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HomeMy WebLinkAbout12082-zFORM NO. 4 TO~N OF 8OUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18326 Date AUGUST 30~ 1989 THIS CERTIFIES that the building Location of Property 13135 MAIN ROAD House No. ALTERATION TO EXISTING DWELLING EAST MARION~ N.Y. Street Hamlet County Tax Map No. 1000 Section 031 Block 05 Lot 010 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBF~R 6~ 1982 pursuant to which Building Permit No. 12082-Z dated DECEMBER 18~ 1982 was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ALTERATION OF EXISTING ROOM INTO A BATHROOM. The certificate is issued to JOSEPH L. TO%rNSENDr (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING - AUGUST 24~ 1989 N/A Rev. 1/81 TOWN oF ~O~j'm0~D I~UILD:NG DEPAF, TME~T TOWN HALL $OUTHOLD, NJ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ~U[L COMPLETION OF THE WORK AUTHORIZED) N? lg082 Z Permission is hereby granted to; · -'r~'w";'-'/'"'~'z:~'"'"": ...... '"'~ ...... :..~ "~~; '~:'~'"~1 ,o ...... ~....~m.~~~, .................. · -~-~..~.._. .,. : ~~--~_...: .... . ............................................................. ~t pmmise~ I~ted ot ............................................................... x:x ........ ~'""~' ~"~"t .......................... CounW Tax:; ~,p No. 1000 Section~ ................ ~ Z.~. Bl~[ ;~;...~.2 .............. ~l~}~t No. ~ ....................... pumu~nt to opplicotlon d~t~ .................................. ~ .......... ?..~?...., 1~.....~.., ~ 0ppmv y Bui~,pg I~spector. ..... Building nspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCL Instructions This application must be filled in typewriter OR ink, and submitted im~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building.............~' Old or Pre-existing Building $15.00 Date.. ,~..~.%,~.\, ,~..~, .~. ........ ............ Vacant Land ............. Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property ................ t ........................................ County Tax Map No. 1000 Section C3~ ~ Block ~ Lot...O. %..~. Subdivision ......... ~ ...................... Filed Map No ........... Lot No .............. l '~.0 ~L'~'~ Applicant Permit No ........... Date of Permit ............................................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate 'X Fee Submitted $ ............................. Construction on above described building and permit mee~e~odes and regulations. Appl~.~.~/.~....~.... ;'.~.~./ ........................ Rev. 10-10-78 TOWN OF SOUTHOLD OFI'qCF~ OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 TEL. 765-I 802 To Whora This Hay Co,cern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /~ A~i application for Certificate of Occupancy is not on file. /-~ No Underwriters ~ ' ' Certificate on file. /~ 'l'hc check J.~; (outdated~ot on.~. ) / / No lleal kh Dept. Approval on file. /_/ No final inspection has been made. P]car;e contact our office on this matter. Thank you for your cooperation. BulJdi. ng Permit Building Dept. No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 } OCCUPANCY OR USE IS UNLAWFUL WITHOUT A ~ERTIFICATE OF OCCUPANCY. CLEAR UP THIS MATTER AS SOON AS POSSIBLE SO TIIAT LEGAL ACTION DOES NOT DAVE TO BE TAKEN. Ti~ ank you. 1 -ii~"per tubing is ,used ' ~L~ water distributing ~ i~m; piping_shall b~. ~"'~ ~e~ K ~ L only OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY FIELD INSPECTi~ 1. ~ ,;, FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CpSE Y o COMMENTS FINAL ADDITIONAL COMMENTS: Examined .~.//.d ..... , 19 ~-~ Approved ~--'~-~-: f. *~.. .... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19 ~'~Z-Eermit No..[. Application No. / .~'~..~.~..?.... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 on 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 appli- cation. 