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HomeMy WebLinkAbout17564-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. OF OCCUPANCY No: Z-26077 THIS CERTIFIES that the building ADDITION Date: 10/30/98 Location of Property: 1705 FOUNDERS PATH SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 64 Block 4 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 27, 1988 pursuant to which Building Permit No. 17564-Z dated OCTOBER 27, 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued ie ROOF ADDITION OVER AN EXISTING DECK ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to PATRICIA ANDRES (OWNER of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A gosas xo. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHALD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 617564 Z Date ......1~ ...~:.~.. Permiss~,isy gr~to: n yy~r ~'.........~.- ~. .~~....... ~~ ....:~4s,... ......~..... ~ ~~~ ...., 19.(J..~ ~~,.-~~ .....r......~ g ....~~~ ~ .. ...... ct premises located at ., f..l~.x3~,r`.......... .1~', ...................................................................~...-.~v/n.~y.a:. ~.c~.............................................................. Counh~ Tax Map No. 1000 Section ..........fQ..l........ Block y7:....... Lot No........I pursuant to a lication dated ........1...~.. .. ~~ ................... Pp ......., 19G[~~., and approved by the Building Inspector. d~ Fee $..`.,C" .. ~. Rev. 6/30/80 FORM fVO. 6 TOWN OF SOUTHOLD Building ®apartmerrt Town lialq ` 5iouthold, N.Y. 11971 $+, ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspoc° for with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property linos, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S°9 form or equal). 3. Approval of electrical installation from Board of Fir-c Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and sin-rilar buildings and installa- tions, acertificate of Code compliance from the ArcYritoct or Engineer responsible far the building. 5. 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or provious owner as to use, occupancy and condition of buildings. 3. Uate of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling (land use --Pre-@;xis tiny; C . 0. ?p 1 5.00 3. Copy of certificate of occupancy $1.00 r Vacant land C/.O. $ 5.00 Uato .. /~~.~7 ~ /8t~ New Building .............Old or Pre-existing Building .. ~........ Vacant Lan~~``d ............ . Location of Property ~lP.`.-~S.~C~~`b~~s ~~~i5` cSO~~Tfi'o/ /~ Noure Nu. may, Street Hamlet Owner or Owners of Property ................... y.... . County Tax Map No. 1000 Section .....~0.'~...... Block ......~'.~....... Lot ....~~....... . Subdivision .................................Filed Map No. ..........Lot No. ............. D/7.5 ~ i>< ~O~'/'F~'.A ~i~i~~ ~/or~ie. ;~ih~Rv~c~~iF~, rho Permit No. .......... Date of Permit ......... pplicant ........:.... . Health Dept. Approval ........................Labor Dept. Approval ............. , ......... . Underwriters Approval ........................Planning Board Approval ..................... . Request for Temporary Certificate .....................Final Certificate ...... !~ ............. . so Fee Submitted $ ...I.~ ~.... .. ~ ~~ ~.~ Construction on above described building and p}erf~~~~'t meets all ap~plicapbl)o~code~s and regulations. Appiioant ....