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HomeMy WebLinkAbout17486-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26169 Date: 12/15/98 THIS CERTIFIES that the building ALTERATION Location of Property: 1125 KENNY8 RD SOUTHOLD (HOUSE NO.) (STREET) (HAFiLET) County Tax Map No. 473889 Section 59 Block 7 Lot 21 Subdivision Filed Map No. Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 29, 1988 pursuant to which Building Permit No. 17486-Z dated OCTOBER 4, 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 ALTER & RENOVATE EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to LAWRENCE & MARIE FIUME (eWeR) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A ~011~ NO. Jl TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL $OUTHOLD, H. Y. BUILDING PERMIT (THIS P£1~v~lT MUST BE KEPT ON THE PREMIS£S UNTIL. FULL COMPLETION OF THE WORK AUTHORIZED) N9 017q86 Z Date ..................................................... , 19 ....... Permission is hereby gr~nted to: ..~~~..~~.~ ....... ...~.~/.~. ....... ..~..~.....;~.~ ......................................... .....~.~....~.:.~.,....L!..~.~..~ ............... .~.....~...~.: ....... ~......:. ................. ;. ...................... = ....................... :. .............................. at premises located at ....L~/,~=~,~ ....... ..~..~' ...... .~..d ........ .~~/~,. .............................. County Tax Map No. 1000 Section ...... ..~....~..-~ ...... Block ...... .~....~. ......... Lot No....~ ............... pursuant to opplicotio, doted ..... .~..~.~,~1,.......~...~. .......... , 19.~.~.., and approved by the Building Inspector. Fee $.,.~.../. .............. Building Insgector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buildinl 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-? form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildir 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. For existing buildings (prior to April 9, 1957) non-conforming uses, oK ~uildings an Ypre-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. C. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .......... %/~./~ ..................... New Construction .... ~ ..... Old Or Pre-existing Building ....... ..... Location of Property ....... ~ .................... d.~.,. House No. Street Hamlet Onwer or Owners of P~o~er~,, Connty ooo, Sectiou... ....... ". Subdivision ........................ Filed Map ............Lot ........... i ........ Permit No Date Of Permit Applicant '· Health Dept. Approval ....................... .. . Underwriters Approval ....................... Planning Board Approval ................. ... . .. . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ .... ~..~. ................ ...... ..... -: FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME ~ .?LUMBING INSULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ I~NSULATION [*~RAMING [ ] FINAL ,,A," Iof, I N S PECTO 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ ] INSULATION [~FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~ATION [~'~FINAL [ ] FRAMING [ ] FIREPLAC~&_~MNEY REMARKS: ~ -'o~ N 41 o~,9.00-W 0 ~- zo z OD ....i ~ 'o -I ~,g" S41 o 57'50"E j I 00.0' I I I / / 32.50' KEN NEY'S 2g' OILED ROAD EARTH PAVING ¢ NYT I~NYT -~ / / / / Approved FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL,: 765-1802 BOARD OF HEALTH ............ '- 3 SETS OF PLANS ............ '-'SURVEY ..................... ~CHECK SEPTIC FORM ....... NOTIFY CALL ..................... MAIL TO: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of thJs 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, a.d. ditions or alterations, or for i'emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admitauthorizedinspectorsonpremisesandinbuildingfornecessaryinspections. ~,.- .~..~._~.. OCCUPANCY OR .... (Signature of applicant, or name, if a cofporanon) USE IS UNLAWFUL // g.~/~f~ ~. ~~ ~-h WITHOUT CERTIFICATE .......... iu"~;]i,;~ ~&~';ds; ~,f ap" ' ' ~ii .... State whether a h 0 Y pp 'can[ o , less e, agent, architect, engineer, general contractor, electrician, ptumber or builder. Nameofownerofpremises . /~...