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 issued 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 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, hous~in.g_.c_ode,~and regulations, and to admit authorized inspectors on premises and in building for necessary inspect~-- .................. (-Signature of applicant, or name, if a corporation) (Mailing address of applican't) (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ........ Electrician's License No ................ 7. ~.~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... ....,/ .... ................................. Name of owner of premises ............................................. '~P]~O¥~) 'A~' NOTEI~ ....... (as on the tax roll or 13t~st deed) If applicant is a corporation, signature of duly authorized officer. DATE:~B.p. '~ ] .~ ~ ~ff'~?r~_ NOTTCY BUlL. DING DEPAR~MEF~ 765-1802 9 AM TO 4 PM FOR THE Ie0LLOWING INSPECTIONS: l. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULAT!ON 4. FINAL - CONFTW, JCTI©N MUST BE COMPLFTP FOR C. O. Other Trade's License No ...................... ALL CONSTRUCTION SFtALL MEET THE REQUIREMENTS OF THE N.Y. 1. Location of land on which proposed work will be done ................ S.T .AT.E..C.O. ,N~.T.R.U.C. TI.O.N. &. Eb,~E[~G.y.... CO,~DES%,~.- ~QT RESPONSIBLE FC)R ..... ./V. .................. ............... .... House Number Street Hamlet County Tax Map No. 1000 Section ..... ~?..~. ] ........ Block ................. ~'~ . Lot... . . [..4~. .......... 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 0 h 4_ . ~,, ~ 4 b. Intended use and occupancy ............ ~ .ti ..vD...~. .............................................. 3. Nature of work (check which aOplicable): New Building .......... Addition .......... Alteration .~ .... Repair .............. Removal ............ Demolition .............. Other Work ............... .~.~./ (/~... (Description) 4. Estimated Cost o 00 Fee ". ........................ (to be paid on filing this application) 5. If dwelling;number of dwelling:units ....... ] ....... Number of dwelling units on each floor.., fi(f~'. ........ If garage, number of cars ........................................................ /~, .....~ ......... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... ~Z'.'~..., ........ 7. Ihmenmons of existing structures, if any: Front ....... ~.d. ...... Rear ..... ~.~ ....... Depth .. ~ ........... Height ............... Number of Stories ....... ~ ............................................... Dimensions of same structure with alterations or additions: Front . ..,~* .r~.. ~ ...... Rear ... ,J'.~..~..~ ....... Depth ........ ,~ .~ ~.t~_.,. : Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ..... ./~/.,,//~. .... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. raze of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ........ I.~./&~/g...7.~ ........... Name of Former Owner ...~¢? ,,:1 .o/.. ~.~?.r,. ~ .... 1 1. Zone or use d~strict in which premises are mtuated ......................... i'/' ......................... 12. Does proposed construction violate any zoning law, ordinance or regulation [~t/9 ....................... 13. Will lot be regraded ....... /?O. ...... ; ....... .,.. Will excess fill be removed from premises: Yes _,No 14. Name of Owner of premises . .~/.io.~.e/¢..C;..~...O.. q .~.~..~.~.~;~dress ................... Phone No..~. 7.?.-./.6.°..~. ... Name of Architect ........................... Address ................... Phone No ................ Name 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. STATE OF NEW,YO~RK, "S COUNT. Y OF. ~.". ff~'!/.(~ ..... '~' ~/o,~-,~./, d. ~7~--~ ~ ~'2' ,,'/ J" - being duly sworn, deposes and says that he is the applicant (Name of individual sign,lng contract) above named. He is the ...................... ~ .................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to 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 mann{r set forth in the application filed therewith. Sworn to before me this ........................ day of../r~. ¢ r~.-* .e~9. · .~.a: ....... 19 Not a_ry Public, ........ ~/_,7 .................... County ~ ~ __ ~t01~It¥ ?tla~,~°~ ~c~wu~;,~ ~'~ ' (SlgliaTure o~ applicant) It0. 52'8125850, ~uuo~r, lmm LX~ir~S March 30,