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HomeMy WebLinkAbout17240-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217163 Date AUGUST 5, 1988 THIS CERTIFIES that the building ADDITION Location of Property 1895 LEETON DRIVE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 58 Block 2 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 13, 1988 pursuant to which Building Permit No. 172402 dated JULY 20, 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 DECK ADDITION TO AN EXISTING DWELLING. The certificate is issued to ARTHUR E. & GLORIA M. FUSS (owner, XxXXXxxxxXXXxxxx) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A .GO~.~ Building Inspector Rev. 1/81 F013M NO. f TOWN OP 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) N 0 01.7 2 it Q Z Date ....sz7.. ~ 19. B. Permission is hereby granted to: ~....~l..a-4.0.-~:~...~~?~...~~.~~ q . ct premises I«ated at.~.$.9.5.....~RrZ.1'.M....1:2~:.....~Q~`~~?!!r?.'~:~ - County Tax Map No. 1000 Section BI«k .....0.~:....... Lot No...J. ~ pursuant to application doted .........~.....~..w~ 19..!..A., and approved by the Building Inspector, Fee Building Inspector Rev. 6/30/80 k v~nwl~f=t~ ~i6 I~~~,~~ rev. s. FORM NO. 6 ~ N ~ TOWN OF SOUTHOLD ~ ( Building Department n Town Hall \ G~~~~~ Southold, N.Y. 11971 i 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 33 7C~7 Instructions A. This application must be filled in typewriter OR ink, and submitted to the Building In~ec- torwith 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-(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 Engineer responsible for 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 property 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, $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ ] 0.00 4.Vacant Land C.O. $ 20.00 S.Uodated C.O. $ 50.00 Date ....~~.~.Lls~ ~.~~g.. NewConstruction,,,.„OldorPre-existing Building ?5. Vacant Land Location of Property ..~~q~.....L~.~~`.~..'~~r~'~....,`~v~~aCc/ !l~'7! House No. Street Hamlet Owner or Owners of Property ~!'~~?!l!.~•. ?r:. (~'lorea t~ ~u5$ County Tax Map No. 1000 Section Block ...©Z......... Lot....(.Q.......... Subdivision ./.~.7 ..............................Filed Map No. ..........Lot No. . Permit No. !./~~v LDate of Permit ..........Applicant . Health Dept. Approval ........................Labor Dept. Approval . Underwriters Approval ........................Planning Board Approval . Request for Temporary Certificate ./.........1.7.~.........Final Certificate ~ . ''c1" oT~ V 1 ~ 4 V Fee Submitted $ ....~4.~ . Construction on above described building and permit meets all applicable codes and regulations. p ~ Applicant ~-•u(~?:.~L.: . F:.'- . Rev. 10-10-78 ~ tk- 35 ~~13 Cog »1~3 -1ELD IGSPCZiUfi ~~UAT:: ~ %061MENTS r- 'bv m ~ 1. ~ H ~ FOUNDATION (1st) c~1 :OUIIDATION (2nd) ~ _ z o 00 ..,0 ROUGH FRAME & ~t PLUMBING ti H 3. m ~r ~ H IIJSULATION PER N. Y. STATE ENERGY CODE x a . ~3 i~ ~ ..-1 y ~ FZidAL o ADDITIOPIAL COMMENTS: x 4 rn ' x ro• H ~.r A o H H O Z [*7 7 r L H x 'fir. a d m -o H # ~ . i I a r" ~-4_C- cti~ t 71 ~ <t ~ ~ i ~ \ 'ti s ` ~ ~ f'c \ a~./~" ~ _ ~ j . l~ i ~ ~ OCC~U~iPANCY 4R 3 f N76 C~<;~Ulti1D W UNLAWFUL w~7F! ~ ~krt.~rr ~QU'T CERTIFICATE F~ ~ ~~,r,:.r w r*- PK ~r ~ OF OCCUPANCY zK& ccr~ us~A ~~trr~ 4faus ALL SL)f'~'pi'd" , X. 8 e~.o~ or X`{ P~.7 s ~X 8 ~~oo,r Se~S'~S /b~~ O,.C. S/~/ e~ aX !o J~.a ~ A~P~P,R,O)VED AS NOTED ' DATE _~~-=-~.a?~ o.P It 7a NOTiF'Y~gU~ It U1Nsy DE~t?4R~-TTy~NT AT 785 1802 9 Afitl T?) a P~ FOR T~iE r ~OLi.OVViNC iAlups;051C}NS I• FOUNDATION 7WpREQUIRED FOR POURED CONCRETE z• ROUGH • FRAMING R PIUMSIN 3. INSUL.ATiON 4. FINAL - CONSTRUCTION MUST 8E COMP6ETE FOR C.O. Au. CONSTRUCTION SHA61. MEET 1HE REpUIREMENTS Of THE N.Y. ~~~'.`TWN • ENERGY DESIGN ~N RRID~S -i ~ ~ o _ . - - ~ D o N gg~ J N „ ~ ~ 3~<#G"w• ~ ~ ~ ~ ~ ~ a~ ~ I 1 /[I i L~ N t w F Z ' h ' ~ N ~ f ~ a ,.