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HomeMy WebLinkAbout23859-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24793 Date DECEMBER 12, 1996 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 380 ROBINSON ROAD GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 34 Block 5 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 25, 1996 pursuant to which Building Permit No. 23859-Z dated DECEMBER 11, 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 ENCLOSE EXISTING PORCH ADDITION & A RAISED FLAGSTONE PATIO ADDITION TO EXISTING ONE FAMILY DWELLING WITH STONE BENCH (RAILING) "AS BUILT". The certificate is issued to CLARENCE & LUCY POWELL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 POEM NO. f 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° 23859 Z Date .., .4`Z.. ...1./...................................... Permission is hereby granted to: .. to Xe--Iclin at premises located at .. ..... .�.�. ..... .. '................................. .... ........... ...... ..... ..................... .. ... .... ..... ... .... .. �..°.../,' 7•••• ?. .. ............. .... .. ........ .... r County Tax Map No. 1000 Section .....4 �..... Block ...................... Lot No. .4;.—1........... pursuant to application dated ....��. r.' .......................`........., 19.?4�r and approved by the Building Inspector. Fee $. ..� : . .... .. �.................... Odir Inspector I for Rev. 6/30/80 r \�.. - rurm liv• u TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN IIALL 765-1.802 APPLICATION FOR-CERTIFICATE OF OCCUPANCY N. This application must be filled in by typewriter OR ink-and submitted to the building inspector with the followings for new building or new use: 1. Final survey of property with accurato location of all buildings+ property lines, streets, and unusual natural or topographic features. 2: Final Approval from health Dept$- of .water supply and sewerage-disposal(5--9 form) . 3. Approval•of electrical installation from hoard of Fire Underwriters. 4. Sworn statetnent from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial buildings multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building, , 6i Submit Planning Board Approval of completed site plan requirements, + U. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-existing' land uses: 1. Accurate survey of property allowing all. property linesi 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 • 14 Certificate of Occupancy - New dwelling $25.001 Additions to dwelling $25.00v Alterations to dwelling $25.00, Swinuning pool $25.001 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 4i Updated Certificate of Occupancy - $50,00 5• Temporary Certificate of Occupancy - Residential $15.00i Commercial. $15.00 Date ; .Vo+vember• 25i . . . . . ..... . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. ii i • : • . . . . . . . . . 380, Robinson Roac GFeenport Locption of Property. • . • . . . • : . + : • i • . . • . • • : Ii • • + : ♦ • i . : i • . : : . ••• • • . . • + • . • • . .• • : :••::•• . • • House No. Street llt�mlet Clarence W., and Luck :K Powell 0 nwe r or Owners of P r o p e r ty� • : . . . • • : . • •• • • + • + + • • • • + • :• : • • • • • : : . . • . : • . • • • • • • • i • • •:••• • i County Tax Map No 1000, Section• + • + .3:1• . .. . • .Block. . i . •0+� : • . . : ii • .Lot. . i . . :O.�� : •: :•..: • • • • Subdivision. . . . : . . . . . . . . . . + . . • . . . .+ : . . ;. • . . ; . . •Filed hfap: + :. . . • . . . + .Lot, . . .:. . . : : • . .•:.... : . : Permit Date Of PermiC� . i. :• • i :. . . . . . iApplicant: . . . . , � � : : i : i . • .: + : :..::: .: . Health Dept. Approval. • • . • + , o : + : • . • • :6i • : + + • . : .Underwriters Approval i . : i : + : • • • • • • • i ••a.•a ;i : : ' i Planning Board Approval. • . .: . • • . i:. i • . • • : : + . •: •- Final Certicate:. . XXi • . • i Request for: � Temporary Certificate: i . + . • ++ + • . •• Fee Submitted: #. . 25�. 00 + . .. . ... . . + +. . :.. � . .. APPLICANT • . FORM NO. 1 TOWN OF 50t•lTHOLD 26 Ic,,. .j BUILDING DEPARTt107. TOWN HALL ;OUTHOLD, N,y. 11971 TE-L.: 766-1802 Received , 1 ) . . pproved �0�. . �! . .• . . 19 .. fGI'er►nit No-••�•J�U•: � . . . • / lk;tpprov4 cd ajc . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . • . . . I (lj dillg 1 �peclor) j APPLICATION FOR BUILiANC PERMI 96 INSTRUCTIONS typewriter or in'ink and submitted to the Building Inspector, will) 3 a. This application must be completely filled in by yp gets of plans,accurate plot plan to scale. Fee according to schedule. 