HomeMy WebLinkAbout17417-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Ha11
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 219776 Date MARCH 7, 1991
THIS CERTIFIES that the building ONE FAMILY DWELLING
Location of Property 3327 R.O.W. MANHANSET AVE. GREENPORT
House No. Street Hamlet
County Tax Map No. 1000 Section 36 Block 02 Lot 23.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPT. 2, 1988 pursuant to which
Building Permit No. 174172 dated SEPT. 14, 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE AND DECK.
The certificate is issued to RICHARD AND MARY BUTLER
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 86-SO-34 JAN. 3, 1990
UNDERWRITERS CERTIFICATE N0. PENDING SLIP MARCH 1, 1991
PLUMBERS CERTIFICATION DATED PECONIC PLUMBING & HEATING-FEB. 17, 1991
/ l~
uilding Inspector
Rev. 1/81
n~osx xo. s
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)
Nfl o1741~ Z Date ..~Arr..'k~:4r......~.7..........., 19.d..1.
Permission is hereby granted to: ~ n ^Q
..,...N:.~:.-.....
ro ~..c~-...~,,:....~Pr,.a....~. ~.~,e.?~t~rr,~.,...!-wi~#ft... ~.c~cd~.. ~
at premises located of .......................~71~.R.4x,d0.-ir}...............
County Tox Map No. 1000 Section 3 ~4I..,.-.... Block[ .......4? 1r....... Lot No....r~.~.t~.......
pursuant to application doted .....~~~ktn~^~4.....~.T 19.~.,~.., and approved by the
Buildingvv~~ Inspector.
Fee $....I..~:...
Building Inspector
Rev. 6/30/80
f..
- ~:-'tl Form No. 6 ~ Q~~ m ~ ,~~1..
t ~1 ~ TOWN OF SOUTHOLD \ • ,a q~-~ ~
M~~ _ ~ Igg BUILDING DEPARTMENT ~ ~ 1
~ ~ TOWN HALL "k. A ~
U~~..~,...•....;_...:, 765-1802 ~ ~ Efi
FS!_Uk,. GE?f.
Tou~r~v o~ yourwc~c.~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building 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 from Health Dept, of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Eire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from 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:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic 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 state the
reasons therefor in writing to the applicant,
v. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over S years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residentia22l $15//. 00, Commercial $15.00
Date .....I,...~?...~ ~
':ew Constructian. Old Or P e-exisrL'~n~/~Buildin
Location o~ P ~pe~y` ;'/cay~.r: lsti-:? ~~:ti::~~.... ~.Y::`.~ :
Rouse N~~o. ~gS,tpreet q Hamlet
~nwer or Owners of Property.n.l.C:~{:~?E':~..//.?~. ~lZt': ~....~~~.u: ~ 6~'
County Tax Map No 1000, Section.....?J.1.°......Block......4~.........Lot..~~•.~
Subdivision ....................................Filed Map............Lot......................
Permit No ................Date Of PermiC................Applicant.............................
!ieaLth DepC. Approval ..........................Underwriters Approval „
Planning Board Approval
tequest for: Temporary Certificate........... Final Certicate..~
gee Submitted: $ „ ~y p
/ ~y/ APPLICANT
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OFFICE OF IIUILDII4G INSPECTOR ~ ~
l~;' . P.o. aox 7zs
°r, ~ ht4'~' ..r TOWN HALL ~ - f1 ~g,
"J ~ 5OUTIiOLD, N.Y. 11971
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C E R T I F I C A T I O N
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Building Permit No.~~Z-
Owner/ lyd! (.s.,~5'?l~"~ •
iplease print)
Plu:r
:er~ ~~'T~,y~O~F.~~~f~r'~/J%/~~ Y'~/1~~~
(please print)
I certify that the solder used in the water supply system
contains less than 2l10 of la lead. „
t
(f umbEr' iynature)
Sworn to befor^_ me this
day of
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765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ J ROUGH PLBG.
[ J FOUNDATION 2ND, [)INSULATION
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REMARKS:
DATE INSPECTOR
s
765-1802
BUILDING DEPT.
1 NSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [)INSULATION
[ ]FRAMING [ FINAL
REMARKS:
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T65-1802
BUILDING DEPT.
tNSPECTiON
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REMARKS: ~--G~~( c~ .
DATE ~ INSPECTOR
~ 765-1802
BUILDING DEPT.
INSPECTIQN
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BUILDING DEPT.
INSPECTION
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REMARKS:
DATE ~ ~ ~ INSPECTOR
765-1802
BUILDING DEPT.
.INSPECTION
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T65-1802
BUILDING DEPT.
INSPECTIC)IV
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Civil Marine
JOHN H. GEIDEMAN
Consulting Engineer
. P.O. Box 476
E. Marion, L. I.
(516) 477-2421 New Vork 11939
To Urhom It May Concern,
I, ~C~Clf"f~ r ~U a u t h or i a e
sl•John N, GBideman to eci; ~s my rurent in atplin~ for hermits
to construct a l-~ ~am - ~rzr~.r?~- /~k~~~~/r~`~~',
on my property at /~~h/~~zh5e7` ~?p' ~ds~/~o~d
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Including: N,Y,S Deft: of iinvirornzenta. nsr~rv~~t~,on
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t~~. ~+a: BOARD OF HEALTH .
