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HomeMy WebLinkAbout12401-zFORM l~O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17968 Date APRIL 25~ 1989 THIS CERTIFIES that the buildin~ ADDITION Location of Property 275 CARDINAL DRIVE MATTITUCK~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 115 Block 06 Lot 010 Subdivision MATTITUCK ESTS. Filed Map No. 4453 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 24~ 1983 pursuant to which Building Permit No. 12401-Z dated JULY 5, 1983 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 SOI~AR GREENHOUSE ADDITION ON AN EXISTING PATIO The certificate is issued to MARY R. RAYNOR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N-067267 - APRIL 17~ 1989 Inspector TOWN OF ~OUTHOLD 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? 12401 Z ...z~..~z..~.z.....~...~ ......... zzt.~ ~ ,o ....,~.~..,~.~..'~' .....~. ~...~~~..~~...~ .... ~....~/~~.~ ......................................................................... ~ ........... .~~~..._~..~ ........ ~,.,~~ ......... ~,.~.~...~..~.~.~ · c,,,~ T,~ M,p N,. moo S,~,, ..... L~ ....... B~k ...~. ......... L,~ N,. ...~.~ ........ Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUP Instructions This application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of' Fire Underwriters. 4. Commercial buildings, industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topogrcptqc features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3, Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ,red to prepare a certificate, C. Fees: ,1. Cert f cate of occupancy New Dwelling,S25.00, Accessory i$t0.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $~0.00 4.Vacant Land C.O. $ 20.00 t/''~"'~"~' 5.Updated C.O. $ 50.00 Date ....... .~. ............. Ne ...... Old or Pre-existing Building ............ Vacant Land ............. Hou~ No, Street Ham/et o, .... ......................... County Tax Map No 1000 Section ...... cc ............ Subdivision. % .... ~ . .Filed Map No ........... Lot No .............. PermitNo.[a~J.L~.DateofPermit ~(4~ZApp,,ca.t...~:.~: ..................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... / Request for Temporary Certificate ..................... Final Certificate ....~ ................ Fee Submitted $ ..................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-- 85 JOHN STREET. NEW YORK, NEW YORK 1003B ~PR1L ~7,~989 D~te ~pplieation No. on file THIS CE~IFIES THAT o~y ~ ~t~ ~u~nt ~ ~ ~ a~ int~ ~y t~ ~nt ~ on the a~ ~ numar ~ t~ p~m~ o~ iE~Y ~A~NO~, CARDINAL l)Rlv~, HA'I'T[TIICK, N.Y. ~ exami~ on and found to be in compliance with the r~uirementn of this B~rd. DRYERS FURNACE MOTORS FUTURE APFUAHCE FEEDERS TIME CLOCKS MULTI.OUTLET SYSTIMS PElT SERVIrI DISCONNECT ,RAbE LL(,Hq]NG. 4 C GOODALE ,,l,l',t. F~ U., 7355 MAIN EOAi~ MATTITUCK, HY, ?''' 2 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST HOT BE ALTERED IN ANY MAI~ER. ~,_i~i~NSPECTiON COMMENTS FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR ILO. BOX 1179 TOWN IIALL SOUTIIOLD, N.Y. 11971 Narch 2, 1989 TEL. 765-1 $0,2 Nr. Henry g. Raynor, Jr. R.R. fl Box 275 Cardinal Drive 14attituck, New York ll952 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_--/ An application for Certificate of Occupancy is not on file. /X_--/ No Underwriters Certificate on file. /~/ No Hea].~h Dept. Approval on /-~/ No final inspection has been made. Please contact ()ur office on this matter. Z Thank you for your cooperation. lluilding Permit f~ I 2 4 0 I Building Dept. ***/--/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y~ 11971 TEL. 765-1802 FEB - 6 1981 This is to advise you that the job under building permit no. 12401Z issued to H. E. Raynor on 7/5/83 for Addition is completed and a final inspection has ( ) has not ( X ) been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly~, Victor Lessard Executive Administrator VL:gar encl. VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD ADDRESS: DATE: Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 RE: BUILDING PERMIT # %~qo~ SEC. tl~ BLOCK ~ LOT (O This Building Permit has expired. You are now in violation of the Town of Southold Zoning Code. Please contact our office, this matter must be corrected. Yours truly, Victor G. Lessard Principal Inspector 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING ~INAL REMARKS: ,/~ ~-~/~--~ // DATE INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined..'7/.ff ......... , 19~. Approved .Z/ff. ........ ,1~..~. Permit No. · .t(. .~- · .Sf..O. .~''~-~ Disapproved a/c ........ '7~ ........... .X/, / (~' ' '/ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No./-o~..<tP'..O. ·/. ........ 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 herein described. The applicant agrees to comply with ail applicable laws, ordinances, l~uilding cod,e, housing code, and regulations, and to admit authorized inspectors on premises and in building for nece~ctio~f~ M//~ ~ · .... ~ [~lgfn~t~ pp _ (Mailing address of b, pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... O (a~/on the tax roll or latest deed) If applicant is a corporation, 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 ...................... 1. Location of land on which proposed work will be done .................................................. House Number %~ Street k. Hamlet County Tax Map No. 1000 Section ........... Block .............. Lot ............... .,,~..~ ~...~~.. Filed/vlapSo. ~k~.~.~,.~ Lot,..:'-~.. I./~.C Subdivision ' (Name) ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: *2/::2 a. Existing use and occupancy ........ ~L4~:v~..-w~..~3,~-.~_. ....................................... b. Intended use and occupancy ......... e'~~. · .~'/~....t~qdr .L .-~.~ .flS.~z.~O-~0....~. ~ .... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition . .~b~.. ..... Alteration .......... Repair .............. Removal ............ Demolition .............. Other Work ............... Estimated Cost .... .O..'9... ...................... Fee ...e ............................. ! i (to be paid on filing this application) If dwelling, number of dwelling iunits ............. Number of dwelling units on each floor ................ If garage number of cars ' If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... I)imensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same structure w.ith alterations or additions: Front ................. Rear ................. Depth ................... ;.. Height ...................... Number of Stories ..................... Dimensions of entire new construction: Front ............... Rear ............... Depth .............. tteight ............... Number of Stories ........................................................ Size of lot'. Front ' Rear Depth Date Of Purchase ' Name of Former Owner Zone or use district in which pr~mises are situated ..................................................... Does proposed construction violate any zoning law,, ordinance or regulation: ................................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No fp ~ Na~ne of Owner o remises .. ~ ................. Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name ~of Contractor . Address Phone No PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-back dimensions from lllx~t~rty lines. Give street and block' number STATE OF NF4ff, Y, ,t S COUN~FY 0F~ ..... iL' ................... ana V(Name of ifidividual ~gning contract) above named. He is the ................. ~. (c ontractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e and file ~is application; that all statements conthined ~ this application are true to the.,best of his knowledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. Sworn to before me this Notary Public, ~~"~~...~ ...... County fl ~__ .~,~~~i~.