HomeMy WebLinkAbout23366-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24597 Date SEPTEMBER 6, 1996
THIS CERTIFIES that the building ACCESSORY
Location of Property 1205 HOBARD ROAD SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 64 Block 2 Lot 8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 5, 1996 pursuant to which
Building Permit No. 23366-Z dated APRIL 12, 1996
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 ONE CAR GARAGE AS APPLIED FOR.
The certificate is issued to THOMAS TYNAN, JR.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL INSPECTION CERT. #12935 - JULY 30, 1996
PLUMBERS CERTIFICATION DATED N/A
Bui ding Insp for
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)
N 2 23366 Z Date ............... -a
r,�l........, 19. ..l�Q..
Permission Is hereby grcu2ed to: -�
. .. ....16-I'l...............................
....... ��.......t1V-.1/....a .(7
Xy ` r
..........C.... .. ....... .. .�. ............ .......... l�' �. ...-...............
..................................................................................................................................................................
..................................................................................................................................................................
at premises located at...........�eza.;5 .... ..../.4.x..�....................................
ESQ ./� .............I......................... ............
.... .......
County Tax Map No, 1000 Section ....... . ... Block.........c;C........... Lot No. „ .........................
pursuant to application dated .................. .......... 19.... �..., and approved by the
Building Inspect
Fee $.,;;170.... :�'.....
.......... .. ...............�......... ....
Building Inspe r
Rev. 6/30/80
Adb-�j��
eo S'q(i,, tG I TOlv1I OF SOUTHOLD y
3U= TNG DEP RT)CE-N-T
TOWN HALL p-�
765-1302
BLDG.DEBT.
TOWN OF SOUTHOLD
,_PDL=CT=ON FOR.CERT= IC2T= OF OCCIJP^uvC`'
I. This application must De ==;led ii1 DST t?TL7eTv'r?ter OF, inn and S:lbmitted to the Duildilg
iSDector with the fo11CWi_1g: =or new building or -new use:
1 . Final Survey of property with accurate location of all buildings, prODerty lines,
streets, and unusual natural or topographic features.
2. Final Approval .rom Realth Dept_ of water supply and sewerage-disposal(S-9 form) .
3. Approval of electrical installation from Board of Fl_e Underwriters.
4. Sworn statement from plumber certifying that the Solder used in System Contains
less than 2/10 of 10 lead.
Commercial building, /=ndustr=al bu''dial-, multiple residences and similar buildings
and installations, a' cartificate of Code Compliance from architect or engineer
responsible for the building.
s 6.. Submit Planning Board approval of completed site plan requirements-
3. For e—_�sting buildings (prior to April 9, 1957) non-conforming uses, or buildings and
.pre-existing" land uses:
Accurate Survey of proDert, showing all D_ rOpertV lines, StTeetS,. Jlli1d'ng and
unusual natural or topograpnic features.
2. A DrODerly Combfeted apDllcation and a consent to inSDect signed by the aDDlicant-
T_ a Certi�fcate or CCcuDancy is denied, the 3uild4ng nspectOr Snal1 State the
reasons therefor in 'wT;t�1g to the applicant.
Fees
1 . Certificate or Occupancy - New dwelling 325.00, additions to dwelling 525.00,
�terarions to dwelling $25.00, Swimming pool 525.00, :accessory building $25.00,
Additions to accessory building $25.00. Businesses 550.00.
2. Certificate of Occupancy on Pre-existing Building - 5100.00
3. Copy of Certificate of .Occupancy - _ _251Z.
4. Updated Certificate of Occupancy - 550-00
5. Temporary Certificate of OCC1DanCV - Residential 515.00, Commercial S15.00
2,Date . . . . . . . . . . . . . . . . . . . . . . . . .
ieTa Construct=on. . . . . . . . . .,.e Old Or ?-e-e_Yisting Building. . . . . . . . . . . . _. . . .
.ocazion of Property. . . ... ` .t�®- ... . . . . . . . ..
. . . _ . . . . . -. :c. .:. . . . . . . . . .
House No. Street Hamlet
?nwer or Owners of Property. . . . . ..Q 'V. . . . . . . . . . . . . . . . . . . . .: . . . . . . . . . . . . . . . . . .
:ounty Tax Map No 1000, Section. . . . . . . . . .Block. . . .... . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . .
ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . iled 2AaD. . U. . . . .Lot. . . .l �.� .( '. . . . . . . .
aa rr rr {� r
ermit VO Date O��lS(J.VJ. . i Perini t. .� .�i . . .ADDlicant. .�,C
Health Debt. Approval. . . . . 1... . . . . . . . . . . . . . . . . .Under-ari tars approval_ . . . . ; . . . . . . . . . . . . . .
tannin- Board Approval. . . .AJ . . _ . . .
eQL1eSt .Or: Tem?Orar'7 Certi=Kate. . . . . . . . . . . __nal Cert=Cata. . . .'I- _
ee Submitted S . . . . . . . . . . _ . . .
:::::::: :::: :::::: :: `:::::: ::
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::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::..................:::
ERVICE NG
::::::::::: ::::::::::::::::::::::::::::::::::::::::: N S
:::::-:::::::: :::::: ::::::::::::::: IZf:::AL INSPECT ..... ..._. ................. . _.._............................................
: :::::::::::::::::::::::::: : :. ... . E1�C `::::: ':::::::::::::::::::::::::::::::: :.
:::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.:.. ............................ ........ .. . ...................,... .................................................
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...................................... . :. _::_.,......:,.. .. ::::::::::::...:::::::::::::::::::.:.4P...................................
_.....................................DATE.. ......... .. .. :::::::::::::::::::::::::::::::::....::::::::::::: :::......_...........
__.....................................................7/30196.
::: ::..::::
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:::.::..'::::::::': . ::::.:::::::rracE .. 50UTHOLD ......:: ::':.:.'::: :..: ::.::::' .: ....,, TOI v :::..:' SOUTHOLD :::..
RESSs [ a :::::: : :::;;;: :: :: : :::::::: :: ::::::€ ::€€ `:: :::: : :: :€ : :: ::::_:::: :: : :
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ADp .......... 17n5 NOgA, ,M hndh
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ISSEIED TQ Tff S;TYNAN
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_.::::::::::::::::::::::::: suasexomrnedon::::::::::T30-96:::: and:ourrcl:to:be:�n:comphancewtl.::..:e:::::ono.....::::::::::::..._........ .................._......._.......
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...LOCATION :: Base.:'::'.. Ist..., 2r�d ::::..'.:: . 3rd 1ltirc
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.........................................................Det.Coca
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HEATERS
SWlTCHS:::. .;.:...RECEPTACIES.,. :FLYTURES FANS....:..:. GFI . 47IZ CONLl .::
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DISHWASHER..._ .DRYER ............ CLOTHES bYASH GAR DISP: MANGE QPEIJ SMFlKEDETECTOR
: ::: :'kTIRNtCE OIL. GAS CIR MOTORS BEIL TRAN SERVICE DISCON]VECT::.:::.
................................:.:.....:......................................... .
.... ..
:::: ......... .
::::::::::::::::::::::::::::................................................................................................. ....:.,ME;TER..... ::xlhfiSEif::ifliiff isP7i4SE::::::::::::ii:::!:::::::::::: ::
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PRESIDENT .:::::: : :: ::
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11tQ; ..: 17it5:cer ote miiSt not be altezed m any manner
... .......
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......_.........................................................................:........................................_-.............................................._........ ....eotorsma..berdenhfiedib:itlieir.ciedentials:*::::::::::::::::::::::::::::::::::::::::::::
:::::::�P............Y.................................................................::::::::::::::......
BLUE.ORIGINAL
::::... -
_ YELLOW COPY:: :PINK.COPY OFFICE:. ::..
765-1802
BUILDING DEFT.
INSPECTION
[ f OUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
REIVIARKS-:. -�U- ee��
7�—�z
DATE INSPECTOR yc--
765.1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] 1 CATION
[ � FRAMING [ FINAL
[ ] FIREPLACE & CNIMN Y
REMARKS: � r
DATE � INSPECTOR
HI „_�!!ST U R ILL011 EVOU-1 u A,V E'
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F UMIA DT I PD) ------
nl,h
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RMIGII FltAffl-. &
HARM I IM
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I 11I.ATI Oil IIE.it 11 y
STATE,
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F I IIAL
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t7J
BOARD OF Nr.AI:TN . . . . • . . . . . . . . . .
FURM No. 1 3 SHTS OF Pi.ANS . . . . . . . . . . . . . . .
1�, TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
111I11.UING I)hl'AR'I•rtIMT CAIRCK'TOWN IIALL SFP'I'IC 1:ORM . . . . . . . . . . . . . . . . . . .
