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HomeMy WebLinkAbout18426-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219579 Date DECEMBER 12, 1990 THI5 CERTIFIES that the building ADDITION TO ACCESSORY Location of Property 3150 BOISSEAU AVE. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 06 Lot 08 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 14, 1989 pursuant to which Building Permit No. 184262 dated AUG. 24, 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 ADDITION TO EXISTING ACCESSORY BARN The certificate is issued to DONALD E. TUTHILL (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uilding Inspector Rev. 1/81 vosest xa 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 AUTHORIZED3 N4 ~ g ~ ~ ~ Z Dote .....~~~.:..T 19..~ Permission is hereby granted to: .~~s~ st'remises I~c~td ~t ~ ........................................................~-5.~~......................................................................... County Tax Map No. 1000 Section Block ..............~....~Lot No.............~...... pursuant to application doted,,.....~~1 19~.,C.., and approved by the Building Inspector. fee $.~u!,„~~. . . u~........ uildi for Rev. 6130/80 Form No. 6 p~~ ~ TOWN OF SOUTHOLD hh Ijl BUILDING DEPARTMENT v ~ TOWN HALL 765-1802 BLDG. DEPT. TOWN UPSUUTHULD 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 17 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. 3. 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. v. 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 9~ 'yew Construction...... Old Or Pre-existing Building..... Location of Property...~~`y,~,,,,,,,,b~,~~55~~U /}1:~ .S:oU]"/tOLr~ house No. Street Hamlet 7nwer or Owners of Property.,'~bN'~/'D, ~,.,.°7' U •7"f~/{~./G~.L•..•••...•••......•...:.••.....• County Tax Map No 1000, Section.... S.J......Block...6............Lot Subdivision ..............................Filed Map............Lot............... i'ermit No. ` ..............Date Of Permit. , g 1, ...Applicant. Dd/~.A-LA• 11 e 1 • . • • • . • • • !Iea1Ch' Dept. Approval ..........................Underwriters Approval.. Planning Board Approval Request for: Temporary Certi~f//icate........... Final Certicate,. Fee Submitted: ~;5.',,,,,,~,e,,,5"z;G.,%.,... . Ree ~ a q kd ~r~c~ ~u~ • rs/~~~9d G a zl ys~ ( APPLICANT -lELD I;:S:'EC:iU;+ ~IUn.E ~ OOMMGN7° \ ~ ,t -a ~Q~ 1 . ~ ~ 0 C ~ _ - - r0U1lDATION (1st) ~I - c FOUNDATIOtJ (2nd) m 2. z o ~ P,OUGH FRAME & PLUMBING a N y 3. ~ m y IIJSULATIOP! PER N. Y. STATE ENERGY CODE 4 . liZ / y0 y~ FI;JAL ADDITIOAIAL COMMENTS: ~ ~ ;•1'1 ' ~ x H H H O\ a a~ _ x d H 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL REMARKS: C.-- C...t~ DATE ~ ~ ~ INSPECTOR ~ .r°~ 765-1802 BUILDING DEPT. 1 NSPECTION [FOUNDATION i5T ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: /C E.'~~~`~--~2 , DATE ~ © INSPECTOR f(~ r ~i Vi xi~~~ . 111. t ' r ~ I R' ` "S. ry p\. 1 { ~ ~ ` .v ~1 3 {,hb p~ 9- .-...._.__-_..S tie ~ ~ I ~ £k' ~ p , C ~ t it ty~ i..~~~~_. . , ~ 0)yNop ~ ~ ; J, 4g_ ~ us _ ~ Z ~ 7~~~~ i tV V ~ (El4 ~ y cf'~ i .N p~~ ~y ~i z U11 i~1LL.ti.~ ~ 4)h pp~ 2~?, ~ ~.1 ~ ~ v ~`~~~~cti ~ 1~ X14 `kh 2~ ~ ~1byt? iii O ~ v/ I. / Y~ ~ i ~~1 ~l =s'~ +i~~ J`~a /1 _ r~ ~ wl~ V C~ ~w ~ ~ ~ ~ ~ n>>I y~' ~c7~ / r- ~a > ~ i fi ( ,Y a.