....~j,,,,,,,...,.
Subdivision Ailed Atap No. .Lot .
(Name
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy !~.JJ~ • •~~~j,Ly
, I?u~~~L r it/G .
b. Intended , ~ '~".F,~ . • - • -
use and occupancyN .
i
3• Rret~f oCwork check which~pplicable): New [Iuilding Addition , alien
P Rc oval Demolition ~ ~ •
Otht VOfk ~ECl.' •
4. Estimated Cos~g,~ o (Description)
.......~i Fee.....
5. If dtvclling, number of dwelling'units , , (to be paid on filing this application)
Number of dwelling units on each floor
_ If gara,c, number of cars ~ ~ • •
6. If business, commercial or mixed occu ant ~ ~ • • • • • ' ' ' ' ' ' ' ' ' ' ' • • ' • • • •
7. Dimensions of existing structur s, if a y; FronPecrly nature and extent of each type of use .
Height • Rear Depth . .
i ...............Nu~bcrofStorics.
Dimensions of same structure with alteratio • ~ • • • • " " " " " " " • • '
Depth nsoradditions: Front Rear....,
. IIeight . , , , , , , Number of Stories . • ~ ~ ~ ~ •
Dimensions of entire new const 'luction: Front , • • • ~ • ~ ~ ~ ~ ~ ~ • • ' ' • • • • • •
. Height Nurrlber of Stories Rear Depth .
9. Size of lot: Front...........,.... Rear
l0. Date of Purchase Depth
11. Zone or use district in which rc ' ' ' ' ' ' • • • • Name of Former Owner , • ~ ~ • • ' '
P misesaresituated..,
12. Does proposed construction violate any zoning law, ordinance or regulation: N,~?, , • . , , , , , , , • . , • •
I3. Nill lot be regraded l4:4 , , L . , Nill excess 611 be removed from premises: Yes
P R N
ame of Owner of remises rral, ?i Phone No. Tb.s`; ;307,5
ELgrJEY. • Address . `~~R44?f!m I
Name of Architect . , , , , , ,Address . ' ' '
Name of Contractor. ' "•••'•••••••••••.PhoneNo...,
IS.Is this property located with in~00 fedetsof a tidal wetland?n*YES....NOY...~•y
*If yes, Southold TownTrustees 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 r}umber or description according to deed, and show street names and indicate whether
interior or comer lot.
II
I
~P ~
FEE: p° Sy~MR~~~
NbTh""~~~t1E
~ 788-iSgx Y AM 'IaD { pM A
I~ FOLLOWING INSPECryONS: ~
1. FOUNf1ATlOly tyyip
FQR PQUREC CONCREfB
2. ROUGH . FRAMING w
9. INSULATION
4. FINAL CONSTRUCnpN MUST
_ ! BE COMPLETE FOR C,O,
ALL CONSTItUCTNaN SMAII
THE REQUIREMENTS Of
i~ STATE CON8TR1,?CryGq G ~ N,Y.
CODES. Np/ RESPONSj~
DESIGN OR CONSTRUCT1pp ~R0R8
?T.ITE OF \E1V YORf:,
=OUNTY OF S.Si,
• . • • • • •(Name of individual signing1contract) ~ ~ • • ~ ' ' ' ' being duly sworn, deposes and says that he is the applicant
bout named.
i
is is tltc i..
(Contractor, agent, corporate officer, etc.) • • ~ ~ • ' " " "
f said owner or owners, and is duly atfthorized to perform or have performed the said work and to make and file this
~plication; that all statements containc~l in this application arc true to the best of his knowledge and belief; and that the
ork will be performed in the manner seG forth in the application filed therewith.
wam to before me this I
/;5^ ...day of .U 19~~
.
Mary Public. N.~:eP~-; . ¢1. ; E; !/Q;2..... County ~
~~py NEIEN K bE YOE • .
No.47~01178 S~illfolk~ (Si;na[ure oCapplicant)
term Eeplree Ntirch 30,~l~