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HomeMy WebLinkAbout17123-z ~ M FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ..,Z-.17037 Date .....June 27, ]988 THIS CERTIFIES that the building , , ,ACCESSORY Location of Property 1.0 Waterview Drive Southold N.Y. House No. Street ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Hamlet County Tax Map No. 1000 Section ...78.......Block .........Lot 9.......... . Subdivision ...............................Filed Map No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated May 16, ]988 17123 Z pursuant to which Building Pennit No. . dated ,June 1 T, 1 988 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 . DETACHED ACCESSORY SHED AS APPLIED FOR Tlie certificate is issued to . , , ,JOHN & MARIA C . BELANC IC owner, !s`.3:~r~Ai~rl'z~ . of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO N/A PLUMBERS CERTIFICATION DATED: N/A Y Building Insp for Rov. x/81 n~oaat xo. s 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 o 01712 3 Z Date 19.t~~ Permission ere~y anted ~ ~ ? .~~ya...~~` ro ..SZi..C~... ..:..4~4~..~ ~ .1~/..c.^.~~K r, ~ - ......9.~C.....r of premises located at .....t~id...~ .......E~~:'~f/.~ County Tax Map No. 1000 Section .........../....fJ...... Block ........,7......... Dort No.....~r-~...~.......... pursuant to application doted ~~1.~? 19.~f,~ and approved by the Building Inspector. ~ ~ Fee $...1..`?..r a~. . . ildin for Rev. 6/30/80 . ~ ~ C~ ff c Cl~~l~,ly~~ : } ~ FORM NO. 6 ` ~ ~ ~ ~ TOWN OF SOUTHOLD 2 ~ I ~ ~ Building Department ~~iii Town Hall Southold, N.Y. 11971 ~I-DC.. D~:rr. TowN of squ~ru~i_r,_„ , ~ 765 - 1802 ~ Y" APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~s...~ 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 installation 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 applicable. 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: Additions $25.00 PO~LTERATION $25.00 1.Certlficateofo000pancy New Dwelling $25.00, ccessory~$10.0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 S'/7~E?~ 3. Copy of certificate of occupancy $ 5.00, over 5 years $ 10.00 4.Vacant Land C.O. $ 20.00 5.Uodated C.O. $ 50.00 Date ~a~al.~$~............'. NewConstruction,,,,,,OldorPre-existingB1uilding Vacant Land Location of Property ...............W~td^Vl~!~V'IVe.................JOC.~-'~-~,Q~~ House No. rn Street Hamlet Owner or Owners of Property 5©~'I.n. ,4. ! :!A!:1~ , ,C,., ~e~ Q~1~. J,~, ~7Q! County Tax Map No. 1000 Section ....I. Y......... Block 7, , , , , , , , , , Lot ...Q~. Subdivision .................................Filed Map No. ..........Lot No. . Permit No. d ~ a,~„ Date of Permit ~.I.i 71~ .Applicant .~Rnle~ . l-:, IS~.4'C . Health Dept. Approval .......~I :.............Labor Dept. Approval ,~11,'J;~, , , Underwriters Approval ......N .............Planning Board Approval . JY.' . Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ ..~p~ ~d Construction on above described building and per t meets all ap Ii,Ea~ble c[o~des~ and regulations. Applicant .....t7L:~ vlt.~'•~` . Rev. 10-10-78 b~e~e,- 4 ~ 3 Cod ?~03'1 FORM N0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..,Z-17036 June 27, 198.8.......... Date THIS CERTIFIES that the building ADDITION Location of Property 1.0 Waterview Drive Southold, N.Y. House No Street .......................Hamlet ' County Tax Map No. 1000 Section ? $.......Block ...........Lot ? 