HomeMy WebLinkAbout18313-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218256 Date AUGUST 8, 1989
THIS CERTIFIES that the building ACCESSORY
Location of Property 64098 NORTH ROAD GREENPORT
House No. Street Hamlet
County Tax Map No. 1000 Section 040 Block 03 Lot 03.5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 7, 1989 pursuant to which
Building Permit No. 183132 dated JULY 14 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 WOOD ACCESSORY SHED IN REAR YARD.
The certificate is issued to SCOTT CORWIN
(owner, XxxxxxXXXXXxxXxX}
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
U r
Buil ing Inspec or
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218257 Date AUGUST 8, 1989
THIS CERTIFIES that the building ACCESSORY
Location of Property 64098 NORTH ROAD GREENPORT
House No. Street Hamlet
County Tax Map No. 1000 Section 040 Block 03 Lot 03.5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 7, 1989 pursuant to which
Building Permit No. 183132 dated JULY 14 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 STEEL ACCESSORY SHED IN REAR YARD.
The certificate is issued to SCOTT CORWIN
(owner,
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
`ri
B it ing Inspector
Rev. 1J81
soaat xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMLNT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ° ~ $ 313 Z Dare 19.~!..l
Permission is hereby granted to:
~.~.as~......~.~::~.!-~-r........
dX..~:
~.~e
U U
at premises located at , / '
Caunty Tax Map No. 1000 Section ........~...D........ Block Lot No....C?.3.:
pursuant to application dated 19.~.~., and approved by the
Building Inspector.
Fee S.•~~•:••~IJ
~(`~0-c. a.~
Building Inspector
Rev. 6/30/80
~ ~U~t~„„,!~gyj!~^"~ ~ TOWN OF SOUTDOLD
IIUILDI2lC DEPART:IENT
TOWN DALL
BLDG pt;F'7. SOUTIIOLD, NEW YORK ? 197 1
gpWN OF gOIjTHOlO
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPALtCY '
DATE.... ~f-~
NEW COSSTnUCT
ION ...._..OLD OR PRE-E%ISTI27G BUILDING.____.VPACALtT LAtID..._....
Location of Property....~t~-,:•--../gn~~~.1/J/~.
NOUSE NO. rtl1° - • ti(~QI,Qj
STREET ~ "
IIAHL T
Ovncr or Ovnets of Property„--~~3j~
County Tax Map No. 1000 Sectio? -
Block Lot'
Subdivision...~i~~~~- ~
Filed Map .Lot.
Permit No. „~j~I~ -_-Date of Permit ,c,s /
--.AppLicaot Luca.~!d.J~-J---
Bcalth Dept. Approval Undcrvritcrs Approval.............
PLannio~ Board Approval _ -
t
Request for Temporary Certificate
Final CcrtiFicate
6~
Fcc Su6nitted:
4..........
. I~
APPLICANT....
~ ~I ~ ~ 2 ~~as.~
Co z~~as ~
!0/14/88
~ FORM NO. 6 I,
TOWN OF SOUTFIOLD
BUILDING DEPART!>ENT
TOWN HALL
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS `
A. 'This application must be filed in typewriter OR ink and subm',itted 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 health Dept. of water supply and seweraj;e-disposal(S-9 form).
3, Approval of electrical installation from Board of Firc Underwriters.
4. Sworn statement from plumber certifying that solder used in 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 (Prior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" land uses:
I. Accurate survey of property shoving 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
shoe single and separate ownership of the entire lot priori to April 9, 1957.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing Co 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, 19$7 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 OI' 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 - $10,0.00.
3. Copy of Certificate of Occupancy - $5.00 - over S years,';- $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50.00
6• Temporary Certificate of Occupancy - $(S.Op Residential
$50.00 Commercial '
~F
'v. 10/ 14 /S$
:1c:LD I;:S:~C:i~;+ ~~Un:~ I~ ~U:`tMENT~
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?OUNDATI017 (pnd) rn
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BOUGH FRAME &
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.PLUMBING o(+
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II7SULATION PER N. Y. y
STATE EPlERGY I ~
CODE I ~
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4. _~y~
F I;d A L I
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ADDITIOPIAL COMMENTS: m `
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4 . o,L~ To~rrr or sou~oi.~
f•+ 1~~~`~i~ y~~~' ~ Ul~f'ICI; OP rsUILDIivG INSPF.C:OR
''a;. ~a~;~Y, x P.O. [SOX I 1 79
r;~~?~ ~ TO1VN (TALL
,y p~ SOtJTifOLD, N.Y. 1 1971
~~~I.7'
1
'S'o [9hcm This, May Concern,
4.e arc unable ro complete your Certificate
of Occupancy because pf the following reasons.
e1n application for Certificate of Occupancy
is not nn file. Exe~aaece
Dto tJnderarriters Certificate on file.
