HomeMy WebLinkAbout12315-zFORM NO. 4
TOWN OF 5OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.Z15413 Date March 24, 1987
THIS CERTIFIES that the buildhng ....... .A.c.c.e..s ,s.o.r. y ..............................
22135 MAIN ROAD ORIENT
Location of Property ...............................................................
House No. Street Ham/et
County Tax Map No. 1000 Section . .0. J ,7 ....... Block ..... .4 ......... Lot ...2. ~ :.1 ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.M 03'.. 1. ~ o.. 1.9. ~ ~ .......... pursuant to which Building Permit No. [ 23.1.5. g ..............
dated .M..aT.. 1.2.,..1.9.8..3 ............... was issued, and conforms to all of the requirements
of the applicable provisions of tile law. The occupancy for which this certificate is issued is .........
Accessory. g,a z.e.b. 9
Th¢ certificate is issued to E. GEOFFREY HIGH & BURTON THIEL
..................... X ....................
of the aforesaid building.
Suffolk County Department of Health Approval ..... .N./.A. ..................................
UNDERWRITERS CERTIFICATE NO - - N/A
PLUMBERS CERTIFICATION DATED: N/A
Building Inspector
Rev. 1/81
IPORI~ lqO. B
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 12315 Z
Permission is hereby granted to:
........
..... ./~..~ ....... /..~ ............................................
;, .......... .42..~..~Z.~..~.,.~: ...........................
,o...,.~.~...¥.Z~.~.~/....~.~.~.~v, ....... Uw~..~--,e.~.... ...... ~......~,,...., .............
· dd/..,~ ....~.....~.../...~.....dc~.~..~ .......... ~..~.~..~,...~...,
at premises located at .................................... 7' 2 ~
County Tax Map No. 1000 Section ..... .c~.../.~.~.. ....... Block ...... ~.....~... ..... Lot No..~..d.:.~..<..f...
pursuant to application dated ........ .~.~.../.....,../...C ............... , 1 ..~......~, and approved by the
Building Inspector,
Bud~hng Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTt FICATE OF OCCUPANCY
OW OF SOUTROLD
Instructions
This application must be filled in typewriter OR ink, and submitted I m 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 dlsposal-(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 building~ *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.
C. Fees:
1. Certificate of occupancy New Dwelling.S25.00, Accessory t$10.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
$ 50.00 Date ..... ~{...~..7...-~...d~.../. .....
5. Uodated C.O.
6. Alteration $25,00
New C on s t; z- u c t, i on Old or Pre-existing Building Vacant Land
Location of Property ............................................
House No. C~ ~. ~ ~. .~.~. ~Z~ ,z~,/ ;~ 6 Street?~, .~.. .~. , ~/, /. Ham/et
Owner orOwnersofProperty ..... r..?,.....f ..... ' ~l,b ~ £
/ .~. Block ~ Lot . .o~.~.~ /
County Tax Map No. 1000 Section .............................. ,~ .......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ~. Date of Permit ~ Applicant ;
?
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,
Re~. 10-10.78
Applicant ...........
FIELD IN'PElION COMMENTS
FOUNDATION (1st)
F'OUNDATION
2.
ROUGH FRAME &
PLUMBING
(2nd)
INSULATION PER N.
STATE ENERGY
~ODE
FINAL
ADDITIONAL COMMENTS:
macy hospital
E. Geoffrey High, F.A.C.H.E,
Associate Vice President
& Chief Operating Officer
1000 North Village Avenue / Rcckville Centre / New York 11570 /516-255-2200
February 9, 1987
Town of Southold
Office of the Building Inspector
Post Office Box 728
Town Hall
Southold, New York 11971
To Whom It May Concern:
Enclosed is a letter received concerning a building permit 12315Z and the
failure fof a complete and final inspection.
The only project that I have undertaken was a small gazebo in the backyard.
Why it has taken nearly four (4) years to "clear up this matter", I don't know.
I have know idea what the information is that you have on Form 6. I don't know
who the applicant was. It certainly was not me. The man who did the
construction has left the area~ and I have no idea where he presently lives.
Si -nc~sed a check for $10.00 -- for what purpose I also do not know.
this~ ends the ma[ter.
ly~ -- i
EGH/lb
Enc.