9........... . Subdivision ...............................Filed n4ap No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated May 16, ]988 17123 Z pursuant to which Building Permit No. . dated June 17 , 1 988 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 TO EXISTING ONE FAMILY DWELLING The certificate is issued to , , JONN & MARIA G. BELANCIC owner. /~sa~~Xt~~~1~ X . of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO......... , N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspecto Rov, 7/81 ~,e I FORM NO. 6 JUN ~ ~ TOWN OF SOUTHOLD Building Department Town Hall 6LDG. DEPT. Southold, N.Y. 11971 TOydN OF SOUTt10LD 765 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ 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 equa0. 3. Approval of electrical installation 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 applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pYOperty 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 inspe on-of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: AddiCio s $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling Accessory-$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00 , over 5 years $ 10.0 0 4. Vacant Land C.O. $ 20.00 rr S.Updated C.O. $ 50.00 Date NewConstruction,,,,,,OldorPre-existingBu1ilding Vacant Land Location of Property ..~ID ..............~Q.Ier~{~~~j.~Y'IU2..........~4(-4~~A~C~...... House No. I Street Ham/et Owner or Owners of Property ..~Ohh.°~:ma~'10...C:~~~/~Q,Y~C,~~,,,,,,,,,,,,q,,,,,,,,,,,, County Tax Map No. 1000 Section g..... , . Block [ Lot . a. / . Subdivision .................................Filed Map No. ..........Lot No. . Permit No. .0.~71.°~.~ Date of Permit .~~~7.~$~.Applicant.~ahlel„1; ;,,1';i.$~.h,er„_,,,,, Health Dept. Approval ............Labor Dept. Approval . . Underwriters Approval N I ..............Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ ..aS; . Construction on above described building and ermit meets a applicable c~~odes and regulations. Applicant ~ ..~'~:::'.~'+v.U . Rev. 10-10-78 C,o ~ 1'10 `'ai. f 1~~23 ~ tos-isoa BuiLDING DEPT. ~r~sPEC°rioN [ ]FOUNDATION iST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [NAL REMARKS: D r ~C . DATE INSPECTOR i E ~ I f ~ ~ ' I i I, i - ~ ~ -r_'""'_'-- -_,__-'-'--T- ~ ~ P ~ \ ~ 1 ~ ~ - ~ N F ~ o ~ ~ ~ ~ ~ ~ fi e ~ 1 ~ ~ .,v N ~ ~ ~ ~ I "oz~` w i ~ -~y - - Q Ga ~ ~ ~ i \ ~0. , ~ ~ ~S ! ~ ~ I ~ ~ k ~t ~ 'h S ° ~ y_, Q o ! } ~ ~ i~ =1ELD I.:~vP C:iUN ~~UA. TE i;Oa~iMENT° ~ ~ ~ ~ w 3 H _ H FOUIJDATION (1st) ~b FOUNDATIOtJ (2nd) ~ ~ z. - - - z fi 0 ROUGH FRAME & PLUMBING ~yV1 H 3. ~ m IIJSULATION PER N. Y. 'j STATE ENERGY CODE x 4 . ~ cn ~ H C FIiJAL ~ ~e ~ r ~ ADDITIONAL COMMENTS: "7~'~ ~ \ x ro\ H `\2 ~ V H p ~'t~\ z . ~ r H . d C*1 b H R o ~ m, o ~ I , V \ / ~ c~ ~ e1C ~ ~ ~ ~ ~ ~ a ~'--.'r't.~-~r V V ~ i I i i ~ ~ ~ ~ I ~ ~ ~ ~ ~ 1 - ~ ~ ~ n ~ ~ o' ~ I ~ ~ ~ i ~ ~ , i ~ ~ ~ ~ i ~ ~ ~ ~ , i I i ~ ~ ~ ~ ~ I ~ o ' ~ i ~ ~ I i ~ ! ~ ! ~ - y`t" SUFF. GO. HEALTH DEPT. APPROVAL N. Si. NO.!°" t'I& f ~ r~ ~ . ~ ~ $U,F~'OLK COUN2Y HEALTI~'D~PAKTMEII~,T MN ~ 1YlA,<ala, t'~; ._,'.