HomeMy WebLinkAbout6877-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22213
Date MARCH 25~ 1993
THIS CERTIFIES that the buildin~
Location of Property 430 GRIGONIS PATH
House No.
County Tax Map No. 1000 Section 70
Subdivision
ACCESSORY
SOUTHOLD~ N.Y.
Street Hamlet
Block 3 Lot 8
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 24~ 1973 pursuant to which
Building Permit No. 6877~Z dated SEP~BER 24~ 1973
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 BUILDING AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUN~YDEPARTMENT OF HEALTHAPPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
MARTIN & NICOLIAN BUSSANICH
- /~uilding Inspector
FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 6877 Z
Date ..................... ,~ep. teml~ez ....... 2.q., 19..~.~.
Permission is hereby granted to:
· . ~',a.r.$£n..k~s s~nl~h.....&..w.~.£e ...................
..... g.~. ~. ~..o.~. ~... :...a.~ h ...........................................
....... ~=uthol~ .......t~.y. .....................................
to ....s.~.~..:.,.~..~.~.~ ~ ?.~.y....~:~.~..~.~..g. .....................................................................................
at premises located at .,~.~,.~. ...... ~[~'~r~.f~,,~OJ~l~.s~ .......................................................................
........................................... .C~i~o~i~ ..... ,...~h ............. ~outhol~..../~L ......................................
pursuant to application dated ............. .~..e..g..t. ..... ?..~. ........................ , 19.~.,~..., and approved by the
Building Inspector.
Fee $. ~.~.*..~.~.. ...........
Form No. 6
TOWN OF souTHoLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be fi&led 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.
Submit Planning Board Approval of completed site plan requirements.
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, buildimg and
unusual natural or topographic features.
2. A properly completed application and a consent to.inspect signed by the applicant.
If a Certificate of Ogcupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant;
C. Fees
1. Certificate of Occupancy - New dw¢ll%ng $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 .... 7~. .............................
New Construction Y Old Or Pre existing Builing
Location of Property .... ~.~ ....... ~..z~,~/f~.i' .~.~z/~..'''''''''''''''..~D..~.~.~. .........
House No. Street Hamlet
Onwer or Owners of Property../)~J ..... (...~,u/
.............................................
County Tax Map No 1000, Section...~ ........ Block. -~ Lot
Subdivision .................................... Filed Map ............ Lot ......................
Permit No..&2Z~.~. ..... Date Of permit~ZJ:...~../~ ./??.~..Applicant .... ~4....~...~.~.~/./.'.~. ......
Health Dept. Approval .......................... Underwriters Approval.
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate .... ..~.....
Fee Submitted: $....~.?.i"..~.. ................. ~ ~~}~.~ ~
............
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Fax (516) 765-1823
Telephone (516) 765-1802
S~OP ~ORK ORDER
TO:
CHRIS M. & DENISE S. HATTON
430 GRIGONIS PATH
SOUTHOLD, N.Y. 11971
YOU ARE HEREBY NOTIFIED TO SUSPEND ALT. WORK AT:
430 GRIGONIS PATH~ SOUTHOLD~ N.Y.
TAX MAP NUMBER - 1000-70-3-8
Pursuant to Section 45-8 of the Code of the Town of Southold,
New York, you are notified to immediately suspend all work and
building activities until this order has been rescinded
BASIS OF STOP WORK ORDER:
F~N.L BATHROOM BEING INSTAT.T.gD IN ACCESSORY BUILDING
WITHOOT OBTAINING A BUILDING PERMIT.
CONDITIONS UNDER WHICH WORK MAY BE RESUMED:
WHEN A BUILDING PERMIT BAS BEEN ISSUED.
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both.
DATED: JULY 2000 ~ ~~TO~
Examined ..~..... ~....L./. .......... ,
Approved ........................................ ,
FOlg~ NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Disapproved o/c ............................................................
............... iiZ;', Zi; ........
Date ........... ~....~....~. ......... ,
INSTRUCTIONS
o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildir
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
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 o Building Permit to the applicant. Such permit~k~
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in pa rt for any purpose whatever until a Certificate of Occupancy~
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 buildings for necessary inspections.
(Signature of appllcant, or name, if a corporation)
0 ..............................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
erof re N,CoLt^N .................................
Name of own p m ses ............................................................................................ .. ......
