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Home My WebLink About23508-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24437 Date JUNE 18, 1996 THIS CERTIFIES that the building ADDITIONS Location of Property 1375 GIN LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 88 Block 4 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 18, 1996 pursuant to which Building Permit No. 23508—Z dated JUNE 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 DECK ADDITIONS & ENCLOSE PORCH TO EXISTING ONE FAMILY DWELLING "AS BUILT" AS APPLIED FOR. The certificate is issued to JAMES & PATRICIA KIMBIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A HZilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24438 Date JUNE 18, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property 1375 GIN LANE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 88 Block 4 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 18, 1996 pursuant to which Building Permit No. 23508-Z dated JUNE 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 ACCESSORY STORAGE SHED "AS BUILT" AS APPLIED FOR. The certificate is issued to JAMBS & PATRICIA KIMBIS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A uIldincf Inspector Rev. 1/81 FORM NO. 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) liT°_ l 2350 Z Date :�.�.. ...!k......................................... 19...: Permission is hereby granted to: ....... .... .... ................... .. A-11 .. . ..�... ..... .............. ... ................ .. `�. ....��..' .._..../..<<S-30 ` r/ fit' 7 ... a w- e-4', ...l� � �� .a. ...�... !..! .. . .... �.� .... ...... .... ............ .. ........... .... ... ..... .... .i.............................. ...... ..............f... ..... ... ...... . ........... .... � .,� .... .>... ........ ................... County Tax Map No. 1000 Section ....Ad?............ Block ......... ........ Lot No. .....f�1............. pursuant to application dated .—'V .elf..................................... 19...l and approved by the Building Inspector. 01/4'n � r Fee $..... ................ 7 .. B� ...... ........ .%................. d ng Inspector Rev. 6/30/80 11 ----- Form No. 6 A-� TOWN OF SOUTHOLD Lq BUILDING DEPARTMENT TOWN HALL 765-1802 T0VV8L_,-... APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. This 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 of completed site plan requirements B. For existing buildings (prior to April 9, 1957) 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 - $20--00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . .tick IF " .I . . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . k..... . . . . . . . . . . . Location of Property. . . o.ZS7. . . . . . . . . . . . . . . . . . . . . . . . . . .. C-,U.4j,,(�. . . . . . . . . . . . . . . House No. Street Hamlet Onweror Owners of Property. . .) jos+►.LL.C-. . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . .Qo.-Y. . . . . . . . .Block. . .�-(. . . . . . . . . . .Lot. . J.1 . . . . . . . . . . . . . . . . . Subdivision. . . .ci . . . . . . . . . . . . . . . . . . .Filed Map . . .9. . . . . . . .Lot. . . . . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Cetticate. .%_�. . . . . . Fee Submitted: $. 44.51 t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . q 66 APPLICANT tiyy� y M., -,)5Form No. 6 (3-Alff Atj � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL MAY 765-1802 Z 2 8LDC; sr APPLICATION FOR.CERTIFICATE. OF OCCUPANCY TOWP�OF S;" A. This 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 of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) 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 - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . .mct(c� . .Ly, .t(mr4. . . . . . . . . . . . . . . . . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. . t!.... . . . . . . . . . . . Location of Property. . . Q.Z . . . . . . . . . . . . . . . . . . . . . . . . . . . .-C,U.4 1,,(�. . . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property. . J."w. .F►.r:?. . J:q:�:✓.�c�A . . .��p?'}��,�. . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. . 