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Home My WebLink About17375-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OC~3PAN~ No E-24127 Date JANUARY 24, 1996 THIS CERTIFIES that the buildin~ Location of Propert~ MONTAUK AVENUE House NO. County Tax Map No. 1000 Section 9 Block 5 Subdivision Filed Map No. ALTERATION FISHERS ISLAND, N.Y. Street Lot 11.1 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 15, 1988 pursuant to which Building Permit No. 17375-Z dated AUGUST 30, 1988 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 REMOVE WINDOW & REPLACE WITH FRENCH DOORS TO DECK OF EXISTING INN AS APPLIED FOR. The certificate is issued to 246 M, INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ! Bu~ing' Insp-~ct~ Rev. 1/81 FO]II~ NO. D TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDII'4G PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017375 Z Permission is hereby gronted tg:, __ Il' ~ // .... ...... 4..~..~...,~.....~..~....~.....~ ................ ....... · ' /~ , ...... ~~..~.~ .......................... ~,~,,.,,~,,~, ........ ~..~_~ ...................... t ......... tit ......... ............................................. ~.~,...~ ..................................... c,,,~ ~ ~,~ ~. ~oo ~,~,,~, ........ ~. ........... ~,~ ...~.~ ...... ~o, ~...~..Z/,.../.. Building Inspector, Fee Rev. 6/30/80 516-788-5~00 " TO~ OF $OUTI~LD ~UILDI~G D~PA~TME~T TOWN I~LL ~65-Ig02 ': APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted co the building iaspec~or wi~h the following: for new building or n~ use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. · l.' ii,al Approval from Health Dept. of water supply and severage-disposal(S-9 form), 3. Approval of electrical installation from Board of Fire Unde~riters. 4. Sworn. statement from plumber certifying that the solder used in system contains less than 2/10 of 11 lead. 5. Commercial building, industrial building, multiple residences'and similar buildinta' and installations, a certificate of Code Compliance from architect or engineer responsible for the building. . 6.. Submit Planning Board Approval of completed site ~lan. requirements. For existing buildings (prior to April 9, 1957) non-conforming usaa, or buildi~ga and ?pre-exis~ing" land uses: ~. Accurate survey of property showing all property lines, atrea~s, buildin~ and unusual natural or topo~raphic 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 scats thc reasons therefor in writing to the applicant. 1. Certificate of Occupancy - New dwelling $25.00, Additions rs dwelling $25.00, ALterationS to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions Co accessory building $25.00. Businesses $50.00. '2.' Certificate of Occupancy on Pre-existing Building - $100.00 3. Cop~ 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.O0 Date ' Construction ...... Old Or Pre-~istin~ Building.. X ' House No. Street Ha~at Cy T~x Hap No ~000, SecClon ............ Block ............. LOC...- Flle~'Map Lo~ lC No ......... Date Of Permit ................ cant ............................. th Dept. Approval .......................... Under'ricers Approval ......................... Board Approval. ' ' · for: Temporary Certificate ..... Final Certicate. O~ ~ J~137 T0~ OF S0UT~OLD BUILDING DEPART~IgNT T0~N HALL SOUT~0LD, NE~ YORK 765 -- 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Permit Health Planning Board Approval HOUSE NO. STREET HAMLET Subdivisin~ ....................... Filed Map ........ Loc .......... Dept. Approval .................. Underwriters Approval .............. Reques: for Temporary Cer~,ifleate ....... Fee Submitted: $ .................... Final Certificate ...... ~. ......... rev. 10/14/88 FORH NO. ~ TOgN OF SOI]~IIOLD BUILDING DPPARTHENT TOKe/ ]IALL 765- 1802 APPLICATION FOR ~EKTIFICATR OPOCCUPANCY INSTRUCTIONS This application must b filed in typewriter OR ink and submitted to the Building Inspector with the fellgwing; for new buildings or new nsc: J. Final snrvey of property with accurate location of all buildings, property lines, streets, and unusualinatural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement fromlplumber certifying that solder used in system contains less' than 2/10 of IZ Iead~ 5. Coa~erexal bu~ldxngs~ 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 Boar~ Approval of completed site plan requirements. For existing buildings iPrior to April 9, 1957~ non-conforming uses, or buildings cud "pre-existing" laudjuses: I, Accurate survey of pkoperty showing all property lines, streets, buildings amd unusual natural or topographic features. 2. A properly completedi 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 ownership 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 ~ode or safety inspection of bnildlngs or premises, or other pertinent informatioh required to prepare a certificate. For Vacant Land Certzfz'aate of Occupancy: I. Am application for ~aeant land Certificate of Occupancy shall be submitted, and a certified abstlract of title issued by a title company shewing single and separate ownership elf,the entire lbt 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. FEES: I. CERTIFICATE OF qCCUPANCY - 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 om pre-existing dwelling - $I00.00. 