HomeMy WebLinkAbout26100-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28082 Date: 11/26/01
THIS CERTIFIES that the building ALTERATION
Location of Property: 435 SOUNDVIEW AVE EXT SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 50 Block 2 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 17, 1999 pursuant to which
Building Permit No. 26100-Z dated OCTOBER 28, 1999
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 ROOF ALTERATION AS APPLIED FOR.
The certificate is issued to LUCIEN ARCAS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Authorized Si ature
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 26100 Z Date OCTOBER 28 99
Permission is hereby granted to:
LUCIEN ARCAS
30 WEST 61 STREET #29 F
NEW YORK,NY 10023
for
CONSTRUCTION OF A GABLE ROOF OVER AN EXISTING FAMILY ROOM AS
APPLIED FOR.
at premises located at 435 SOUNDVIEW AVE EXT SOUTHOLD
County Tax Map No. 473889 Section 050 Block 0002 Lot No. 006
pursuant to application dated SEPTEMBER 17 99 and approved by the
Building Inspector.
Fee $ 75 . 00
—40t We
Authorized Signa re
ORIGINAL
Rev. 2/19/98
s kX
Form No.6 Q_c)Y-\ _ !,
TOWN OF
BUILDINQ vic)(?>W 19 ba_
TO L
76 19
APPLICATION FOR CE IF
8tDG.DEPT.
TOWN OU
This application must be filled in by typewriter or ink and su initte to he ment with the following:
A. 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-9 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 buildings 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.
B. For existing buildings (prior to April 9, 1957)non-conforming uses,or buildings and"pre-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 Building- $100.00
3. Photocopy of Certificate of Occupancy-$0.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00
Date. I 0 "� I
New Construction: Old or Pre-existing Building: (check one)
Location of Property: 'At"�
I tA,-)
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section C, Block �" Lot (10
Subdivision f Filed Map. Lot:
Permit No. /CO Date of Permit.)o AApplicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary.Certificate Final Certificate: (check one)
Fee Submitted: $
Q
Applicant Signature
BUILDING PERMIT REVIEW CHECIK LIST
Applicant/ / Date
Owners Name- ` < /�G' �i4f IfGn,' Reviewed: /O 2?
1
Architect/ Date
Engineer: ' 44-1-1 14 ► Submitted:
SCTM M
District: 1.000 Section: -"o Block: 4;? Lot:
Project 0, r K d y/e, /� _ Subdivision
c
Location: a /�'1'� � Name:
Single&separate Req
certification: Ye / No.
/) /y�jJ �•_ eq
Zoning District: ` ✓ [Lot size: O V V" Actual: 0+���� ) [Lot coverage Proposed:
Req Rat. Reg
[Front Yard Proposed: [Side Yard Proposed?/�7� — 1 [RearYard Proposed:� )
Project Description: 44&e p-e1
AGENCY PERMITS Permit
REZUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval: x
Flood Plane Elevation ???
Flood Zone:
to •
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
UK' Lo;
DATE INSPECTO
i,D INSP CT ON RF,PORT a DATE II COMMENTS
H
1NDATiON ( IST) it n -------------------------------
II Il �
TNDATION (2ND)_-- _ -- --------------
a u -
li ii r
JGH FRAME & ii----- JI --- -- — -- W
PLUMBING
SUi,ATION PER N. Y. IIS iii �
H
- -iN
STATE ENERGY If u
CODE
-al
H--- II
FINAL
ADDITIONAL COMMENTS:
r>y�
zx G
C"
a.�n.�a w c.ucma..0 . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
13Z
CALLErmined. v . 19MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved. j%; ..,., 19.... Permit No. �. .. ....................................
Disapproveda/c ............................ ..............................
(Building Inspector)
LICATION FOR BUILDING PERMIT 44
Date. . . VR. . . . . . . . . , 19 7 .
T �
--- ------''� INSTRUCTIONS
a. 'This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
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 mist be drawn on the diagram which is part of
this application.
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 issue 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 neces ections.
insp
.*,..... ....... ................
(Signature�of applicant, or faa corporation)
�
(Mailing address of applicant)
I
State whether appli ant is owner, lessee, agent., architect, engineer, general contractor, electrician, plumber or builder
................. tkrkar...................... ...........................................................