~,~ b2.r ~.. d ~{ .C~e+!t~--:L ................... . ua~. to-toga FORM NO. 6 TOWN OF SOUTHOLD Building Dapartmont Town Hall ` ,,<JOUihold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildinys, property lines, streets, and unusual natural or topographic features. 2, Final approval of Health Dept. of water supply and seweraye disposal-(S-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, acertificate of Code compliance from the Architect or Enyineer responsible for the building. 5. Submit Planning Board approval of crimpleted site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildinys and "pre-existing" land uses: 1. Accurate survey of peoperty 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: 1. Certificate of occupancy $5.00 // 2. Certificate of occupancy on pre-existing dwelling ! land use --Pre-Fxis ting C . 0. $ 1 5.00 3. Copy of certificate of occupancy $1.00 l11 Vacant land C.O. $ 5.00 Date .. ~~,/".7 ~ /`~~ ....... . New Building .............Old or Pre-existing Building .. X......... Vacant I_an/`d.............. . Location of Property ~°~.:3~. ~ClNb~~'S ~/-~i7i ~SO«Tf1o~.l~ .. , . _. .................................... ........ Nouse No. Street flar171Pt Owner or Owners of Property ..~.~.'~:5, ~~F~.E't~ ~~7//.~,~~5 .............................. County Tax Map No. 1000 Section .....(0.~...... Block ......r'.C....... Lot ....~3....... . Subdivision ..~.7 ..............................Filed Map No. ..........Lot No. . . . . . . . . . . . . . ~~`fJ'` ~d h~ ~O~'>~~6' ~~Cii~T~-~,' , ~~~/'lC, ~/~J/r~l UC%hE/U% ~ d Permit No. .......... Date of Permit ..........Applicant .. . Health Dept.Approval ........................Labor Dept. Approval ........................ Underwriters Approval ........................Planning Board Approval ..................... . Request for Temporary Certificate .....................Final Certificate .......'~ ............. . Fee Submitted $ ............................. Construction on above described building and p~e/r`~,ni~t meets all app~lica//bl)e~cod/es and regulations. Applicant ....G/ `/.2.4.r ~...~ ~4:G-! ................. . Rav, 10-10~'rD r'1ELD ~:SP2C: iU;i ~~DniE ~ i;OaYMCNTS `4 ~• '9 i ~ - a H H c'OUIlDATION._.. (1st) ~~ c ?OUNDATION (2nd) _ _ ~~ 2. z ~ ROUGH FRAME & \ PLUMBING • - 0 O tih y~ 3, IIlSULATIOP! PER N. Y, .. "~~ STATE ENERGY ~' CODE ~ ~~ ~ O ~ ~y~ ~ ~-p.~71.tf ra ,~ 4 . //~ . y O \~V FINAL ~ ., ~ ADDITIOPlAL COMMENTS: x ' ~ m x ~ H ' H ~ H p O m r x • c v n . ro 3 /S rn~.% AP~~'~~ AS KGfED DATE: ~ Z"7 9.R S 736 fEE: °~' NOTI~OE~PA NT AT _.._ . 786-7&02 9 AM 70 4 PM fOR THE fOLLOWlMG INSPECTIONS: t. FOUNDATION TVMOREQUIRED FOR POU~ED CONCREtE 2. ROUGH ~ FRAMING A PLUMBING 3.~1NSULAT,(ON Q. FINAL ~4f,~-,,,.•~ CONSTRUCTION MUST ~ BE COM4~lETE FOR C.O. A~.L CONSTRUCTION SHALL MEET i -ItlE-.-13EQUIREMEN'fS--Okk-Ib1E-N.Y. i S'~ATE CONSTRUCTION 8 ENERGY ~ C~pES. NOT RESPONSIBLE FOR D S~N OR CONSTRUCTION ERRORS /7' I ~~~"o vev Fd> . 5 ~~ ~ ~~ ~~~~~ ~ ~~. ~~.~ ..... NJWM.... ~,..~:MWmun~+....nom«,:»:.«.~.....+...-.---...~. ~~ - .Y,s{ ~I~USd'.. (/~C,~d>Yd~1C~. i ' 5..d, ,. Gor 8~ ,~, .AND 4~ few .B6NNE'7%- __ " _7 /' 0 b L~, a ....v ~ DKIVLFWAY dAtt.. k,3 f -_`. ~ 3~~,c ~~. `p it P_ F U y' ~' a . z7` y v ~ R ... 1u ~, ~. / 1c t n t_ ~ .