HomeMy WebLinkAbout12509-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27047
Date: 04/19/00
THIS CERTIFIES that the building ADDITION
Location of Property: 6005 HORTON LANE
(HOUSE NO.) (STREET)
County Tax Map No. 473889 section 54 Block 7
SOUTHOLD
(HAMLET}
Lot 21.2
subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 23, 1983 pursuant to which
Building Permit No. 12509-Z dated JULY 23, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MARGARET CONWAY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. E-067620 04/12/00
PLUMBERS CERTIFICATION DATED N/A
~~ignature
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK ~,UTHORIZED)
12509 Z
Permission is hereby granted to:
(,.~..0..~ ...... ~.~......~....~ ................
_ . .~..~~.~..~.::~.?...~... ...............
~o ......... ~~ ....... ~ ........ .C~~....~ ....................................
at premises located alt ......'.~....o...Q.~ .......... ~....J.~.'~.....~.....,C~.. ,~,.~..~ .......
pursuant to applic 'o d .............................................. r
Building Inspector. ~__~,~ ~
~ee ~....0...~.,.....~. ...... '~-
. ~
.................
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, proI
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposa
y ' es~
~9 form)
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in syste~ qgnta~ns
less than 2/10 of 1% lead.
5. Con~ercial building, industrial building, multiple residences and similar buildings
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.
For existing buildings (prior to April 9, 1957) 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.
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 dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00
Date ....
New Construction ........... Old Or Pre-existing Building..Z~.. .......
Location of Property.. ~P~%~ ~-~ ~-~S
House No. Street Ha~et
Onwer or O~ers of Property...~~..~.~
County T~ Map No 1000, Section .............. Block ................ Lot ......................
Subdivision .................................. .. Filed Map ............ Lot ......................
Permit No ............ Date Of Permit ................ Applicant .............................
Health Dept. Approval ........................ .. Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Yee Submitted: $ ............................ (:.~ ....., ,, ~.~'/~
~O~?OV7 ~ ~PLIC~T. '
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
MARCH 9, 2000
4TN NOTIFICATION
MRS. MARGARET CONWAY
6005 HORTONS LANE
SOUTHOLD, N.Y. 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
~3XX An application for Certificate of Occupancy
is
not on file. (Enclosed)
XX
xx
No Underwriters Certificate on file.
The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT % 12509-Z*
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
*THE ABOVE BUILDING PERMIT HAS EXPIRED.IT IS UNLAWFUL TO OCCUPY
OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN
ISSUED. TO AVOID A VIOLATION BEING ISSUED, PLEASE APPLY FOR THE
C.O. SO THAT WE MAY CLEAR UP THIS MATTER.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
January 28, 1998
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
Margaret Conway
6005 Hortons Lane
Southold, New York
11971
To Whom This May Concern:
We are unable to complete your Certificate of
because of the following reasons:
XX
XX
Occupancy
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The Check not on file. $25.00 Due
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 12509-Z Permit has expired
Please contact our office on this matter. Thank you for
your cooperation.
SOUTHOLD TOWN BUILDING DEPT.
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
March 26, 1990
Margaret L. Conway
6005 Hortons Lane
Southold, N.Y. 11971
Dear Mrs.
Re: Building Permit 912509-Z
Premises: 6005 Hortons Lane, ~hold, N.Y.
Suff. Co. Tax Map ~100'0-54-7~
Conwa¥: -'~
During a review of our files, it was noted that the above
building permit has expired and a Certifieate of Occupancy has
not been issued for your deck addition.
According to the Code of the Town of Southold Article
XXVIII 100-281 and 100-284 a building permit is needed for
construction of an addition to an existing dwelling. It is
unlawful to use said addition until a Certificate of Occupancy
has been issued.
Your final inspection has been made. Your check that we
have is outdated. We return it herewith. We have your
application, but still have not received the Underwriters
Certificate.
Please send us a new check in the amount of $25.00 along
with the Underwriters Certificate so that we may issue the
Certificate of Occupancy. Kindly clear up this matter as soon
as possible so that legal action does not have to be taken.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
VRW:gar
encl.
Vincent R. Wieczorek,
Ordinance Inspector
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 5, 1995
Ms. Margaret Conway
6005 HOrtons Lane
Southold, NY 11971
Re: Building Permit #12509-Z
Premises: 6005 Horton's Lane, Southold
Suff. Co. Tax Map #1000-54-7-21.2
During a review of our
building permit has expired,
never been issued.
files it was noted that the above
and a Certificate of Occupancy has
According'to the Code of the Town of Southold, Article
XXVIII 100-281 and 100-284 a building permit is needed for any
construction of additions, accessory structures or new
dwellings, and it is unlawful to occupy or use said structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
ELDG. DEPT
TOWN OF $CUTHOt D
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted m ~ to the Building InSpec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of pzroperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and COndition of buildings.
3. Date of anv housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
New Dwelling.S25.00, 'Accessory ,$i0.00 Business $50.00
1. Certificate of occupancy
2. C0rtificate of occupancy on pre-existing dwelling $ 5 0.0 0
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Uodated C.O. $ 50.00 Date ..........................
6. Alteration $25.00
NewCons tr'uc %ion '~ ..... Old or Pre-existing Building ..., ......... VacCt Land .............
Location of Property ,~;~/~)~Oo.~.. ~. '.~ ....... i~.. ..... ~/'~" "~" ~'-~" '/"" '~/~/'e[
Owner or Owners of Property~ ~ ~..~ .~~ .... ~../~_. ·
Health Dept. Approval ........................ Labor Dept. Approval .....................
Underwriters Approval ...................... Planning Board Approval ......................
Request for Temporary Certificate Final Certificate . ·
Fee Submitted $ ............................
Rev. 10-10.78
FIELD INSPECTION
FOUNDATION
FOUNDATION
(1st)
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C~DE
FINAL
DATE 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
NAME:
ADDRESS:
RE:
BUILDING PERHIT ~ 12~¢?
SEC. 5-¢ BLOCK
LOT /?
This Building Permit has expired. You are now
violation of the Town of Southold Zoning Code.
Please contact our office, this matter must be
corrected.
Victor G. Lessard
Princlpal Inspector
TOWN OF SOUTHOLD
OFFICF. OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. ! 1971
TEL. 765.1802
Th~s is to advise yon that the job under building
permit no, 12509Z issued to Margaret Conway
on 7/23/83 for Addition is c~'plet'ed and
;1 f'(~l'~ {nspection has ( ) has not ( X ) been done.
rn order to complete this file, it is necessary chat
a Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for $25.00 payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrnn~e with this off~ce for an inspectio~ (late
,Occupancy or uae in unlawful without a CertlflcaCe of
Occupancy. Please help us to clear up Chis matter so that
legal action does not have to be takee.
Thank you for yo.r prompt attention.
Victor Lessard
Executive Administrator
VL:gar
encl .
THE NEW YORK BOARD OF FIRE UNDERWRITERS
80793-2 BUREAU OF ELECTRICITY
~ 40 FULTON STREET, NEW YORK, NY 10038
Date APRIL 12,2000 Application No. on file 20195500/00 1t 067620
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the,applicant named on the above applicalion number is in the premises of
JOSEPH A. ~CONWAY, 6005 HORTON LANE, SOUTHOLD~ NY
in the fbllowi~g location; [] Basement [] 1st Fl.. [] 2nd Fl. OUT i Section Blo,ck Lot
was examined on APRIL 07 t 2000 and found to be in cqmpliance with the National Electrical Code.
FIXTURE FIXTURES RANGES , COOKING DECKE OVENS DISH WASHERS EXHAUST FAN~
OUTLETS RECEPTACLES SWITCHES NCANDESCEN' FLUORESCENT OYHER AMT. K,W AMT. K.W. AMT. K.W. AMT K.W. AMY. H.P.
2 2 1 2
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT. TIME CLOCKS BELL IUNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
AMT, ~(.W. OIL H,P, GAS H,P, AMT. NO. A W, G. AMT. AMP. AMT AMP~$. TRANS· AMT H.P. NO. OF FEET AMT. WATi'S
~ ~SERVICE-DISc~NNEC~T~ · NO~OI ~ ~ ~ ' S~ ' '~-~ ~ ~!~"R ~ '~V~ ~ ~-"~l~': .... C~''' -~'~E ...........