R 1996SOII'I'IIOLD, N.Y. 11971
7 6 5- 11102 NOTIFY:
TO DEPT. CA
W .�
N F UTH
F,x�mi rredl.. , 19./..� ` MAIL. TO: ,lam c
LZApprove( � 19 I'e nn i l: 1kr. V (���..D x...�.C?��.............
Disalrp e( a/c .. ...
... f{ac !
.. ...... ...
lkrilding bispector)
A 11 CA'I'LON FOR BUILDING PERMIT Date. . . . 1-3
. . . . . 119 �
I N S'1'RI1C'1'I ON S
a. 'Ihir alrlil icaLion mist' be c(x(qiletely filled in by tylxwriter or An ink and sthuitted to Lbe ikrilding Inspector with
3 sets of plans, accurate plot plan Lo scale. Fee according to sche(hrle.
b. Plot plan drawing location of lot and of lxrildings on premises, relationship to adjoining prenises or 1xiblic
streets or areas, and giving a detailed description of lnyrxrt of property 1,11st be drawn on the diagrm which is [)art of
this application.
c. 'Ihe work covere(1 Iry this aplrl icaLion rrry not be carnrenced before instkrnce of ikrilding Perrnit.
d. Il(xxt approval. of this appticatidxt, Lire Iklilding Inspector will issue a Ikri1ding Permit to the applicant. .Slx•h
permit shall he kept on Lire prenises available for inspection throtgjmout the work.
e. No Imilding filial] be occupied or used- in whole or in part for airy lxrrlx)se whatever until a Certificate of
Occuparx.y dial]. have been granted by the ikrilding InspecLor.
APPLiCNI'ION IS IlEFG'sllY MADE to Llre Ikrilding MpartmenL for the issuance of a ikAl.ding Permit ptrrsuanL to the
lk)ilding 7m)e Ordinance of the 'Town of: Southold, Suffolk Cam►ty, New York, and other applicable Laws, Ordinances or
Regulations, for tl)e construction of Imildirrgs, additions or alterations, or for reioval or demolition, as herein
described. 'll)e applicant agree's to ccintply with all. applicable laws, ordinances, Imilding code, Ixxrsing code, and
regulaLions, and to a(hit mrthorized inspectors on premises aril in Wilding for necessary inspections.
c..........................
(Sigrr)Lure of appl itra ', or name, if a corporation)
(Mailing address of: applicant)
Stage whether al-yl icant is Owner, lessee, agent, architect, engineer, general crx)tracLor, electrician, plurb)er or Wilder.
' q/Z-GJ d?L ........... ............................................................
.....................
Name of (Afi)er of prenises .........1,a. ...�1 /( ._. �� :.........................................
(as or the tax roll c5r latest deed)
If applicant is a corporaLicm, signature of duly miOxm ized officer.
.........................................................
(Ns11ne and title of corporate officer)
ikjilders License No. 1}t.....G-. --.-:76.........
Phsibers License No. ..... .................
F.lecLricimrs License No. .. .. . ....... r.. ccA a_
OLher 'rrmle's License No. ....................
1. location of: land on whidr proposed work will be clone.;........................ ... ...... .
1.a�. .......... c f` �`� % .......................... ................
lkxise rkrrber Street Itaulet
r C,
(:cxmrt:y Tax Kip No. I(l(X) Section ........? �... Dltx.k ........4. ... Lot .....d...//...../
Stdxlivisi(x) ...................................... [ filed Flair No. .. 1 ...... iot ..l�j (. 2
(Name)
2. State existing use and occ.•tgkancy of premises and intended use and occupancy of proposed constnietion:
a. Existing- use arxi occuparcy ..... ....................................................
.....................................................
1). InLemled trse and occt pan y
7, N•lture ol` i+otk (cIw!cl( wli1(J1 allilimible): tk--%j Ik►Ildiuil ,,. ., , Acklition .......... Alteral.iol► ..... .....
Itc:lull . Iten►oval ............. lknr)I ILion ..... ... Other Iknl( .
4. Issl t11c11e<I ( )st: .. s��.. .0.0 ..... fee ............. ................................
(to lxt paid o11 filing this nirpl icatioll;).
5. If thmllinil, ouid)er of (kaellinil units . ........... lini)er of (IoelIIng unil'n cx► efi(:h fl(x)r ............... .
l f garnlle, Ixnb)er of czars ......_. .......... .............