'i'he checF: .i:: (cut,daL•ed/nut on file.) 'd~0 - ~mocc.y
Dlo tlcal.th Dept. 1lpproval on file. ~aZ.S~~ clams
P:o final insi~ec:t:ion has been made.
Please contact our office on this matter.
Thank you for your cooperation.
nuildincJ PcrmiY. II 3 _1 ,3 Z
i3uildinq Dcpt.
+"'I_I t!o Plumber ;;older Certificate on file.
( al.l pormits icrvolvi.n9 plumbing briny
issued after ,1pri.1 1,17F34 )
- D ~ I~ a ~ BO.1RD OF HEdLTH
FORM1t N0.1 3 SETS OF PL,1NS
' SURVEY
` ~ TOWN OF SOUTHOLD CHECK
y1 QUILDING DEPARTI4IENT SEPTIC FORPI
T06'VNHALL
BLDG. D PT.
TOWNUFSOUTHOLD EOUTHOLD,N.Y.77U71 NOTIFY
n LI TEL.: 7G5~1B02 CALL .
Examine.... ;I. , , r~ D1A I L TO
Approved . 199 permit No.~ ~ r4
Disapproved a/c T~ ~ ~I l'~.U~J~
V
Q ~ ; b,..
~y~ 5' ~ ~ (Building Inspector)
AA ~
APPLICATION FOR BUILDING PERMIT
$I
BLDG. DEPT.
TOWN•OF SOUTHOLD Date • , , , , „ 15
INSTRUCTIONS
a. Tltis application must be completely f-filled in by typewriter or in ink and submitted to the Building Inspector, with 3
:eta of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
=anon.
C. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the p;e ices available for inspection throughout the work.
e. No building sh~Tl be occupied or used in whole or in art for an
p y purpose whatever until a Certificate of Occ pancy
shall have been grart~ted~y the Building Inspector.
APPLICATION ISfiHEREBY hfADE to the Building Department for the issuance of a Buhl t ^ r[n~t~ u~uao the
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New ork, "~d othei~~pp~ii~$Pe )rawspOrd' es or
regulations, for the+`ec~nstruction of buildings, additions or alter3)<iop~ or i~r~v 1 or demolition, as herein described.
Tite applicant agrees to comply with all applicable laws, ordinances, buildin^ code, u,~ing ,and re^tilatio a to
admit authorized inspector on premises and in buildin; ior.~eces~ary it}s~pect~,~ - s «r~k$
Ln r ,gym d' . ,
..w t ...\~:v:A........ ,
(Signature dt" ap})llcant, or name, if a corporation)
(h4atling address of a licant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....~v.,Yae~.......... .RPPFUYEP n$ NorEo
.
r"
\ame of owner of premises , u? , , , VW1n~ DATE; B.P. #
(as on t)tc tax roll or la NOTd Y UILO P''PA~.TntIEN"i AT • .
~R•~
Capplicant is a corporation, signature of duly authorized oCf;cer'. 7bb•180? 9 A. 'tq 1 F ~ ~ 0R T1tE
FOLLOWING !NS,'" .D''
1. FOUNDATION Tv11(;REOUIRE6
(Name and title of corporate officer) y0~ L FOR POURED CONCRETE
Builder's License No.
~Q~~~ ~~~Gr~` •3. SULATIONAMING R PLUMBING
Plumber's License No. , . • , C~ ~ r 4. FINAL - CONSTRUCTION MUST
~~~~~;~c~~QQ.L,G BE COMPLETE FOR C.O.
ALl CONSTRUCTION SHALL MEET
Electrician's License No . .oCC THE REQUIREMENTS OF THE N.Y.
Other Trade's License No. ~ , STATE CONSTRUCTION & ENERGY
CQDE8. NOT RESPON3191£ FOR
D~SKiN OR CONSTRUCTION ERRORS
Location of land on which proposed work will be done. ~
R.a.w.
House Number ~S/trccL Hamlet ~ ~ ~ '
County TaxhlapNo.l000Suctioppn .......f~.......: Block Lot..;;
Subdivision ....~'VIf~~{!ay !JW~!~ Filed hlap No. Lot .
