HomeMy WebLinkAbout25649-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26454 Date: 05/17/99
THIS CERTIFIES that the building ADDITION
Location of Property: 1295 THE CRESCENT EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 30 Block 2 Lot 21
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 15, 1999 pursuant to which
Building Permit No. 25649-Z dated MARCH 25, 1999
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 AS APPLIED FOR.
The certificate is issued to WILLIAM M SINGER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ldin Inspector
Rev. 1/81
FORM NO. 3
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)
PERMIT NO. 25649 Z Date MARCH 25 99
Permission is hereby granted to:
WILLIAM M SINGER
360 CENTRAL PARK W APT 6B
NEW YORK,NY 10025
for
CONSTRUCTION OF A DECK ADDITION FOR AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at 1295 THE CRESCENT EAST MARION
County Tax Map No. 473889 Section 030 Block 0002 Lot No. 021
pursuant to application dated MARCH 15 99 and approved by the
Building Inspector.
Fee $ 75.00
Authorized Signature
ORIGINAL
Rev. 2/19/98
TOWN OF SOUTHOLD 3 OCY_
BUILDING
DEPARTMENT
L5
765-1802 /J'�ciwa5
APPLICATION FOR CERTIFICATE OF OCCUPANCY
liation must be filled in by typewriter OR ink and submitted to the buildir
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form)
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildi
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings a
`-'pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applican
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - .25e,.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . . . . . . . . .5-1��f�5 �1. . . . . . . . . . . . . . . . . . . .
New Construction. .. . . . . . .. .
11
. Old Or Pre-existing Building. . . . . . . . . .
Location of Property. . .. .'4y.�. ... . . .. . ns. . . . . . . . .,. . . . ."�[l✓t 511. . . . . . . .
House No. Street
r , Street Hamlet
Onwer or Owners of Property..V.V. ter. . .frt�i�JP�Y►„�ff;+ng . . .. . . . . . , • „ • „ . . . . . .. . . .
J
County Tax Map No 1000, Section. .. . .1.3 0. ..Block. . .QQ R� . . .Lot. . .s.-I . . . . . . . . . .
Subdivision. . . .NUr4-LIZ'" f(tJIA-J�, , ,Filed Map. . . . . . . . . . . .Lot. . ao. . . . . . . . . . .
Permit No.d5t_�- . . .Date Of Permit. . .- /.p ~ gl. . .App1icant.lf"0.4�. .•.fX .
. . .
Health Dept. Approval. . . . . . . .. .. .. . . . . . . . . ... . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . ... . . ... .. . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. ./. . . . . . .
Fee Submitted: $. . R 5.P R. . . . ... . . . . . . .. . . . . .
. . .��•'• f .•. .APPLIC .LI... .. . . . . . . . . . . . . . .
s�o7a2
C o t�aG 5q
BUILDING DEPT.
I
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ J INSU
[ J FRAMING INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
h) A41w�
DATE to INSPECTOR /"''�
i�
70-1302
BUILDING DEPT.
SECTION
[ ] OUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE CHI NEY
REMARKS:
DATE p INSPECT
�3
9LD INSPECTION R19PORT DATE COMMENTS
0 .�
UNDATION OST)
y
UNDATION (2ND) n
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STATE ENERGY _
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ADDITIONAL COEII4ENTS: a
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BOARD Op 11BA1.Tl1 ..... . ..": .....
-Pout NO. 1 3 SILTS w KARS...... ... ....
.
TOWN Or SOUTl101.D SURVL'Y .... .. ... .
.. . .. •;,:.>:«.. . .
BUILDING DRl'ARTFIZNT MUCK ........••:'.. . . . . ..... . . .
'l'OWN 11ALL SLTPTIC PORH ... . ... . . . . . . . ... . .
SOU711OLD, N.Y. 11971
TBI.n 765-1802 NOTIFYted l
CALL X
. .—Z 19.V Perinit No. .............:..................... .
At-4woval.... ...,.
...................................
Disaphruvecl a/c ............... .. .
