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Home My WebLink About17688-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18219 Date JULY 26z 1989 THIS CERTIFIES that the building. ADDITION Location of Property 240 CHRISTOPHER STREET SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Sectlon 70 Block 12 Lot 23 Subd~vzs~on Filed Map No. Lot No. conforms substantially to the Application for Buzldlng Permit heretofore filed in this offzce dated DECEMBER 9~ 1988 pursuant to which Building Permit No. 17688-Z dated DECEMBER 13r 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whlch this certificate ls issued is DECK ADDITION TO EXISTING ONE FAMILY DWW-T~.INGASAPPLIED FOR The certificate ~s zssued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A BRUCE J. & SARA M. BLOOM Rev. 1/81 lrORM NO. Jt 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) NB b17688 Z Permiss~on ~s hereby granted to' ~...~.....~.~..~.._~... ~~_~ .... ~ ~....~~~. ~.~... ..... . , ....... ~~~.'~:~...~ ......... ~ ~~...~~: ~?.~...~~...-:~'...... ............... premises located at .. w~...~.~ ..... ~.~... ~ ....... ~:~/. ............................................ ................................. ................................................ County Tax Map No 1000 Section ...... pursuant tO application dated ..... /~/~... Building Inspector. Block ......... ./...,,~,.. Lot No ...... .~..,.~... ........ , 19.~.~., and approved by the Rev 6/30/80 TOWN OF SOUTHOLH BUILDING DEPARTHENT TOWN HALL SOUT~OLD. NEW 765 - 1802 11971 ICATION FOR CERTIFICATE OF MEW CO.';STKUCTION ....... OLD OR PRV--EXISTING BUILDING ...... VACANT LAND ........ ................... ........... HOUSE NO. R HAMLET O~ner or Owners of Property Couoty To=: Hap No. 1000 Section ...... Block ....... Lot S,~bdiviszon ....................... Filed Map ........ Lo[ .......... Fqrm~ No ........... Date of Permit .......... Applicant ................... Health Depth Approval .................. Underwriters Approval .............. Board Approval Request for Temporary Certificate ....... Final Certificate ................ rev. 10/14/88 FOl~ NO. 6 TOWbl OF SOUTllOLD BUILDING DEPART~EN~ 'l'Ol~ UALL 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: I. Fimal 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(S-9 form). 3. Approval of electrical installation from Board of Fire Undem~r~iters. 4. Sworn statement from plumber certifying that solder used in system contains less than 2/]0 of ]Z lead. 5. Commercial buildings, industrial buildings, ~ultiple residences and similar buildings and installations, a certificate of code compliance from the 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: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A ~roperly completed 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, I957. 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 code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. Fur Vacant Land Certificate of Occupancy: I. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire lot 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. ~CERTIFICATE OF OCCUPANCY - 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 on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $I0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $~5.00 Residential $50.00 Comm~ercial FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIOHAL COMMENTS: ,, TOWN OF SOUTHOLD g,s~pp~oved ~/c ............................... ~ ~ ~ ....................... ~mld~spector) ~PPLICATIO~ FOB B~ILDI~G ¢E~IT BOARD OF HEALTH .......... 3 SETS OF PLANS SURVEY CHECK .................... SEPTIC FORM .............. NOTIFY CALL ................... M^ L TO: Date ............... I~ INSTRUCTIONS a Tins apphcatlon must be completely filled in by Wpewnter or In ink and submitted to the Bmldmg Inspector, sets of plans, accurate plot plan to scale Fee according to schedule· b Plot plan showing location of lot and of bmldmgs on premmes, relationship to adjoining premises or public or areas, and gwmg a detmled descnptmn of layout of property must be drawn on the diagram which is part of ttus~ caUon. c. The work covered by ttus application may not be commenced before issuance of Building Permlt d Upon approval of thru apphcat~on, the Bmldmg Inspector w~I1 ,ssued a Bmldmg Permit to the applicant. Such p~ shall be kept on the premises available for tnspectmn throu~aout the work. e. No bmldmg