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
5
1. L~ation of land on which proposed wore will be done. ~ap No.: [ Lot No.
Street and Number ................ ~.~.~ .......~.~.~..~.~.~.~ .......... ~.~ ..................... ~.~.~.~.~ ....
Municipali~
2. State existing use and ~cupancy of premises and intended use and ~cupancy of proposed construction:
a. ~isiting use a~ ~cupancy
b. Intended use and ~cupancy
10.
lh
13.
14.
Nature of work (check which applicable): New Buiiding..................f Addition .................. AIter(~tion ...... ~ .........
Repair .................. Removal .................. Demolition .................... Other Work ............................. , .......................
, ~ ~ Description)
Estimated Cost .......................................................... Fee Z ............
(to be paid on filing'~'l~'is i~'l~ii;~;~i;~i ................ "
If dwelling, number of dwelling units ............................ Number of dwelling units on each flc~or-' ............................
If garage, number of cars ...................... . ......... ..................r ......................................... "t-' .................... : ...........
business, commercial or mixed occupancy, specify nature and extent of each type'of u~e ............................
If
Dimensions of existing structures, if any: Front ....~ ....................... Rear ......................... ~ ...... Dbpth-- ....................
Height ........................ Number of Stories ................................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Re.~r ............................
Depth ................................ Height .......... ~.........' ........ Number of Stories ................................
Dimensions of entire new construction: Front .................................... Rear ............................ ['epth ........................
Height .................... Number of Stories ....................................................................................................................
Size of lot: Front .... ./..Y...~. .................................... Rear ....... ./....~..3... ........................ Depth ./..~....~......-~......./...~...~.
Date of Purchase ......... ~...~...?.. ........ .7./. Nome of Former Owner .......................................................
Zone or use district in which premises are sitUate~i ..... Z....Z~....~...-~.../....~..~-~..,~'....T../...~....L......~.~..~'..~....~....~...L..~..~'..~..
Does proposed construction violate any zoning law, ordinance or regulation:............. ...... ~....
Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes /
Name of Owner of premises ..~...~...~.......~...~'....~....~.....M'../...~.../..~.. ...... Address ................................ PhoLn
Name of Architect .............................................................. Address ................................ Phon
Name of Contractor .................................................... ........ Address ................................ Ph0n
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b<
property lines. Give street and block number or description according to deed, and show street
whether interior or corner tot.
COUNTY q
(Nay
above named. L,
He is the ...........
ck dimensions from
names and indicate
............................................................... being duly sworn, deposes and says that he is the applicant
individual signing contracf)
(Contractor, agent, corporate officer, etc.) j
of sa d owner or owners, and ,s duly authorized to perform or have performed the sa~d work ondto make and file
this application; that all 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 forth n the app cat on filed therewith. /
Sworn to ~e~m, this . C'-~.~.~__.~ ~_~ ~. j
............7day of ...... ~:"~':G '~9.../~.-~., ~ , ~ " , /
Notary Publi~ ................................... · ....... ; ......... County ~... ~..~'~.~
',.~ ----'-~ (Signatbr~ ~f app-T~ant
BY THIS CERTIFICATE OF COMPLIANCE THE
NEW YORK BOARD OF FIRE UNDEI WRITEI $
BUREAU OF ELECTRICITY '
40 FULTON STREET ~ NEW YORK, NY 1OO38
CERTIFIES THAT
Upon the application of
upon premises owned by
CHRIS HATTON
430 GRIGONS PASS
SOUTHOLD NY,11971
Located at
Application Number: 1058963
Section: Block:
Described as a Residential
430 GRIGONS PASS SGUTi-;OLD, NY 11971
Lot:
CHRIS HAI'TON
430 GRIGONS PASS
SOUTHOLD, NY 11971
Certificate Number: 1058963
Building Permit: BDC: NS11
occupancy, wherein the premises electrical system consisting of
electrical devices and wiring, described below, located in/on the premises at:
First Floor, Detached Garage, Outside, Pool/Spa,
was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was
found to be in compliance therewith on the ]2th Day of June, :2002.
Name QTY Rate Rating Circuit Type
Additional Charges
pool & pool house (converted garage)
No visual defects: an elctrical survey has been made of the exposed electrical equpment in the premises indicated. No obvious unsatisfactory
condition was found.
seal
1 of 1
This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated.