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HomeMy WebLinkAbout17080-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inapectox Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26911 Date: 02/04/00 THIS CERTIFIES that the building ADDITION Location of Property: CRESCENT AVE. FISHERS ISLAND (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 6 Block 6 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 10, 1988 pursuant to which Building Permit No. 17080-Z dated JUNE 8, 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 & INSTALLATION OF NEW WINDOWS TO EXISTING STRUCTURE AS APPLIED FOR. The certificate is issued to AMERICAN LEGION POST #1045 FI (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A C uthorized Signature Rev. 1/81 R r'° FOEM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 0 ~ 17 ~ 8 ~ Z DateG96.r:1r~^~......Gl 19. af~ Permission is hereby granted to: .~..!y1-~ at premises located of ......./t.~ Z/.~1.liXl.,t.........~~%~!~/~........... County Tax Map No. 1000 Section Block ....//.4~~~...(>...~/Lot No........~..~........ pursuant to application dated ......r.F~....., 19.61. ,i, and approved by the Building Inspector. . Fee d Building Inspector Rev. 6/30/80 ~ r ~ UULLU L1Vb UGY N1l1 C1L1Vl I ~ ~ I TOWN HALL ~ 765-1802 ~J (~~1 71999 ~ 'J APPLICATION FOR CERTIFICATE OF OCCUPANCY - 7C:•,~•, Th~~~~:pli ation must be filled in by typewriter OR ink and submitted to the bi ....~.-"ins 4 'th the following: for new building or new use: 1. Final survey of-property with accurate location of all buildings, property streets, and unusual natural or topographic Features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system cone less than 2/10 of 1~ lead. 5. Commercial building, industrial building, multiple residences and similar t and installations, a certificate of Code Compliance from architect or engir responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prier tc April 9, 1957) non-conforming uses, or buildi "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building a unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the app If a Certificate of Occupancy is denied, the Building Inspector shall state reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.0 Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $2 Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - .25~, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date J.........A New Construction.......~.^~..(O~ldjOr~,~jPre-exis~t*i,~ng Building............. Location of Property ~~?.:::':~?4:T~...1..,1.~'Nr"~.~a0'.....~!'~T1~~:~'~ House No. Street Hamlet ' ~ Onwer or Owners of Property..C':1]?~F~~. ~1...//.~~......,Q~...... County Tax Map No 1000, Section.............Block......p.........Lot..~.~......... Subdivision ....................................Filed Map............Lot....``.~~.,,,,...~~.... , Permit No ................Date Of Permit................Applicant~'me!'1(a~.~il~:~ Health Dept. Approval ..........................Underwriters Approval.........JJJJJJ...... planning Board Approval Request for: Temporary Certifica,~te........... Final Certicate..~...... Fee Submitted: ~?~..~........~~-~`n,~ ~PPLICANT ~tYlmA~cr..r~ C~~.S~'fs`~ P~~ ~t0~ c©-~a~91) w A _'"'".gr oc v~ 0 $e m ~ g w LL__~.___ ~ . J a IL 2 .J ~Z" ~ ~ {Qj ~~2 ~ c.~Ox'~ vf0 ~ ~ z~ a ~VU,o~z~ ~ ~r ~ ~Op~~~~ o ~~V~~~Z i Q ~°f~c s~'~u~i~nzz a~Y I ~~~~'7QU~~ a 444 H a 4 D hq'. NMet QI-V1 V~Q cc ~ ~ ~ M i 1 ~ r--~ r3 V e`-_ F ~ ,1 ' I-v ''ti. v 3 3 h C° ~ ~ ~ v o - - - X. I ~ ~o ~ r_. v q /X' 3~ ~ -Y ~n° ~ ~ r:~, w~y . ' ~ gut, ay ~ Y eW' my , +®~~m~+' e~ `va:C.W N?`eM N~tifh.. ~ V . ~"..n r'; , IIUARD OF HEALTH ~ 3 SETS OF PLANS ~FORDA,?'~p, 1 SURVEY • • . TOWN OFSOUTHOLD CHECK BUILDING CEPARTMENT SEPTIC FoRri • • • . • • TOWi" HALL NOTIFY • ~OUTH(ILL. N.Y. 11971 CALL TEL.: i i5-1802 MAIL T0: Examined~j/g~~~..., 19 Approved~~{~~~~ 19 Permit NoQ./, .7 Q, . ~o~ Disapproved a/c . (Building;nspector) APPLICATICNFOn~'°~%it.isiNiif-`::Riff"ii'i p~y~ i Date /.o....., 19~iff INSTRti~TIONS a. This application must be completely filled in by type~~~riter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schNtiule. 