....................•...••.••••••.•..•• •............
w
(Iknilding Inslioctor)
FiriqQ1 5199 PPLICATTON FOR BUILDING PSIMIT
Date. .. •�•-J. •,19.6• •1•
BLDG.DEPT.
r�F SOUTNOtD INSTRUCTIONS
a. This application oust be canpletely;filled ain by typewriter or in ink and submitted to tile Building Inspector wi
3 sets of. plans,,accurate plot plan to scale. Fee according to sdtedule. sea ar public
b. Plot plan allowing location of lot and of buildings on premises, re Ci be a P ° d PrOmi
agrun� �►ld► is part of
streets or ureas, and Giving a detailed descriptio 'oi layout of property
this ar4Aicotio(i.
nced beFora isauac►ce of Building Fe>rmit.
c. lite work covered by this application may not be crnme
d. Upon approval of tills application, the Wilding Inspector wilt woos s hluild1V9 Peadt to the applicant. Sud'
permit shall be•kept on the Premises available for inspection throaghout the work. vimtwer until a Certificate of
► e. No building shall be occupied or used in whale or in part for a►p► PurPO"
Occupancy shall have been granted by dte lknilding Inspector.
APPi.1CNr1(N 13 j== kmw to the Building Deparumnt for the isauac►ce of a building P404t WrVU"
to the
Isuilding Zone Ordinanp of the Town of Southold, Suffolk County, New York, and other applicable Las, Ordic►ahces or
ite,ulations, for the construction of buildings, additions or alteraCiocw, or for recaoval or demolition, as herein
described. the applicant agrees to ccnVly with all applicable laws, ordinances, building code, hcwt% code, wo
regulations,l and to adroit authorized inspectors ort premises and in building for MQMkiari Inspa'c:io^r.
(Signature of applicant, or&navg, fa corporation)
......"(Mailing address of applicant) ,,,Yy py
State wltetiter applicant is owner, lessee, agent, architect, engineer,'general contractor, electrician, ,plucber or buildit
of o ............
���,Gv�yi ..�i Gey .'. :1.�:.�c�1.Q FM•���.(� ............
Namc wcner of premises rl/..�.E. i M .
(as on tate tax loll or latest decal)
If applicant is a corporation, signature of duly autilorized officer.
(Name anti title of corporate officer)•
Builders License 130.
PluTbera License No.
Electricians License No.
Other Trade's License No. ....................
F.W.e.qu. .
Ivcation of ld on %Mndeich% proposed work will be do . •••••••••••••..•••••.•`...
an
.1s ......... �:................ .aiom . . ...............................
louse tkrber street lia+alet
County Tax Map No. 1000 Section ......tel Q....... Block ....�......... lot ..�1...........
Subdivision PAel.k.fle4orA. .64".,P.4".,' riled flap No. ........:...... lot CIO..........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of PMPosed construction:
a. rxisting•use acid occupancy .. ••••-•�••••••••�••••••••••••••••••.•.••.••••.•
b. Intended use aqd occupancy .IlV.'C. .d.��JL7 :Gf �e 44•• e•• .`�� �..
fl:ttttre of Work (dmcictwtiidt apnticebta)>t Now lluilding .......... Addition ..✓.!.G.�A Ce ion ..;....... �
llepoir ............ Paaaral 66466606:.664 UCditOtttit)n ,........... Other Pork ........................ 6666.
05,
r,fiatltneted Cost ... ,•Ti.orf........ fen. ...:..................... ...... ... .. ....
(to be paid•on f1ling this application)
1f clwmllIng, txniter of dwelling ueita ............ ti<>OW of cAwelling units on each floor ................
1f garage, tvAbe'r of cars 6...6.................................
If business, cmnerclal ormix4occupancy, specify nature and extent of each type of use......................
a ,
Uimenelats of existing structures, If any: irronC....� hear ...fQ,6666... leptlt .. �..........
Might .........16...........6 N►nber of Stories .......QL..............
Dimenslons of mm strudrare with alterations or'additionst I:ront ............... Rear ...............
