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Home My WebLink About17748-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O(~cu~ANCY No Z-24554 Date AUGUST 6, 1996 THIS CERTIFIES that the buildin~ Location of Propert~ 340 ROBINSON ROAD House No. County Tax Map No. 1000 Section 34 Subdivision ALTERATION GREENPORT, N.Y. Street Block 5 Lot Filed Map No. Lot No. Hamlet 13 conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 30, 1988 pursuant to which Building Permit No. 17748-Z dated JAB~ARY 8, 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 ALTERATION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate ie issued to DAVID MERZ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-376826 - FEBRUARY 1, 1996 N/A FOI~M[ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ gl?~8 Z Permission is h~..~.by grgnte, cl to: · ~...~ ...... ~~..? ....... ~~......~.~ ...................... at premises I~ated at ...~ ....... ~.~ ...... ~ ................................ ~.~...~ ........... ............................................ ~~~,,~,..~.~ ............................................. Coun~ Tax Map No. 1000 Section ....... ~ ..... Bilk ~ Lot No. pursuant to application dated ..... ~/~.~. .............................. , Jg~.~.~ and opprov~ by the Building Inspector. Fee $. a~ Rev'. 6/30/80 BUII,DIN(; D EPARTHF, NT 7 APPLTCATLON FOR CLRIII~UAIL O~ OCCUPABC ThJs application must be fi.lied in by typewriter OR .Lift( and submitted to the buiJding Jl]specl]or wtLil the roi.Lowing: for new bui.lding or new use: [. }"ina] survey of property with aCCLliate ].ocation o[ all bui].dings~ property lines, 2. F.Jna.l AppL~ow~i from ileaJth Dept, of water suppJy and sewerage-disposal.(S-9 form). 3, Approve] of elec. tr'ico.J iust.alJaL'ioa From Board oF Fire Underwr:Lters. 4. Sworn statement [rom plumber certLfying that the solder used in system contains ]ess tiJau 2/10 o[ J% Jead. 5, Commercial buiid:[ng, 'LodusCr.LaJ build:L.g, meltiple residences and siml.Lar buildi.gs alld ~llsta[].atious, ace. rtiCicate o[ Code Complimlce [rom architect or engineer responsJbJ.e [o[ the bu,J lding. ~. Submit Planning Board Approval of completed site plan requirelJlent8. For existing buLJdi, ngs (prior to Apri.i 9, 1957) non-conForming uses, or bu£1diogs aud "pre-exi. sCing" Jancl uses: 1. Accurate survey of property showing ali property ]Joes, streets, building and 2. A properly completed application and a consent to inspect signed by the appiicanI:. Ifa Certificate of Occul)ancy :Is denied, tile Building Inspector sha]l state the remsons therefor io writi,g Lo File app.[Jcant. 1. Certi[icate of Occupancy - New dwei.lisg $25.00, Additions to dwelling $25.00, A~.terations to dwe[].i~g $25.00, Swimming pooh $25,00, Accessory building $25.00, Additlo,s to accessery I)uiJd.iug $25.00. BusJsesses $50.00. 2. CerL-Jftcate of Occupancy on Pre-existisg Building, - $~00.00 3. Copy of Certi[icate o[ Occupancy - . .25~ 4. Opdated Certificate of Occupancy - $50.00 5. Temporary Certificste of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Buildisg ................. 340 ROBINSON ROAD GREENPORT, N.Y. Lecation o[ Property ......................................................................... IIouse No. Street ~{amlet Onwer ar Owners of Property DAVID MEP, Z Csunty Tax Mai) No 1000, Section. 34 ,.Block. 5 .Lot ,13 Subdlvisiou .................................... Flied Map ............ Lot ...................... Permit- No .... 17YiSt-Z ...... Date Of PermLt...JAil..6,.1989.AppJ. icant..DAVID.~ERZ ................. llealth I)epL. Approval .......................... Underwriters Approwl] .......................... PImmLsg Bomrcl Appreval ......................... Fee SubmitLed: for: Temporary Certificate ........... Fioai Certicate ........... APPI,ICANT ?'~mL I,,5. ~.~ zON !!DATE FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & ?LUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: OGCUP~ ~C¥ OR' USE IS UNLAWFUL WITHO] IT CERTIFICATE OF OC( UPANCY If copper tubing is used for water distributing system; piping shall be of types ,K or L only, j) / T ? m~o CO~V~*E~r ~EFORE ,ERTIFICATE OF OCCUPA JCY ~'-~ SOLDER USED IN WAD SUPPLYSYSTEMCANN~T -~ ~/~'~o~ ~ EXCEED 2/10 of 1~ LE~ ~D. ~ ~ee~/~o~ ~ ~q ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING ~r]FINAL REMARKS: DATE ~-_~/~/ ~ FORM NO. 1 TOWN QF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTH SURVEY ...... ~ ............. CHECK ..... ; ................ SEPTIC FORM ................ Examined ./'.~.~.~/,/,/,. ....... 19t:~. . . Approved ..... /~, .~/.4~..., 19... Permit No ............ Disapproved a/c ..................................... (Building Inspector) SOUTHOLD, N.Y. 11971 NOTIFY /-//,7 TO: TOWN APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 sots 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 tkis appli- dation. c. The work covered by tiffs 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 a~ay purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Dep,'u'tment 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. The applicant agrees to comply with all applical~Ie laws, ordinances, t~ilding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insla"~ctions. ~ (Signature ot applicar~, or name, if a corporanon) .................. f..eve (Mailing address of applicant) , State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......... ' ........ t ....................................................... (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co~oorateofficer) Builder s License No .......................... Plumber's License No. coJ Electrician's License No..5! .~)./.O.e..~. ........... Other Trade's License No. ~ 1. kqs~ion of land on ylffch proposed work will be ~one.~.~..~. ~. ~.. (~: ~.¢5 ~(~, , , ..... ....... ..... House Number S x ' ' ' ' ............. Hmnlet County Tax Map No. I000 Section o~ B}pck ~ Subdivision ..................................... Eiled Map No ............... Lot ............... (Name) ~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~/~o b. Intended use and occupancy .................................................................. 3. Nature ofwqrk (r. heck w.&ich app icable): N. ew Bu Id ng ' R~ ~ ~ , - ,~ ..... Add't'on ....... Alteration . ~<' --~v~,- ~ · · ¢.',- ........ l~.emoval .~ ..... ~ Dem~,:,:~- ~ ...... ' ....... · r' ~ (Description) 4. Estimated Cost ~.tflO0 '~r ...... [ ........................... tee ................ . . / (to be paid on filing this application) 5. If dwelhng, number of dwelhgg units . . Ir garage, number of cars .... ./ ....... ' ....... Number of dwelling units on each floor· / 6. If business, commercial or mi~ed occupancy, specify nature and extent of each t e of us 7. . ..... Yp e ..................... Dimensions of existing structures, if any' Front ,,,. , , · · ~ ............ ~ear .......... Denth ne,gut ............... Number of Stories../. ..... ' .... ~' ............. D,mens, ons of same structure with alterations or additionsl ~' ~ i i i i i i. 'Rear...' ........... · epth ...,~ ~ ,, ~... Height . . Nu · . ----~ ~ ................ moer otstones..x'. ........... 8. Dlmenslotl~i, ri~Iv construction: Front ..... . Rear . . De-th ..... Height ............... Number of Stories .. ~ ....... ... · v ............. 10 Date of Purchase . ' ............ ~'~ .......~-: ...... .... ' ....... ~ ................... Name of Former Owner ~/2ffff~/~F--~/./~..~...~ ....... ~ a..Cone or use district in which p}emises are situated ...... ' ........... : '~ ........... 12. Does proposed construction viblate an,, zonin~ ~ ...... -"- .... ; '. .... ',//eX ............................ {~' I~;;;;~ng;;aoe~ ~n~'~s' 'A'~; }/'~ 'ff ~,'ff~,~.~. ...... Will exoce_.ss F313 b~e.re, moved, fxom premises: ~ y~ "~ ' Name of Contract,,,- d)w ,W~'~ . .. · ·. ':'r. ~ ....... Phone No ................ . . · ......... Phone No .......... 15:I~s~ thits property located w~_th:tn300 feet of a tidal wetland* *YES.~,~.NO '' ~'' -..tr yes, Southold Towln Trustees Permit may be renuir ' '''' ~ 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 number or description according to deed, and show street names and indicate whether interior or corner lot. . HELEN lC DE VOE NOTARY PUBUC, Stato of New NO. 47078'/% Suffolk Term Expires ~fch i10,19 / ' l ~/ (Signature of applicant) STATE OF NEW YORK, COUNTY OF ............ ~.S .......... ('~ ..................................... being duly sworn, deposes and says that he is the applicant of'nd'v'd i ' t) amc i ua sigm~gcontrac above named· lie is the ' ' i (Contractor agent corporate officer etc ) ' ' ' of said owner or owners, and is duly! authorized to pe,rform or have performed the said work and to make and file flfis application: that all state~nents contaihed in this application are true to the best of his knowledge and belief; and that the Work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this ....................... day of.[ ............... 19 . Notary Public, e~ County