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HomeMy WebLinkAbout17067-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217351 Date SEPT. 26, 1988 THIS CERTIFIES that the building GARAGE ADDITION Location of Property 460 PVT. RD. #8 EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 23 Block O1 Lot 3.2 Subdivision XX Filed Map No. XX Lot No. XX conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 1988 pursuant to which Building Permit No. 170672 dated JUNE 6 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 GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to SEYMOUR LEVINE AND WIFE. (owner, j of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1f81 noses xo. a 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) N ~ 0170 6 7 Z Date 190.. Permission is he by granted t . f a . l . ~ - . . . . ~ ......~%~9c~~.....,,....~.~..~~..........~...-~1-.. ~~S- to . . . .K.,~?:...........G~~~'1~.............~~~~a....... ....G ....~....o. v at premises located at ....~~.4~r.Q.........J.~..~~~..~ County Tax Map No. 1000 Section Block aL~ot No...~r...r~ pursuant to application dated 19CJ..d~ and approved by the Building Inspector. Q eJ Fee ~ .......~'f•~~• •ul~din.... ....tor...... i~ Rev. 6/30/80 ~ ~ ~ ~ 0 d ~ ~3 FORM NO. 6 SEP TOWN OF SOUTHOLD Building Department r Town Hall p~UG. ,ir_pT. Southold, N.Y. 11971 TOWR Or S~>U~'h10~.~?,,,,,~. a 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~~r~~ 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 instal{ation 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 applicab{e. 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: , 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 $ 5 0.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 l(~~~.~~^ j~~ S.Updated C.O. $ 50.00 Date l . NewConstruction_,,,,_OldorPre-existingBuildDDing Vacant Land Location of Property ~ ...............1.~. !`li'..~Q.... , , .....~~f ~ / rifd/~ House No. Sheet Hamlet Owner or Owners of Property .-a-- y... ~ . County Tax Map No. 1000 Section ~ Block Lot . Subdivision .................................Filed Map No. ..........Lot No. . Permit No. ~~~~Q. Date of Permit `'J~.~o.~Applicant f~LCf~II S ~O'r?! , Health Dept. Approval ........................Labor Dept. Approval . , , , . Underwriters Approval ........................Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . / cN Fee Submitted $ . °?S . Construction on above described building and mit meets a plicable codes and regulations. Applicant . . neg. io~~oae COya~/;735% A~a 7~~~ :1::LD IL .--~..U;i ~jJA: OOtKMENT° \ m ~ ~ ~ -u ~ 1. i. ~ _ HV H MY` FoutJDnTION (~st) FOUNDATIOtJ (2nd) _ _ - e _ - 2 . ~ ,v o ROUGH FRAME ~ -PLUMBING C{ H C~j 3 . ca IIJSULATIOP! PER N. Y. y STATE ENERGY CODE ~ ~r ~ ~cn~\ 4 . ~ S y doll FIidAL i~ eo ~C ADDITIOPIAL COMMENTS: x~ . ~ 0 C -i, x \ .n H \ 77 H N O ' x H~ Z b m -v H l 7~11~ ~ 765.1802 BUILDING DEPT. INSPECTIAN [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION [ ]FRAMING [ INAL REMARKS: C C-~ DATE ~ ~ INSPECTOR ~ „ a. /~~7 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN TION [ ]FRAMING [ INAL REMARKS: .3 h DATE INSPECTOR ~ 7d~ 7 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T (1 ROUGH PLBG, [ ~ FOUNDATION 2ND [ ]INSULATION [~RAMING (]FINAL RE RKS: V DATE ` aa" INSPECTOR . . - r- ~ _ - - - t - -f - - - - - - Oh13"~~~..TI6V r- ~ ~ - ~ ~ ~ ~ -r - - ~ ~ _ - ~ ; ~ r- - _ ~ ~ ~ 19 ~ C - - sy xuxyo.~,0~+ ~ ! ~ r- ~ i ~ - - - s n~' ~~Et~re"~'`c-~, _ ~ ~ ~ ~ ~~is r~~ , - - - ~ - =tit i~l.'>~/~ ~ ~ ~ ~ - ~wr~~ - - c~ur-s~. rim - - ~ ~ ~ ~a r ~ r-~ = - ~ ; ~ - ~ ~ - y i ~ i t ~/_'c r-- ~ ?ZUt?fr ~~~-~G~~.~.af"~IarC>C 4 - _ _ _ ~ _ ~ Via. , ' - - _ ~ ~ ~ `9 ~ ~ i I ~ ~r ~ r - i - I AY7+~ I ~ - r- - - - - - ~ ~-L' e ~ - ~ - - -°'--T~~ ~ ~~~~`F ° - - i ~ - - ~ r ~ - - - & ~ j - ~ ~iN~A~NFUL - -r- - - ~ ~ - - ~ - r - - --r ' ~ , ~ ~ - - i ~ ~ i --r-- ~ i I~ ~ i d BOARD OF HEALTH 3 SETS OF PLANS Q•.~'- - • • Q 198 FORM NO. 1 SURVEY b:l~.. . V TOWN OF SOUTHOLD CHECK ~'~``?y~ • • - - ~.