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HomeMy WebLinkAbout23452-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24625 Date SEPTEMBER 11, 1996 THIS CERTIFIES that the building REPAIR Location of Property 3600 VANSTON RD. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section ill Block 5 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 1996 pursuant to which Building Permit No. 23452-Z dated MAY 16, 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 REPAIR & RESTORE EXISTING BATH-HOUSE & STAIRS AS APPLIED FOR The certificate is issued to HURT LEWIS (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Xa ild'ng Inspector Rev. 1/S1 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) NEl 23452 Z Date ...........`_' .../4�'................................. 19..�.��.. Permission Is hereby granted to; �c ... ....,l ��............................................ .�../�.'. .........I/.if.-I................... to .. a-�i�r.... . ...... . .... r ................C- .... ....... ............. ...... :... ........ ..... .. . ............. ... ......................................................................................................................................................... .................................................................................................................................................................. atpremises located at............................................................................................................................... ................................................................................................................................................................ / County Tax Map No. 1000 Section ....11�<.//............ Block..................��........ Lot No. ..............,............. pursuant to application dated ................. .. ....�..........................., 19.. l�` ...., and approved by the Bullding Inspector. i Fee$.. 5... ....... Zuil�dZg.. ... .................................. Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 6' TOWN. HALL , pd 765-1802 I APPLICATION'• FOR CERTIFICATE OF OCCUPANCY p- A• Y„ Ths 'application must be filled in by typewriter. OR ink and submitted to the building 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 buildings and installations, a certificate of- Code Compliance from architect or engineer responsible for the building. • 6. Submit Planning Board Approval ofcompleted site plan requirements. B. For existing buildings (prior to April 9, 1.957) non-conforming uses, or buildings and '!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 applicant. 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 - $5.00 over 5 years - $10.00 .4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . !/�U�l . . . . . . . . . . . . . . . . . . . . . . . . . .'. New Construction. . . . . . Old Or oe-existiing Building. . . . . . . . . . . .Location of Property. (,r�„, . . . . . , , , , , , , %' ?�j House No. Street Hamlet Onwer or Owners of Property.. . . . . . . . . . ..P. . . . . T. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . . . ,�.J .� . ... . .Block. . . . . . . . . . .Lot. . . . . ,�', , , , , Subdivisio i►.� P-A .,�, . 5'.::l.0 VJ led Map. . . .�:s .Lot. .mod Y . . . . . . . . . . . . . Permit No, Date Of Permit. . . lij . .Applicantt V/2c1�/4nC Gr � f � G�cc/J' . . . . . . . . . . . . . . . . Health Dept. APproval. . . . . . . . .`�l , , , , , , , , , , ,Underwriters Approval. .``;/!;; , , , , , , , • . . . . . . . . . . Planning Board Approval. . . . . . . . . . I14. . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . , Fee Submitted: $,©�,,�• , , , • , . , , , , . . . . . . . . . � �, • . . . . . . . . ... .. .,... . . . . . . . . . . . . . . . . . . . . APPLICANT CO Y�nas :.:,a Volt I DIX I FMIIIHA FI Oil .......... FUMIDAT1011._ .......... --------------------------------------- 401101 I"ItAIII," & C) .......... ............................. 4, ------------ O ............... I WHILATI Oil I-lilt 11 • Y . STATIi'� IIIIHIto.y ............. N� AIM I'( I OIIAI. ------------- II ----------- CCA tW-AVFAIL_ -D CCA� . POST _ 1'D 3G" 'TYPICAL_ cXTEFZI0(t 5-7Ak?,S trf �---- — 5/4 x 6 �4 x 4 C CA -T KEA t>5 C CA lS T P-t^t G E K APPROVED AS NOTED / DATE: B.P.# 3 fy� t FEE:' 5` BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING OCCLP P °t,v OR 3. INSULATION a A UNLAWFUL 4. FINAL - CONSTRUCTION MUST ��'�" �x 4 CCU �OS'j ��@�p ` �e��� BE COMPLETE FOR C.O. M� � E T�jFIC ALL CONSTRUCTION SHALL MEET 1 i i! � MASON P r THE REGUIREM`NTS OF THE N.Y. t=TCs . 31—D`I F OCCUPANCY STATE CONSTRUCTION & ENERGY �l �a CODES. NOT RESPONSIBLE FOR t>axw GF A - -- DESIGN OR CONSTRUCTION ERRORS l I_ _ r �. SCALE: /Z1 - D I I APPROVED BY DRAWN-BY- J C. DATE• L r� •.. fr/ `i"� �.'�'f � ��� s Rt✓si DEN � � Ia�S DRAWING NUMBER EtvirhoriME` 7 EAST -� CHARRETTE PRO-FORM 920PY PRINTED ON 920H CHARPRINT VELLUM I H O R s 0 w /o - 318 o D Q' _ _ 5.77'ts.ao 405.LI t s N a>. a a SATK 140.J9 STAIRs y L ENE •r L r� 319 Z- STOitY S`6 3 J� _ �• M� a_ a• a/ o. Q�+mod '1\sg9 �, ti• Care FI u ` �\ T•GARA6E � pW tt8• for V��V✓✓ �. C G 320 �c S,31 N.7!'43'So'W. _NJ .E A c 162.o0AX J,5'lo � W ' BEAC +t. oFMEw roA %s6 Sa,•s33° NJAtv ce �'°' � t"v. t o r ' c4 tbodt j o eidetad 'cc 4,o. L S 2 b J� `, `s-A SO, 10=a"0"* MAP OF PROPERTY �LsfDLaa�� 6n aSte Val'� `'"`W. ct=��`� SURVEYED FOR — NOTES — cv.N 9 oIItro °n °���^-;` eURT G. LEVY IS s El - CONCRETE MONUMENT- + car: •;,,ir,"t :,e ea:,�n �._is -- - TIE LINE . i''a• �. n• _s:o+ti. rsjy ,.,.,�+ AND AtzEA To TIE LINES) - J.04S �1liL►:$ . ABEL LEWIS . GUARANTEED TO TITLE GUARANTEE TRUST AT - NASSAU POINT GOMPAclY + ANO TO R.IVEitNEAD SAVINGS BANK, A SufZVEYED FEBKVAKY 2, 1956. TOWN OF SOUTHOLD, IV. Y. OTTO W. VANTUYL SON P- . \1, ('-t -A-4 P SCALE : 100 = 1•• L:ICEN5ED L.Ac1D 5UMVEI'OV-5 G[2.EENNOV-T, N. Y. o r Nc)'S. SNowry S'FFE�. i (anti -. f= --�lR'P'�—f� 0F but � 0L K- COUNTY F��E CCA f-FANvFAIL_ 4 x4 C.CA . P05T TD T REAvr.) T"TiCAL_ EJ<T EELIOR STf�IRS -- --- 5/4x 6 + 54x 4 CCA -TREAo5 r-- 2x IZ CCA LSTFRI?'AGEK APPROVED AS NOTED 1' DATE1s��'` — T FEE BY: !�S NOTIFY BUILDING DEPARTMENT NTT AT 755-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED Ct'.NCRETE pp''��ii��. 2. ROUGH - FRAMING & PLUMBING CCUPA.��t L191 3. INSULATION 4. FiNAL - CONSTRUCTION MUST USE IS I _!�6��1�UL • BE COMPLETE FOR C.O. ix i .CCf� FOISTALL. CONSTRUCTION SHALL MEET -rn MASoN ViT��UT CERTIFICATE, THE REGUIREMuNTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Y E�(�C 1P�ANC CODES. NOT RESPONSIBLE FOR t5E.L-OW GFA da l� li I DESIGN OR CONSTRUCTION ERRORS SCALE = I-D I APPROVED BY �yyy yZ'` DRA WN-B DATE: Jr. 1 I Ol C DRAWING NUMBER CHARRETTE PRO-FORM 920PF PRINTED ON 920H CHARPRINT VELLUM - �o.ax'r�V-.`tit BOARD OF HEALTH . . . . . lj FORM NO. 1 3 SETS OF LAMS z�. . . . . . . Wr3W6 tl . TOWN OFSOUTHOLD SURVEY 7. . . . . . . . . . J BUILDING DEPARTMENT Cl1ECf. � . . . . . . . . . . . . TOWN HALL SEPTIC FORr _ . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 N GT ZFy CALL Examined . . . . . . � . . . ., 197. . . . . . . MAIL T0 : Approved . . . . . . . l.� . . ., 19� Permit No.o? .. . . . . . . - - - . .i . . . . . . . . . . . . . . . _ . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i .` . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .