HomeMy WebLinkAbout16897-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
ZI6812
No ........
Date Aprzl 22, 1988
THIS CERTIFIES that the buridmg . .A. c c.e.s s. 9 .fy .............................
Locatlon of Property .2.3.05 .L.a.u. re~. W.ay. .......... L..a.ur.e..1 .................
House No Street Hamlet
County Tax Map No 1000 Section 12 I Block 04 Lot 18
Subdivision .................... Fried Map No ...... Lot No ............
conforms substantially to the Apphcatlon for Building Permit heretofore filed in tins office dated
·...A p..r z 1 2 .22 I 988 pursuant to winch Braiding Permit No I 6897 Z
dated ..... Apr£1....22, ..... 1988.... .. was issued, and conforms to all of the requirements
of the applicable prowmons of the law The occupancy for wluch tins certificate is issued is ....
Accessory garage, :tn front yard, as approved by Z.B.A. 7/69.
The certificate ~s issued to . MARION SMITH
................ ..............
of the aforesaid bmlding
Suffolk County Department of Health Approval . ...tI./?. .................................
UNDERWRITERS CERTIFICATE NO ....... N IA
PLUHBERS
CERTIFICATION DATED:
Braiding Inspector
TOWN OF $OUTHOLD
BOILDIN6 DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No_ 1 6'8c)~ Z
Permission is hereby granted to:
...... ~...~s~...~:..%...I./.~ ~ .....
........ ..':. .................
ot premises loc.ted at ..~..?.~.....~.~.. (~....~., ..... B~.......J~..:..L/..: ............
County Tax Map No 1000 Sect,on . J..~,/ . Block ....... ..~....~.. ..... Lot No . ,/. ~ ......
pursuant to opphcation dated .... .~...(' ~' ........... 19.~..~ , and approved by the
Building Inspector.
Building Inspector
Rev 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y, 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR Ink, and submitted m I~aama~a to the Buildmg Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildmgs, property lines, streets, and unusual
natural or topographic featu res.
2. F~nal approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3. Approval of electrical instailation from Board of Fire Underwmters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and ~nstalla-
tions, a certificate of Code comphance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed ate plan requirements where applicable.
B. For existmg buildmgs (prior to April 1957), Non-conforming uses, or buildmgs and "pre-existing"
land uses:
1. Accurate survey of p:Coperty showing all property lines, streets, buildmgs and unusual natural or
topographic features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings.
3. Date of any housmg code or safety inspection of buildmgs or premmes, or other pertment informa-
tion required to prepare a cert~hcate.
C. Fees: Additions $25.00 POOLS $25.00ALTERAT[ON $25.00
1. Certificate of occupancy New Dwelling.$25.(lO, Accessory';$[O.O0 Buszness $50.00
2. Certificate of occupancy on pre-existmg dwe~hng '$ 50.00
3. Cop¥ of cert~ficate of occupancy $ 5.00, over 5 years $]0.00
4.Vacan~ Land C.O. $ 20.00
5.Updated C.O, $ 50.00 Date. A~.r.%], .~5. ,. .1,9.8,8. ..........
New C OhS %ruc t zon ...... Old or Pre-e×lsttng Budding ............ Vacant Land .............
Locat,on of Property ...(~.q. ~ ~[..[~..t~.~..~ .F~;~;~.~;t,~;]~, .[~ ................................
House No, Street Hamlet
Owner or Owners of Property . . .~.QR. ,$Lv~r~ .................................. · .. · ... ·
County Tax Map No. 1000 Section 121 .... Block .. 4 Lot...~.8. .....
Subdlwsion... N/]~I~: .Filed Map No .... Lot No.
Permit No .......... Date of Permit .......... Applicant ..................................
Health Dept. Approval .................., .. Labor Dept. Approval ........................
Underwmters Approval ....................... Plannmg Board Approval .....................
Request for Temporary Certificate ..................... Final Certificate .......... ~. ............
Fee Submitted $.
Construction on above descrlbedApphcantbUddmg ...... and permlt.~, '~' '~'~~ r~eets ali ~icable codes and '~'o'~regulat~°ns' ...............
Rev 1010-78 .~(~ :~q ~'~q ~ON~
FOUNDATION
(lst)
FOUNDATION (2nd)
2.
ROUGH FRAME &
FLUMBING
3.