000 . . . . . . . .Block. . .Lf. . . . . . . . . . . .Lot. . /.I . . . . . . . . . . . . . . . . . Subdivision. . . .6A r. .14�,A-a. . . . . . . . . . . . . . . . . . .Filed Map. . .9. . . . . . . .Lot. . . 1y. . . . . . . . . . . . . . . . Permit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . .. . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . \Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. .k. . . . . . . Fee Submitted: . . . . . . . . . . . . . . . . . . . . . . A� . . . . . . . . . . . . . . . . . . APPLICANT r / � H� rn wo p GO Q 0 � o Sec-4,t,,, F� �v r�10 C.�L S LAu tl l�c s cY� lea,� uo"A Hal q (o� [/ _ —_-- - -------- _-- - -- -- 14-- �4( re c� Oa 'r c rHrj CIS_ (� - �� ii �� (r --�!— -- i� --�� f! ►'I II .Il� I 3��rr P .(ljoo� I _ 00 "� ts7r ax -door 11�Aw,. Cm cv x10, Flpul � I Floo- ri r� P, 9 Aa�IGt 'o 2x6 " !b 'off 137s Loy po&e44 -- FAO i w6 .foto-r64 —/ NS lad VrF„J 2)(V P� 'EKtST�Nb cFIL�Nb I�sN�..aer .� Ialq f ZY � 4f I%� ai� otir S pw.c1S' T4•1 AS ohVy If Vor SW 13�I )(64 �,�� 108( I 1D�r I C26 Gz6 C-a-6 �z4 i ,! �'`YV r� t�nor Sly/ ot Blob y Lv4- r�. �( �r.�O r1o.� G z�• G � ` Gr •r1Sy 2 F+ Ar..s f i 4 i G ' G E E E J T R�r}zEb J�}.r�6cfJ v - o�r T*A P R IoE any aOPKE-4, DoA vUT DCS 3-o U 4-4, s';L • �lo�,� y SY�.p Co LL lT ; J ` ' I 2 vy s�co t 6dr 'Act,r C-5 If J 2�y Xy I �� Y co•,s�-mac.. F pJ J STl4VcTt�IQ�L ,.c, �✓ �� ply woo I too A, Kr►�6 rt (J So w►��.o r� • L..+ -- T /9l( C e A L.v► 9fA �l �r �xbv. FCn�� oc��l l6 0 D2c-C VoorrK9 rr Xb �r � �1v�2Y1Sto�nS - fi Ki�b� • 13�s h b�.4 Ohl G o 4- •J�iX�.d i i i I /F IC -lopckF1 Q< _. . f \ .gOARD OF HEALTH . . . . . . . . . . . . . . . �p 1 - 3 SETS OF PLANS FORM NO. . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . . MAR 2 9 nigp TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 - TEL: 765-1802 NOTIFY: CALI. . . . . . . . . . . . . . . . . . . .. .. MAIL TO.. . . . . . . . . . . . . . . . . . . . . T�sanined.'. .... ., 19 9. 1 - / 1 Approved..aP. G......, 19.T�1 Permit No. .......... ....................... Disapproveda/c .................................. ..................................... �.�.�.............�..c ................L7?'e ..... ... . . r (Bui in )...�1�i. APPLICATION FOR BUILDING PERMIT M �Date.� 14!'�. .(.(F . . . 119 96. 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 an 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 application. 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 issue 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 HERW- 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. (Si re of applicant, or name, if IIa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...........> .w er:................................/ .. ............[...................................................... Name of owner of premises ....1..�.C,.t-:�:� ..G'.K.�...�Gt;f;�lG.�....{�.l+:tta.. ........................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ..........................:.............................. (Name and title of corporate officer) BuildersLicense No. ......................... Plumbers License No. ......................... Electricians License No. Other Trade's License No. .................... 1. Location of land on wwbich proposed work will be done.... ............. . ......................... ......�s .7 .......... l l.':�..�^� :e.....................S ............!V ..._................ House Nmber Street Hamlet County Tax Map No. 1000 Section ....R.Y....... Block ... .......... Lot .....E�........ Subdivision .. .LAG C C�y�'..................... Filed Map No. �q7 8R .... Lot ... ........ 2. State existicig use amid'occ�rpam5cy,of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. !ti►jI�/..1:CSIG�?! -Q.................................................. b. Intended use and occupancy .::: ( ...rar,i�...e e.CotC. .�O.QrCr. ..�..n, ...�' A,� ............ ol— 3. nature of work (dieck wIiidk applicable): New Ikjildirq. .......... Addition ... Alteration .......... Itepair ............ Ileittoval. ............. Datiol i t ion ............ Other Work .................................. CLo,5jFo PO)Q(-- ,o S (Description)4. Estimated Cost fee. ...................................... (to lie paid on filing this application) 5. If rk-relling, rititiber of dt-mlling units ............ lbiber of duelling units on each floor ................ Ifgarage, titsibser of cars ...................................... 6. If liusioess, commercial or mixed occupancy, specify nature and extent of eaditype of use...................... 7. Dimensions of existing structures, if any: Front................ Rear ................ Depth ................. height ......................... Umber of Stories ..........I............. Dimensions of sane structure with alterations or i4litions: . Front ............... Rear ............... Depth .................... fleiglit .................... Umber of Stories ............... 8. Diniensions of entire new construction: Front ................ Rear ............... Depth .............. . 11eiglit ......................... Nxiber of Stories ..................... 9- Size of lot: Front .............. Rear .................... Depth .................... 10. W-to of Purchase aO JX C........ Name of Former Owner ...t!'AX-kelt?�i4 ....................... 11. Zone or use district in viltidi premises are situated ............................................................... 12. Does proposed construction violate any zoninglaw, ordinance or regulation; ........................ I 1 . 13. Will lot he regraded ......1............. Will excess fill he reaxwed from premises: YES NO 14. Names of Owner of premises �'.R'KfA.ki"&t........ Address 14100e No..ZLf?71%.? Maeof Ardiftect ..................................... Address .............................. Phone No. .............. Name of Contractor .................................... NkIress ...............................Phone No. .............. 15. Is this property within 300 feet of a tidal wetland? * YES ........ No *rr- YES, sounni) mqN mmsIms PE-turr my Bc. Rapitro. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions Fran property lines. Give street and block rtisiber or description according to deed, and show street names and indicate tAiether interior or corner lot. r ef 771 10V 7-- mwllz w. mW Yow, 13?r 0/'M t- i�,e QXR417 OF ... SS v 46 ........ ...........being duly sworn, delioses and says diat he is Lite applicant (M-Mie of individual signing contract) aliove nixtied, lk-- is Lite ....... ....................................................................... (CAintractor, agent, corporaLe'officer, etc.) of said owner or owners, mid is (July aut.horized.to ix-rfonti or have perfonivad die said work mid to make arxl file LI i is application; Lhat all sLaLeirents contained in this application are tnie to die best of his knowledge aixl lxllief; and thaL Lite work will lie performed in the manner set forth in Lite application filed therewith.. .1.1x)rn Co b WAYNE ULRICHefore me this NOTARY PUBLIC,STATE OF NEW YORK ........... ....clay of .2�.... 19 3.�.... QUALIFIED IN NASSAU COUNTY M 11880 COMM.EXPIRES MARCH 30 R)Lary Milk ..... ............... (Si tune of Applicant) N . m Pciz .. � I �\.J l \ � 4�..� till ; �� ' f �- � •V A7 Q tVY�fy'V �tf r. iE �i�� 4.V L ht`�� t • 32_ f 6A t HOOP i ! O •-� f '4000 DECK � E- i FLOOD P-000 ZONE ZONE 6� A-q CEO < f1 moo ' a LU - 104 F CQ TAX MAP DATA : I004-8E-4- l z /+QBUR _ PCH. lL ! =rPiCKET FE+� '�_l11'E vJ^►.k. t �- "' Ls= QNLt-E aC2 W d � 3 a v m co i to this Survey is a vlow on of Section 7208 of the Now Yoricfdtakt t F;ducati-La"" cS S`JRVE YED K Y14zi9fa _ N the land surveyors inked seal a RC D F QIC I� VAN T' Y L V.r ,,bossed seal shall not be tonslderai �2 EP E Q TD MAP OF SAY HAVEN-AT `OU T H O'..O, to a valid ooPY —"—1 p.Grantees indicated hereon S y I`[LED ►�.� i)iE 5 _lPG. CC,C1.ERK5 !FFfCE A5 MAP No.2ylQ. to the person /�, t/ rson for whom ¢ r red.and on his behalf What is preps Cale company.Sovemmental agency gn•/ Q- lending institution listed hereon and +C.L PQ V r'1 S !+VEY0 R, — _R-SE !P0 2T a y v 6 �O t tolheessigneesolthelendinginstF 1 V VT?4 _ l __�..s~.._ _ ` # ��LS�o- 1S 2c6 PJ�' } tution.Gua:an:ees are not transubsequ" Fp LAN G SJ to additional ir.stltutions or subaa4tratM owners [ MAY 2 BLDG.DEPT. TOWN OF SOUTHOLD