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HomeMy WebLinkAbout18267-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18226 Date JULY 28, 1989 THIS CERTIFIES that the building ACCESSORY Location of Property 985 BOISSEAU AVE. SOUTHOLD N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 063 Block 02 Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 28, 1984 pursuant to which Building Permit No. 18267-Z dated JULY 6, 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 ACCESSORY BUILDING IN REAR YARD AS APPLIED FOR. The certificate is issued to ELEANOR S. WALDHEIM (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 rosai 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~ j Z Date 19.$•1 Permission is hereby granted to: / ....9.:~s....~....a.~::..... ro ...~'A?~o::~~a.u.c.~.'...hkn....Aws~....1~.Q:~,~1.,....ls!~....~..ar.-,~4~s~.. , . 1 ....j1~.qq, ..................(.~..................c.....................n..~.......................... at premises located at ......e.gS....~.~...lfS.4e~4.:......4?.i,~~(~.~ County Tox Map No. 1000 Section ......Q.~3..... Bplock .......0.~...... Lot No....5~^7 pursuant to application doted .....~~Y.?:'S,....5~~...,A 19t~.9.., and approved by the Building Inspector. Fee S••e~.~:.../ Bui ding Inspector Rev. 6/30/80 TOWN OF SOUTNOLD ~'S~ I.Jcrc~,~9.,~_L BUILDING D>:PART4ENT rr~~ G TOWN UALL U f5 ~ ~y.,LL~~ ~~~~^pg J~f~~ SOUTUOLD, NEW YORK 11971 ybs - laoz JUG. 281989 ~~~sicir: titer APPLICATION FOR CERTIFICATE OF OCCIIPAtlCY TOU/rti~Or;;OUT;IOLO ~..,~~f„v..,~.._ _ ~Q~:_W DATE. ri0 - " NEW COtlSTRUCTION ...._.-OLDyOR PRE-E%ISTItlG IIUILDZNG..._..DACAtlT LAND.....•• Location o ~p5? 4 ~'•n f P r o p e r t y , , , - _ - - - ~ (9'C~,Q~Q,I(,~ ~"C , UOUSE NO. STREET - DAMLET Ovner or Ovncrs of Property,....,, County Tae Map No. 1000 Section •~~3 Block LoC Syibdivision..., r - Filed M5/a/~jfp '.Lot. ~~rait tlo. !~~'°~-.Date of Permit-~^7.<.------- APPlicant Bcalth Dept. Approval - " Undcrvritcrs Approval.---,-,---. PlanninC Board Approval Request for Temporary CerCiFicatc Fiaal Certificate _ FCC $ubalCCCd: $..~~..-...~~.C~~ - ~_,Jyq r APPLZCANT--~6~~~L.C._:.... 'v• 10/14/88 ~,ac,~ 3~8`f3 ec~ ~ i~aa6 I I I FORM N0. 6 ~ TOWN OF SOUTIIOLD BDILDING DEPARTl1EtlT TOWN MLL 765 1802 APPLICATION FOR CERTIPICATE~F OCCUPANCY INSTRllCTIONSI A. 'This application must be filed in Eypewri[er OR ink and submitted to the Building Inspector with [he following; for pew buildings or new use: 1. Fioal survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. i 2. Final approval of Tlealth Dept. of water supply and sewerage-disposal(S-9 form), 3. Approval of electrical installation from Board of Pire Un~erwciters. 4. Sworn statement from plumber certifying Chat solder used ;n system contains less than 2/10 of 1Z lead. I S• Commercial buildings, industrial buildings, multiple residences and similar, buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. SubmiC Planning Board Approval of completed site plan requirements. 8. For existing buildings (Prior to April 9, 1957] don-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 properly completed application, a consent to inspect sighed by the applicant and a certified abstract of title issued by a title companq which shall show single and separate ownership of the entire lot priorlto April 9, 1957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings 1, or premises, or other / pertinent information required to prepare a certificate. CL For Vacant Land Certificate of Occupancy: I 1• An application for vacant land Certificate of Occupancy shill be submitted, and a certified abstract of title issued by a Citle companq showing single and separate ownership of the entire lot prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied,jthc Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: I. CERTIFICATE OP OCCUPANCY - New Dwelling $25.00, Additiolbs to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. A~ccssory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $$0.00. 2. Certificate of Occupancy on pre-existing dwellivg - $IOb.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years~i- $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $x:5.00 Residential, $50.00 Commerciale ' I ! 'v• 10/14/58 f ~7i ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/INSULATIO~~N© [ ]FRAMING FINAL REMARKS: ~~G DATE ~G INSPECTOR 1ELD IBS:";,:lu;. ~~U,;;"c, I~ COMMENT° -v m o0 1. ~ J!J H _ - - - rOUIJDATIO*! (1st) - - - N ~ np ?OUNDATIOW ( 2nd ) _ - z o ,9 00 ~OUGH FRAME & - ~J PLUMBING JJ H 3. m m y IIJSULATIOII PER N. Y. ~ • ^ STATE ENERGY CODE ' } y 7~ ~ v .