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMME~TS:
~, FOlt. M NO. I C
T~WN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Approved .............................. , 19 ...... Pern~t No ...... ~ .............
O, pproved
Apphcahon Mo ....................
(Budd,~g Inspector)
APPLICATION FOR BUILDING PERMIT
Dote ~'~ ~/~' /~ .~...
...................................................... 19. .
INSTRUCTIONS
a This opphcat~on must be completely fdled ~n by typewriter or ~n ~nk and submitted m duplicate to the Burld~n,_
Inspector
b Plot plan showing Iocahon of lot and of buddmgs on premfSeS, relationship to adlommg premmes or pubhc streets o,
areas, and gwmg a detaded descr~phon of layout of property must be drown on the dmgrom which ~s part of th~s opphcat~on
c The work covered by th~s apphcot~on may not be commenced before issuance of Bu~ldmg Permit
d Upon approval of this apphcat~on, the Buddmg Inspector wdl ~ssue o Buddmg Permit to the apphcant Such perm.
shall be kept on the premises avmlable for mspechon throughout the progress of the work
e No bu~ldmg shall be occupied or used in whole or m port for any purpose whatever unhl a Certificate of Occupanc.~
shah have been granted by the Buddmg Inspector
APPLICATION IS HEREBY MADE to the Budding Department for the rssuance of a Buddmg Permit pursuant to th-
BuHdmg Zone Ordnance of the Town of Southold, Suffolk County, New York. and other apphcable Laws, Ordnances o,
~egulahons, for the construchon of buddmgs, additions or alteratmns, or for removal or demohhon, as harem descnbed
The apphcont agrees to comply w~th all opphcable laws, ordinances, bu~ldmg code, housmg code, and regulahons
(S,gnature ;f'~p~'l[a~r~t~';'r'~a'~'~'; ,f a corporat,on) .....
(Address of applicant)
State whether applicant ~s owner, lessee, agent, orchftect, engmeer, general contractor, electrician, plumber or builder
Name of owner of premises .......................................................
If apphcant ~s a corporate, s~gnature of duly authorized officer
(Name and t,tle of corporate officer)
1 Locohon of land on which proposed work wdl be done Mop No ...................... Lot No .............
2 State ex~stmg use and occu~ncy of premises and mtended use and occupancy of propos~ construchon
a Ex,st,ng use and occupancy ..................... /.....~.~.~.~Z .......... ~.~.~.~.~.~..~
b Intended use and occupan~ .... ~ ~/ L~ ~/W~ ~ ~ ~
3 Nature of work (check wh[ch agphcable) New Building ............ Addition ....... Alteration .
Removal . Demohhon ........... Otb. er Work (Describe) .........
Repo,r .....
4 Estimated Cost ......................... Fee .... ~2 ..........................................
(to be paid on hhng th~s application)
5 If dwelhng, number of dwelhng units ....... Number of dwelhng umts on each floor .
if garage, number of cars ............
6 If bus~ness, commercial or m~xed occupancy, specify nature and extent of each type of use
7 D~mens~ons of ex~stmg structures, if any Front .............. Rear ............. Depth . ..
Height ... Number of Stones .................................................................
D,mens~ons of same structure with alterations or addmons Front .................... Rear
Depth ... Height ....... Number of Stor~es ..............
Dimensions of entire new construction Front
Height .... J ~..... Number of Stories
s,ze of Jot Front ... z- Rear
9
I0 Date of Purchase .... '"' ' ' /~'~. ~ ~ Nome of ~F~,rrn, er Owner
11 Zoneorused,stnctmwh,chpremmesares,tuated . ~ ' ~ ~) ...... '~"'
12 Does proposed construction wolate any zomng law, ordinance or reflulat~onP
13 Name of ~ner of prem~ses ~'. ~/Z~ ~ ~ /
A~re~ .........................
Name of Arch~t~t ........ Address ................ Phone No
Name of Contractor Address .................. Phone No
PLOT DIAGRAM
Locate clearly and d~st~nctly oil buildings, whether ex~-~tlng or proposed, and indicate all set-bock d~mens~ons fron
properb/ lines Gwe street and block number or descn according to and show street name~ and ind~cat-
whether it~terlor or corner lot
STATE OF NEW YORK, SS ~
COUNW OF ................