~~_.m••, ~t_ BUILDING DEPARTMENT SEPTIC FORM et_oc;. r~e~) TOWN HALL 70WIV OF .?OUYFI't"_L> NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL MAIL T0: rQ,p(~- Examined .lP/. 19 Approved ~i 19 ~ermit No............111 Disapproved a/c /7a i (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ f Q~ Date 19 . ' 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 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 Regulations, for the construction of buildings, additions or alterations, or far removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, build' g code, hou ' code, nd regulations, and to admit authorized'iri'spectors on premises and in building for necessary ins c ons. ~~C~~~ .f ( gnature o. a p icant, or me, ~f a corporation) ~ o~~,~ X1,2 C~ie~ o G~~- (Mailing address of applicant) r,. , State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . Name of owner of premises . L L'~~~~' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOL COUNTY LICENSED Builder's License No. ~,'~.~5...~I... . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. House Number Street r Hamlet ~j3~~--~y~ County Tax Map No. 1000 Section Block ! Lot .{rs.~.~-=f-~ . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of pre/~mises and intende/d~use and occupancy of proposed construction: a. Existing use and occupancy .J.~~..~L.~.... P`.G..S'. ' ti ~ , b. Intended use and occupancy 1.~~j....~~.G S G~.c,~GLt~2•- r - , - ~ ~ ,;.7} ( p licable New Buildin Addition tion 3 P g Altera~`^ . Nature of work check which a oval . Demolition , Other )}!ork . Repur Rem', till G~ crlpS' o ) 4. Estimated Cost S~`o ~ Fee , ....r.~.;. . . I (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 Q/-~,~ . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front Rear , . Depth . g Dimensrons'of same structuNu`mber of Stories . ' ith alterations or additions: Front Rear . P 8'. Imensions of entire new const~ ~ Height ~ Number of Stories . ' j~uction: Front ~Q....... Rear ...Q~......... Depth 3©............ Hei ht Nutn , ,»ze of lot: Front ,/po ~ ber of Stories ~ . 9. ~ Rear ~9.~ Depth .~.~,7............... . 10. Date of Purchase 1 Name of Former Owner . 11. 'Lone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation: .v . 13. Will lot be regraded /1!v . ; • • • . • . ...........Will excess fill be removed fro enyises: No 14. Name of Owner of p emises .L,C vl':'~~..... Address ~ 41E~^'/it ~"~io erNo.7J.'/.' , ?a?, , , , C~~~.. ......Address /~0.9~!'. Cy7Cfl~clE ..Phone No.7~'Y.'.7o7~ 15. ICs thisCproperty located " '~••Address ....:..............Phone No. ,within 300 feet of a tidal wetlandl *Yes No *:Cf yes, Southold Town Trustees Permit ma be reqqu~ired. PLO DIAGKAM Locate clearly and distinctly all„ buIldings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block',number or description according to deed, and show street names and indicate whether interior or corner lot. AP R VED AS NO'iEp 3° 9S~ DATE: fc~,~~~ B.P. # 70 (a 7~ 0'/~~/¢/L~c„ FEE: d pO ~ NOTIFY UI ING DEPA" pryr AT 76fi-1802 9 AM TO 4 PM FOR THE ~ FOLLOWING INSPECTIONS: I /i=+ra! t. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE `Y ('Roposc-b 2• ROUGH . FRAMING ~ PLUMBING w 6fh+AGE i 3. INSULATION N+= 4. FINAL - CONSTRUCTION MUST 1 BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. CODES. C NOT RR SPON BLE FOR DESIGN OR CONSTRUCTION ERRORS Sao ~ I COUNTY F . sTATB o~~L,%~.n... ~ s.s • • ~Z~ • . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~~JJ~t He is the ....~.~!J!::~L~.`... I (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 amd 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 . ~.~.......day oaf . ~?1. 19 Notary Public, . V4.~..... County , ' 0178 S 3ufloYlkCounTQrk . Term Expires March 30,19,. (Signature of applicant) ,..-~a.,~iv„S::e,it,,; Jav: `JL,yY x(o.R-+-+v' w _ '4• N ~ *~sp , ' © ~ ;t fig. .,,r''' ~ ' error N 1t. A: ~ . M' ~ ~ y • ~~u' e?,~;~-,;~>=~5~ : a1 --r_, ~I,~ Off'" ~~'.,~G~.~" r~ T" Y ;ri r' , , . , ~rYt i+ ~,/y I+~~, ~ , .;.,;Y,;f,;~,:,~. ~ ~ ~ ~ l~ ~r wh , . A 4.. ~i ' f • r Y •o 4. ' ox ~r , } o,,, ~ y Q 1 M O - ,9I ~;a,~ ~ - - _ .~'Jy`.. i'',:~ @. 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