A Voluntary, Not-For-Profit Hospital founded in 1913 by the Sisters of the Infant Jesus
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under bui}ding
permit no. 12315Z issued to Burton Thiel & Geoffrey High
on 5/12/83 for Accessory 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 $10.00 payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please, help ua to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very truly yours,
Victor Lesaard
Executive Administrator
VL:gar
encl.
Summerl2ouse'
~y G. John Baxter
In 'asking John Baxter, a southern
architect who is weB-versed in colonial
building traditions, to design a little oc-
tagonal outbuilding for us, we also asked
that he incorporate the kind of orna-
mental detail that he would use if build-
ing it for himself. A fine classic look is
the result: a simple spire of a roof finial,
chamfered posts with beaded paneling
betweefi them; four-foot benches whose
brackets and aprons repeat the shape
under the cornices. The drawing shows a
'wood floor, but a brick pattern is sug-
gested as an option; the roof can be
w. ood shingles or copper. The whole is
on a brick foundation wall, and the diam-
eter is a'com£ortable nine feet, eight
inches.
SUGGESTED MATERIALS:
Ail material should be dressed
Floor joists- pressure treated pine
Flooring-2 x 6 cedar or redwood
Bench and Panels-cedar or redwood
Ail 8 x 8 vertical posts and finial--
cedar or redwood
All other material-- paint grade,
CORNICE
DETA1 L
(~) ~^c<c-r
FAN'FAIL A'T H IF'$ .
~FhOOR PLAN
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined.. ~..~..~...F..~,'., 197.:
<Z., i&. .5. Permit No.
Disapproved a/c ........ '. ::......~ .................. /
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Application No. /~.~. -~../' .........
Date . . .~/.../~.. ........ ,
1
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 b~ 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 all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
plicant, or name, if a corporation)
...... .....
~ (Mailing,address of applicant)
°~S-'~lC~co~n~ac~tor ' ctnc~an -lumber
State whether applicant is owner, lessee, agent, architect, engineer, general o tra to, e~e ' ' , v or builder.
Naine of owner of premises .... .I~.% .~.~...[. ~.',.q.~[...~P... 6. ~.o.ClT..~. ~..C~...~.: .~/ ..........
(as on the tax roll or latest deedy
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 Hamlet
County Tax Map No. 1000 Section .. ~., ./. '7 ........ Block ..... "'/'L~I ......... Lot .............
Subdivision ....... .~ ............................. Filed Map No ..... ~. ......... Lot
(Name)
State existing use and occupancy of premises and intended use and oc, cupanc¥ o£ proposed construction:
a. Existing use and occupancy ..... O::~...~. ~.~....~,J~l~ ..........................
b. Intended use and occupancy ........ ~....~..~.~..~.~.'..~.. ~~....~..~
3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
~. .~ ~ .dyrff).:: : ........... ~¢ / (Description)
4. Estimated Cost ................... 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, commerciai or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth .................... i. · Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
9. Size of lot: Front ...........~ ........... Rear ...................... Depth ......................
10. Date of Purchase ........... ; .................. Name of Former Owner .............................
1 1. 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 promises: Yes No
14. Name of Owner of premises ..: ................. Address ................... Phone No ................
Name of Architect ........................... Address ................ ... Phone No ................
Name of Contractor ......... ................. Address ................... Phone No ................
PLOT DIAGRAM
Locate clearly and distinctly allI 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 NEV~417'OR~ aa :_ _
COUNTY OF~ ....
(Name of fndividual signing con, ct)
above named.
being duly sworn, deposes and says that he is the applicant
He is the ...................... !. .... ~ ...................................................
- . ~l~'~ntractor~, agent, corporate officer, etc.)
of said owner or owners, and is du~;: a~-t-o~ffd~form or have performed the said work and to make and file this
application; that all statements con%ained 'm this application are true to the best of his knowledge and belief; and that the
work will be performed in the mann¢ set forth in the application filed therewith.
Sworn to before me this
......... /.~-~ ..... dayof .... ~ .......
$o~/~Pub~ic, ' '2'~" '~ ~ County
~ / ~ Et,lZ^IlUlt A~IH lq[VlaL~-~--~ ['~ ' ' (Signature of up'Ii'in'ti
[ ~IOTAR¥ PUJBHO, Auto of Now York
~o, ~2-81~8~0, Suffolk County