· .../~/..L'~. .....'.'.~...~...(.,.?-~ .../~.. .................... being duly sworn, and says that he is the apphcan
(Name of md~wdual slgmng apphcahon)
above named He is the ....... ..~..~/'~'...?....~. ...............................................................
(C~ntractor, agent, corporate ofhcer, etc )
of smd owner or owners, and is duly authorized to perform or have performed the sa~d work and to rn~ke and
th~s apphcahon, that all statements contained ~n th~s apol~cat~on are true to the best of hm knowledge and behef, ant
that the work w~ll be performed ~n the manner set forth m the opphcation filed therewith
Swam to before me th,s ~//,~. ~ , ,. ~, -.J-
....... ....... X .... ,,,:?
~~ Pi-J~'~L ~LO~-g St~tJ e'~ ~e ~ ...............................................................
Notary Pu~ ........ . ~~..~. ..... ~'/~_~'l,y~ S~,,oW, c,t~a~...
TO~V~ OF SOUTHOLD, ,NEW YORK
ACTION OF THE ZO**%q'NG ]~OARD OF AFPEAJLS
ACTION OF T~ ZO~NG BOARD OF APPE~ OF T~ TO~ OF SO~HO~
Appellant
at a meeting of the Zonmg Board of Appeals an A~J~t 2~e
was considered and the aetlon iD-dxcated below was taken on your
( ) Request for varmnce due to lack of access to property
( ) Request /or a special exception under the Zomng Ordmance
tX) Request for a varmnce to the Zonmg Ordinance
( )
the appeal
I SPECIAL EXCEPTION. By resolution of the Beard it m-as determmed that a special exeeptmn ( ) be
~ranted ( ) be denied pursuant to Article Section Subsection paragraph
·., of the Zonm~ Ordmance, and the dec~slon of the Bufldmg Inspector ( ) be reversed ( ) be
2 VARIANCE By resolution of the Board it was determined that
(a) Strict apphcat~on of the Ordinance (would) (would not) produce practical
hardship because
(b) The hardship created (r9 (~s not) unique and (would) (would not) be shared by all properties
ahke m the marnechate vicinity of this property and m the same use chstnct because
(c) The variance (does) (does not) observe the spirit of the Ordinance and (would)
change the character of the chstnct because
(would not)
and therefore, it ~vas further determined that the requeaed variance ( ) be granted ( ) be denied
and that the prewous declsmns of the Braiding Inspector ( ) be confirmed ( } be reversed,
FORM ZB4
ZONING BOARD OF .~PEALS
Betty t~mvill., Seczeta~F
Southold ~u Bo~d of A~X~
Mat:t:Ltuck, ]MM YOrk, lUbJOC~ to the fOlAOvf31g COlidLtLOeis
Examine
Approved~ ~.
Disapproved a/c
FORM NO 1
TOWN OF SOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC
TOWN HALL
NOTIFY
SOUTHOLD, N.Y. 11971
TEL., 765-1802 CALL
MAIL
,19 .z.
, 19~. 3. eerm,t No / do .~-c/. 7
oOakb OF HEA~
3 SETS OF PLANS
SURVEY ..........
FORM .............
TO:
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, w
sets of plans, accurate plot plan to scale. Fee according to schedule
b Plot plan showing location of lot and of buddings on premises, relanonsbap to adjoining premises or pubhc sl
or areas, and g~vmg a detmled description of layout of property must be drawn on the diagram which is part of this
cation.
c. The work covered by this application may not be commenced before issuance of Budding Permit.
d Upon approval of this application, the Building Inspector will issued a Bufldmg Permit to the applicant. Such
shall be kept on the premises available for inspection throughout the work
e. No bmldmg shall be occupied or used in whole or in part for any purpose whatevel unto/a Certificate of Occup
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bu/Idmg Permit pursuant
Building Zone Ordinance of tke Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc
Regulations, for the construction of buddings, additions or alterations, or for removal or demolitaon, as herem desc~
The applicant agrees to comply with all apphcable laws, ordinances, bu,ldmg code, housing code, and regulataons, an
admit authorized inspectors on premises and m bmldmg for necessary inspect~3i~
.: ......
(Si=nature of applicant, or name, if a corporation)
P.O .Box 95.3, .C.uL. chog.ue, NY.. 11.9.3.5
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buff
at~grq~¥.fpr.ap~!l~a~ ...............................