17 or ublic streets iy., Plot plan sltowin location of lot and of building 011 Prcrr►iSk baedra°,nlaP tl°ieactlli dram wl iclt is partof this aPP1i- 'v n a detailed description of layout of property or areas, Anil giving g c:. n. c. The work coverer by this application may not be conutteticeil before issuanceg f$adding Permit. lic • Such permit d. Upon approval o tltis application, the Building inspector will issued a)3uildin Permit to the app sllall be kept orl the premises available for inspection tilrotaglgit the Nvork' whatever until a Certificate of Occupancy e. No I)uilcling shall' be occupied or used in wllole or ill art for ally Purpose shall have been granted bjy the Building Inspector. Permit t�rsuai't to tltc AlIPLICA.TION IS IjEREBY MADE to the Building Suffolk Conent NowliYork,aand otherf a �applicable Laws,Ordinanccs or Building Zone Ordinance of the Town of Southold, Suffolk County, removal d. Regulations, for the colhstruction of buildings, additions or alterations,(ding code, llous ngecode, and aregulations5 and c10 The aP1?licant agrees toy catnply with all applicable lawfoori cessary,inspectio s adinit authorized inspectors on premises and in building I (Signature of applicant, or naritc, if a Cor[Ioral iOli) PO Box 2065 , . Greenpo> t,, NX. 11944. ((viailirtg adclress of applicant) lessee a ens, architect, cl}ginecr, general contractor, electrician, pltrlilber or builder. State whether applical4t is owner, g a Agent. . . . . . . . . . . . . . Clarence W. and Lucy• K.• •Powell• • • • . . . - . . . . . . • • Nate of owner of prelplises . . . . . . • . . . . • (as on the lax roil or latest deed) If alihlicant is a corporation, sign5ture of duly authorized officer. (Name and title of corporate officer) Builder's License,No. . . . . . . • • • I . • • Plumber's License No. . . , . . . . - . . . . . . . - . . . • Elec:lriciin's ..ice.Ilse NO. . . . . . . . . . . . .. . • . • • - Olhcr Trade's Li,'cense No- . . . • . . . . • 1. I,oc,.j1.i0n of land �rl which proposed work will be done. . : . . . . 380 Robinson, .$94d. . . . . . . . . " . . . . . . - . . -Greenport , . . �,il t Number ll Ilanllet �'ounty Tax Nfiip`No. 1000 Section 34 Block .05. . . . . . . . . Lot . . .14 . . . . . . . .. Filed Map IN]o. . . . , . . . Lot . . . . . - :. . . , . (NaIlle) 2. Slate existing use and occupancy Cif premises and intended use and occupancy of proposed cbtl5tructiUrl: I Private one—family dweing• with raised, patio. AS. -BUILT . . a. L•.xisting use all(l occupancy ll . . . . PRIOR TO 1971 1). inlendril use lnuf occupancy Private one-•family .dwelling• With• raised• patio, �S ,BUILT . . . PRIOR TO 1971 PArios.- (Orr 14 4 bus't+Pr�or-fo Iq? 1, ' Raised Patic as built 3- Nalum of work (check whicli'appl!cable), New Building . _ . . ... . . . . Addition . . . . . . . . . . J,Iteration pr ra.r• _-I'to- Repair . . . . . . . . . . . . . . Rernoval ... . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Allork . . . . . . . . . 1. . . . . (DCSGr]I7fiC�n) 4. Estimated Cast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . .j. . _ _ . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwellinnq r' mber of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each flgor . . . . . . . . . . ... IfgaraR of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. If busing •'Ornmer-.:ial or mired occupancy, specify nature and extent of cacti type of use . !. . . . . • . . . . . . • • - • • • 7. T.)Ilnensioii._ of exlstinp. structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . D�ptll _ • • • • Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1. . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rearl. . . • . . . • • • . • • . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . .I. . • . . . . I . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear • • . . • • • Ue��th . . - - . Height . . . . . . . . . . . . . . . Number of Stories . . _ . . . . . . . . . . . . . . . . . . , . . . • - . . . , . . . . . . . . 9_ Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . .. 11. Zone ar 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 prempos: Yes Nc) 14. NaiT1e of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Plione ;No• • . . . . . • • • • • • . N'a►r1c of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Thorp NO. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . T'1-OT DIA( RAINI Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all sets-back dimensions from property,lines. Give street and block number or description according to deed, and show street namjes and indicate whether irlte.rior or corner lot_ i See copy of survey attached lepp In - T• Y.) Sl6 L � ^ 9 AMI TO 4 PM FOR THE FOLLOWING Ilr SP CTIOfgS: r "1jjtjfY REQUIRED _ FOP, P"OURED)CONCRETE INSUt_ATI()N'' F1a49Af- - 'CONSTRUCTION FvjijS F � BE COIifsPL..ETE FOR C.O. � ALL CONSTRUCTION SMALL IELF THE: REQUIREMENTS OF THE N.Y.STATE .CONSTRUCTION & ENERGY !i I CODES. i'40T RESPONSIBLE FOJ L?IsS1 'NOR COlaISTRUCTION ERRORS i STATE OF NEW YORK, S S c COUi�r�` QL , . SUFFOL.. • _ . , , • (9 CSo_ .�( 0t1 _ . . . . , being duly sworn, deposes and sa�� S that lie is the al)plicarit . � '. y� (Name of individual signing contract) i above named. j Ileisthe . . . . . . . . Agent. . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work al I to make and file this application; that all statements contained in this application are true to the best of his knowledg and belief;and that the work will he performed in the manner set forth in the application filed therewith. j Sworn to before me this . . . . . .. I9 9.6 Notan' 111)lic, R ' P TT.JR. . . . . . . . County NOTARY PUBU State of N.Y, j No.4725089:,Suffofk Cour�y ! , . • . • • . . , Term Expires May 31, 19 F3 (Signature of"applicant)