Loading...
HomeMy WebLinkAbout17430-zFOI~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17334 Date SEPTEMBER 21, 1988 THIS CERTIFIES that the buildin~ Location of Property 880 SOUND ROAD House No. County Tax Map No. 1000 Section 35 Subdivision ALTERATION & REPAIRS Street Block 1 Lot 10 Filed Map No. Lot No. GREENPORTr NEW YORK Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 22, 1988 pursuant to which Building Permit NO.17430-Z dated SEPTEMBER 15, 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 isALTERATION ~ STRUCTURAL REPAIRS ~PARTIAL FOUNDATION) TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to RAE TATTENBAUM & MARJORY FINE (owner,)~{J~) of the afdresaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building Inspector Rev. 1/81 ZeOl~ NO. ~ TOWN O~ $OUT~OLD 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~ 01~30 Z Permission is hereby granted to,: ..~__. /~ -- __ ~ ,~ .... ./..~.~.....~~~.......~.~...; .............. ~ ~,~..~ ........ ~ ...... ~_ ..~...~~~ ~.~ ............... ~......'.~~Z.. .... ..~ otprem'se,'ocotedot ........ ~.~...O........~../f/~.~.. .......................................................... County Tax Mop No. lO00 Section ........... ~'~...~. Block ............/- ....... Lot No ......... /.,...~, ........ dated ~/C- ~/~' ~ pursuant to ~pplic~tion ~':"'~7)~'7~'~ ...................... , 19 ......... and approv~ by the Building Inspector. Fee $~~. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. ]'his application must be filled in typewriter OR ink, and submitted .- ~ to the Building Inspec- tor 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 sewerage disposal-IS-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. §.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling. S25.(10, Accessory ISlO-O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... -existing Building ............ Vacant Land ........ NewC°nstructi°n · .OIdorPre Location of Property ......... ' Hou~ No. Owner or Owners of PropertV ........... County Tax Map No 1000 Section ..... J~ Block .... { .... /.~). Subdivision ................................. Filed Map No .... ~ ....... Lot No. PermitNo.(~!'~.LJ.~..©. Date of Permit .. ~.. · pplicant .. Health Dept. Approval ................... Labor Dept Approval Underwriters Approval .................... .. ..Planning Board Approval Request for Temporary Cerl:ificate ..................... Final Certificate ....................... Fee Submitted $...~. ~..0.O. ................... Applicant . .'../F~'..~., .~.~/.~ ~.?..~ ..................... Rev. 10-10-78 3575 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST r ] ROUGH PLBG. ~, ,UL~T,O. ~~ FOUNDATION 2ND ~ _ FRAMING [ ]FINAL ~~ RKMARKS: d~/~ ~ DATE INSPECTOR Examined ......... , ... Approved. f ./f,,/.C.."., 19~.Permit No/t.7.~..~. ·~. ../~ Disapproved a/c ..................................... ................................ (B~i'lding~Ja'sp eot or) APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLO ~2UILDIN~ DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ CALL ....... MAIL TO: INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 2 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. ¢. 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 throu~out 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 Construct/on of buildings, a,.d, ditions 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, and to admit authorized inspectors on premises and in building for necessary ins~~/,..~f~,~..t..,~.~ Q~"~tt l~& ~P'~q~t~ (Si~,~t(~re-o'f-a~l~li~'ar~t, or name, if a' c~rl~o'r.4 neon') ' ' ' .... ZP. (Marling address o~l'apphgant) State wh. eth~fse31~l.i~al~li~l,q!