^~1C;ic., jj / 0 6E~b A DA`~~F~IIk: H. D. REI'. # (P SD-/~~~^' 'n x:52 , , ~ NO. t;±.~[:~"~f~,N.J. ;,~~?'{~q°;" The sewage disposal and water supply ~ , 1,;~ ~;,t_ x;_;.iv5,~ facilitios for this location 1:.FVe been ~ inspocted by this deparC>uent grid fougd fir, ~ ~f, s9s~ lq,~~.. :~q , to be satis;t.G~ory. rF;: n 11.,5?fi , P,AS~; Chie f E1 g( Qne ~ erv cas T ~t„ ~ r r"`~ ' 1 .t S ~ r f N f f b. < f**rw swaw.wh~ ~ ~ it. 4 I~-~.;~ z ~ ~>_~c l;; .1 t jY Z IN N 3- /'1 . .Cl A:. oT. ~ ! ~ j x x r"' _ i ~ V ~ ~ R1 p". N ~ sl ~ J i < ~ ~;'Ot ul' t. ~ 35'9' ii ~ 1 l f!1 ~,~;;~q r~. ~ ~ I;; i~ SCALE: r~~~e ~ m r ~ = irw~ ~1 p" < fem. ~ ry ~ ~ F ZO~.q I ~ ~ ~ Q = Stska mss' n h ' i ~ ~ ,.,___w,_., . • O , l7 ~~,{i:', Well ?w, '!i C7 I S r' ~ E I i UNAU7HORIZEO AL7ERATlON OR ADDRiaR{ . ~;5"~t ~l ~ ? ~ TO THIS SURVEY IS A VIOLATION Of SECTION 7409 OF THE NEW YORK STATE , J"'^,,.-.. I fOUCATION LAW. r ` ' ~ ~ - I COPIES OF TNIB SURWY MAP NOi BEARING s~ ~ •I ' W iNE LAND SUI:VEYOR'S IN&p ECAL OR sT ~ ~~,lu'J I EMBOSSED SLAT SNAtI NOY 6E CONBIDERFA t;~~'.- ~ ~ TO B[ A VAIID i:UE CGPY. r'-~'~'y ~ ~ E'er I ~ GUARANTEES INpICAT[D NERCON SIfAiL RUN .,,,I'hM a . C V[/"4Y/ti \ t~^ `„fit) ONLY i0 THE 11,SUT i0(: 4/tNM THE SURVEY l I IS PREEA(Rp, A.ttl U,. HiS OJiAIF TO THE ~jtt~ TITEE COMPANY, G:?V~.;:: VALN~AE AGENCY AND . ;4 ~ LENDING IY,S4iTUiiJH 45fw N.NEON, AND CgRTIF. i0 TNF ASSIGNEES OF iHF LEtIDING INBi4 iUGON. GUARANTEES ARE WOi TMMSFERABlf f f0 ADDIiEUNAI INSTITU11UN5 O~LSU~SFi,GYfsaL.~ owNFRS. STAMP ~~;5 ~ s._,.~I W t^ SEAL ~~y`~~Q,~~F' f~~1.,.IJr~~t.:l.,.l 1• u.lUrnntB~x~~t 1't~tlx?~ Rr,w:rECUTE T`i~'ka - ' M ~,JQi ~~I. 11I:PUY,Yi1C43 CLF.O"J 'FA.E I'YB~yH+:~ (T~~rN.t~Fi~T~~ t. 1 w RODERdCK VAN TUYL. P. G. ~"ttUfN of :SGU-r~NOt.D , N .Y. r - LIC. LAND SURy, YOR~.(iRK 8!'y: y~Y / BURR. G0. DEPY.OF WEALTM BERVIC5Y.4 BTA'CEMBNT OP IM'(Ait+lT-E i ' „I.~ FOR APPROVAL OF GONBTRUCTION ONLY N ,T . Ntiller Placo, , , ~ - ,'kn~ ^,;~~m~{ ~ TM6 WATER SUPPLY AND 6~1NAi1'~K ~~,,~"D-n~" `J DIBPOBJIL BYBTHM6 FOR TMIS R9RSJ- ` DATE: c(o 5/F DENCE WILL CONFORM TO TNB 6'!a ~.7a~ ~,~L,. _ ` ;~.~4' I - BTANDAR08 OF SUFFOLK C0. DN*P'T, REAR H. B. REP. NO.: M _ yy OF HEALTH- BERVIC~6S. Ya ,,1 APPROVED: ' ar. l6) „t~ 1T APPL,tCANT kvK/T'.. ~ ,a t33§~~ly . - s r ,u~N ~ D r~~a~! BOARD OF HEALTH 3 SETS OF PLANS U'..I~.... FORM NO. 1 SURVEY ~•.K........ . TOWN OF SOUTHOLD CHECK ...~..~'.y./ . I!ll BUILDING DEPARTMENT SEPTIC FORM ' nl.nr. r.~~<°r. TOWN HALL ~Tt)inrR~ c?s r:,rrEertlC3l.o SOUTHOLD, N.Y. 11971 NOTIFY r2 e~ y TEL.: 765-1802 CALL pp MAIL T0: a4 Examined . 19!~V~ ,lp~ ' ' Approved . 19 b~Permit No.~,~~~.j ~C./Ak /I 9 Disapproved a/c ~ r~ ~Y,~/-tif e.. p (B Id~ s e tor) ,APPLICATION FOR BUILDING PERMIT ~lj Date ...°.'.•$y 19~g 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 Depaztment 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 cod housing co e, d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. - vim""'] (Signature of appl~or name, if a corporation).. . V~? , ` Y ,(Mailing address of applicant) l/~~yj' fiek"i~tr"igt~r: it1 v?V,i^1.4t,";X:~ .a ; ' ~yyn,~o~~ ~ ~ ' State whethe~ ~'ct~~P4iteB;'~i~rsr+~~l~$t+~~~ita ,architect, engineer, general contractor, electrician, plumber or builder: ~ 9'1,t ~'i 341tdr~tr ~r ~R . . Name of owner d~1 p~~'~s . ~ ~gx}•tp• -;:a .,,~;..t...... . ~ ~ ~v'trt' _ , (as on the tax roll or latest deed) If applicant is a corporation 4sigriature vif`duly authorized officer. t ,~z3-~.