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 propet~ty must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be com. enced before issuance of Building Permit. d. Upon approval of this application, the Building Inspect, r will issued a Building Pe.-mit to the applicant. Such permit shall be kept on the premises available for inspection throughu t the work. e. No building shall be occupied or used in whole or in p t for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. is APPLICATION IS HEREBY MADE to the Building Dep.u#ment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Cg"unty, 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, ordi ances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for ~e~ssary inspections. E (Signuttire of 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. .d.~Ala!1.~:~ Name of owner of premises . ~ YY3.~.Y.1. L.'s?. t>1 ...l~F'.:~t .~`.T-t.....~0.5T...lQ .~..Jr . (a on the tax roll or latest deed) If applicant is a corporation, signature f duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. Plumber's License No. . Electrician's License No. ~ . Other Trade's License No. . . I. Location of land on which proposed work will be done . . CYeS~,~;. S,~YeeZ" House Number Street Hanilet County Tax Map No. 1000 Section ~ •G• • . • . • • . Block ....Q..~r........... Lot ~ . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises and intended lose and occupancy of proposed construction: a. Existing use and occupancy ~r>^~k;eL't ~~~'7"~ ~'........I` V.!h.~TG,(J.?? [:•~.?7.~!,`t..... . b. Intended use and occupancy t ~,,,i 3. Nal:ure of work (check which applicable): New Building , Alteration • • • • Addition l`~: Repmr Removal Dl;molition , .............Other 1Vork . iI ~ (Description) ' Q~ 4. Estimated Cost . ,ter. q~.a.... . Fee f!... . (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number ofcazs 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing stnictures, if any: Front , . , r:...... Rear Depth . Height Number of Stories . . Dimensions of same structure with alterations or additions: Front Rear . Depth :Height .........Number of Stories . 8. Dimensions of entire new construction: Front . , Rear ...............Depth . Height Number of Stories ~ . 9. Size of lot: Front l:; Reat ~ Depth . 10. Date of Purchase Name of Former Owner i I . Zone or us., district in which premises are situated ....:..i . 1:2. Does proposed construction vrolate any zoning law, ordinance or regulation : . 13. Will lot be'regraded ..:r...... • ~ . . . Nill excess fill be removed from premises: Yes No 14. Name of Owner of premises , ~ Ads ress Phone No............... . Name of Contractor ~ • • • ' ' • ' ' ' ' • • • • Ad ress ...................Phone No..... . ame o Arc itect . • • • , • • • • ~ • • • • , Ad ress ....:..............Phone No.l . 15. Is this property located w thin 300 feet of a tidal wetland? *Yes No *If yes, Southold Town Trustees Permit may be:~re uired, PLOT DIAGI~Aivi Locate clearly and distinctly all buildings, whether exis ng or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description ac ording to deed, and show street names and indicate whether interior or corner lot. ! I I ~ . ~ ~^^a ^p ~ ,y.,•A .a,~,a . n _ $ A v ~ i 53 ~ . `i'~,.9 ' STATE OF NEW YORK, S S ~ , • !~l!'i..~~~'`~'-<-~- ~ ~ • • • • . , . 'being duly sworn, deposes and says that he is the applicant CO "NTY OFName of mdrvidual si ninl ( g g contracU above named. He is the Contractor a ent ( g 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 contairfed 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 ~ k .......day of . ~T~; ~ 19g ~ 'Votary 1?ublic,~S~:3'~':?`~ ~ County . ~ ~or~ (Signature of applicant)