HomeMy WebLinkAbout4103-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z18998 Date APRIL 30, 1990
THIS CERTIFIES that the buildin~ ADDITION AND ALTERATION
Location of Property 875 SHIPYARD LANE EAST MARION
House No. Street Hamlet
County Tax Map No. 1000 Section 38 Block 001 Lot 009
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 24~ 1968 pursuant to which
Building Permit No. 4103Z dated OCTOBER 24r 1968
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 BUILD AN ADDITION & MAKE ALTERATION ON EXISTING DW~.T~.ING.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
B~.T.~.N J. MORGANSTERN
Bu ~'~di~g Inspector
Rev. 1/81
FOP~I NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE ~
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISE~ UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 4103 Z
Permission is hereby granted~o:
at premises ,ocoted at ............... $...~-~.~-~.....~.-..~... .................... ': .........................................................
....................................... ~.~ ~.i~..~a,~..t,o~
pursuan¢ to application doted ............................. ~.~.,~.,0.~.~..~........~,.,.., lO..~...~..., and approved by the
Building Inspector.
Fee $..~..,....0~.. .............
Building Inspector /
TO~ O~ ~OU~OLD
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF ~CCUPANCY
This application must be filled in by typewriter OR i~k and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location oD all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply ~nd 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.
5o Commercial building, industrial building, multipl~ residences and similar buildings
and installations, a certificate of Code Complianqe from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site pgan requirements.
B. For existing buildings (prior to April 9, 1957) non-c~nforming 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 ~
I. CeL~.ifi~aLe ~J.' Occupancy - New dwet£ing $2J.O0, 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 ~ $I00.00
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 $!5.00, Commercial $15.00
Date ..~Q .................... ...... .... ..
New Construction....Y~. ...... Old Or Pre-existing Building...; .............
875 SHIPYARD LANE F. ASTHARION
Location of Property ................
House No. Street Hamlet
~ HELEN J MORGANSTBRN ·
Onwer or Owners of ~roperty ............. ~ .................. ~ .................................
County Tax Map.,o~- i000, Section .... ~ ....... . Block ..... O1~.. .. ...... Lot ....... ~ ....... ......
Subdivision .................................. .. Filed Map...; ........ Lot .................. ... .
lOgg
Permit So .... ~ ........... Bate Of Permit ............. Applicant ...........
Health Dept Approval Underwriters'Approval
Planning Board Approval ..................... .. .
Request for: Temporary Certificate ........... Final Certicqte ...........
25 O0 check 2249
Fee Submitted: $.. '. . .
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPE(
TOWN OF SOUTHOLD
April 19,
!TOR
1990
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
353 - 2
Ms. Helen Morganstegn
875 Shipyard Lane
East Marion, N.Y. 11939
Re: Building Permit ~4103
Suff. Co. Tax Map ~1000-38ql-9
Premises: 875 Shipyard Lan~ East Marion,.Y.
Dear Mrs.' Morganstern:
The above building permit has expire~ and a Certificate
of Occupancy has never been issued.
You are in violation of the Code of ~he Town of Southold
as this building permit has now been voide~.
Please contact this office immediatel~ to avoid legal
action.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Victor LeBsard,
Principali Building Inspector
VL:gar
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 19,:1990
Ms. Helen Morganstein
875 Shipyard Lane
East Marion, N.Y. 11939
Re: Building Permit 94103 (11961)
Suff. Co. Tax Map ~1000-38~1-9
Premises: 875 Shipyard Lane East Marion,.Y.
Dear Mrs. Morganstern:
The above building permit has expire~ and a Certificate
of Occupancy has never been issued.
You are in violation of the Code of ~he Town of Southold
as this building permit has now been voided.
Please contact this office immediate1Y to avoid legal
action.
Very trul~ yours,
SOUTHOLD TOWN BUILDING DEPT.
VL:gar
Victor Le~sard,
Principal~Building Inspector
FOI~M NO. 1
BU]LDIN~ D£P~RT~£N~
TOWN CLERK'S OFF'ICE!