DECK-- 1
G.F.C.I=-I
AMOUNT
FEE PAID a PLEASE REMIT BY CHECK OR MONEY
YORK BOARD OF FIRE UNDERWRITERS
JOSEPH A. CONWAY AS CASH SENT BY MAIL WILL BE AT RISK
6005N HORTONS I~ OF SENDER,
SOUT~0LD, NY~ 11971
11
Per
TH~S IS YOUR BILl
Examined..~~.
Approved ..
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
19
· .~.~.., 19~..~. Permit No..]..e~..~..~. ~..~
Disapproved a/c .....................................
................................ .......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Application No...L .~....~7..O..C~ ....
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
Reguiations, for the construction of buildings, additions or alterations, or for removal or demolition, as herei~ described.
The applicant agrees to comply with all applicable laws, ordinates, building code, housing code~and regulations, and to
admit authorized inspectors on premises and in building for necessa~'~sl~ections.
(Signatu¢~of applicant, or name, i5 a ,corpor...a~)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ......... ¥. r..!~,.~. (.,~ ~,. ~.".~.:{.....k,~,¢ yx..[~fi.(,k...~.:/,4 ...............................
LIL (as on the tax roll or ~test 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 Hamlet
County Tax Map No. 1000 Sectmn .... ~..~ ......... Block .... .~ Lot .....
Subdivision ................ '~ ................. Filed Map No..~ ........... Lot..
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed const~ction:
a. Existing use and occupancy ........ ~)$~q. 7 ..... ~3'~'. ¢~ .' .~ (fi... ~:~q '.( .( f;~ ~ .....................
b. Intended use and occupancy ...... :{:.-.v...., :, ..... ~? .....:. ...... .;. :.. ~ ........................
3. Nature of work (check which applicable): New Building .......... Addition ~ Alteration ..........
.Repair .............. Removal .............. Demolition .............. Other Work ...............
,,o (Description)
4. Estimated Cost .......... Fee
(to be paid on filing this application)
5. ~ If dwelling, number of dwelling units ............... Number o f dwelling units on each floor ................
If garage, number of cars .... ' ........................................................ . ............
6. If business, commercial or mixdd 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 ................... .... Height .................... Number of Stories ........
8. Dimensions of entire new construction: Front ..... ~..~tL( .... Rear ..... g .~.. ~. .... Depth i.°~ ~ Yl i i ii i
?Ieight ............... Number of Stones ............ ~ ..........................
· ' ' iq.a?.
9. ,size of lot. Front ....... .~..Q ......... Rear .................... Depth [ ~"
10. Date of Purchase .......... ~ .................. Name of Former Owner .............................
11. Zone or use district in which pr~mises are situated ....... ~ ............................................
12. Does proposed construction vioilate any zoning law, ordinance or regulation: ...........................
13. Will lot be regmded .... ~.~.i.:.~.~. ............ Willexcess fill beremoved from premises: Yes. x,._~ ' ~')
14. Name of Owner of premises .~.t{[ ...(-~>:t4~.~ ..... Address ................... Phone No ...............
Name of Architect ......... ; ................. Address ................... Phone No ................
Name of Contractor ........ i ................. Address ................... Phone No ................
Locate clearly and distinctly all
property lines. Give street and bloct
interior or corr er lot.
PLOT DIAGRAM
buildings, whether existing or proposed, and. indicate all set-back dimensions from
number or description according to deed, and show street names and indicate whether
STATE OF NFrA~OR~,.~_ /./~ S S
COUNTY OF~~'.ff.[....ff ~
....
above named. //
(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
applic-~,tion; 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 manner set forth in the application filed therewith.
Sworn to before me this
' · ........ ~._.~._.~..day of;.....~.~,~.<~_.: ~..., 19.~. .
$9)4ry Public,' ................... ~ouCrll~x (ff~/~
· . ~LI~ ~ ~w~ // (Signature of app, lic~nt)
NOTARY ~LIC, ~ato of New YO~ ~ [ ~
being duly sworn, deposes and says that he is the applicant