{4,~~ z i co ~ l>, ~ ~ 4 I GY { rt ~ ~ ~ tla ~ ~ 0 r-~ ~ 1 ro w ro~ voo g~°~ 5,'~' _ I (yam ~ ys, oryX ErG~ i,., ' ~i f 1 1 t a~~[~~~~, BOARD OF HEALTH _ . ~ 3 SETS OF PLANS FORM N0.1 SURVEY ~LJ TOWN OF SOUTHOLD CAECh BU1LDl{VG DEPARTMENT SEPTIC FORA BLAG. DEPT. TOWN HALL ' TOWNUFSOUTNOLD SOUTHOLD,N.Y.11971 NOTIFY ^J~~ 3L5~~- TEL.:7G5-1802 CALL Examined 19 ~ MAIL T0: 3~S U _~i-[~~.~, cc ea u-- Approvcd ..0~~~ 19 Permit No..f. ~~`~6 ~ f o Disapproved a/c e A D AS NdTED .02.--.. DATE:~d.P.M Build bInspector) FEE: CATION FOR BUILDING PERMIT NOTIFY BUI G DE ` j C~ 766-1802 9 AM TO 4 PM THE Date .l 11......., 19 FOLLOWING IN TIONS: ~1, FO - TWO REQUIRED INSTRUCTIONS F ONCRETE 2. GH .FR MIN ~ gLl(M8 (~ICt ' a3 I La a om~t e ely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets ~f ace r~~~l~ ~~I~`Nt ~,c,~(e~.TFee according to schedule. b: t tton o of and of buildings on premises, relationship to adjoining premises or public streets or ar~~~,c~~~~ Ac~~scgn of layout of property must be drawn on the diagram which is part of this appli- cati ~Q~B M4 N gtion may not be commenced before issuance of Building Permit. p e Building Inspector will issued a Building Permit to the applicant. Such permit shall ~ '~yut~R~yg~gr inspection throughout the work. e. 8 ~"~~yd in whole or in part for any purpose whatever until a Certificate of Occupancy shall hagfl~+.ep~ra,~ttpy~b7CJlyg $MI~yR I~Eector. ' APIF ~i~PtT qq,, the Building Department for the issuance df a Building Permit pursuant to the Building' o t ~~'3outhold, Suffolk County, New York, and other applicable Laws, Ordinances or Rcgulat'o A~ 0(-11~tngs, additions or alterations, or for removal or demolition, as herein described. The ap ti o it~^'i 5i plicable laws, ordinances, building code, housing code, and regulations, and to admit a t etta~ Qt1 p ~~t~~r~1i~s~~~~~a~nndd m building for necessary insp~_stio'ns-_ - ON~T~t(Mt Mt13T y~-~~ . V''~~4~~~"Y~ gE COMPLETE FOR C.O. P`-!, , of ; ALL CONSTRUCTION SHALL MEET (Signatu e o' a t or am , if a corporattonj THE REQUIREMENTS OF THE N.Y. ;3I ~ d T'~~L p~E~~ v.~b / STATE CONSTRUCTION & ~NERGY .......5. .I,l,,,,,,,,,,,,,,,,, CORES. NOT RESPONSIBL`~ FOR (Mailing address of applicant) DESIGN OR CONSTRUCTION ERRORS ' State whether app]cant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 4w1~'ER ...............................II.1~~............................................................... Name of owner of premises ..D~Nf~~U E° T (I T }~1~, (as on the tax roll or lateAst~{d~eed) If applicant is a corporation, signature of duly authorized officer. A"'CCU~AI Y{,?Y o (Name and title of corporate officer) UE'e1 .~~~tr+~e Builder's License No IT®uT CERT6FiCATE Plurnber's License No . . Electrician's License No . CCU~At 41C~ Other Trade's License No . . ~/s B~rtss~RU qv~ Boa' ,~v Y~niNt~arr b~Y>UE 1, Location of land on which proposed work will be done . . 3 15"0 ~o~s~'t=,4v ,~~F S®vTIfDGp Eiouse Number Street. ~ ~ ~ ~ ~ ~ ~ ~ ' ' ' ' ' ' ' " Hamlet County Tax ~\tap No. 1000 Section Block , .6, , , , , , , , , , Lot g.............. . Subdivision Find 1<Iap No. Lot , . (Name) Stale existing use and occupancy of premises and intended use and occupant ` ~ Sf{O)" ~ S'TO/j'~~proposed cens~tStSo, a. Existing U/LpIN~ _ - b use and occupancy .....~~:....I..... tt.