~ ~ :~~itd'"'` 3 SETS OF PLANS • • . •
~~~~~~~~~~~~TOWN ~ORM Nb. 1 SURVEY
OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
~ TOWN HALL
aLC<;. p"+'L SOUTHOLD, N.Y. 11971 NOTIFY
TOWN (iP 5 UTHOL TEL.: 765-1802 CALL
MAIL T0:
Examined .~,Y~?.,l.~w 19y ~ .
___.~.m„..e,_,_____,._._~.„...._ .
~ ~7 .
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Approved . ~~W, It} 19~$. Permit No..~. ~ 7, ~ `v!
Disapproved a/c
SEP 21988 1
• BLDG. D
• • ~(,Py, , , , . TOWN OP SOUiNOLD
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date 19S'S_
INSTRUCTIONS
a. Tlils 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
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 buildings, additions or alterations, or for rem a~,demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinanc , buIlding de, housin code, and regulations, and 'o I
admit authorized inspectors on premises and in building for necessa i~ s ction . t~
• • • • • • • • • • S ••~Y~~ •
ignature of applicant, or name, if a corporarion)
(Mailing address ofapplicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner
f~es .../~,~,C~?.rrj:Ci~...~G!~/~'.1~ .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . N:~: •
Plumber's License No.
Electrician's License No.
Other Trade's License No . ~ p
1. Location of land on which proposed work will be done. ~I /l>'~e/~7~c'• , !~~.C,tJ: ,
A / / .
•/!!,!ti~'I•l~,Tr,'/?.,~"C~7~. ~t~~:' C~?rLit='/)~if~G'<..~.~~U7~7-rr~~t~~.
House Number Street Hamlet
County Tax Map No. 1000 Section ......:~'.4~ Block Lot ....2~~:.~........ ,
Subdivision Filed Map No. Lot..'.............
(Name)
2. State existing use and occupancy of premises and intend~red use and occupancy df proposed construction:
a. Existing use and occupancy W~.~vi7,h/, ..~~'t~l~jt?I';rt/ .
b. Intended use and occupancy ~ • ~Y~~ _ ~ ~ f%?//yic~
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal , Demolition Other Work , .
(Description)
4. Estimated Cost , ®®C7 Fee .
(to be paid on Filing this application)
5. If dwelling, number of dwelling units , Number of dwelling'~units on each floor . . . . .
If garage, number of cars . . . I , , , .
6. If business, commercial or mixed occupancy, specify nature and extent of eacH type of use .
7. Dimensions of existing structures, if any: Front , . I1/.an.*?.... Rear Depth . . .
Height . .Number of Stories . , , .
Dimensions of same structure with alterations or additions: Front j........ Rear . .
Depth ......................Height , , Numbefi of Stories .
c i
8, Dimensions of entire new construction: Front Y Rear ~ • ' ' Depth , . ~
Height Number of Stories , r '6 ~ ' • • • Depth , , , .
9. Size of lot: Front....... Rear......... 2,,,,,,,,,,,,,,,,,,,,,,,,,,,,
10. Date of Purchase .............................Name of Former Owner , , , .
11. Zone or use district in which premises are situated ........~C~°!CJ.?~/,~,~!~~ .
12. Does proposed construction violate any zoning law, ordinance or regulation: . ~l . .
13. Will lot be regraded , ~n , .......Will excess fill be removed from premises: Yes No
14. Name of Owner of premises R!r.~!!~~~!', .....Address i ......Phone No.
Name of Architect 4`jrcp^l~ r ..Address Mz
orrl>~~G~~! daft . Phone No.Z.°!:'.s'`~3::r9.f'(`'. ,
Name of Contractor ....i'?.-(~% .Address . ....~,79A~.~'"°°'!"7 Phone No....... .
„ ,
IS.Is this property located within 100 feet of a tidal!iwetland? *YES..,.NO....,
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate cleazly and distinctly„all buildings, whether existing or proposed, andjindicate all set-hack 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.
~C' Q~<r'CLiE°O'/ ~~~P,~r S ~ JG',vdC'' 1 ,
STATE OF NE1V' 012~~ Ck S.S
COUNTY , , i
. bein dul sworn, de ases,,an a
• O ~ ~~.1>~Y.u~~c-V~........ s y p `~,.~~~"hf'~'~`~n~'&Pplic~nt
(Name of individual signing contract) ~ rtr'lud { ' j
above named. ~ I ~ u
'j t
He is the 'i..
(Contractor a ent, orporate officer, etc.)
of said owner or owners, and is duly authorized to per, or.have performed the said work and~to'make and file this
application; that 511 statements contained in this application are true to the best of hi's knowledge and belief; and that the
work will be performed in,the.manner set forth in the application filed therewith.
Sworn to before ma this ,
~44-:day df . 19 A
Notary` Public , ~ County
Nobry Public, S»M of Nwv Y
• i j po.4878806 (Signature of applicant)
QualNled in Suffolk CourHy r~r/
~ommiasion Expires December 8.1