�1 , . . . ., 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 Occy v 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 inspections. `Jl '.r . . . . . . . . . . . . . (Signature of applicant, or name, if corporation) l v... . ISU �. •� o . . . . . .. y . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee,. agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises ��s� .�-. 1�1�. . . . . .�. rn►� . ? .�- 4'.� . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If appl'ca i r i ature of duly authorized officer. (Name and title of corporate officer) Builder's License No. . 5�. /4-'. . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. .. . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�!t `� . . . . . . . . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section. . . . . . .�.�. . . . . . . . . . Block . . . . . . .�. . . . . . . . . . Lot . . . . . . . . . .. . . . . . . . ... SubdivisioniRM�q-Mw . 3�1� p �� .�.�4.A.16�l 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . b. Intended use and occupancy . . v. . . . � fie:t .�.� . r`' v� � y\: . . . . . ... 3. Nature of work'(check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . . . Alteration Repair . . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work.:.. ': •.c :.. . . . . . . . (Description) 4. Estimated Cost . .Q.1) . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . F:•. , .`.: : . . . . . / to be aid on filin fhis a "" ,, P g'.�-.�,.�_.pPIic�tion) 5. If dwelling, number of dwelling units . . r7. . . . . . . . Number of dwelling units on each floor • • . . . . . . . • If garage, number of cars . . . . . 6. If business, commercial or mixed occupancy, specify nature and exte�tt�f`ei h type of use . . . . . . . . . . . . ... . . . . . . . 7. Dimensions of existing structures,if any: Front . . .).� �!` :3. , Aear . . . '"!�- , . . . Depth . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ._. . . : . . . . . . . 9. Size of lot: Front �.(? : r�J . . . . . . . . . . . . . Rear . . . �w7 .�G? . . . . . . . . . . Depth . . `��� . . . . . . . . . . 10. Date of Purchase . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. I I. Zone or use district in which premises are situated ! . • !J. . . . • • • , • . • . . . • • • • , • • • • , • • , • 12. Does proposed construction violate any zoning law, ordinance or regulation: . ./ d. . . . . . . . . . . . . . . . . . . . . . . . . . . 13: Will lot be regraded `40 . . . . Will a ess fill be removed from premises: Yes No 14. Name of Owner of premisesk9.4,q t? i1 . . . . . . . . . . . . Addres�nu' C VAJLPhone No."J. . . . ... . . . . . . . Name of Architect . Address . . . . . . . . . . . . Phone No. _ . . . Name of Contractore.)U1 :'6--. ?'i,-:�`:� , , • • . • . Address a0.l.�io s: �C .Pkfhone No. 4-. i:`�y: :5. Is this property within 300 feet of a tidal wetland? *Yes. . .- No. . . . . . . . . ' *If yes, Southold Town Trustees Permit may be required. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. i 'TATE OF NEW YORK, S S ;OUNTY OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) Bove named. .eisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . (Contractor, a�g t, corporate officer, etc.) :f said owner or owners, and is duly au ado per orm or have performed the said work and to make-and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the •ork will be performed in the manner set forth in the application filed therewith. worn to before me this pp . . . . . . . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . ., 19 .l votary Public, . . . . . . •: . . . \ . . Coun N JOYCE M.WILKIN$ . . . . . . / Notary Public.State of Now Vb* . (.ignature of applicant) No. 4952246,Suffolk County- Tsrm Expires June 12,1 L'