HomeMy WebLinkAbout18310-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Of.£ice of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z,- 18554 Date NOVEMBER 9, 1989
THIS CERTIFIES that the building ALTERATION
Location of Property 350 MAC DONALDS ROAD LAUREL NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 145 Block 04 Lot 14
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 12, 1989 .pursuant to which
Building Permit No. 18310-Z dated JULY 14, 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy far which this certificate is
issued is SKYLITES IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to BERTRAM & MARJORIE wAF.KFR
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
---`1~S:d ~ -R/~'° 0.71
Bui ing Inspector
Rev. 1/81
posaet 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° 8 3 0 Z Date 19. P
Permission is hereby granted to:
~.~.~.4
r~-. ...:~..:~~......N.:~.:....l.~..9.~.2... ~ M
to .~~AM.t..C.W......~~....r4n,~...S~~~Arw~A.cr~~..11'X19...~~tan.~4~{....J...?..1~!~AL!:!.y
1 I I
at premises located of . ~5.~.......!..'../.Q?!....M~3..........~.7..~:tr~R~,,.
Caunty Tox Map No. 1000 Section ....L.~.~5........... Block ......~.~....pp. Lot Na......1.~
pursuant to application dated . 19.51...1., and approved by the
Building Inspector.
Fee $..~.7~.:.~... /J
Bu ing Inspector
Rev. 6/30/80
TOWN OP SOUTHOLll
BUILDING D1;PART2IENT
_ TOWN HALL
SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY / r f~
~~11 DATE.!!:. ~ c! - - - . .
NEW CONSTRUCTION ~/(~I ,OLD ORy~/~PRE-E%ISTING BUILDING......VA~Cf-ANT LAND...____.
Location of Property..Y~~, ~~..:~F//-G~_~ . /o2Ai~~'~i'
HOUSE NO.~ ST/R~EjET IIAMLET _ - -
Owner or Owners of Pzoperty-.~~-reN~~~/.}?-~~"~/~~~i~G~.~f~-~~j~~-
f / G~ .
County Tas Map No. 1000 Section Block L',~--_, Lot-/../ y~~yy
Subdivision Pnil//edM~jap ........Lot..l~e/~/'~1< /O
Permi[ No. !.0.?./~ :l:.Date of PermiC~~,~~,(~,f..,P ~7-~Applicaat G!-~~~!;OC.
Health Dept. Approval
Underwriters Approval..;:-,,..--•-.
PlaaninB board Approval
Request for Temporary Certifica[e Final Certificate
Pee Submitted: $.:Jfio.6
APPLICANT...~L„1~~~~~'/.~/e~-G!l~''.
0
,/1 )
~e°• ]0/14/88
3~Ss-Y
Co ~ 1855 o~
L ~ f
FORM NO- 6
' TOWN OF SOUTHOLD
BIIILDING DEPARTPBiNT
TOWN HALL
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A, 'This application must be',filed in typewriter OR ink and submitted Co 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 Heath Dept. of water supplq 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 is system contains less
than 2/10 of IZ 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 (}'rior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" land 4ses:
1. Accurate survey of prgperty 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 abstracC of title issued by a title company which shall
show single and separate ownership of the entire lot prior to April 9, 1957,
Zf 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:
1• 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, 1957 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:
I. CERTIFICATE OF OCCUPANCY - 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 of Occupancy - $20.00
S. IIpdated Certificatg of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $25.00 Residential
~ $50.00 Commercial
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INSULATIOfI PER N. Y.
STATE ENERGY
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6 ~ ~ BO.1RD OF HE.ILTH
D O FORMNO.t 3 SETS OF•PL.1NS•::;::::: .
A SURVEY
G ~ TOWN OF SOUTHOLD CHECK .
G BUiLDINGDEPARTMENT SEPTIC r•oRri
TOWN HALL
EOUTHOLD, N. Y. 11071 NOTIFY
~((JJ~~ - pp TEL.: 7G5.7802 CALL
C•xamincd..~~Kt'y..I~,,, 19.1 r1AIL TO: .
Approved . ~ ~ 19~~. Permit No.~ (a
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMtT
Date 15 .
INSTRUCTIONS
a. This 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
~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
~ation.
~ 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 pet7rtit
shall be kept on the premises available for inspection throu;}tout the work.
e. No building shall be occupied or used 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
3uilding 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 applicable laws, ordinances, building code, housing code, and regulations, a to
admit authorized inspectors on premises and in building for necessary inspec
PP r n e, tf a corporation
yy~~ ~i
(Mailing address of applicant) ~ ~ .
State whether applicant is owner, lessee, agent, architect, enginea~,~ al contractor, electrician, plumber or builder.
, ..'7., . f•~~.~ Rs~4~`G.~$,~ C r,
l~. np. . . . .
\'ame of owner otprerr~isas~~ ~:,l.~l~~~~~~ , ~
o , ) •
(as on t ~tl~tte~t. dee`'d) ' ' ' '
;f applicant-is a corporation, shnature o'f duly authorized officer. Td,I
r.~..l fit t.~ et^, '~;,.li{ , r-:
y{t~da~lgatr~~ti~~;a'tic°ot)S~fi'a@C~off'c'er)
°."i`~^Ai/l~ di ~!l~fl;Itl,3f;?t5~):~
Builc~r/~ Li,~.#2~+'I~hit3~aW.~sih.:~=rd:<,,~
r riC•#t11~ 44S:,r')d3itt~;il~~~.'.. ItP-. ~tii
il'.• . .
