HomeMy WebLinkAbout12365-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19342
Date SEPTEMBER 7, 1990
THIS CERTIFIES that the building
Location of Property 54300 ROUTE 48 &
House No.
County Tax Map No. 1000 Section 52
ADDITION
75 RUCH LANE SOUTHOLD~ N.Y.
Street Hamlet
Block 3 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 5, 1983 pursuant to which
Building Permit No. 12365-Z dated JUNE 6, 1983
was issued, and conforms to alt of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is WOOD DECK ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to ELEANOR RUCH
(owner)
of the aforesaid building.
SUFFOLK COUN%~f DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
N.o
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~6~ z ~,ote ......... ..~a.~.~.......4 ................... , ,,.~.~
Permission is hereby granted to:
.......... ~/_~.,u.7.../.~.....~.c~ .........
...... ...~...~...~..~ .... z~.o~ .T.~......,,.~..o~.~ ......
...... _~,~...~...-z..,~..~..~.. ....... ~ ......... ~...
~o ......... ~.~.~.~.....~.~ ....~:~....~_~....z ~...~ ..........
........ ~....~.~....~~. .......................................................................
et premises I~oted at ...'~.~ ......... ~.~..~ ................................................
.................................................................................................................
co~,~ ~ox Mop No. ~000 S,~o, .~ ....... ~k ...~ ........ Lo~ No..~.Z ...........
Building Inspector.
Fee ,..~......~~~.'
Rev. 6/30/80
Form No. 6
TOWN HALL .
765-1802
· APPLICATION FOR CERTIFICATE OF --' ' ........... ·
OCC~ANCY~
· %. This application'must be filled 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 %lectrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contm~,s
~ less than 2/10 of 1% lead·
5. Commercial building, indus, trial building, multiple residences and sJ/nilar bui/dings
and installations, a certificate of Code Compliance from'architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements·
B. For existing buildings (p~ior to April 9, 19~) non-conforming 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. ,.o
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
1. Certificate of Occupancy - New dwellin~ ~25.00 ~,,~,
Alterations to dwelling *25.00, Swimmino -oo7 *~~.'~J~
6 ~ ~ ~zo.uu, 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 C~r=ificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.90, Commercial $15.00
Date September ~, 1990
::ew Construction ........... Old Or Pre-existing Building .... ~ ...........
Location of Property... p~ppp .~..~. ~.c~.~.~qq.t~.qld, NY 11971
~ouse No. Street Ha~tlet
Onwer or Owners of Property.· Eleanor L. Ruch ~ -' * '
- ~- 052.00 ,, 03.00
County Tax Ma'p No 1000, ~ec~on ...... · ........ ~lock .......... . -001.000
' N/A ' N/A '
Su sion ................................... Filed Map ............ Lot ......................
Permit No 12365
.............. Date Of" ~- 6/6/83
.. re ...................... Applicant. Valemkime.R~w~.V ............
N/A
~lealth Dept. Approval .................. N/A
........ Underwriters Approval.· ,,
Planning Board Approval.. N/A '!',
Request 'for: Temporary Certificate ...... Final ..XX. .....
· · .... Certicate...
Fee Submitted: ~ 25.00 "
........................ . ......
ouu7. . .......
~PLIC~,NT ~le~.or L. Ruch
-
FOUNDATION (1st)
COMMENTS
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
?DE
FINAL
ADDITIONAL COMMENTS:
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 building
permit no. 12365Z issued to V. Ruch
on ~/~/8~ for ~d~i~n is completed
a final znspection has ( ) has not ( X ) been done.
and
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 yo~,
Victor Lessard
Executive Administrator
VL:gar
encl.
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
DATE:
NAME: VALENTINE RUCH
ADDRESS:
RE:
FEBRUARY 2, ]989
54300 NORTH ROAD
SOUTHOLD, N.Y. 11971
BUILDING PERMIT # 12365Z DECK ADDITION **
SEC. 52 BLOCK 03 LOT 01
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
Requires inspection and Certificate of Occupancy.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 7654802
Examined ~ .~.~.A4ZS.....~...., 19 .~.
Approved . ~../q'..~7.....~. ..... 1~..'~. Permit No.~q'~. ·z
Disapproved a/c .... ~ .............
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Application No. ~'/.~..~..~.~.~. .......
a. Tins 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 tlie 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. \1 IF3 ~x
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....cp..04 ~ ?.R, ..... .B.c..~.~.. ~.>...~Z. ..............................................................
Name of owner of premises
(as 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 ...... ~..~...Z/~..~. .........
Plumber's ~icense No ..... .....~ ............
Electrician s,License N6. ~. ................
Other Trade s License Nfl( ...................
/
1. Location of land on wjiSch.proposed/__ ---~ -- ~-w°rk will be done ..................................................
. .S.4.?. ~ ...... . .~q.~.'.r.~... !~..e..~.~. ....................... .S.o. ~ ~a..o. ¢.? ....... ./. ............
House Number Street Hamlet
......... - ! .....................
County Tax Map No. 1000 Section Block .................. Lot.. / /
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 ...O..M.~....~...tB. i,/_.X..' .~..~..~.L./-.I./? .~ ....................................
b. Intended use and occupancy . .~..D.p.E-. ~......W..0.Q.W'd.....D..E.Ce..~ ......................................
3. Naturelofwork (check which applicable): New Building .......... Addition ....... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work .~4.0(?. ?....O~.C..l~..
~> iO .~.. ~ (Description)
4. Estima[ed Cost ...................................... Fee .: ...........................
~ (to be paid on filing this application)
t :
5. If dwelling, number of dwellingiunits ............... Number of dwalling units on each floor ................
If garage, number of cars .... i ..............................
6. If busifless, commercial or mixeld occupancy, specify nature and extent of each type of use .....................
7. Dimemions of existing structurqs, if any: Front ............... Rear .............. Depth ...............
Height i ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear ..............
Depth i ................... ~.. Height ...... . ........... Number of Stories ......................
8. Dlmen~ions' of,entire new constrUction: Front . .I. ~..~ .C?. i'. ..... Rear ... !].~ f~ :' ..... Depth ..~..C/. ~..(~>. :,. . .
Height[ . .I. ~ ........... Number of Stories ................ ........................................
9 ~ize ofilot: Front ~ Rear Depth
10 Date of Purchase : Name of Former Owner
11. Zone o[ use d~stnct ~n winch premises are s~tuated .....................................................
12. Does p~oposed construction violate any zoning law ordinance or regulation: ....~.
13. Will lotl be regraded ....~..O.~r ................... Will excess fill be removed from premises: r?, Yes a ~.
14. Name c f Owner of premises .~/~.L~..~.'r'.(~.~../.~.0.c.~..AddressX.ffd~o ~,P,p . . .PhoneNo
Nmne c f Architect ......... i ................. Address ................... Phone No ................
Name c f 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. G~ve street and blockmumber or description according to deed, and show street names and indicate whether
interior or c~ ,rner lot.
!A cr c
......... ~.~i. · .~ being duly sworn, deposes and says that he is the applicant
(Name of individual sign!ng contra'l~)
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; {hat 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 manne~ set forth in the application filed therewith.
Sworn to before me this
.......... · ..~-~. .... day of.. ....· ./. · .'..] ~ ...... 19(~.~
No~rg..Pu~ic .............. /::~.xC~r-/~.. ~?~-/f.¥.... County 0 ~.
~' ~01~y PUl~ttC, State ~!. ~w ¥o1'1~ ...........................................
, Tsro} [xpires ~tarch 30, 1~ (Signature of applicant)
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