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HomeMy WebLinkAbout12719-zFORM NO. 4 TOWN OF 8OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18277 Date AUGUST 14~ 1989 THIS CERTIFIES that the building Location of Property 53820 MAIN ROAD House No. County Tax Map No. 1000 Section 61 Subdivision ALTERATION & ADDITION SOUTHOLD~ N.Y% Street Hamlet Block 4 Lot 7 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25~ 1983 ...pursuant to which Building Permit No. 12719-Z dated NOVEMBER 2~ 1983 was issued, and conforms to all of the requirements of the applicable provisions of the Yaw. The occupancy for which this certificate is issued is REMOVE REAR SECTION OF TWO STORY STORE & REPT,ACE WITH ONE STORY STORAGE AREA]kS APPLIED FOR. The certificate is issued to ALBERTSON & KATZ (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF.HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-060777 - MARCU 1, 1989 - ~~J' u~ild'~in~gi~g inspector Rev. 1/81 FO~ NO. ~ TO~ OF SOfT,OLD BUILDING DEPART/vtENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ...J~ ................................................ . Permission is hereby granted/to ...~.~.=~.......L~~ ................ ...~..~~...~..~....~..: .......................... ..................... ,raises ;ocated at...~'~. '~...~ ,.~...?. at pr ................................. : ...... ~". ........ ~ ........................... County Tax Map No. 1000 Section ...... ..~...,.L ......... Block ....... .L~.. ........... Lot No....~.~/ ................. pursuant to application dated .... ~..~......~..;.~.-.'~. ...................... , 19.~, and approv~ by the Building Inspector. Building Inspector Rev. 6/30/80 TO~N OF SOUT~OLD BUILDING DE?AET~IE~T TO~N RALL SOUTDOLD, RE~ YOR~ 765 - 1802 Heclth Planning ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Property. ........................................... STREET HAMLET Owner or Owners of Property ................................................. County Tax Map No. 1000 Section . -- Block ....... Lot' ..~..%... Snbdivi.-ioo ...... ~; ...... .. ........ Filed Map ........ Lo~....~. ..... HO. .~ --~-~.Date of Permit ........ ~pplicnnt . Dept. Approval .................. Underwriters Approval .............. Board Approval ................ Rcque=~ for Temporary Certificate ....... Final Fee Submitted: $ ~ Certificate 10/14188 g0 FORM NO. TOWN OF SOUTIIOLD BUILDING DEPART}lENT TOWN U~LL 765- 1802 · APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONSi 'This application must be filed in typewriter OR ink and subm'itted to the Building Inspector with the following; for new buildings or mew Use:' I. Final sUrVey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic festa s 2. Final approval of Health De-t. of .... re . ; . ~ wuLer supply and Sewera~e-disposal(S_9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used la system contains than 2/]0 of ]Z lead. , ' 5. Commercial buildings, industrial buildings, multiple resli euces and similar. buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (Prior to April 9, ]9570 non-conforming uses, or buildings and "pre-existing" land uses: ~, ]- Accurate survey of property sbowing all property lines, st:feets, buildings and unusual natural or ~opographic features. 2. A properly completed application, a COnsent to inspect slg~ed by the applicant and a certified abstract of title issued by a title COmpan~ which shall show Single and separate OWnership of the entire lot priorl to April 9, ]957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspe'ction of buildlngslor premises, or other pertinent information required to prepare a certificate. For Vacant Land'Certificate of Occupancy: ]- An application for vacant land Certificate of Occupancy sh~ll be submitted, and a certified abstract of title issued by a title COmpan~ showing Single and separate oWnership of the entire 10t prior to April 9, 195~ shall also accompany the application. If a Certificate of Occupancy is denled,.ithe Buildln~ Inspector shall state the reasons therefor in writing to the ppl~cant. FEES: ]- CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Addltidns to Dwelling Alteration to Dwelling $Z5.00, Swimming Pool, $25.00. Aiccessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $150.00. 2. Certificate of Occupancy on pre-exlating dwelling - $ 00.00. 3. Copy of Certificate of Occupancy - $5.00 - OVer 5 years~i- 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy $50.00 6. Temporary Certificate of Occupancy - $~5.00 Resldentia! $50.00 Commercial THE NEW YORK BOARD OF FIRE UNDERWRITERS u~,~'~m~ "UREAU O~ E'ECTR,C,TY ~- 85 JOHN STREET, NEW YORK, NEW YORK 100,38 Date ~'~}[Cfi 0],~9~ ~pplicationNo. onfile ~0~/8~ [~l 0~0'/~{~ o~ly the electrical equipment ~ ~scrib~ belo~ and intro~ ~y t~e appJlca~t ~m~ on the above application nu tuber in the premises of thefolto~in~ tocatlon; ~ B.sement ~ ~t Fl. ~] 2nd ~. Section Bilk Lot ~s exutnined on },'~j~,~ll3~dy ~J~ ' 'J })~ ¢) and found to be in cotnpliance with the require.tents qf this Iloard. FIXTURE FIXTURES RANGES OVENS DISH WASHERS PANS DRYERS FUTURE APPLIANCE FEEDERS TtME CLOCKS UNtT HEATERS MULTi-OUTLET DIMMERS SYSTEMS NO. OF FEET .SERVICE DISCONNECT S E R V I C E OTHER APPARATUS: OOF NEUTRALS A W. G OF NEUTRAL 760 LO,fO CR~]~' tlRI~I~', This