Plumber's License No. .
Electrician's License No. .
Other Trade's License No.
Location of land on which proposed work will be done. , , , , , , , - -
House umber Street Hamlet ~ ~ ~ ~ " ~ " "
County Tax Map No. 1000 Section `.'y. ~ , . Block . , , ,~..r~,/~~/, , _ . Lot . , y
Subdivision ...r~~~/~~~~~..... Filed flap No. ?4~...... Lot ~-~.~~'~d:
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~~~~'.'~~~~~SF
b. Intended use and occupancy
,y ,
...L.
3. IQaturc of work c
( heck a•hic applicable): New Uuilding '
Repair rfmoval Addition,..... .Vterations
R~~ ~ ~
• • Demolition t~14'~r1pd`;-, ,
4. Estimated Cost O l~' , Q~ • . • a.Ssc •t • • •
• 4~,.u,.t._..-......,.~.,~ ion)
/ Fee f*iaU.
. ..~~~~#33 .
5. If dtvclling, number of dwelling units ttO e~ o~ 1n~ P rca ton)
If garacc, number of cars , , , ~ " • • " " Number of dwcllins units on' each' poor'..
6. lfbusiness,commcrctalormi.~edoccupancY,s ccil'•.•••••••~~•~~••••"•"""""''••••~•••••.••••••
7. Dimensions o!'cxisting structures, if any: Front, Y' nature and extent of each type oCWSC ~ . • ~ • •
Height . Number of Stories ' ' Rear Dcpthi.. • . •
Dimensions of same structure ~tvith altcratio ~ • ~ • • • " " " " " " • • • • • • • • • • • ~ •
Depth : ns or additions: Front ...Rear • • • • • • • .
.Height . .
' 8. Dimensions of entire ncty construction: Front , • ~ • ~ ~ ' ' ' ' ' 'Number of Stories . • • • ~ • • ' '
Height Nymbcr of Stories • • Rear Depth • • . • . • .
9. Sizcoflot:Front
10. Date of Purchas~y',°~, ( . Rear Depth .
"""•••••....NamcoCFormcrOtvncr
11. Zone or use district in which premises are situated , , ' ' '
12. Daes proposed construction ctplatc any zoning law, ordinance or regulation: ,/„(/O, , ,
I3, \1'ill lot be regraded >y~ , • „ - • • • • • " • " " " "
14, Name of Owner of premises .~~F • • Will excess fill be removed from premises: Ycs • • • Nc
Name of Architect • Address ~~y, ~;~;,v, Phone No..29~',~~?J~;4
Name of Contractor ; ~ ' ~ ' ' ' ' ' • • • • Address ...................Phone, No.. •
IS.Is this property looted ""•••Address .PhoneNo..
*Zf yes, Southold Town Trusteesnp~rmitemay bearequiredetlaud? *YES.•...170....•~•
I PLOT DIAGRAM '
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and bloc!; number or description according to decd, and show street names and indicate whether
interior or comer lot. /
aP~ as Novo
• ' QATE ~ ~ ~ 8,p tl 1$ 0
i ~ il' ` 'A.
, ~ FEE:..~"r7. RY. .
~ NOTIFV i3LJIL.0ING DEPARTMENT AT
OR 765.1802 8 AM TO 4 PM FOR THE
O EV~ ~INC~Wi~~ ~ FULL,OWING INSpECTIUNS.
YY ` 1. FOIJNOATION - TWO RECIUIRED
1IS CER'~~~1Ca"~ Fqq pOUREO CONCRETE
W`T 0~ O~CVp~1~ 2. ROUGW -FRAMING Ri PLUMBING
1 ~11~V~ 3. INSULATION
4. FINAL - CONSTRUCTION MUST
SE COMPLETE FOA C.O.
ALL CONSTRUCTION SHAD. MEET
~ THE REQUIREMENTS OF• THE N.Y.
' STATE CONSTRUCTION •.ENEROY
• ~ CObEB. N07 RESPONSI9LE FOR
DE$ION OR CONBTRUCTION EIIRORB
TgTE OF XEtS' Y'OR(i,
S
• . • • • • ~(\amc of individual si~nin • • • • • • • • • • • • • ' ' ' • • being duly sworn, deposes and says that he is the applicant
rove named. 5 o contract)
is tltc
(Contractor, agent, corporate officer, etc.) • •
said owner or owners, and is duly authorized to pcrCorm or have performed the said work and to make and •plc this
alication; that all statements contained in this application arc true to the best of his knowledge and belief; and that the
rk will be pcrt'ormcd in the manner sia forth in the application pled thcrcwitlt.
om to bciore me this
.....~da/y o/f~.. /./.,~c~..........., 19
ary Public, .1~K-~t4'...`1 N1¢ III!
v~-..0....... C
HELEN K.DEVDE • • • • • e:.. .
H Nom47W8
8,Su9nIkCHoeit~
TarroExpiresMarch30,19 I ~ (Signamreofapplicant)
.
~ ~ ~ ~ -