~m 4 . ? / y ~GJ~t FINAL o . i ' ADDITIONAL COMMENTS: x " m ' x '0 . N 9 ' H O ~ m • r . o . 1, m ^o H BOARD OF HEALTH•••.•••.•••.• ~ 3 SETS OF PL.1NS , FORMN0.1 SURVEY TOWN OF SOUTHOLD Ck1ECK BUILDING DEPARTMENT SEPTIC FORM BiD(i. DEPT. TOWN HALL N OF SOUTHOLD SOUTHOLD,N.Y.11971 NOTIFY ~~s--ad`~~ • TE/L.:765~1H02 CALL , Examined.... ,,,,19$9, MAIL T0: t~ 2 Approved 19~~ Permit No.I, ~°Z~ Disapproved a/c . ..............................`~~1r4+... "w" (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . NL(~/.~...~5 . 15 ~9 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 showin; 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 orlrsed 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 applicab]e Laws, Ordinances or Re;ula[ions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant a;rees 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 ins ectians. ,,p(p~ (Stgnatulicant, or name~?'r1~.).. . r • ,cgo!ssERU • ~ t!F•, • $ouTHol,Q,,, N•~ ' (Mailing address of applicant) O9 7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................4.t~ .n1.6R.................................................................... . name of O,vner of premises ..~.~.~An/a R....S. ~9 DH. ~!.M . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpo~r^ate officer) y' Builder's License No. Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1, Location of land on which proposed work will be done. ' .~'gs..8o~ssEA~..R~~N~E..........,s'o~.T,~.o.4~.....~ ~ . y .....ii.4.~~::......... House Number Street. Hamlet • • ~ • County Tax Map No. 1000 Suction 6~23.~.Q0.. • • • • . • . Block ..Q a+.~.C?Q• , , , , , • • Lot •h~7 Q~-~-r®O Subdivision Ailed t`tap No. . n ImC) LOt (N. ' State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~`~-~5'' D~/v!~' ~[^•.~•1• • • • • • , , b. Intended use and occupancy ....5!Q.R~3 ~G• . s..~.~J•~~ x~~ l~? 3. A`ature otwork (check which;applicable): New i3uilding y.' ' Repair Removal Addition ........f~~'c~u • • • Demolition Other 1Vork . -C~ 4. Estimated Cost . ~ ~`(D~cscript.on) • Fee . . ~ • :~Y.a~........... s,"+C (to be paid on filing this application) 5, If aarallen num bcr of carswellin;.. • • • . • • , • • . d g units Number of dwelling units on each Moor......... 6. If business, commercial or mixed occu anc ~ • • • ~ ~ • ' • ' ' ' ' ' ' ' ' ' ' ' ' ' ' • • • • • • P Y, specify nature and extent of each type of uge . 7. Dimensions of existing structu~res, if any: Front , , ~ ,Rcar ' ' ' • ' ' ' ' Height . Number of Stories ..`P9, , tt...... Depth . Dimensions of same structure with alterations or , dditio s: Front ~ ~ ~ • • " " " Depth Height. Rcar.................. Dimensions of entire new construction: Front • • Number of Stories , , , . Height . Nujnber of Stories . . • . Rear Depth . 9. Size of lot: Front Rcar . .....p..,.L.~... Depth lt). Date of Purchase p91•,i9&'t~. • Name,of Fo,[mcr Owner -~9//~, .~/E,NI/,A!(z . 11. ZonePr Pse distri;t~~~chacmises are situated ,r:~l,,~, , , , • • 12. Does ro osed construction violate an zoning law, ordinance or re ulation: ~ ~ ~ • • • ' ' l3. Will lot be regraded I,/t,/,(~ g •~Q• • • • • • • • • • . • • • • . ..Will excess fill be remov~l from premises: Yes No 14. N,~rne of Owner of premises ~J~'RNok S,.led.~lpd~l,~adress`(85.~,6oLSSIEAu. ,l:~y,E,. Phone No. ~/pS. ; .a? ((p.$ , , , Name of Architect ~ ,Address . Name of Contractor ...................Phone No............ . IS.Is this property located within "'Address.. .Phone No........'. *If yes, Southold Tows Trustees Permit may bearequiredetland? *YES....NO.... PLOT DIAGRAM Locate clearly and distinctly alb buildings, whether existing or proposed, and, indicate all set-back dimensions from property Gnes. Give street and, blockl,number or description according to deed, and show street names and indicate whether interior or corner lot. i I - i . { 1 ~I i I ~'9- •~k i STATE OF KE1V Y'ORR, COUNTY OF . . • • • ' • • • • • ~ ~ ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (A'ame of individual signing contract) above named. I M 11C IS t11C (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 this 1PPlication; that all statements contailjed in this applic~[ion arc true to the best of his knowledge and belief; and that the •~ork will be performed in the manner set forth in the application Mled therewith. 'wom to before me this rotary Public, ...Ga:~~?~:'r; ; . !L til.~-.Y~:....... County ~~J/~ ,Q ~ HELEN K DE YOE • • • • • . , ~ ~.~~PrZ-~-r..~ NOTARY PUBLIC, State of New YaN No. 4707878,SufrolkCouMy (Signature of applicant) Term Ezpirea Mamh 30,19~~ i