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Home My WebLink About17893-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218364 Date SEPT. 12, 1989 THIS CERTIFIES that the building ADDITION Location of Property 2765 MINNEHAHA BLVD. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 87 Block 03 Lot 31 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Peruut heretofore filed in this office dated MARCH 8, 1989 pursuant to which Building Permit No. 178932 dated MARCH 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 CONSTRUCT DORMERS AND FINISH SECOND FLOOR. The certificate is issued to DIANE & SOHN BARES (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING SLIP 9/8/89 PLUMBERS CERTIFICATION DATED MATTITUCK PLUMBING 8/15/89 ~1~./ uilding Inspector Rev. 1/81 rows xo. ~ 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~ 017 8 9 3 j Date .........~.Q.~:F.~.......7 19....1 Permission is hereby granted to: ..~.,~s~-:.. ~a:.~.......i.~.a ~ .t ro C':~?ti:s,-~`:.. cap-w......4~-h.1~,...~:~,-,~.~:-;.~i.....~5..~..-.~..4R-.....4.~a~ o,,t~j, ct premises located at . °~i~.~°.5:.....~..~.!!1K....f+Z.K!~R:.......SSArYti.JEt.. County Tox Mop No. 1000 Section Block Lat No pursuant to application doted ~.~YV . 3 19 and approved by the Building Inspector. Fee 3 ~^v: •J.. /L tom' Building Inspector Rev 6/30/80 . 3 _ ~ _ TOL1N OP SOUTIIOLB v ~ BUILDING D>:PART2SCNT W S~ ~8 ~ ~ ~ TONN IIALL SOUTIIOLD, NEW YORK 11971 B:OG 7EP7 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY DATE _ "'x"~" ~ ~Y;~~ NEN CONSTRUCTION ._.....OLD OR PRE-E%ISTI~N+G ~BUILD~Z`NG~(.'/~..._.VACANT LAND........ Location of Property..°~7~'r....~~~:~,_./'`~v .l, UOUSE NO. //STRCET UAMLET Owner or Owners of Property.:~.°.Q"'*~ ~ Y~ ~~G'~ ~S 'J -7 County Taz Map No. 1000 Section Y./_... Hlock Q Lot .v_...... Subdivision Fil~e~.d//Map ........Lot.......... Permit No.~?~1:`~'._.Date of Permit'%'~°.':`..~_..APpLicant£~'` Health Dept. Approval Underwriters Approval.............. PLaaniag Board Approval Reques[ for Temporary Certificate Final Certificate Fee SubmitCed: APPLICANT. ~ 3g~~G l~~ e~ z~~~~ rev_ 10/i4 /88 f . L ` FORM NO. 6 ' TOWN OF SOUTHOLD BIIILDING DEPARTMENT {4 r TOWN AALL 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCIIPANCY INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; For new buildings 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 of IIealth 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 solder used in system contains less than 2/10 of 1Z lead. 5. 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_ Submit Planning Board Approval of completed site plan requirements. B_ For existing buildings (Prior to April 9, 1957 non-confornxing 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 signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ovnership of the entire lot prior to 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 or premises, or other pertinent information required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: I. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot prior to April 9, ]957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 1. CERTIFICATE OF OCCDPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25_00, Swimming Pool, $25.00. Accessory building $25_00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate o£ Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial rev. 10/14/S8 TEL. 7G5-1802 oc,~FF~G~ CO~~ TORN OF SOYTTHOd.D r. " ~ OFFICE OF BUILDIiQG INSPECTOR ~ ~ ~ ~ ~-I' P ~ , °o~, r;, P.O BOX 728 j ~ y~ ~ TOWN HALL SEP ~ 8 O `r SOUTHULD, N.Y. 11971 M~~ ~ ~b0 8%~G Dr_~ To+nrr~ of souTF+o~o C E R T I F I C A T I O N Date~_ / Building Permit No. /7~9~ Owner ~d,!, ~ ~~c.p ~ (please print} Plumber ~o,"~ ~ < t 2q,-~`~.n4 ~~p (please print) J f I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. , 4 Y~~~ (plumber's s a Sworn to befor: me this f%~day of ~%1~fir7- r ~~?r 19~• Notary Pub1 ~ ~ tlotary Public, 1 ,`/,~fC-~~-County `~~H~.~~n~ 13otary puldic, Staff of New Yak No. 4920758 (1uai6ed in Suffolk Caurdy Tern Exp~ros Feb. 16, 1990 1cLD i:. ~ . ~ ~I:inT . ~,MMLNT~ ~ i a -o 1. ~ ~ H FOUtJDATIOiJ ( 1st ) c POUtJDATZON (2nd) ~ 2. ~ zo P.OUGH FRAi~SE & PLUMBING N H 3. / _ ~ ~ INSULATIOtJ PER N. ~ ~ STATE Et1ERGY CODE c 'J' r ~ ~ 4. a ` i FI;JAL Jr vs ADDITIONAL COMMENTS: m m x .ti H 9 H O , Z . ~ C~7 9 r .e _ ~ 0 m ro H . ~ ?~~j~ 765-1802 ` BUILDING DEPT. INSPECTION [ )FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ) tN ULATION FRAMING [ FINAL C7 REMARKS: DATE ~ ~l INSPECTOR Y ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST f ] RO GH PLBG. [ ] FOUNDATION 2ND INSULATION [ ]FRAMING ~ ]FINAL REMARKS: DATE ~ J~ INSPECTOR 7~~,j 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ROUGH PLBG. [ ] F NDATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: ~ DATE ~ INSPECTOR ~~J 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( } ROUGH PLBG. ( ] FOUNDATION 2ND [ INSULATION [ ]FRAMING I [ ]FINAL REMARKS: / ~LC ~S~ _ _ / _ CTS A .t o Q, /L.cl U.C~- DATE INSPECTOR G~1NIHllli4 a 0 1 a a a 4 n x ivy ,7 ~ > < T ~ ~ k n ,.z N ~ 3 to ~ m X p o m m f1 3 a t.