~ _ ~ (Name:art8l~t~h7e A4f ©4frp`oYafe"officer) Builder'sLicetiseN'ot:``~~?..~~.•~~••~••••••••• Plumber's License No . . Electrician's License No . . Other Trade's License No . . I. Location of landpon which proposjIe'~d~~ work will be d~olne . . House Number Strecce//t ~-7 Hamlet County Tax Map No. 1000 Section ~ 4....... Block Lot . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~-1??C eta t~~~~~` b. Intended use and occupancy .'EAR • /~X~o 3. Napure of work check whiRempplicable): New Building Addition ,r, ratio Re air 'oval . Demolition , er >~.t/~,l . q (Description) 4. Estimated Cost ..,(i,,~ 0.6.. . Fee , . (to be paid on filing this application) 5. If dwelling, number of dwelling, units Number of dwelling units on each floor .:-r............ . 'dfgarage,numberofcars g ~d occupancy, specify nature and extent of each type of use . . . 6 Hei htness, commercial or Nubs, if any: Front ...'v.'`f Rear'S~f'.... , , De th :34: , , . 7. Dimensions of existin structur ber of Stories . ~ P . p ith alCerations or additions: Front . /it. Rear .yy . „imYh sio~~ f same structure w Height , , , , , , , , , , , , , , , , , , , Number of Stories . ~ , . " 8. E;emh~sions of entire new c Num ction: Front ~ , . , Rear Depth d g ber of Stories . .....A ...............p...:.: .............,....'r i, 9. Size of lot: Front ~Qd • ..7...........: Rear ~D, P De th .JS.~O.. , 10. Date of Purchase 9 7 ± • . • Name of Former Owner . I1. Zone or use district in which premises are situated.,,,t~'BFI,Zt~h,J,-1,s.1,t;,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 12. Does proposed construction violate any zoning law, ordinance or regulation: . ,!d'd . g • • • • • • • , . • .........Will excess fill be removed from premises: Yes No 13• NameooP Architec p . • d . • • 'ip~!~!NG/G , , , , ,Address S/.~ .~7p. ~~'R.a ST..... Phone No ~.°!.".8627,-,>,J .VO?Tit 9EWbEN n~, s p7 . • ~ ................:Address ..........,......~YlPhona No. Name of Contractorremr~e Fl~r/J~ie Address 20.:SOKNP.$D..6'~!°.T'. Phone No. !/.7,7.-46.?4:.. . PLOT DIAGRAM Locate cleazly 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. OCCUPANCY OR ~ USE IS ~ DATE: ~aR rr ~ s UNLAWFUL FEE: ~ ~ ~ . WITHOUT CERTIFICATE ~U"~"° DE«- 786.180Y g qM ~ 4 PM lrOR THE OF OCCUPANCY FoLLD>~l~ T. FOUNDAT1pN 1YY0lIE~t?NIEp FOR POURED CONd1ETE 2. ROUpN . fRAM1N0 • M,AJIIASNi1p 3• INSULATION Q. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT$ OF 1T~IE N,y, STATE CONSTRUCTION S ENERQY CODES. NOT RESPONSIBLE FOp DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S.S COUN"CY OP . • • • • • • • • • g • • • . • . • . • being duly sworn, deposes and says that he is the applicant (Name of individual si ni~g contract) above named. (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 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 1:o before me this y ...,...,.,19 tt~=~K~ da of Notary Public, ~...:~..rl.°:e-, County HELEN K DE VOE' ' ' ' C l!C! _~~2~'~~ . ~N~4707876 folk~~y b~ r~y~ (Signature of applicant) Term Expires March 30,19._