SOUTHOLD, N. Y.
Exomined ....................................... · ]9..
Approved ~ 19 ........ Permit No. '~"//O ~ ~
Disapproved a/c ..............................................................................................
(Budding Inspec~
Application No......~.~./(.j..(,}.~,~ ......
°ate .............
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in 'ink and submitted in duplicate to the Build'!ng
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relatiionship to adjoining premises or public streets o~
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 befo~re 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 progress of the work.
e. No building shall be occupied or used in whole or in part for any p~rpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS H.EREBY MADE to the Building Department for the i,ssuance 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 ~or removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code and regulations.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engi.neer, generd! contractor, electrician, plumber or builder.
Name of owner of premises ......................................................................... ~ ..........................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No.: ...; ................................... Lot No.: ........................
Street and Number .......................................................................... ~ ..........................................................................
Municipality
2. State existing use and occupancy of premises and intended use an~J occupancy of proposed construction:
a. Existing use and occupancy /1°£.5
b. Intended use ondoccuponcy..~...~....~. ........................................... :. ..........................................................................
3. Nature of work (check which applicable): New Building .................. Addition v Alteration
Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................
4. Estimated Cost ....~Z.......~...c?.......J~... ................................ Fee ..........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................
If garage, number of cars .............................................................................................................................................
6. If business, commercial or mixed occupancy, specify natc/e and extent of each type of use ............................
! f
7. Dimensions of existing structures, if any: Front ....~...6. ...... ~....... Rear ..... ~..(J.........~.~..I ..... Depth ....~..~.....~. '~
Height ........................ Number of Stories ......................................................................................................
/ e ~.~,~ /j' ' ? ...... ~"
Dimensions of ,~ame. structure with alterations or additions: Front ...... ...~--f:.~........'-fz.... .......... Rear .....~Td.?........~.... ....
'2//g //'
Depth ..,~..~Z......~,m ........... Height ............................ Number/of Stories ...........
8. Dimensions of entire new construction: Front ....... .,~.~ ...... .'/5.. ............. Rear ...... ~..e. ...... ~ ...... Depth ,~.~.'./...~q.. ......
Height .................... Number of Stories ......................................................................................................................
9. Size of lot: Front ................ Rear ........................ Depth .../...~-.~..: ..................
10. Date of Purchase .../.'~....~..~.'.....~......./.~...~.../. ................... Name of Former O*ner/~.ff(?...d..~...T..~./~..m..?...~.~..?...~.ff~.~..~../.
11. Zone or use district in which premises are situated .....~....~..~ ......................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? . .~...~ ...................................................
13. ~Nome o~ ~wner or prem~ses,M~-.Z.~2~d.L~....~v~zf, ig~z~7~__~ress ~./.,5-..,3-/~./~/¢'~8~..../~'~..~.)'J~l~'/g.o,)qe
Nome of Architect ...................................................... Address ............................................ Phone No .....................
Nome of Contractor .................................................... Address ............................................ Phone No .....................
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. ~
L__J :"-'
STATE OF NEW. Y,/DRIf,,,i ./ .~ ,-,~ ~ S S
........... ~:~. ........... being duly sworn deposes and says that']h~the applican~
(Nameof,ind[vidual,~_ __ _ -~'/ . ~..~ . --_signm~gapplicati°n)
(Contractor, agent, corporate officer, etc.)
~-~~"o~s, and m.,~ty'authorized to perform or have performed the said work and to make and file
this application; that al,I statements contained in this application are true to the best of his knowledge and belief; and
that the work will be/performed in the manner set fo~h in the appli~tion f~ied th~ewitb. / z ~ '
Sworn to before me ~is ~ , ~ /(~.r~ .~- ~~-
................... 'k ........... .......... 3 ...... III .
EDWARD BOETINER
NOTARY PUBLI~ 5t.te ot New Yo~k
Appointed for Westchester County
':om~gssion Expires ~rch 30~ 19~ ....