~ j w° ~ i ~, N aq m U . t`v 9 ,,5 UP i o `~ a , ~ ~ V L c~T' &8 ~~~ °~~~ S 38,31 r 5 ~~,v lJna~~"hnrnoct altn+ation nr sdsJhion to BS:in survrY ~ n vKrl9Plun. ai ~ soaion 72<Y} of Eha Now Vak cutatb ~ Pd.tcxuan tsw. ~eDic-s a$ lhin sunmY n9~ no4 tigatffeq " t^r,n lnnsl ssprvoYOr'o hsitad sail tX 4~ km ~ valid truo aapd. ~ considera~ Csusrsntasa Indiea2oc hns~oon shelf t soP3 an3Y 2nt4au pur.;on 4or wtrom 9ho survey to Geenarest anU an h4n tsn',SatE to tho ~k"a rwnt,n~t°f..>rova.'nman9al n43ancro a~ ten„ryng.InBtitutNrn licierJ hsaoan anA -4a5tie BaPiflnnsa oQ 8uo lantra9 lr~al- 4utian.(s"Unran462s xfe t50t 4t''iu9','.5'6rah1® fa ccYJkionel inaYltalYlana of suhsirJUen4 awna's. .scl,ev~y~U F~r~ nr 5©u7'~-t ©c., t~, hl. Y. T~r~.b No's. ;; -. ~p447'6-7 ~~ ~~ ~Q 5~ ,F"~ L O?' rV UMrBEIi*S 2.~'F""E`'fl. YO ~sM1fa/' OF F'06rNp~'/~LS ~57'q~7'E3; k /LEG !N sSCli-'F'i1LAC GO, CLEtg.K's cusFICE f~S ~YtAP NO. 834. t7 ~ M4NUM£MZ" 6Ugl2RNT'"b'~"p 70 rN7'6"2° CdUN7"y/ T!7'4E Guf1~tRNrY ~' Ma,e7~AOE C0Pr1!'ANY r,s su,xv~r~'v JUNE r, r~6~. tlaN 7"u~~. ~ Saw LICEN.'+`EO L.gNP SuKYE`Y©~P.S G,,rz~~sNP©~z; N. Y. I ~~5~~~~ ~~~ 765-1802 BUILDING DEPT. 1NS~ECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ] FRAMING [ FINAL REMARKS: ~~ DATE ~ INSPECTOR ll [ ] FIREPLACE ~ CHIMNEY FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..!.D~°~.7....., 194. Approved ..~.~Pe.~.!....., 19~Permit No. ~.f.~6.Y.: Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PL6NS ;../.......... SURVEY ....// .............. CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL T0: Date ~~'. ~.'Z. ~....., 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 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 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 inspectio/ns./ 1 /~ ,,{p~r e f7 T ~Y ~7 ~'vy L .~~1G C..~~ o~tc .. .~1 ...................... (Signature ot" applicant, or name, if a orporanon) (Mailing address of applicant) State whether~~yyapplicant i`s/o~wner, lessee, ag~e[nt, azchitect, engineer, general contractor, electrician, plumber or builder. ...........Y...^~.... v.~rn.. f Y d. c / cry ........................................................ . Name of owner of premises ......S, , , . 3 r v~ / (as on the tax roll or latest deed) If applicant is a corporati~gnat re of, dply authorized officer. ..... ..~ ............. ~.r.-~s: (Name and title of corporate officer) Builder's License No. ....~~.g. ~ ~ . Plumber's License No. `~ ........................ r/ Electrician's License No . ..................... . Other Trade's License No. . ~ .................. , f~~ ~ S I. Location of land on which proposed work will be done. ..~.`.'.~?' ~ Y y ` ° "'r- cb2vs ~~ ~v, `~' ......................................... e~ao 5~,,~ ~Y.~.~~v,•~ ...........~ Y.. .................... .................. ,/'/ HouseNumber Street ~~ ~ ~ f~ f` `'~GV~~ UU Aux e~.s a_ Hamlet Sev vo County Tax Map No. 1000 Section ... ~.1,.. ..... Block ..... y ~"~ .. ........... Lot.:. ~y ..... ...... Subdivision .':- :................................. Filed Map Na. ?' ,~~, ....... Lot .. ~g........ . (Name) 2- State existing use and occupancy of p/remises and intended use and occupancy of proposed construction: a. Existing use and occu ane ... ~f `.`: ~ `/" t ~ P Y .........