shall be occupied or used in whole or m part for any purpose whatever untd a Certificate of Occur~ shall have been granted by the Bmldmg Inspector· APPLICATION IS HEREBY MADE to the Bmld~ng Department for the issuance of a Building Permit pursuant Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordman, Regulations, for the constructaon of buildmgs, add~hons or alterations, or for removal or demolition, as harem descx The apphcant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, a~ admit authorized inspectors on premises and in building for necessaW~spections. //~/~ (Signature ot apphcant, or name, If a corporanon, (Mmhng address of applicant) State whetlier apphcant is owner, lessee, agent, architect, engineer, general contractor, electrlcmn, plumber or bu Name of owner of premlses~a~. ~.c. .~.. W .&..~'~..(~..' .'~: .. ~..~.~. ~ ................................. (as on the tax roll or latest deed) If applicant m a corporatmn, mgnature of duly authomzed officer (Name and title of ~grporate officer) Builder's hcense No Plumber's L~cense No. ElectncIan's License No Other Trade's License No ................ 1. Locatlonoflandonwtuchproposedworkwlllbcdone ..~(~. P/.~O.~ ~/.,,/ ¥'ke,... xT, . House Number County Tax Map No Subd~mion Street O00Se t,o o (Name) Hamlet · Filed Map No. ~./.~f/ ..... Lot . 2· State exls~m/z usc and occupancy of prcnllses and lntendcd use alld occup[lnc¥ of proposed corlstrilCtlOn: a. Ex~stmguse and occupancy... ~C ?. ,91 .............................. b. Intended use and occupancy 3. Nature of work (check which applicable). New Budding ..... ' .... Addition .Iteration ...... Rep:ur ............. Removal ............. Demolition ................ ~ ~' 4~' (Descnphc 4 Estlmate'dCost . 2..30.?.?.t .'7- .................... Fee...~..O..?~. ..................... (to be paid on filing this apphcation) $. If dwelling, number of dwelling units ............ Number of dwelling units on each floor ........... If garage, number of cars ........................................................... 6. If business, commercml or mixed occupancy, specify nature and extent of each type of use ............... 7. Dm~enmons of existing structures, if any Front .............. Rear ............ Depth ........... Height ............ Number of Stones ............................................ Dn'nenslons of same structure with alterations or additions Front .......... Rear .............. Depth ................... Height .................... Number of Stones ................. 8. Dimensions of entire new construction Front ............. Rear .............. Depth ........... Height .............. Number of Stones ........................................... 9 Size of lot Front .................. Rear .................... Depth .................. 10 Date of Purchase ......................... Name of Former Owner ................... 11. Zone or use district in which premises are situated ............................................. 12. Does proposed constructlon violate any zomng law, ordinance or regulation- . .......................... 13. Wall lot be regraded ........................ Will ex~ess fill be removed from premises Yes 14. Nme of Owner of premises .~/.~c.e. . .~.'. ¢..)~.~..c9.... Address ~..~ .~.A .~67~.~. ~7-~ .% t.--'. Phone No... Name of Architect ........................ Address ................. Phone No ........... Name of Contractor .......................... Address ................... Phone No 15.Is this property located within 300 feet of a tidal wetland? *¥E$ .... ~'O'.'~ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearIy and dlstmctly all buddmgs, whether existing or proposed, and, mdicate all set-back d~nenmons 1 property hnes. GlYe street and block number or descnphon accordmg to deed, and show street names and hadlcate whe interior or corner lot. STATE OF NEW YORK, COUNTY OF ............ S.S ................................. being duly sworn, deposes and says that he is the apph, (Name of individual signing 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 apphcation, that all statements contmned m this apphcahon are true to the best of hm knowledge and belief; and thai work will be performed in the manner set forth m the application filed therewith Sworn to before me this ......... f .......... dayor ......... HELEN IL DE NOT~q:Y PLIBL C, StaLe of New Y°d~ No 4707878, Suffolk Count~ Term IExmres Ma~h 30,