(Name)
State existing use and occupancy oC premises and inten~dfed ufn~se,~and occupancy of proposed construction:
a. Existing use and occupancy ......~~~Q!.. ~.~OL-d .
b. Intended use and occupancy • • • • • • S~OV~ • • S
I
•rs~: i
{ ''°Ij.
r i
3. Aaturc of wort, check which a • { '
Repair ( PPlicable): New [luilding Addition
. , . Removal ratio ~ ,,pQt .
Demolition ~cr t ;~Q,pl~.
4. Estimated Cost . ~S-o ' 0~.. (Dcscnption}
Fec....~b
5. If dwelling, number of dwcllin lto be paid on filing this application)
g units , , , , , Number of dwelling units on cash floor:.. , , , • • , • • . •
ICgara;e, number of cars
6. If business, commercial or mixed occupancy, spccil'y nature and extent of caclnaype of use . • •
7. Dimensions of c i n~ structures if an Fr • • ~ ~ • • •
Huigftt Ps ~.d Y~ oni aO .Rear , a~ • • .
• •x F! Number of Stories , ~ ' ' ' /t-~ • • • • • • • DaPth .
Dimensions of s structure with altcratio • • • • " " " " " • • • • . „ ~ • • • •
Depth ns or additions: Front • ~ .Rear . • • . • ~ ~ • ~ • • '
.Height . .Number oCSto ~ • • •
8. Dimensions of entire new construction: Front , " " " " " " nes . • ~ " • • • " '
Hci~ltt Rear . • . • • • • • . .
Nurribcr of Stotics . . • D@Pth
9. Sizcoflot:Front.
10. DateoPPurchase Rear........... p....
Depth ...~W . ,
1 1. Zone or use district in which • • " • • • ' ' ' ' ' • • • Name of Potm.cr Owner ' ° •
12. Does ro PrCmises are situated , , , , , (/.~Q,,,f! den~a.~ • " " " • • • • • • • • • • • • . „
P Posed construction violate any n law, " • • ' • ' ' ' ' ' ' ' ' ' • • • , ,
13. 1Ci11 lot be re;raded zOII1 S ordinance or regulation: ~ " • • • " " • " "
• GAO.. . ;
I4, Name of Owner of premises , • " • • • ~y'!l exccs~,•~11 be rc~l.oved from premises: • yos "No
Name of Architect Y`~~• ~o~w.~,nj • • AddressaaL • AV'~:.ta?,~ ,
~ . .Phone No..4 ~7; ,
Name of Contractor • • ......Address ...................Phony, No.. • . .
15.Is this property located within "Address.. ,Phone No. ~ •
300 feet of a tidal •cretland? *YES•. .NO....• r
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGIZAhf
Locate clearly and distinctly ail ,buildings, whether existing or proposed, and. indicate all setback dimensions from
property (fines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
~b X l~ w~~~ ~~~I u~~115 qve, axW~k~' S~'vds or I~" c~,~`~vS
(~av ~~;~'S ''~'x(~'' x lay a~n I(~'~ C>e,~~~S. S~~ is Ski}h~ vdi'd1r\
' ; ~ rat .
aV1
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• ~(la ~~~u;'~etS~s lix y~~ 1~i~~C G~~AVIh+?~
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4
r,~TE o~ ~'~~v Yoas,_ ' i ~ ~
OU,\TY OF ~ ' `~.S ; a ~
s ....:.37 e,+9 1-.t o~•"t ~53l; `-!sue
\'argc d,f rtfidY~~id115'PSa n~I~.. r ct• • ~ ~ • • being duly sworn, deposes and says that he is the applicant
rout namctl:, ~ -e
E~'"'E-? i~ ACi'~f .°~E~~.»? )
•,'sa.f`r°'.;,sFtat:i'~RdliFl~"irl "
:ist$c .
said owner or ow . • •(COnIraClOr, agent, corporate officer, ctc.)• ~ • • ~ ~ • ~ • ~ ~ • ~ • •
Hers, and is duly authorized to perform or have performed the said work and to make and file this
nlication; that all statements containc~ in this application arc true to the best of his knowledge and belief; and that the
rk w!!1 be performed in tite manner se forth in the application tiled therewith.
om to before me this
• ....davof.. ~
:ary Public. h:'.4I/ .
County
~r~
NELEN 14 DE VOE • • . . , •
NOTARY PUOLIO,g to of New York ~y,~~ ' ' ' ' • ' ' '
Na47078>B,I,SuNolkCau / yR~ ~Si;naturepfaPPlicant)
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