Name of owner of premises . .F~.R~IO.N..S.HI~.H .
(as on the tax roil or latest
If apphcant is a corporation, signature of duly authorized officer. OA;E
N/A
(Name and title of corporate of~cer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No ...........
Plumber's License No ...........D
Other Trade's License No.
Location of land on which proposed work w~ ~e done
(no ~) Laurel .~ay
House Number Street
County Tax Map No I000 Section 121.
Subdivm~on N/.A. ..
(Name)
i,.'. ' ~,,)> ~,.~ .~ 'M FOR THE
1 ~t,tJNU,Xr'I~N ' ,O REQUIRED
¢f)~ POUREO CO,C,
2ROUGH FRAMING S PLUMBING
~INSULAItON
FINAL CONSTRUCTION MOST
8E COMPLETE FOR C O
ALL CONS~CUON SHA~ MEET
~E REGUm~E~ OF ~E N Y.
~A~ ~N~ & ENERGY
~ ~ '~S~ FOR
Mattitu~ ~~ON ~RORS
Hamlet
Block 4 Lot ~8
Filed Map No .. Lot ....
2
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy res~.dence
b Intended use and occupancy ~ar.age .............. ~,.~ ..,,~1;~I ~a
· lr,~,.~.j,.~,.~.rl~m~t~~ - ._
3. Nature of work (check which applicable) New Bmldmg x . Addition .. Alteration
Repmr .... Removal ...... Demohtlon Other Work ....
(Descnpllon)
4 Estimated Cost $1000.00 Fee . 50,00
(to be paid on fihng this application)
5 If dwelhng, number of dwelling units . n/.a Number of dwelling units on each floor .n./a ..
If garage, number of ca~s 2
6 If business, commercml or mixed occupancy, specify nature and extent of each type of use .. n./a ......
7 Dimensions of existing structures, If any Front. .. Rear ......... Depth.
Height ........ Number of Stones ...............
Danenslons of same structure with alterations or additions Front ...... Rear ........
Depth .................. Height ................... Number of Stones ..................
8 Dimensions of enhre new construchon. Front . Rear ........ Depth .......
Height ..... Number of Stones ....................
9 Slzeoflot Front ... Rear
............... Depth ...........
10. Date of Purchase . .1.9.42. ............... ;, .,,Name of Former Owner ............
11. Zone or use dlstrmt in which premises are situated...A. ...................
12 Does proposed construction violate any zomng law, ordinance or regulation ...n9 ...............
13 WS1 lot be regraded . n./.a ...... Will excess fill be removed from premises. Yes Nc
14. Name of Owner of premmes . MAR. ION .S.M:~?[i ' . Addr~° ~ ........ ) Laurel Way? .... Phone No. ........
Name of Architect ........... AddressMa.ttJ. tuck,. N... . Phone No .....
Nmne of Contractor ............. Address ........ Phone No .....
15. Is thzs property located wzthln 300 feet of a tJ. dal wetland? ~Yes ..... No ...g.
*If yes, Southold Town Trustees Permit maybe required.
PLOW DIAGRAM
Locate clearly and distinctly all buddmgs, whether existing or proposed, and. mdicate all set-back dunenslons from
property hnes. Give street and block number or description according to deed, and show street names and ~ndicate whether
interior or comer lot.
STATE OF NEW YORK, ~:,~ · ~ ~
COUNTY OF SUFFOLK S.S t~%~ ~O.,~;
MARK S. KOSAK .... ' ' ~'~d~
.......... ~r~.~ ~n.,~ ~ .... , deposes and says that he is the apphcant
. (Name of lndlvldual. . slgnln=, _c°ntract) ~ 1~0,~,~
above named " ' '" ~l~ll.~--
He ~s3h~ ,, AA~g~~ ~p~licant
' '~g~qa~ ~ 'g'*J~ (Contractor, agent, corporate ofhcer, etc.)
of smd owner or owners, ~d ~s duly authomed to perform or have performed the smd work and to m~e and file t~s
apphcatmn, that ail statements contmned m th~s apphcahon are true to the best of hts knowledge and behef, and that the
work wdl be perfo~ed m the m~ner set forth m the apphcation filed therewith.
Sworn to before me thru
. 15th dayof April 19.~8
Nota*eubhc, S~91~~.~ - .. X County
..................
F~/ ~~;~ (Signature of applicant)