6. If: Wnhv ss, cannerclal or mixed (WrUlua►cy, specify nnl.ure rrlxl extent of each Lyle of use......................
C. eo"
7. Uinten.1dona of existiog aLruetzires, if any: Frcx►L.. ..1.9.. ...... Itear .. .. l.d....... Depth ...c�?.o........
IkeiWit ... ...... �.......... miner of SLories .. .. ... I.. ............ /
/
Uintenslcxts of srllne sLnrrCure with t1lteraLicx►s or .xklitions: I�ront' .....mod.. hear ...C-xC3 ....
Del)l11 .....off. 0.e...... Ileil)ll ... ....... .`{.,... Maier of ifurien .. . .........
l r
0. ❑imenaicx►s of enLire new ccxistrm.-Cioti: FrooL .....� ..... [tear ... o..... Ik�plh c< ......
.............. Usiher of St.ories .......I............
9. Size of lot: li'r(xtt ..../J�.......... Mnr .....lPd ......... I)eplh e of ......� .....
10. Par Plu'clane �C oZ 9 ��G l+�¢.✓ ...� ,�f. .... N.-xlte of Former O,+ner _.... ... ...................
I. Z.1xte or use district in iAticli premises are aftuated ........�L'n-s L. I u—N. ?—.......................
12. Ikxs prolx)ned cuts rmtion violate nny zclnlug law„ordiname or rellulnl:ion: ......... IQ..........
IJ- Will lot lie regraded ....... 0 ...... Will excess fill lie r(',noved fran prclnises: YES 9D f
Ill. Miles of Owner of pranises .t 4 t,.. ...... Atkirera -C�f2 4��$ )(rr�a�(f llxx►e Ito. ..............
Ham of Architect .................. ... ............... Atlilresa ....._... ..._... lllone lJo. ..............
ck ....... .. lress � Q.` . ltJne of (txttnclnr s 1�p. 11►o)e tn.� e
15. is Ills pmlx:rl:y within 300 feet of a Licht wetlalxl? * YES tX) .., ...
*Ili YIiS, Scull N I) 11-AM 'lNi1SI1 rm L'IsiZl11'1' MAY m Rup tail).
PLAT I)lAGRAtl
lcx:flte clearly a(xl (IiisLinctly fill lxlildings, vAlether exlsLing or prolx)sed, mxl Itxlient:e till set-back dlniensionn
frcmi property lines. Give street ncxl block rxulmr or dencripLicxl according to deed, All-Al (Jlaa street nEvnen mxl in(licnte
ivltether interior or comer lot,
r
MAH, M' UM YMK,
(XllIt11Y (N' ...
�. ......C. .• !.5... . ........... ..1)(0111 duly nworn, delx)nea filx) nays that he in tl►e n)pl icmll:
Mile of I►xllvldutil. nigniog contracL)
alx)ve 11;01KA,
Ik! it: (Im .......00. 'J",QRe..1 ........................ .........................................
Woot:rnctor, ngenL, corlm-i to officer, etc.)
Of Mlid nwJx!r or owigmt►, mxl is duly nullorim-d to lmrfolm or lnvu lxirfolijud 1.1m a;tid work tnxl to nrilm 111MI IIIe Ill(;
r►ppl ic.ntioo; Lhal: oil I nLatelnents contalmd in Chin application fire bite to llte bellt: of Ilia laxx+ledlle 111A Ix;lief; mMl
Il►n1. (he w(►1l( will W performed In Lhe manmr vet: ford in tle appliciltion filed therewith.
;)A)rn to IM-flift ure this
........ ..........day of ... ...... . ... 19.. I6..
�� .•.. \tk)t.:lry ..................
HELENE D.HORNE (31giviLove/of )pliIcmlL)
Notary Public,State of Now York
Flo.4961364
Qualified in Suffolk County
Commission Expires Play 22, '19.�
Al
UnauthOdZed alteration or addition ✓�ZS�S��—� �OD•OD Q
to this survey is a violation of f T
Section 7208 of the New Yok State
Education Law. 7 S —�CoPles of We survey map notHearing �the lard atxvayors Inked sealor
embossed sees stWi notbe
eld to be a v aua copy.
Guarsrtwa kdteasd harson ahal�run 1_ \
only to dw parson kx wtwm ttte swMy ,l
is pnpend,and on his b*WI to the j W
title company.govemmwtW agarttyy and
landing institution Asted hereon and
to dfa assignees of Ole lending budtudw. Z t
Guarantees are not transferable
to additional institutions or subsequent
owners.
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