HomeMy WebLinkAbout24644-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25538 Date: 02/11/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1150 LAUREL AVE SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 56 Block 1 Lot 2.28
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 6, 1997 pursuant to which
Building Permit No. 24644-Z dated FEBRUARY 6, 1998
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 IN REQUIRED. REAR YARD AS APPLIED FOR "AS BUILT"
The certificate is issued .to`JOSEPH & ALLISON CONWAY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
J
Buildi4K4 Inspe 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)
Date.....FEHRUARY........6........................... 19..98....
24644 Z
Permission Is hereby granted tQ;
.......JOSEPH & ALL I SON CONWAY
................................................................................
PO BOX 902...........
.......SOUTHOLD.v.NY....1147.........................................
to .....G.AN.RT.RW.�T... 5H.R f?....I.N...R F.G! J.I.R.R A...R.EOR...Y A.R A...........
.........A.O..APPL,I,ED..FOR..: AS„BU,I,LT."....................................................................................I......
..................................................................................................................................................................
........ . .............. .,, .............................................................. .,..............................................................
................................ . .......... ...............................................................................................................
at premises located at................11A50.....LAUREL„AVE,,,,,,.............................. SOUTHOLD...........
..................I.............................................................................................................................................
County Tax Map No. ....4,73889...... Section ...Q.56............. Block ....0001,,....... Lot No.
pursuant to application dated ...SEPTEMHER. . . ..... .........................6 , 19......97...., and approved by the
.. .. . .. .. .
Building Inspector.
Fee$........35.00.....
........... . ; ... ................... ..... .9. .
.... .......... ... . . ... .
uildin In ector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
.SECS 765-1302
3 D'E:P.T- II
�PPLICATION 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.
�:. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 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 - .25', ,
A. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . � �2. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . Old Or Pre-existing rBilding. . . . . . . . . . . . . . .
Location of Property. . . . ��?u . . . . . . . . . . . . . . . . aVx . . . v . . . . . . .L!�." .L . . . . . . . . . . . . .
House No. Street Hamlet
Onwer or Owners of Property. . . . � `P.h. . .,:f�A F:�... . . . . .!`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . .S.�. . . . . . . .Block. . . . I . . . . . . . . . .Lot. . . .''.� . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
?ermit No. . . . . . . . . . . . . . . .Date Of Permit. . . . . . . . . . . . . . . .Applicant. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . . . . . . .I. . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Manning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
bequest for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .l�. .
eeSubmitted: S . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-5 1J ��3 APPLICa�v'T ,
CU ���s3
76!i-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I CATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMA KS:
DATE INSPECTOR
I''l 1:I.11 II'I I'I:Ir U11 IIP 1.0111' •..T;:' DA 1.4 -
__::;. ._ _ _ --t-. -n:.- _n_-.-.. . r.-� .....-r•---.. .-_...- -.__ .,_,�(_.UI11rL111•r -wwr•r• _n_--...._..___ '�
TI
I�f 11 l l 11 l n'I'1 111) ( 1!1'f) •11.
I`WIM)ATIU1.1 (1110) v`
-----------+.ww-..-w.._ r _ ,. ----.wn�r.r���..�ww
Illllrc:ll 1.11n111: �
111.1111111 NO o
----• ------ -. --------••----------rn--r--w--war--�ww----w------www w-----wr ..
' 1-I1!r111.A'I'I I111 I'I:ll It. T . .
ti
r:rllll:
-....w..w...--wnw-..«..—w....w .. ..w-•,.......w 11 � ^
mo ------- --
- ._......_-.,www;'-_ -__-w-w www-w-.,_ w_ww--w-w-..-,w--..------ -_--- --w-_-----_
AIIIII'I'Iu11AI. (;(111111;1r'11i1 ��
.+....__......._ ....._...««w�_--w. -- ---------------------------r..----r..----------------.:-nw--------ww-
1 �ITITI R ft1T}!i-1f'��
v
r•,
— I
1 ,
BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK
'
5��� i� �9 199T ' ,4t__ ' TOWN HALL SEPTIC FORM . . . . . . . . . . . .. . . . . . .
L
SOUTHOLD, N.Y. 11971
TEL: 765-1802
.-.=w�.,�:< q NOTIFY:
-q,.ytt:1 OF CALL 70. J_�S4,f. _ . . .
E, mmmined... �6.......... 191k, MAIL TO: . . . . . . . . . . . . . . . . . . . .
Approved... .�.6......... 19.1,5 Permit No.�7 a.�j�-ef.: '. ....................................
Disapproveda/c .................................. ....................................
-•---•................................ ./. .......
..... ... .. ......
-(Building Inspector-
' A ICATION FOR BUILDING PERMIT
Date: . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. 'Ibis application nest be completely filled in by typ6writer 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 mist be drawn on the diagram which is part of
this application.