~'nst~l~sr4~lag~.ta.,t, architect, engineer, general contractor,' electrician, plumber or builder. t~O}~t,..'.~a! E (as on the tax roll or latest deed) If applicant ma corpor~/~,~[~ ~,j,~uj~ ffuthorized officer. ........ ;~7~' 'trNt' ¢O' *~,7~',JtM:4~,?;t'e ;k~.' ' ', .......... Plumber's License No ....... ' .................. Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done House Number Street Hamlet County Tax Map No. 1000 Section ............. Block ........... Lot .................. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intemted use and occupancy of proposed construction: b, Intendeduseandoccupancy .................... . ~ . ... o ' "' 7'";~'"= ' Natu[e of wor~ (check wluch app cab e)' New Bud n" ' ^.,.,... ' ~' :;~2 .. / Repmr . .~..~ ...... Repoval .............. Demolition .......... i ....0~o~... i ........ OCCUPANCY OR' USE IS UNLAWFUL OUTCERTIFICATE OF OCCUPANCY STATE OF NEW 2t"DRK / · ~ individual s'i;'nii~g c~. ' aoovc nanleo, i COOESc'NOI RE$1N)NtlIBU! FOR OESION~,OR CONSTRUCTION I[RROR$ ...... being duly sworn, deposes and says that he is the applicant fie is the ' : ' (Co file ) .................. ~' ~., ~ ntractor, agent, corporate o er, etc. of said owner or oxvners, and is dulyI authorized to perform orhave performed the appl[ca[{on; that all statements contaii~ed in tt?is app cat on are true to the best of hiS:id work and to mai~ and file this wor~: wul be performed in the manner'set forth in the application filed therewith, knowledge and belief}:a~ that the Swum to before me this I '.~,~,, ,i ......... . .... .da of2. .... ,9 ,, . ~ . . ~j~-.~'~-81261~60, SuffOl_k ~e,~_,~>-- t~']gnature of apphcant) Term Dqaire$ Ootol~r $'i, 1 t~ 6. If business, commercial or roi.xed occupancy spec fvnamre and extent of e Dm~ens]ons of ex,sting structu,res, If any' Front '~,J~' ' I~ .... ' ...... lq',, ,, i~ . _=, ...... ~'.' ............. '~' ............. we~th .. --~'='- ............... mUmoer et ~tories ~ ,e""-,, ,-,~ ~---- ~'~,~ e-" ,' .... ~- ~ ! .......... Dimenmons of same structure · , · ' .... .'.' '=)i0'J'O7r-~' "ZT.>' d>'//,~'k"~''~' ............ ,-, . ',v~th alteratmns or addmons= l'ront .......... : :."I~enr/ ~c tn , ' lie ..* - -~' ............ P ............. ,s ~t Nu Dm~enstons of entire new construct on' ~-.. · ~ - - - 'J.,~ · · · ~,nt . .,~2wrm~., .~,~.. 1;ear ............... Uept.q ~,:.~?.~..~. ...... Height ............... in/her of Stories Re~ "'~"' ~>X' > ............................. ), ........ 9. Size of lot: Front ..... i ~...f..~.. i ~.. ~..~..I r ...... 4V... ............ Depth 10. Date of Purchase ..... . ...... Name of Fo=er Owner ...,d,,ff4f. v.Z~:.~.';,~,/~.', .. 1 I:.Zone or use district in which pi*cruises are situated ............................................... '12. Does proposed construction violate a,,nT, z~ning law, ordinance or regulation: ..... ~t~)i ............ 13. Willlot be regraded ,. ~ /V ~ .. .-~ -, ....... '.' ' ' ' 7//,,' ' t.&/,.; -,. · ._..: ...... Wall excess fill be removed frqm premmes: Yes ~'-*.~arne o[ .uw.n.e,r o~ premises ./. '.ld~ad/,~...~.' ..~-./.~.C'~., Address ~.og.,f~t~'0.. ~.'?',~9 .~.. Phone No ,,amc or ^rcmrect .... ~ t'_~5//,~ _,~ ' '-' ' ............... . ., ~ ~ ';~'2-'/~' · ':aT.~ .... . ..... ^uuress ................... Phone No ......... 15. gsam; I~; sg°n~;Tt°;r't' ff"d~'L' F3.. (.','.r/-z. ~..~.../-,,~ .2~.~(~. Address . .'~. S.....'~..."{~. Z-~'.... Phone No. P p y locatea Wxthzn :lOO feet of a tidal wetland.9 ~YES .... NO.~. ' ~If yes, Southold Towln Trustees 'Permit may be required. ... PLOT DIAGRAM Locate clearly and distinctly al!l buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth6r interior or corner lot.,