certificate must not be altered i~ any manner; return to the office of the Board if~ GENERAL MANAGER Per __ may be identified by their credentla{s, ~E ALTER~ED IN ANY MANNER. FIEL~ I~?ECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL COMMENTS ADDITIONAL COMMENTS: 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 RE: BUILDING PERMIT ~ I~ I~ sec. ~ I ~0c~ ~[ This Building Permit has expired. violation of the Town of Southold Please contact our office, corrected. LOT You are now in Zonin§ Code. this matter must be Yours truly, Victor G. Lessard Principal Inspector TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tlALL $OUTHOLD, N.Y. 11971 TI'.'L. 765-1802 This is Co advise you that the job under building permit no, 12719Z issued to A Alber%son on 11/2/83 for Alteration is completed and a final inspection has ( ) has not ( x ~-been done. fn order to complete thin file, it i$ 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 ia nnlawful without a Certificate of Occupancy. I'len~e help us to clear up thin mstter no that legal action docs not have to be taken, Thank ynu for yo.r prompt attention. Very truly y~, Victor Lensard Executive Administrator VL:gar encl. '"" Iff gti N- . CO~,fl~TR ill ,4" , /-,- OF: W[~'T LINg' OF', Examined..}~..~..~.., 19~..~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . .~..~.'~?.~..~...' .'?.., 19~..~. Permit No).~. ?. t.~..~... 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 in triplicate 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 issue 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,f d~gulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ~ ~ (Signature of applicant, or name, if a c'orl/oration) / (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, encneer, general contractor, electrician, plumber or builder. .... .......................................................................... Name of owner of premises ~..~..'.~/~..~..~..O...,~.....o~.. ~./t~..~....~ .................................. (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 ..... 51~25: .~- F ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... /~...,~..~..~.,.. ~,..~:/...?..~..~..~,/~...~."~...'~ ...... ........ ,. .............. ........................................... Itouse Number Street Hamlet County Tax Map No. 1000 Section ..... .5..Z ....... 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....fi,' .~..~.~..~.'... r. ~. ~..~. .... .~'....~. Y~./~...~.....~..~....~..~. ?.~.~. ,7- b. Intended use and occupancy .... .'~..~.~.. ~_~ .................................................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .' .... Repair ....~.. ....... Removal ...... ~ ..... Demolition .............. Other Work ........... ~... .~ (Description) 4. Estimated Cost ........................... Fee ...................................... : (to be paid on ~ing this application) 5. If dwelling, number of dwelling Units ............... Number of dwelling units on each floor ................ If garage, number of cars ......................................................................... 6. If business commercial 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 ..................... ¥~/~. > ........... D imen~lons of same structure w!th alterations or additions: Front .....~.~'. ~".2. ....... Rear Depth ~ .................... i. - Height ...................... Number of Stories ................... 8. Dimensions of entire new const/uction: Front Rear Depth Heighti ............... Number of Stories ........................................................ 9. Size of lot: Front ...... ~..., ........... Rear ...................... _Depth,. ...... /~, ....... ./.... 10. Date of Purchase . · .~'dr..d'0'7'..,/~.~ ................ Nalne of Former Owner ~Z'..~.. 1 1. Zone or use district in which pr~mises are situated ..... /~ .7. / 12. Does proposed construction vioiate any zoning law, ordinance'o'r'r;~iai;o'~:' i i i ~.' ~. i i i i i i i i i i i i i i i i i i i i i i i 13. Will lot be regraded ............................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~.-~,q..,~.J'.d..,~. ~ ./.~/~..2~,.Address ~24~./d2./q.J~/.~. Cq?eff.~d.~hone No.. Name Of Architect..' '~'~'/'',.._1 ~-.. l~- ~ .......... Address ................... Phone No Name 9f Contractor ...'7~.:....~7. ~'. ............ 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 clorner lot. STATE OF NEW~O~R[,.. ,_ .~ ...(r(.:..c~-d..~.'. ~..a~.. : being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . .' .................... :~7(-0~ ....................................................... ; ,: (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;i that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed ~n the manner set forth in tlxe application filed therewith. Swon3 to before me this Notary Public,~. . County APPROVED AS NOTED FEE: ~'-~, J BY: ~/, ~'. L,. NOTIFY BUILDING DEPARTMENT AT FT~5-1B02 9bAlM TO 4 PM~OR THE ~ L ~ LLOWING' TNSPECTIONS: ,. POUN~AT,ON-TWO REQU,RE~ OCCUPANCY OR FOR POURED CONCRETE 2. ROU~ - F~MING & PLUMBING 3. INSULAT[F)N 4 FINAP - C~N'STRUCTION MUST BE C'~4pl ~ FOR C. O. ALL CONqTR~ICTION SHALL MEET THE RE©[URrMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS USE IS IJNLAWFUL Wii'~%T C[RTIFICATE ~F OCCUPANCY