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HomeMy WebLinkAbout17006-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17582 Date DECEMBER 8~ 1988 THIS CERTIFIES that the building DJ)DITION Location of Property 1025 SOUNDVIEW AVENUE EXTENSION House No. Street County Tax Map No. 1000 Section 50 Block 2 Subdivision Filed Map No. SOUTHOLD, N.Y. Hamlet Lot 12 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1988 pursuant to which Building Permit No. Z-t7006 dated MAY 17, 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to D. FRANCIS & GAIL LEGHART (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~ALTH APPROV~kL N/A UNDERWRITERS CERTIFICATE NO. N-043412 - NOVEMBER 2, 1988 PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 ~OW'M' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 017006 Z Permission is hereby grant, ed to: // /? -- County Tax Map No. 1000 Section ........................ Block ...................... Lot No ......................... pursuant to application dated ........................................................ , 19 ........ , and approved by the Building Inspector. Fee $.~~.. Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY T--- 85 JOHN STREET, NEW YORK. NEW YORK 10038 ~1~ Jp¢ication ~o. on,lie THIS CE~IFIES ~T ~. ~.EGHART, 1.025 SOUNI)~I'EW AV~; ~;XT., SO~'~HOLD, ~ ex~min~ on .nd~ound to be in compliance with t~e r~ui~me~ RXTURIS RANOlS OVENS RXTU~ SWITCHIS 7 5 :7 S E R V I ¢ E C~ CC, COND. (; & S CONTRACI'OI{ ~OY; 2]5 SOIJTHOL1), NY, ll. 971 This certificate mud hot be manner; return to th offic~ of the ~rd if incorm~ P~r their cre~ntiak. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, NoY. 11971 765 - 1802 _JL APPLICATION FOR CERTIFICATE OF OCCUPANCY ..................................... Instructions A. This application must be filled in typewriter OR ink, and submitted i / to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all bui[dings, property [ines, streets, and unusual natural or topographic features. 2.FinaJ 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 p~operty 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: A, dditions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory '$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.C. $ 20.00 5.Updated C.C. $ 50 00 Date ................... NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. LocationofProperW /~.~..~. 30ON'~VJ~-IV' AVE ExT, ~Tt~L~ ~, y Hou~ No, Street -- ~ . ..... Owner or Owners of Property .... ~, ~Ct~ /et ................. .......... .......... County Tax Map No. 1000 Section ...... ~ ...... Block ............... Lot ............. Subdivision .............................. Filed Map No ........... Lot No .............. Permit No.[.~..0(~).(0.. Date of Permit .......... Applicant ................... Health Dept. Approval ........................ Labor Dept. Approval .................... Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Certificate ..................... Final Certificate .................... Fee Submitted $ ............................. Construction on.above described building an~ ~plicab~codes and regulations. Appl cant . .~.~ t~..~.. :.-/~ .... =., ....... , ............ Rev. 10-10-78 e~. 3~,.?to ~ rc o ~ 135 ~ 'OUNDATION ( 2nd 1 .FLUMBING/ ~NSULATION FERN./. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 2'65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS/ULATiON FRAMING [//,]'FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: [ ] FOUNDATION 2ND [i/J/INSULATION [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. Ii,FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL RrMARKS: /____O~L/~ o~/ ~~ // / TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the foil, owing reasons. /--VAn_ application for Certificate of Occupancy /is not on file. /~//NO Underwriters Certificate~on-file. /~/The check is(outdate~n file.~J~~ /_-/ No lIealth Dept. Approval on file. /_--/ No final ins,pection has been made. Please contact our office on this matter. Thank you for your cooperation. Bui]dJ. ng Permit t~ / ~ ~ ~ Z Building Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT. INSPECTION [ '~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :~ND [ ] INSULATION []FRAMING []FINAL REMARKS: ~~ DATE f ~ HAZEN AND SAWYER, P.c. ENGINEERS /:'z,,4 N ' '!0 o [ i ~ HAZEN AND SAWYER,E,~,NEE,,$,~.c. Date .......................... of ................ By ....................... Chkd .................... ~ HAZEN AND SAWYER, P.C. 765~ 1 ~ 9 AM Date .......................... of ................ By ....................... Chkd ................ ~... Job ................................................... FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTIIOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ .../~ 7..~.....~.~...~, PLaY'SE TAKE NOTICE tlu~t your application dateS... ~ ................ 19 ~. for pemdt to constn~ct ~.. . '. · 'at .~~ .~ ................ rtouse mo. ~ Street I-tom~t County Tax MapNo. l O00Section ... ............ Block ..... .,.......~ Lot .. .... /,~., Subdivlqon ................. Filed Map No ................. Lot No ........ is returned herewith and disapproved on the lbllowing grouRds .... ; ........ ~ ¢.~/ .... ...... -. . FonM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTIIOLD, N.Y. NOTICE OF DISAPPROVAL ../.~ ~..~.....~.~...,~,~, PLEASE TAKE No'rICE that 5,our application dated....'~.,~../..~. ................ 19 ~. for permit to construct ~.. . '. at ~ ...Block ..... ~. .Lot ...... '~.~.. County Tax Map No. 1000 Section . .' ................ Subdiviqon ................. Filed Map No ................. Lot No .................. ,~ ,.~,,,,,-n~,,, ,,er,.,,,,,,,, .:,nd d,~=,,,,ro',,e,, o,', ,:,,,.' ,'o,lo,',,i,,~ ,,,,'o,.,,,d~ ~::"...'~. ?-~......./~ .".'?/. .... · l Jmldin~f, nspector C,. I , ! FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ................. 19 ... Approved ................ , 19... Permit No ...... , ....I ' Disapproved a/c ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT I~eceived ........... Date .................. , 19... INSTRUCTIONS a. Tiffs 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 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 Iff building for neces~, c~_,___~.~.~a~4,,,~_,,&.ff State wl~ether applicant is owne~, lessee, agent, architect, engineer, general contractor, eiectrician, plumbe~ or builder. Name of owner of premises ..... .~..d. jt~vsd ..... ~..~q ~6Xv~.. ....................................... (is on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..i.c/, 0 .~. J.. ~. T .......... 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 Hamlet County Tax Map No. 1000 Section ....... ~ ....... Block . . . ..~. ............ Lot./~. .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy oxf proposed construction: a Existing use and occupancy ...... .~. ~-C5~./.d E~t. ~ (~: .... [ .-~'/. l ¢ .................... b. Intended use and occupancy ..... .~ tr-a ~ ..................... 3. Nature 0fwork (check which applicable): New Building .......... Addition ...q-~...... Alteration ........ ;... Repair .............. Removal .............. Demolition ........... ~... Other Work ................ (Description) 4. Estimated Cost .... (O~.(~9.C). ......................... . Fee ......... . i ............................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unit~ on each floor ................ If garage, number of cars ............................................ : ................... - ......... 6. If business, commercial or mixed occupancy, specify nature and extent of each tyne of use ...................... 7. Dimensions of existing structures, if any: Front..~....~ ....... Rear . ~ :'. ...... Depth..~ .... He~g t . . . ~ ....... Number of Stones .... ~. ............ ~,~..~ ...... ' ............. ~ ........... Dimensions of same structure with alterations or additions Front . ~...-~... . I ..... Rear .. ~-?. ~ .... Depth .... ~.~/.~. ............. Height ..... j,..~. ......... Nu'n~,~ ;f'Stories...-~.. i .'~,~... 8. Dimensions o~,entire new construction: Front ,,~' ......... Rear ~'~'.. i · · Depth [..~. . . Height .C~ I Number of Stories ~ ~, '. '"" .... ~ ........ i' ' 9. Size (~£1ot: Front ..... .~.~. .............. Rear..: t.'./~'~ ............. Depth .... 't,~' ./."~...l.' ........ 10 Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ......................... : ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... : ......................... 13. Will lot be regraded ..... ~. .................... Will excess fill be removed from premises: Yes N~ 14. Name of Owner of premises . C':-....~-,.ec~.."~.... Address ... IO. ~.~.~o',~dPhone No. 77(> Name of Architect .................. t .......... Address .......... ! .... Phone No. f. ............. Name of Contractor ./~-~ . ~}.~..~.,1~,~.~/. Address lO~.¢~t~C~'! .J~.. Phone No ~ ~.~..~.~.O/ 15. Is this property located withinl.00 feet of a tidal ~L~J_~r. ~'¥~ ..... ~q'o' ..~.: ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, end, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and sho~ street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............................................................. ~ .... ~ ....i' ~ ................ (Contractor, agent, corporate officer, etc.)., of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and file this application; that all statements contained in this application are true to the best of hi~! l~nowledge 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 of ..... ~ .......... 19... Notary Public, ..... ~...~.'...J~)..~.' v .~..~e~..... County 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Approved .... , 19 . . . Permit No ............ Disapproved a/c ..................................... :,. .............................. ....... /( B~l'm g Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH . -- . SURVEY........... CHECK .......... SEPTIC FORM ............. : NOTIFY .~.¢3 .[ 7~ J~ CALL ........... 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 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 buildkng for necessa7 ~.~ ~ ~.. /(Signature of appli~nt, or name, if a corporation) (Mailing fiddress of applicant) State whet~ applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........f' . ........ ........................... . ........................................ Name of owner of premises ~.., ~F-~.~... ~... ·...~: ./~..I: .Z.. · · ./'~. ~'/d~i'/'? .~. ................ (as on the tax rb{l or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUS,T BE SUFFOLK COUNTY LICENSED Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..Iaaa(.... . .,. or; ...... ....... . ............ House Number Street Hamlet County Tax Map No. 1000 Section ........ ~ ..... Block .... ~>~ ............ Lot .... /~,~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occt~,pancy of proposed construction: a. Exist ng use and occupancy ,...~..~..~..[. /~. .......... ' 031: ............................... b. Intended use and occupancy .... ,.~tL.L/T)-~ ..................................................... 3. Nature of work (check which applicable): New Building .... ' . Addition . ~ ........ Alteration . .4-~..'. .... pal ' D liti ' Oth k Re r ............. Removal .. ·, ........ cmo on ........ ' ' ' · · 'i · · ·er Wot ............... i (Description) 4. Estimated Cost ...,/~ ~0 ............................. Fee .......... i ............................ · (to be!paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling uniis on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of eaqh_tyte of use ................... 7. Dimensions (~f~existing structures, if any: Front...'~.,,A6~.. ........ Rear . .~ .! ....... Depth..~.~. .......... Height ~gb( ..... Number of Stories .~ . D.epth ..... ~#v.... ............. .Height... c~.~>,~ ........... mumb~ 9f~Stories ... r~ .... ; .......... -~-&. D~mensmns of,~J~re new construchon: Front .... ~b'...' ..... Rear ....c~.f. ....... Depth .//t~ ........... Height ..... cl.. ........ Number of Stories-. ...... /, ................. ! ......................... 9. S~ize of lot: Front . .j,q./~: ./~,,~;, ......... Rear...'..~, ~ ..... //)ep~ .~..~.. ,~. .............. 10. ~Jate ofPurchas~ ./[<'./~.'g./~/.~ ............ .,~. Name of,Forrper Owner (-;qT.'/~-~F//:'~. ~.~-~.00~ ...... 11. Zone or use district in which premises are situated ./~-~/~.~-t.~_,/ ........... : ............................ 12. Does proposed construction viglate any zoning law, ordinance or regulation: .~.O ......................... 13. Will lot be regraded ....... fi~//,~ ................. Will excess fill be remove:d from premises: ~ Yes ('~No'~ 14. Name ~f ~wner ~f premisesb~an~i` (.~`~-.~a~. ~-Address ~a~.. `5dv~i~.~.~ ~ne N~.~&~-~ ~ ~ Name of Architect ........... , .............. Address ............. eoA~ [~& P~ne N~.. 'ti45 .......... Nmne of Contractor ~0 J~ra[. .............. Address/0~.~ra~[~..~.. ~o. ~ ..... ~.2q ~:.~1 15. Is this property located within 300 feet of a tidal wetland? *Yes .... No ..~. · If yes, Southold Town Trustees Permit mayb~ required. PLO~ DIAG~M Locate clearly ~d distinctly ~1 bu~d~gs, whether existing or proposed, and, in~dicate ~1 set-back dimensions from property lines. Give street and block number,or desc~ption accord~g to deed, and sho~ street names and indicate whether intefiororcornerlot. ~L ~l~ t~ $ ~1~o~ zoi-,g ' NEW YORK--' STATE OF i COUNTY OF ..... '/rg' ' '~ ..... :/S.S , ~, , ... .~./~'.~ L ~L~.'~..I~C...""" beingduly sworn, deposesand says that he is the applicantl i ' (Name of individual signingi~/)ntract) .... '.above named. I He is the ' ' ' '(Contractor, a.,[gL~h corporate officer, etc.), of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained h~ this application are true to the best of hi~ 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 ...... .........