Loading...
HomeMy WebLinkAbout27956-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28178 Date: 01/18/02 TRIS CERTIFIES that the building ADDITION TO ACCESSORY Location of Property: 419 SIXTH AVE GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 42 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 10, 2001 pursuant to which Building Permit No. 27956-Z dated DECEMBER 10, 2001 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 ADDITION TO EXISTING ACCESSORY SHED AS APPLIED FOR. The certificate is issued to GREGORY S & JOHANNA WILLIAMS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 58606H 01/16/02 PLUMBERS CERTIFICATION DATED N/A Authorized Sign re 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. 27956 Z Date DECEMBER 10, 2001 Permission is hereby granted to : GREGORY S WILLIAMS 419 SIXTH AVE GREENPORT,NY 11944 for ADDITIONS AND ALTERATIONS TO AN EXISTING SHED AS APPLIED FOR at premises located at 419 SIXTH AVE GREENPORT County Tax Map No. 473889 Section 042 Block 0001 Lot No. 008 pursuant to application dated DECEMBER 10, 2001 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 7 Form No.6 h 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 2012 ,E 4r TOWN HALL 765-1802 RI_7C. CE"T APPLICATION FOR CERTIFICATE OF OCC This application must be filled in by typewriter or ink and submitted to the Building Department 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 I%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. �� O New Construction: ✓ Old or Pre-existing Building: (check one) Location of Property: `7l .l ( 6 f Wy e e�/ o/'` House No. Street Hamlet Owner or Owners of Property: RL,< O l Suffolk County Tax Map No 1000, Section Block Lot Subdivision / Filed Map. Lot: Permit No. b Date of Permit. Z O( Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Tempo Certificate Final Certificate: (check one) Fee Submitted: $ p cant Signature �Rc. G 0 �S Electrical Inspection Certificate Date Electrical Inspection Service, Inc. AMI/cation# 1/16/02 375 Dunton Avenue 58606 H East Patchogue, New York 11772 (631)286-6642 Issued to: Williams Street: 419 6th Ave Village: Greenport Zip:11944 Town:Southold Section: Block: Lot: Introduced by:Above Lk.# was examined and found to be in comp/lance with the Alanona/E/ectr/ca/Code ❑ Commercial El NV Defects ❑ Pool ❑1st Floor 91Indoor ❑Basement ❑ Hot Tub © Residential ❑ Def. Garage ❑Attic ❑2nd Floor ❑Outdoor ❑ Addition ❑Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 3 5 2 4 1 Dishwasher Washer/Amp Dryer/Amp Oven Range/Amp Garbage Disposal Furnace Oil Gas Circulator Smoke Detector Bell Transformer Meter Amps Phase UG/OH Telephone Television Carbon Monoxide ❑/ ❑ Other Equipment. Building Permit# SHED Hugo S. Surdi President Rough Inspection: 12/17/01 Inspector: Quentin Reynolds Final Inspection: 1/15/02 Inspector: Quentin Reynolds This cerdflcate must not be altered in any manner.Inspectors may be identified by their credentials 11 1 11111 ( Illfll ua•UIIilll Q f `U'1 ,..1 11�. y C IdYll1C IV — .��rt J 4 D 1p„N Set Null ill 01,101150 00 _f Poet On title Nis o'lo°c 4 Fence r �'• y 81�' 4 FRAME d o ,oS11EV y Gil W� a c:> O T 38 a ,Shed 117"el. 1 C) -y FRAME 0o Cn j a �o West L�'ne o-f l he• lncorp-Village al'• Greer,pnrt 1 Cn Cyd00 f. 46.1) o �u ry 101 STY ry N A68 SH ' GJ i Y J �a GJ h1; DWLG30, �_ r• i o~ Cj CSF rti• T m I0 -91-11 9i A i cue �R 1 � 1 Post 040" •) i 50 Posl r z•s ( s .40 I w6f o;;«w 1'50,00 o.lE/W� 46ledpe 1'w b r_. Set StK Fd.aim S R)14 C-40 { . V I/4rT; +1.419 V ff !+!E V 1 SUR VEY OF PROPERTY Surveyed by Situated .at S_ M/TH fVUIY6 6REENPORT _ (Portly in the In corp. Vi llogej �!