~ .................................................... ~// b. Intended use and occu anc ....l`'CG~ ~1 °' P Y .......~ ...................................................... APPLICATION FOR BUILDING PERMIT 3. Nature of work check which a Re air ...... ( PPlicable): New Building .....~.... , Addition .......... Alterat.,i~~??n .. P ........ Renfoval ............ . . Demolition .............. Other Work .<~!x~ ~~aJ l!rwQ (Description) 4. Estimated Cost.......r~~ 5 6rJ ..................... Fee...................................... (to be paid on filing this application) If era e, number of cars ~ units ..... , l ....... Number of dwelling units on each floor .."`, , , , , , , , , , , , S. If ~wellin number of dwellin~d occupancy, specify nature and extent of each type of use ..-- , ... . 6. If business, commercial or mix ••.~.••l~~.~•.••~•~ ~~~~~~~~~~~~~~~~~~~~~~~""""""" o ...... 7. Dimensi y~ 1,~ ~~tjfglchruNu ~es; if any: Front :./: ~ ~'....... Rear .'~; S!.`1'.... Depth . ,`L ~, , Height ii . 1. ;+, i ! ,., , Timber of Stories . .. . ..... ...... . ................ . . q ,v ~..-s Dimensi 'same structure with alterations or additions: Front . , , ."'-, , . , , . , , , , Rear . -':.. , ..#' ; Depth ~ . ; : •y~ ~*~~~... I3eight ......` ..............Number of Stories .'- .......... . 8. Dimensi ` f en`ti~'r~t~consgruction: Front ............... Rear ...............Depth `-` Height .~'"1„n,,,, ~..~.L`Il~r'p,ber~dB'Stories . '- ~ ~ ~ ~ ' ~ ' ' ' ' ' 9. Size of I : Fr~~?Pllti:, rt~, ~.~;r....q...... Rear ....C ~ f ,~; (/~......... Depth ..S; .~ f:~~, ........ . 10. Date of try'. `: `::"......1 ................... ame of Former O ner .•--....................... . 11. Zone or use district in which premises are situated . , ~E- 5,/ ,~c,µ , ,~,~, ~ . , , 12. Does proposed construction violate any zoning law, ordinance or regulation:... ~~ ....................... . 13. Will lot be regraded N y .. ..j .. , , , ,Will excess fill be re~ioved fro premises: ,Yes No 14. Name of Owner ofpremises6y,,,,,,,,,,,,,,,,, ...:`.. ~s ~arvy 6h'72~v~r Address T":"~;z~evsV;, Sa~tG~~~~one No. - Name of Architect ' , ,Address ..Phone No. Name of Contractor f~t chi .t~ci~ . ~"• "1'~t'e.~'it%dpddress .`~~~ $ , ,7, ,'`yi S71 Q~ ,phone No. ~f.>7 ~ ~' Y' IS.Is this property looted within 3 0 feet of a tidal wetland? *YES....NO.X.. *If yes, Southold Towh Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al( 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 whether . interior or corner lot. fdi ~~ .r 2K 6 ~a~~~ws /6 ~~ / 1` /"ly/V co /~~i,5 61nG/Z~hl~1t~ / ~.~~ v5'z d 72 1- T'.z-r'~" u~ d¢y~~~~~ ~ ~ ~' J ~ ~~~.~ ~~ ~ S`~ o cv- G-,; f.~e/ acv-o ss / o ~ ~~~f STATE OF NE1Y YORK, COUN O ~ ...... ... ..`.'~`~U'tX-~. (Name of ind vvidual slgni • ' ~ • ' ' ' ' ' ' • • • • being duly sworn, deposes and says that he is the applicant ng contract) above named. He is the ...................... (Contractor, 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 aPPhcation; that all statements conta+ned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner,'set forth in the application filed therewith. Sworn to before me this Notary Public, .....~~, , ,9Y.•; ... hJ?, U®~-.. County / (~/may-, / kOTARY P BLIC~St~atgg o~ New Yark ' ' ' ' ' ~y!~'. ~ •/6G2^~ : '~ `::!~4 ... . No.470I878,Suff4lkCouMy (Signature of applicant) Term Expires M&rch 30,19~y I