3. Copy of Certifidate of Occupancy - $5.00 - ever $ years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated CertifiCate of Occupancy - $50.00 6. Temporary Certificate of Occupancy -$15.0,0 Residential Commercial FOUNDATION (~st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITION[L COMMENTS ' APPROVED AS NOTED ........... NOTIF~ BUILDING D[PARTM[N~ 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOuNDAT~N . ~REQ~RED FOR ~URED ~N~iE 2: ROUGH -~i~ i ~1~ "'"'"~"' OCCUPANC .... ""'~~': Disapproved a/c ..................................... BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N,¥. 11971 CALL ................ TEL.: 765-1802 MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ............ , INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 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 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of build/nas, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, houshag code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspec, t~o!~Sr~ · ~ ~ ,/2/,~ (-~..~-/? ........ (Sigrrature-~f appti~a"nt} or name, if a corporation) ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .../~. ~..."7~-.. ............................................. f/ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL,CONTRACTOR'S MUST BE SUFEOLK COUNTY LICENSED Builder's License No. [ ,o~ ?~). 7.~- .'7'.fi[/. ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on wbich proposed work will be done. ~....Cf..(2.....~.... ~...~~ ........ [louse Number Street Hamlet County Tax Map No. 1000 Section ... :7 ........... Block .... ~..... ........Lot ................. Subdivision ..................................... FileS Map No ............... Lot ...Z/t..t ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b.a"Existinguse'and°ccupanCYIntended use and occupancy ......... ................. ~f~.' · · ~~ ............................. ~.. i~i~,, ............ 3. Nature of work (check winch ap~hcable): New Building .......... Addition .......... Alteration Repair ... ........... Removal .............. Demolition .............. Other Work ............... a o . (Descrip~tion) 4. Estimated Cost ............ ". · :'. .............. Fe .O. ............................ i (to be paid on filing this application) 5. If dwelling, ' ' ' number of dwelling t~mts ............. Number of dwelling units on each floor ................ If garage, number of cars ..... i ..................................... ~.,.~., ............. 'g ....~..~. ....... 6. If business, commercial or mixed! occupancy, specify nature and extent of eachOtyp~·of use ..... '~ ):..'?.4 ......... 7. Dimensions of existing structure!, if any: Front,: .~.,.,, · .. ,3,~ · .. *.. ~,ear-- ....... ,, ....... Depth ....; . ..... Height ............ Number of Stories .... ~" ~ ~' · ~ ' " ' ' Dunenslons of same structure wl~h alterations or additions: Front ................. Rear ........ · .......... pth ' ight De .................... i · He ...................... Number of Stories ...................... - 8. Dimensions of entire new constrt~ction: Front .......... . ..... Rear ............... Depth ............... Height Numbebof Stories , ~, ~ 9. Size of lot: Front ........... 'i :~' 'I'''' >;,;v R.egr..';; ..... k:~;' ~,4.5 ......'... Depth ...................... 10. Date of Purchase ........... ~.. ................ Name of Formel Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any z. oning law, ordinance or regulation: ..................... ?../...t~ ...... 13. Will lot be regraded .......... ! .....?(.. ~ ........ Will excess fill be removed from premises: Yes Nb 14. Name of Owner of premises .... ! ................ Address ................... Phone No ................ amc of Architect ...~ ..... ,./2 ........ / ......... Address .... , .............. Phone No.,,.~.,f..~ ~'7'z~'/' ' ~Name of Contractor .~.ywf_ .~~ ...... Address /.~4~.(~.7. d~. ........ Phone No.~.ff,..../. ....... 15. ~s this property located ~ithin' 300 feet of a tidal wetland? *Yes ..... No ..M~(~ . · If yes, Southold Town TruStees Permit maybe required. . PLOT DIAGRAM Locate clearly and distinctly all l~uildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nBmber'or description according to deed, and show street names and indicate whether inter/ororcorn~r~~ ~"~ //~ ~ ~ STATE OF NEW ~ORK,t ~ COUNTY OF .~. (Name of individual signin above named. He is the ....................... r ~ .... being duly sworn, deposes and says {hat he is the applicant contract) (C~tor~agent, corporate officer, etc.) of said owner or owners, and is duly 'authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the wo~,k will be performed in the manner !et fortl~,:i,n the application filed therewith. Sw~m to before me this