( Prol'E��Stonal Land Surve or\ TOWN OF SOUT�I�LD 120 MEOPORD AVE. y SUFFOLK COUNTY PATCHOGuE.N.Y. NEW YORK Phone 975,3192 4 I SCA EE:1"•25' UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS 1..i. ' A VIOLATION OF SECTION 7201 OF THE.NEW YORK STATE kM I Survey uaronteed to: ! CATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE 1 gg I �+f BE CONES ERED TONKEDAL 00 VALID TRUE S$SE0COPYSCE CERTIFICATIONS TIONS THE TITLE GUARAcNTEE COMPANY 'T'128h5S'7 INDICATED HEREON SNAIL RUN ONLY TO THE PERSON FOR WHOM YV ONNE WENGLER 1 THE SURVEY 13 PREPARED,AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY, AND LENDING I11411TOTION RALPH M. W E NGLEI? LISTED HEREON, AND TO THE ASSIGNEES OF TILE LEND. !NC INSTITITION. CERTIFICATIONS ARE, NOT TRANSFERABLE - - - .—TO A0017IONAL INSTITUTIONS OR SU ISEOUENTpOVNERS.M DATES SURVEYED:-MARCH 24,198/ WEN6l.1 ER r..wwrnus••rr.w,.,.,,,• .._.._._..__.... 1 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING [ FINAL [ ] FIRE E & CHIMNEY REM RKAf 6 DATE INSPECTO IW9f'RCTI0H •REPORT ]DATE aQas saa=-arscxw-s-_.asa=_.= "�`Saaaaataaxz aaaaaa J IOMATION ( !3T) TDATION �(20D) ROUGH FRAME PLUMBING reULMON PER N. T.- .STATS WMGY COM AA I FutAL LDDI[TIaN" cONNaRTS o TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDWG DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT Check Septic Form N.Y.S.D.E.C. Trustees Examined iL eo 20 oL Contact: Approved 1 /o ,2044— Mail to: Disapproved a/c Phone: Buildin APPLICATION FOR BUILDING PERMIT BLDG.OTOM OF UT Date h 2001 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 waterways. 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 a 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 what-so-ever until a Certificate of Occupancy is issued 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 inspections. (Si tore of applicarn or name,if a corporation) �0 C 141 ue 61 (Mailing address of ipplican) State whether applicant is owner, lessee,agent, architect, engineer, general contractor, electrician,plumber or.builder 0�m-Cr Name of owner of premises Cf'eq0, Fvtn a (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Lo a 'on of 1 on w 'ch proposed work will be done: In House Number Street Hamlet p County Tax Map No. 1000 Section Block Lot 3 4 Subdivision Filed Map No. Lot (Name) 2. State existing use arid.occupancy of 'ses and intended use and occupancy of proposed construction:- a. Existing use and occupancy ek 4! relLsince- b. Intended use and occupancy 3. Nature of work_(check which applicable):New Building ) Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures,if any: Front ( Ream . _(!U.;ih,-, Height Number of Stories Dimensions of same structure with alterations or additions: Front 1. Rear , Depth Height Number of Sto 2 C.L71 8. Dimensions of entire new construction: Front Rear_ ?Depth Height Z� Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owners e� 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: A/0 13.Will lot be re-graded /I IO Will excess fill be removed from premises: YES NO 14.Names of Owner of premises/ Wf l 4ktS Address Je Phone No. V21-2-IM Name.of Architect Address Phone No Name of Contractor Irk--s AddressY Phone No: 7?" 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF } being duly sworn, deposes and says that(s)he is the applicant (Nan#of' vidual siKug contract //above e 1 (S)He is the ontractor,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 application; that all statements contained 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. dayof 20,� / � Notary Public A�4ignature of Applicant For � � Oxy �6I`0c, a 4VX4- ora Yw Qsfht d! t a,c�; i' i�ilfliG A P VED AS NOTED DATE• B.P.#=2�� 01Xb� NOTIFY BUILDING DEPARTMENT AT fly 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING & INSUrTION / CONSTRUCTION MUST A FINA t� T� a- BE Cl*PCE FOR C.0 .IS _Ufjj.I `F4bL ALL COIN�STRUCTION $ M dt9Ya � THE REQU) S�E N.Y. OiC �IC -` STATES���QQ 0 ERGY CODE R FOR DESIGN goppa ��to