Depth .... 11eig1tt HAbter of Stories ..........
............ ................... ...
i. nittenslote of entire new construction: Pront ....(. ......:.. hear ....414....... Depth .��..'�... ....
Ikt jOtt ......................... tAniter of Stories .... (C-o L rj � �1�Z xt6,t;�e>d b'y►�
t. Size of Lott Prom 4 hear .... .......... flapth .1.4m ...
1.4...........:....
10. Nita of Purdtese ...1(� ��:........ Name of l:otmer (anter
I1. Zone or use district in�+hid� prentiaea are situated F• l.lfc .� rQ, �. ...........
12. I)xs sed construction violate ✓ Z,..
props ,, rr any Bening lea, ordinance or regulation: fib...' .................
13. Will lot be regraded_ ....UJI ............ Will excess fill be rwaved hon Prem se a YDS NO L•S'
14. :Danes of Owner of prentaea ���..�s�f 4�:... Ackiresa A1�sce�f�N�c•;OSS......
Diane of Arch Itect ... Address 6666.. 6666 .. 6666... Phone Na. ............
r�
� �.}. �t�s �r�teNQck �o4d
Nene of ContrsetoOAtt.Dl>'t►1gRAJIS�1OM g4M!�5...... Ack� lress •SaO b�'e#'� 'li�� .1..•...mone No.S1/0fpj4:#034
IS. Is title property within 300 feet,of a tidal wetlatxl.? * YES .......... �..........
ally YDS, Sam=MM 441US116it3 P1'riM MY M it0f)t11RIT.
PLOT ni'ACRAM
locate clearly and distinctly all buildings, Wbetber existing or proposed, and indicate all set-back dimensions
fran property linea. Give street stxl block Dinner or description according to deed, and she+ street 'n"rea anti Irxlicate
tdtether interior or corner lot.
V
St'/liti ar N1a Yam,
(xA1pN1Y Ur .......................
��............beinll duly stern, delxtses atxl sftys Lhat be in Lite aOpl.icfntc
(Nana of Indivichtal signing contract)
nbrrve unmecl,
IleIn Lite ............... .. .. .................................................I.........................
(Contractor, agent,corporate officer, etc.) ,
of tutid ( mter or owners, aW in duly auLitorlzed to perfonn or have p> rfornml Lhe said: vork mxl to tmke aril file this
n1j)llentidrt; Lhnt all stateumte contained in titin application are true to Lite best of his ktxxwledge etxl belief; tttxl
that the vtrk will be pertbtmecl in the n inner met- north in Lite application filed therewith.
yuorn to before me this
J'5...........day of .c. ............19../...,1..
Notary Public ..:. •�•�,l•`:.••••• •
•(Sip;tunhtre of Appli t)
JOYCE M.WILKINS
Notary Publk,State of New York
No.49522:46,Suffolk Con
Term Expires JUne 12,1>
I
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OWN.OF. SOUtHOLD
SUFFOLK COUNTY; NEW � ,tT .
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'?' '",+,• �+ ', f A UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED' r,.!1•n_ a� •M..4 st1 '
t +.•a;- •. s t. SUR V[Y•It A VIOLATION Or SECTION 7909.00 TIN:,,,� 4\ r�
f NEM YORIt STATE EDUCATION LAW CHICAGO T Raslf►IMII *4�a'}>:* M'•
"� �'•\0'' ' T ••' .R COPIES OF YMIf,EURVE,'NOT RE•RINO TML LANG', ''+ ' N ' t'' t y; Y•"T7 li
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INOICAkTEO.MEREON SMALL*ON ONLY TO 0 A C. T/:L #,• ^.