` c. The work covered by this application may not be conmenced 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.
APPLICATI(I1 IS HC[tM 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, ordipapces, building code, housing code, and
regulations, and to admit authorized inspectors on premises and in buil for necesssssa tions.jl
. ./........... .. ......
•(Si ture of applicant., or namm.e iporation)
C1..lac!... ............... �. -
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer,'general contractor, electrician, plumber or builder.
Name of owner of premises ... Qe� ..: .... a
.. ........................ ..................
(as on the tax roll or latest deed) � a
If applicant is a corporation, signature of duly authorized officer.
........................................................ /
(Name and title of corporate officer)
Builders License No. .........................
Plunbers License No.
Electricians License No. .....................
Other Trade's License No. ....................
1. I.rxation of land on which proposed work will be done............................ .. ... ........... ....
..... , ................� u �..... ..............0...........��.r�.�G.........................
Ikmuse Number Street Hamlet
//
County Tax Map No. 1000 Section ......... Block ....//........... Lot . .' -0.....:.
Subdivision ...................................... 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 J........................... ........................................ ..
b. Intended use and occupancy ...... :2 :al .............. ...... ..............
ti
3. VaLure of work (check vAiiClk applicable):' New lkjilding ......1__._ Add i t i on .......... Alteration ..........
Repair ............ Himioval. ............. Iksiolition ............ Other Work ..................................
(Description)
4. Estimated Cost ......................... fee .................................
(to be paid on filing this application)
5. If dwelling, mini)er of dwelling units ............ tkuber of (Imelling units on each floor .................
Ifgarage, number of cars .......................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use......................
7. Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
lk-igilt ......................... Mmiber of Stories .......................
Dimensions of sane structure with alterations or additions: Front ............... Rear ...............
Depth .................... height ..................... Usiber of Stories ...............
8. Dimensions of/otire construction: Front ..... Rear ..... Depth .t .. ..... ....
Ileillit ......................... Number of Stories ...../.............
9. Size of lot: Front .................... Rear .................... Depth ..............
10. Date of Purchase ...................... Name of Former Owner ........................................
11. Zone or 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 premises: YES NO
Ili. Names of Owner of premises ........................... Address ............................... Pixx-be No. ...........
Nameof Ardiftect .................................... Address .............................. Phone No. .........
Nine of Contractor ......*............................. Address ...............................Phone No. ...............
15. Is this property within 300 feet of a tidal wetland? * YES........... NO
*IF YES, SOLMUD M4N 110SM-9 PEFHfr MY BE 13WHRI-M.
Pi.o,r 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
xiiiether interior or corner lot.
A-
S UNIE (T M;,W Y(X?K,
SS
aliffly Or. ........
.........1i (1i W ............being (July sworn, deIx)ses and says LhaL he is Lhe applicant
(Nim of individual. signb.)g cmiLract)
above nured,
Ileis the ... ........................................................................................
(CxmLractior, agent, corporate officer, etc.)
of said owner or owners, and is duty authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this al4)lication are true to the best of his knowledge and.kllief. and
LhaL Lhe work will be performed in the iminner set forth in the application filed therewith.
'k,x)r n to before n Lhis
day o ..... .. . .19.
Notary I't lie .. ..... ....
.. ......
i-.),nature of Applicant)
PoSuft of N5@WY*rk
GL950
ri,487
kn Sq!!!t OMW lk.CouatV
I
i `t -•
• I T
00 00
CO
N I ro CV
4-
0
�t
al
I
I
I .
I
I .
61.9,
to �
01 .
fa. �OU
4N DATION a
(.. r
W 41.0 a2i .a'
O 141 (D
/ 0
LC) rA7 tD
IO
4
. I
c"L/
�.00, 1
N, 13004 00 W. 150.00
PROPOSED WATER MAIN
AVENUE
f
-v,
„�i "fi+u>^r� .#n��"�.'Y-o".:'ac �'� ���•gm„ur 's�"`e���V���XF4..�4 � � � ���.,�,Y�"� sc � .�- y �}i..
s �,�'a��t�7 cy.� � •w� ,�,� 'kkTT n ,�,.�^k;=a°t ++� ate. `�+ �+e}t ..c�. � ',.��'�-.<
..pY�r:.. fi...._. .. .. .. S�_x1.• .����„: � q( 4' ! yy 'ice-+'.:�'
The The
Su"Olk Ranch
This is the roomiest shed going b ause of its height An excellent addition to your property. Great for storage
yo add a loft or two. T ed is 9' high and is a space and comes in a variety of sizes. Window is,
beautiful way o your storage needs. included for that extra special look. 8' high walls.
w
F
0
w"I �k