Nameof owner of premises ...............................� ....................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.........................................................
(Nam and title of corporate officer)
Builders License No. ... � (P.�l..M.T......
PlumbersLicense No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
1. Location of land on which proposed work will be done....
..........lfl ................���►,,�1/r.�.mc.. X tS .......................................................
House Number Street / Hamlet
County Tax Map No. 1000 Section ....... ..... Block .......QR ...... Lot ri..............
Subdivision ...................................... Filed Map No. ............... Lot ...........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. R)dsting use and occupancy ...5!!15��..�S��a11�x..�tflC��ih/� f n�j�! K°o»? ..............
b. Intended use and occupancy .... :!l3�f....m.R!� :� ..�ltirVC�(!K�..:./,4!I!�� M.a..............
............ nrsuuvai ............. Demolition ............ Other Work ..... ........ •. . . . . . . ..
` •
Estimated Cost
�� (Description)
s.... fee .............................................. ..........
,(to be paid on filing this application)
If dtaelling, numiber of dwelling units ....I....... timber of dwelling units on each floor
If garage, canber of cars —'
.............................
If business, commercial or muted occupancy, specify nature and extent of each of use....................
Dimensions of existing structures, if any; Prost,,,- y,�
y. Rear ...... Depth .................
Ileight ........ . 0�2....... Number of Stories ........z.•� ..
Dimensions of sane structure with alterations or additions: Front .... (........ Rear ....
Depth .......`�.�-........ Height ..W. A ........ Number of Stories �.;? ......... .........
Dimensions of entire new construction: Prost ....... �?... Rear
Depth 17
Heiglit .......... ............ UJIMber of�Stories .
Size of lot: Dont .....1/(?.......... Rear ....//(R........... Depth ..!? ............
1 Date of Rhrcliase ..................... Name of Former Owner ........................................
1. Zone or use district in which premises are situated ....&:.1-.t2•,, 11
2. Does proposed construction violate any zoning lav, ordinance or regulation: ..,VO.
................
3. Will lot be regraded , b.......... Will excess fill be removed from premises: YES
NOD
'+. Names of Owner of premises
..................... Address .............................. Phone ..............
Nae of Architect Address .... ..
......... Add ..........................
.... Phone No. .............
Nae of Contractor LOtL< At%% ..GCAµ,?........... Address ��OSa2X.(SV.�.,. Q�t;^r��d...nxx* No.
i. Is this property within 300 feet of a tidal wetland? * YGS .,✓
*rF YES, SOUIIM MQN IR MMS PEE IIT MAY BE REQUIRED. .
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
-om property lines. Give street and block neer or description according to deed, and show street names and indicate
nether interior or corner lot.
Ai
0
V1
VIE OF NW Yow,
SS
1NIY O ....... ...... ..
:E.L�f�F1ct•a1...�fltti ..............
being duly sworn, deposes and says that he is the applicant
nme of individual signing contr f)
rve named, L _
is the . ..�,QL�(A.GJ.'7Y,...........
..................
(Contractor, agent, corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
plication; that all statements contained in this application are true to the best of his knowledge and belief; and
it the work will be performed in the manner set forth in the application filed therewith,
)rn to before me this n
....... ...day of
3otary Public .... .xD...�1�
HELENE D.HORNE (Sj nature of Applicant)
Notary Public,State of New York
No.4951364
Qualified in Suffolk Coun
Commission Expires May 2? o pp�
4rcc,-s S,--E Lev41-fn' OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY APP OV D AS NOTED
DATE: B.P.
nv.t
W'rPt-Y BUILDING DE
1301 9 AM 7 0 4%*R THE
FOLLOWING INSPECTIONS:
I FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
0u) �14-CW '1?00� SFn Ya 9OUGH - FRAMING & PWMBING
:NMLATION
I. CONSTRUCTION MUST
RE COMPLETE FOR C.O.
!aJA. CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y
'
DATE CONSTRUCTION & ENERGY
COME& NOT RESPONSIBLE FOR
DFSIGN OR CONSTRUCTION ERRORS
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