~ H I "a O p v c n T u C m Z ~ ~ ~ ~ > ~ N ;°0 x aA ~ rv s' ~ _ ~ " O _ wpm m ~t ~ z 'j J "J new ~ N a ~ i w.-. ~ m fit O 7E `+i z Z ,.gym ] ~ v 3 - rw z £ m m 3 ~ ~ ~ ra i ~ ..m ~ m ~ n u 3 C C _ ~ ei O O Z ~ 'C y £ > m m ~7 Z 2 N 3 ~ $ ~ ~ ? a y 1 c b m n ~ m a ' imp O °x c^ a R n o a f ; z c ~ ~ r+ a~ c~ LF c tt c m ~1 O o• tr^ - N ~ i= ~ o f T 0 u g >Z ~ " s c a a< m 0 J m " ^wi ~ = a ~ m 1 ~ Q ~ n v~mi n m x i ~ i1 a of a ~ E ~ ~ m 7! 91 (is m o n ~ g 2 ~O~ m m ~ ~ ~ F p ^^7J Q 9 fN ~ ~o z O m - Zm ~ p. ~W ~ Gl m g i $ .Z1 m ,D m s^ ~E s m F j ~ aLY r~_ ~ ~C 9 ~ p J m n o c ~ ~ m z 3 ~ m a m N~ ~ Z a i S'9 m t N ~ g y mN~ t o o ~ ~ a i~ m w A n ~ ~ ~ c ~ i 3 u, ' 9s - N BOAFD OF HEALTH 3 SETS OF PLANS • FORM N0.1 SURVEY TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL SOUTHOLD, N Y 11977 NOTIFY - TEL.. 765-1802 CALL ~,,,_n•$•.•'19~•c~ MAIL T0: Eramincd 4~`i.Yl O.~ ~d ~t~ Approved /+~1~"t . 19~~ Permit No.~. ~ 8 /f~ Tir-~ Disapproved a/c . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date - 15 . . INSTRUCTIONS a. Tlus application must be completely filled in by typewnter or rn ink and submitted to the Building Inspector, with 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 ad~ommg premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app capon. 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 Bu4dmg Permit to the applicant. Such perm 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 Occupan~ shall have been granted by the Buildurg Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Re;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here escnbe~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, a e 1 ns, and admit authonzed inspectors on premises and m building for necessa nspect ~ ~~r (Signatur of applicant, or me, if a corporation) .3(~ . luusroc,{ , ..1~. ~ ~ ~Na`~ht~~6nr ~J y• ~ t~ (Mailing address of apphc t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde Name of owner of Premises ..b.ICLyIL . ~....~t2Ct . J.R~4f1 ..~...~cx.~-5. . (as on the taY roil or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's License No. ~G` . . Plumber's License No . Electrician's License No . . Other Trade's Lrcense No . I. Location of land on which proposed work will be done . . / / ~ . House Number Street Hamlet County Tax Map No ! 000 Section • . Block rJ Lot l . . Subdivision Filed ATap No. Lot (Name) State existing use and occupancy of premises and intended use and oc~c~up~anc/y o'f proposed construction a. Existing use and occupancy . ~`"h~'-~. • • ~ ~Z~"'v,d . . . b. Intended us ...t~''.17.-G . • ~~~~J. //~~j~, e and occupancy G~~:'Vr'?...~.~, ,'~r~~i . 3. Nature of work (check w huh applicable) New E3uildmg Addition V AlteraUOn . Repair Removal Demolition Other Work (Descnptton ~ o /.JrT1.... ~ . 4. Estimated Cost a • Fee . (to be paid on filing this application) 5. If dwellin„ number of dwelling units Number of dwelling units on each Cloor . If gara^e, number of cars . 6. If business. commercial or miYCd occupancy, specify nature and extent of each type of use . . 7. Dimensions of existing structures, if any Front Rear Depth . Height ...............Number of Stones . Dimensions of same structure with alterations or additions Front Rear . Depth Ileight .....Number of Stones . 8. Dimensions of entire new construction. Front .....3 y Rear Depth Z,SQ~, , Height ..............NumberofStones...................................................... 9. Size of lot. Front Rear Depth . 10. Date of Purchase ....Name of Former Owner . . . 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation• 13. will lot be regraded ...................will excess fill be removed from premises. Yes P 14. Name of Owner of premises .............Address ...................Phone No.. . Name of Archrtect ..Address ...................Phone No............. . Name of Contractor ....................Address ........Phone No.... . 15.Is this property Located within X00 feet of a tidal wetland? *YES_'y.NO_... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buddmgs, whether existing or proposed, and. indicate all set-back dunensrons fro property tines. Give street and block number or descnption according to deed, and show street names and indicate wheth intenor or corner lot. F~ STATE OF NEW YOP.K, S S COUNTY OF . • • • • • • • • • • . • • • • . being duly sworn, deposes and says that he is the apphca. (Name of ntdrvidual signing contract) above named tic is t}te . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or ]rave performed the said work and to make and Gle tl' applicatOn, that all stateinents contained m this applu~uon arc true to the best of tus knowledge and belief, and that tl work will be performed m the manner set forth m the application filed therewith. Sworn [o before me this g J....... day of ...1'+;l.a-?-~4~:......, 19~/• \otary Public, C`: ~:.Y~.. County ..G.~..... HEIENKDEVQE 1 (Si;nature oCapphcar ROTARY PU&IC, Site ~ ~wMyyapk TermF~wr~ Mi C(eb~3U 16u~-((. fj