~g.~e_ .qc :~~ ...~..~ ' (as on the tax roll or latest de~0~R0¥£D AS NOT[D If applicant is a corporation, signature o f duly authorized officer. (Name and title of corporate officer) Builder's License No .... /d F<(;,.~,/71--~ Plumber's License No ......................... Electrician's License No ....................... DATE: /o/~./;~,, B.P. # _! '7 q$/~ & FEE: ....~-~' ~' BY: .. ~' ~,/'''''' NOTIFY BUILDING OEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS. I. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C,O. Other Trade's License No ...................... 1. Locationoflandonwliichproposedworkwillbedone..././~..~...~....' ....... O~ ~ ~.Y. · ..... House Number ..... Street ORS' .... County Tax Map No. I000 Section ....... ~7.~. ....... Block ....... 7 ......... Lot...c~..~ ............ ...................... Lot ............ (Name) 2. State ex]sun use andoccu anc of renuses and ~ntended use and occupa c · ' ' g p' y p ' · ' ' ,a~,cy ofproposed constrnction: a- E×isting use and occupancy 3. Nature of work (check which applicable): New Building ' Addition .......... Alteration ....... Repair Removal Demolition Other Work o© i (Desc ption) 4. Estimate'd Cost .... ,..afl ....... / .................. Fee ....... ' ............................... (t~b ' fill gtli ppli ti ) e pmd 5 Ifd~ lli on n ~sa ca on b fd Iii it N b- fd t1' ~ ' ' · ye rig, gum ero we ngun $ ................ /.lin ero we mglunltsoneachfioor ............... If garage, number of cars .................... , i ' 6. If business, conunerck? or mixed occupancy specify nature and extent of each type of use ..................... 7. Dimensions of existing stmctures if any: Front ............ ~Rear~lj~~~;t4110~:! ........ He ght ............ '... Number of Stories .................... ~.. '~' .~. ~ ....... Dimensions of same structure with alterations or additions: Front .... ~. ~ .~. ~.~. Depth ...................... Iteight ...................... N~~. 8. Dimensions of entire new construction: Front ............... Rear .~. ~~ ~t ...... Height ............... Number of Stohes ....................... ~ ~[~4e tO~ e ~.* ' ' ' 9. Size of lot: Front Rear ; . ' ~r ~qfi~he,':2;6~'"t ~X ...... ................................... ~.~. Dept~ .~ 10. Date of Purchase ........................ Name of Foyer ~4~1~.,~ ..... I 1. Zone or use district in which premises are situated ..................... ~Ott t-t,'<oc.e r~':~ ~ ........... 12. Does proposed construction violate any zoning law, ordinance or regulation ~.~t.~.):i ;~./j..,. ~ ,'I }% ~r['. ..... 13. Will lot be regraded ............................ Will excess 14. Nme fp Ye .premises: Yes No of Owner o remises ............... Address :wp' ~ ....... ~one No. N~e of Architect .................... ~. · · · Address .... .~ .... Phone No. N~e of Contractor ........ ' ..... ~ O~ ..... r. ........... .................. Address ........ t t' [.. 2. ..... Phone No ............ i... 15.Is this property located within 300 feet of a tidal~e~l~n,d? mil yes, Southold [~'~- Town Trustees Permit may be requxred. ... PLOTDIAG~ ~ ~ ,~/~.:~, Locate cle~ly ~d distinctly fll bulldogs, whether existing or proposed, md[indicate ri set-back d~ensions from 'prope~y ~nes. Give street ~d block number or dese~ption accord~g to deed, ~d s~ow street nines and ~dicate whether interior or comer lot. STATE OF NE~V YORK, COUNTY OF ....... S.S ........ ('I~ .... 'fi ............................... being duly s,vorn, deposes and says that . amc o ndividual signing contract) above nanled. he is the applicant Itc is the ........................................................................................ (Contractor agent corporate officer etc0 ' ' of said owner or owners, and is duly authorized to perform or have performed the isaid 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 work will be perfor/ned in the manner set forth in the application filed therewith. Sworn to before me this No; 4707878, Suffolk ~un~ ' , ' ·