~r, _ I ~ 1 ~ j~~°o~ ~ ~ ~ ~ ~ ~ ~ f *i~ ~ ~ ~ ~ 5.44°~'4 30"~i. ~C3Q.ty • I~t i OP ITt _ ~ A {orm~r~y Uzmant~~: { N ~ ± ~ _ A A ~ ~ ~ C Y ~ ~ ~ - ~ ~ u a.a. ~ z. ~ K a. s try ~i Z~ o m. c ~g - ~''''~'J 9 ~ R ~ ~ -r- ~ 7~ y~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. ` [ ] FOUNDATION 2ND [ ]INS CATION [ ]FRAMING [ FINAL ` REMARKS: ---~~a~ ~ f 1 r Stf I E t R f DATE ~ 3 ~ INSPECTOR II f ~ ~ _ . ; BOARD OF HEALTH 3 SETS OF PLANS FORM NO.1 SURVEY d? TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM TOWN HALL EOUTHOLD, N.Y. 11971 NOTIFY - TEL.: 765-1802 CALL Examined . 5:~. , 19~~ MAIL T0: Approved 19~$ Penni[ No. J.~.a.~QzL. C~ Disapproved a/c D t~.~...~~.~t1~my~.~.~?~ , ~eJ BLDG. tJ4iY i. .~'`.pC., TOWN OF SOtJIhPOLp (Building Inspector) APPLICATION FOR EUILDING PERMIT Date ......7 f,/.:3....., 1S~g INSTRUCTIONS a. Tltis 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 Re;ulations, 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, buildnng code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ' (Signature at"applicant, or name, if a corporation) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. QW vi vl" Name of owner of premises 5.~~'t^!~':........1.~.~',-~.(-j t1 (Z; _ E; , I,- u ~S,S„ ,~,,E', (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. 0............ . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. .I `¢'--~01^ S~'f 1^o~es t~4.s" f~~~rn-.. Dr ..sovd-c~~t~ Nil Ito? I{ouse Number ~ Street\ ~ ~ ~ " " " " " " Hamlet County Tax Map No. f 000 $eCilOn ......©5~ Blpck ~ , , , , , , , , Lot ~d . Subdivision Filed flap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy O~a~v; , o~1c', /...;1 eE' b. Intended use and occu ane Fxt~ vryt~ ~ ti;~, P Y 2"::.~. Q. Irature of work check which P " ( Rc applicable): New Eluilding , , , , , Addition K Alteration Re air {rtoval Demolition . . Other 1Vork , . 4. Estimated Cost . 2,dvTi (Description) i Fee..,.................................. (to be paid on filing this application) P If dwelling, number of dwelliri'Ig units , . , , , , , , , , , , . Number of dwelling units on each floor . Dimensio bcrofcars . If ara^e, num ed occupancy, specify nature and extent of each type of use , If business, commercrbl or mtXres, if any: Front , , , , , , , , , • ' ' ' ' ' ' • • • • • • • Hught Rear Depth..,............. ns of exrstin ~ stru Number of Stories . . . Dcmthsr~ns,o s m fructurc''withaltcrationsoradditions: Front Rear IIcight Number of Stories imenstons of entire new cons' g Nutruction: Front . He.r ltt Rear . Depth . knberofStorics. . Size of lot: Front Rear..........:....,,................................... 1 .Date of Purchase Depth • P ....Name of Former Owner • ~ • • • • • Il. Zone or use district in which jemises are situated . 1 Z. Does proposed construction viglate any zoning law, ordinance or regulation: • • ~ • 13,x. iVill lot be regraded , , , , , Nill excess fill be removed from premises: Yes No 14. Name of Owner of premises . .Address . Name of Architect ~ ..................Phone No.............. . Name of Contractor ........I Address ...................Phone No............... . yes, Southold Tow ' • • Address ...................Phony No. 1'.ls this property looted within,~00 feet of a tidal wetland? *YES....NO.... *If n Trustees Permit may be required. . PLOT DIAGRAM Locate clearly and distinctly alj buildings, whether existing or proposed, and. indicate all set-back dimensions from pr perty lines. Give street and block number or description according to deed, and show street names and indicate whether int rior or corner lot. -t__.__~ T__,__ , I ~xrsrrnl~/~ ~i ~ tr~~ ~~tJ I °tkr i ~2p~ it . STA E OP NE1V YORE, CO 'INTY OF . . .S ...1.......` .................s............,....,. Vein dul (flame of individual signirjg contract) g Y sworn, deposes and says that he is the applicant abov named. lleisthe (Contractor, agent, corporate officer, etc.) ~ • • • • ' ' of sad owner or owners, and is duly I~authorized to perform or have pyrforrned the said work and to make and Gle this aPPli anon; that all statements contairScd in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manner $et forth in the application filed therewith. Sworn to before my this ' , ...day of . l , 19 ~Jr County Vota Public, , HELEN NOTARY PuBtIF sw of~New Yak t%~ Y ~ ~ ~ ~ . No. X707878, 8ultdk ~ ' TamExpirealMroh30,t ~ C^ r~ure of applicant) C