~9~1 , sT•aR,4~ c~QI~P~~~M~,~~s ~s,~oro roP sore MuxcK ~rc~ b. Intended use and occupancy ature of work check which, " Re air , , , ~ • • . • • _ . R`I~applicable): New Building Addition Alteration . P moval Demolition ~ir,Vl j ~ it + 4. Estimated Cost ~(D~scription) b V ~d.Ii Fee ~ (to be paid on filing this application) 5, IC dwelling, number of dwelling units , , , , , , , , , , , Number of dwelling units on each floor , . , , . 6. If business, commercial or mired occupancy, specify nature and extent of each ype of use . , Height , D.,~r,',t, , , , , s, , , , Nures, if any: Front , !'~'~t, Rear Depth ~ mbcr of Stories ...'r~•.. ~ . Di P ensrons of same,structure'with alterations or additions: Front . , , , , , , , , Rear .:~+/h(~, , • . , . . De th . 1•k ,6 , , .Height , . Sft'/y~ .Number of Stories ...`./,~~1•-, , • 8. Dimensions of entire new constnrction: Front . Rear . .Depth Height Number of Stories • • m 9. Size of lot: Front ~-~7 ~ , , , Rear , o / ~ ! ' ' ' ' ' ' 10. Date of Purchase I, DeP4f~ ~~'•~,95'_ p i Name of Po cr O ner "";`°fVC E"'"7"t`7''~'hF/LL.... . l 1. Zone or use district in which 'remises are situated RE5IDEhrGE - /~~-~qL ° ~ ' ' ' ' ~ • ~.y.t g• 12. Does proposed construction violate any zoning law, ordinance or regulation` .'}:yltT.±91•tFJ• n•Irr~•""• • • • • 13. Will lot be regraded ..~d . •I,t! d'~"~ A•tYi•?m~r ~~±let•,>~t':..... 14. Name of Owner of rem.}ises QQN~fl, v~{yiLt' ' ' ~Vdl excess fill be remowyeDd fr~ymy,~prerltjsgs;..rt~lpp;~~,~'es Nc p NONE' .T.. Address,t~GlSS~s'.4u~~?s,(1~1$"t'~1'onelyp.~;/n!t3~fSS~... Name of Architect ' ' • ' Name of Contractor S~`t ~ • ' ' ' ' ' ' • • • Address . . . . . . . _ . IS.Is this property loc~,ated within• •Address .....,,°;~;,•,.,+;:},'Phone'No:;.. , 300 feet of a tidal wetland? *YGS~::;-.N0.1~ , *If yes, Southold Toc~n Trustees Permit may be requrs,d, PLOT DIAGRAM . , Locate clearly and distinctly all buildings, whether existing or proposed, and;inc(cat,~ a11,St~f _tic , d` ~ nsions fron property Gnes. Give street and bloc~C number or description according to deed an' ''show'street 3t ~ ' ~ ~e interior or corner lot. C~s SAC-~'Q~`;' , = ~am,~~,an~'}ndicate whether . J C1t ST/N!s 8 d EHBN BL.[tG'!f wflLLCr , , . ~ ~~:PT SuRUEr 6„ - ~q.~rA,c1f~D - ~ i cuRRIC~+9TSD. ,,,,,f~~ wog-a~-~ Br=RG~ °y'"i ~ u~ ~ ~ ~y rta~.: : N~4 waoD arzessvree r~sar,~n ~4PARoX=~'45'~~~To'~.` .~:sat~lt;=~~~ _ , g,. A~% t i ~ ¢ ji ~ I ~ I ~ 1 12,E ~~~J~~ ~ ~ 4 b"x2"' CI~ME,vr wAC4S/ RErA~Fokci~ hoc D,~LoW GR~4~6 ~ er., ,,;~,i nz, STATE OF NE~V YO1~J;,', ~ - ~ • • being duly sworn, deposes and says that ]te is the applicant • • • . • • • •(1\am~ of individual sr , gn`ng contract) above named. i lie is the of said owner or owners, and is dui (Contractor, agent, corporate officer, etc.) • ' ' • • ~ ' ~ ' ' ' ' ' ' ~ authorized to perform or have performed the said work and to make and file this application; that alt statements cont~mcd in this application arc true to the best of his knowledge and belief; and that the work wdl be performed in the manner set forth in the application Gled therewith, Swam to before me~,(this I • ..day of!V.. 19 Notary Public, , , , , ,/1:. . County ~1:y1..dC~ NELEN K. DE VOE l • . NOTARY PUBLIC, State mi New York ' ' ' ' • ' • ' ' ' No. 4107878,Su1foIl~Coun (Signature pf applicant) Terra Expires M:rch 30,1 I