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HomeMy WebLinkAbout16961-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-17079 Date July 12, 1988 THIS CERTIFIES that the building ACCE S SORY Location ep t 8205 Peconic Bay Blvd , Laurel, N Y o__roper.y ............................ · ........................ :.: ........ House No. Street Hamlet County Tax Map No. 1000 Section ! 26 .Block 09 .Lot 16 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Hay !, 1988 pursuant to which Building Permit No. 1696 I Z dated ...H...ay..1. !: i .?.8..8 ........... 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 ......... ACCESSORY STORAGE BUILDING AS APPLIED FOR Tile certificate is issued to PAUL & THERESA GADIGIAN ..................... /o¥.'~',.,'~i~,'x'~i~'x' .................... 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. 1/81 FO~M' NO. B TO~VN OF BUILDING DEPARTMENT TO~VN HALL $OUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB ] 696t z Permission is hereby granted to: ......... ............ l.~:..=......~...~ ...... .9,.~..~~ ............. .,..~. ,. i ol -~ -- ~.t premises located at ......... ~ .... .~ ................... County Tax Map No. I000 Section ...... )..e.a%..(R ........ Block ...... .(~.?J. ........Lot No....I...~. ............... pursuant to oppJicati0n dated ......... ..~..%...~ ....................... , I9..'~..~, and appr0v~ by the Building Inspector. uilding Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall So~971 APPLICATION FOR CERTIFICATE Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with 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, a certificate 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 pzoperty 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 POOLS $25.00 ALTERATION $25.00 New Dwelling $25.00, ~ Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.v oa= o.o. 20.00 5.Updated C.O. $ 50.00 Date ........................ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..7~.~% ~?;lO~.'~, PC.~..I~.),/~'. .~-.~.-~ Hou~ No. Street Owner or Owners of Property . . '... -. County Tax Map No. 1000 Section ... ~ ~;¢ ....... Block .... ~ .......... Lot.. J.~ ........... Subdivision ................................. Filed Map No ........... Lot No. ,, ............ Permit No.. J .~. ?..~ 1.. Date of Permit .......... Applicant .P~..~ .~......~..~..-.~../.~/~. ". ....... Health Dept. Approval ....................... iLabor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Tern po_r,a ry Ce rtificate ...................... Final Certificate ....................... Fee Submitted $. .' ..... Construction on above ~'~~nd~e~ mee~ ~ described building and meet all applicable codes and regulations. - Applicant . ..; .m ........................... Rev. 10-10-78 gso?o FOUNDATION FOUNDATION (2nd) ROUGH FRAME & .FLUMBING e INSULATION PER N. STATE ENERGY CQDE FINAL ADDITIONAL COMMENTS'. 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [ J FOUNDATION 2ND £ ] INSULATION ]FRAMING ~]~ FINAL REMARKS:~)~ ~'~, (~,~q ~ ~-'~ Or , DATE INSPECTOR 'TO~/~ 01= ~OUTt~ LD ' BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORW ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL ................ MAIL TO: '-.0..-30 19~9~.. Permit No.}t~c~b[ ~ · Approved .... .)72..O.tt..., ........... ................................ ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 scaie. 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 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 inspe~fis. ~, ~c~/-~,,,,-~z..". r.-.7.~: ............. .,. ........ · ' ' ' : - ~ (Signatu~p!ol~¢aff~m:name, if-a coriSbmtion) ' ' ' :i : ' ' .... State whether ~p~o!i ant ~s ownerj lesse~'; agent,, architect, engineer, general3qo:ntractor, electncmA,,.IMumber oi' builder. Name of owner or premises .. i .Z :..,'.. ............ : ....... (as on the tax roll or latest d, eed!5 ~ ' If applicant is a corporation, signature of 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... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section /~ & Block .~i Lot ~ f~, Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ................................................... . Repmr .............. Remoyal .............. Demoht,on .... ~ .......... ~' 'e~]] ........... i -. Ilttll )escrip~ion) 4. Est,mated Cost .... ~-. .... '. ~ ........................ Fee.... ............ ~...~.... t~..~. ........... i " (to be~_._~s ap~ lication) 5. If dwelling, number of dwelling ~nits..~ ...... Numbe. r of dwelling uriit~'B}P~a~.~o~r-.* .~.....--:w.. ....... If garage, number of cars ..... i ......... '..___________________~..~).~..~.~. I../).~...~ ~i~.~..~../?~.....&'..f..~...~.~..~ .. .............. 6. If business, Commercial or mixedi occupancy, specify nature and eXtent of each type of use . .3T~.~.,Of/~..~. ~ .~../~..... 7. D~menmons of ex,sting structures,, if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions'of same structure wi h alterations or additions: Front ................. Rear .................. Depth ............. He t ~r~-,...~==l~ . ........ ,gh ...................... Number of Stones... f .................. Dimensions of entire new constn .ction: Front . ./..o..~ .... . ..... Rear . .1..o/. ........ Depth . .~..t ........... Height ~/' /.'41~,~! ~. ~. Num of Stories 9. Size of lot: Front .................... ,Rear ...... . ....... ' ......... Depth ...................... 10. Date of Purchase .......... : ................. Name of Former Owner ...~.~.-,~.~.~...~. ............ 1 1. Zone or use district in which pre: nises are situated ....................................... ............ 12 Does proposed construction violhte any zoning, law ordinance or regulation: 13. Will lot be regraded ... t~.O.: . ~ .............. Will excess fill~be removed from premises: Yes No 14. Name of Owner of premises ~.4~ .-. ~i .,~4). ).~/.'~.~ i... Address /.~..~'..a~.~.Q.t/..Sj./y..q/~ Phone No..~.t~, r3.~. Name of Architect . j ~ ..... ,~.,,, .... ~.~ ........ Address ................... Phone No ..... ~. ......~[... Nme of Contractor~...' .i~.. ~/;~ddress /~J1/£5. g~.j~/~. Phone No. 7~.. ~.' .~.~ .~.D. .... 15. Is this property located ~fthfn 300 feet of a tidal wetland? *Yes ..... No ~... *If yes, Southold Town TruStees Permit maybe reouired. ! PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. ' '8. NOTIFY BUILDING OEPAflTMENT AT 765-1802 g AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I I. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE I 2, ROUGH · FRAMING & PLUMBING 3. INSULATION I 4, FINAl. CONSTRUCTION MUST 6E COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEEr THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY STATE OF NEW YORK, . s,.s ...................... .......... , .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyl 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 ~et forth in the application filed therewith. Sworn to before me this ]~otary Public, State of New ¥orJ{ No. 31-4727507 /~// (Signature of applicant) Oualified in ~ew York County Commission ix~!res'~opL SURVEY OF PROPERTY AT MATITTUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. ~000 - ~ 2 6 09 SCALE I"= 30' DEC. 3l, 1987 AREA = 18,803.78 3Q. FT. OR O. 4317 AC. P' P. o. eox eoe ! i CERTIFIED TO: ,,~ CITIBANK~ N.A. AND / OR ITS SUCCESSORS AND ASSIGNS "~ \ PAUL GAD/GAN THERESA M. GAD/GAN \ 'e. 0 \ ~repored in occordance with the minimum standards for titJe surveys as established b/ .~ 0 \ the L.I.A.L.S. and approved and adopted ', for such use by The Hew York State Land Title Association.