lg+ .HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT TME PERSON FOR WHOM THE SURVEY IS PRE►AREO, !.'� ' '1 +y. yy i..., +
�+ .AND ON HIS/EHALF TO THE TITLE COMPANY.GOVERN~ L Y A#: : �`ii:{'+'t,f�'.'. •
,fit W NEAREST WATER MAIN MI-! N•SOIIRSt OR WATERTPRIVATE PU/UC MENTAL AGENCY AND LENDING INSTITUTION LIST[0.` '�;:" •� t'" t �7'•:S' �'1 '
MSUPF.CO.TAX MAP DIST.JamaECTION eye /LOCK +• kl,�y.` r I,Yy;•*• Tt ',p:e rl�'I'•I
:. ,• MTNERE AMC NO OWELLIMOV WITHIN 100 f( LOt M[REON,ANO TO TME A9710NL[S Or THE.LENOINO +•i •.Qt� y� y•;•,!pwt>Q',,.;
` + LTO►, NI ►ROFY,'. INSTITUTION.GUARANTEES ARE NOT TRAN/r[RA/L[,. ;�;
'OTNtR THAN TNOSt/NOIMN N[R[ON.' - - `;t ' TO ADDITIONAL INSTIFUTIONS OR SU/SEOUENT...: :'i',• ,1. i ti Ii'; Rr ,k, ', 1. 'q$Oyr-
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tWILL CONFORM TO THE STANDARDS OFTM[89FFOLK000NTTDE►ARTMENT •�1-'• p � .� •�' •`s1 `•f 7 �F '
MOISTANCEf /MOWN HEREON FROM PROPERTY LINES �♦ , ,• r+, 7 �Stri ,7
OF HEALTH E[RVICp,, i '.• 'p „ w, TO EXISTING.STRUCTURES AMC FOR A•SPECIFIC I A, *��.�++�aaa��� I
A/PLICANTI•t.! .,� '•1•.':r .r, PURPOSE AND ARE NOT TO/E USED TO ESTABLISH - ,}`• .:i.' _J• Qi; Ifl
I PROPERTY LINES OR FOR TNt ERECTION OF FENCES.
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SUFFOLK''COUNTYON,JUNEIIIt975,AS;FILE;N0:6264, '2`' ANDL'ANO,SURVE SURVEYOR N N
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BUILDING PERMIT REVIEW CHECK LIST
Applicant/ Date
Owners Name: So! elz- Reviewed:
Architect/ Date
Engineer: Submitted: 3/1'0
SCTM#:
District: 1,000 Section: Block: Z Lot: Z
Project /fit Subdivision �_ _/ � 5
Location: 2�5 0.pSC�nfi / 7` / �ie/en. Name:
Single&separate Required
certtfica ion: (Yes/Nol
Rey. 6 �// Req.
i
Zoning District: [Lot size: Actual: • / [Lot coverage Proposed:
Req- Req.R �/ i e Req-
[Front Yard ! Proposed: 1 [Side Yard/)Sf/.- Propo [Rear Yard Proposed:_]
Project Description: aCK
AGENCY PERMITS Permit
REQUIRED FOR REVIEW Ni A1NO YES Numbe
Suffolk County Health Dept.
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval:
Flood Plane Elevation ???
Flood Zone:
Notes: )I(IA � c(
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Off/(LE, S cr,
�1 APPROVED AS NOTED
C 0 z
OCCUPANCY R � DATE: 3-z�-q9 B.P.# k - e e
USE IS UNLAWFUL FEE: '�`r s BY:
o NOTIFY BUILDING DEPARTMENT AT
WITHOUT CERTIFICATE n
F 765-1802 9 AM TO 4 PM FOR THE
( FOLLOWING INSPECTIONS:
OF OCCUPANCY O
! 1 FOUNDATION - TWO REQUIRED ,A ' SP Tj
1 FOR POURED CONCRETE p
2. ROUGH - FRAMING & PLUIMBMK3 ,
3. INSULATION
4. FINAL - CONSTRUCTION MUST T a�
BE CnMPLETE FOR C.O. wo
ALL CONSTRUCTION SHALL MEET
oQ THE REQUIREMENTS OF THE N.Y.
� 91 Li SX z STATE CONSTRUCTION & ENERGY
Ira CODES. NOT RESPONSIBLE FOR
i DESIGN OR CONSTRUCTION ERRORS
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-T4 No. 1000 - 30 LA)
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