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HomeMy WebLinkAbout12586-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15334 Date March 10, 1987 THIS CERTIFIES that the building DORMER ADDITION & NEW FOUNDATION UNDER · ' · EXTS T IN'G 'ONE' 'FAMTIJY ' DW'EEL IN'G ........... Location 300 Lake Drive South~ld, New York of Property//~s~ Ho] ....................... 's't/e$i ....................... ~[~r~/e~' County Tax Map No. 1000 Section 0 8 0 . .Block 4 .Lot 6. I Subdivision M/o Reydon Shores .Filed Map No. 631 .LotNo. 4, 5, & 6 conforms substantially to the Application for Building Permit heretofore filed in this office dated August 26, I983 . pursuant to which Building Permit No. 12586z dated.......September ..... . ...........9' 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 ......... DORi~R ADDITION & NEW FOUNDATION UNDER EXISTING ONE FAMILY DWELLING The certificate is issued to ANNETTE LaTORRE ..................... lo¥.'~;,'/~'g~ ..................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. N 6 5 7 9/4 5 N/A PLUMBI~RS CERTIFICATION DATED: '~'~' '~'lding Inspector Rev. 1/81 FORM NO. 2 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 AUTHORIZED) 12586 Z Permission is hereby gran~et~to: o, premises I~oted o, ...... Coun~ Tox Mop ~o, 1000 Se~n ....9.~..9 ........ BI~K ......... ~ .......... Lot No ......~ ............... p~r,u~,~ ,o opp~,io, d*,~d~~...~.~ .................. , ~.~, o,~ ~pprov~ by t~e Building Inspector. Rev. 6/30/80 FORM NO, 6 TOWN OF BOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~a laaaaa~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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings 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 '$10.00 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 o.oo Oete ..... 5. U~dated C.O. 6. Alteration $25.00 NewCons truction ...... Old or Pre*existing Building ............ Vacant Land ............. Locat,on of Property Hou~ No. f Owner or Owners of Property County Tax Map No. 1000 Section ........... Block ,.,,,,,.,,.,,,, Lot,.,, ', ........ Subdivision ....... /,~/ ..... '.~...Filed Map No..~:)..~. ['.,..Lot No .............. Permit No ...... Date of Permit . .Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval . ~ /O5;~ .~ J/'..~f n r ...................... ....... -. ....... Planni g Boa d Approval Request for Temporary Certificate ..................... Final Certificate , ,.~/, ................... Fee Submitted $.?~, ~.', 9?, .................... Construction on above described building and permit meets all appli,~b~codes and regulations. pp cant ... L,~ ~,.x~ ...... ~¥~_~ :;. ;.,. ;,. .................. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No Owner h~/L~~~_~ (please print) (Please print~ Date I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this /~ day of ~ , Notary Public,~c/~ County ( Plumbej signature ) Notary Public NOTARY PUBI.IC, State of New Yodr No. 4707878, Suffelk Ceunty~.,; Te~m Expires M~;ch 30,19 ~/'/ TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN tIALL SOUTHOLD, N.Y. ! 1971 TEL. 76S-I 802 This is to advise you that the job under buildlng permit no. 12586Z issued to .Annette LaTorre on 9/9/83' for 'Addition is co~'pleted ;] f-(r~'l--~Sp--e-~tion has ( ) has not ( z ) been done. and rn orde~ to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the encloaed form, return same to the above office with a check for $25'OOpayable to tbe 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 _youths, Victor Leasard Executive Administrator VI,. ga r encl . 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION /ND [~ INSULATION FRAMING [ ] FINAL REMARKS: ~,i // INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ~./ FOUNDATION 1ST ~] ROUGH PLBG. FOUNDATION 2ND [£~]INSULATION FRAMING FINAL REMARKS: DATE looo12z THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIC+IT~ ~]~]~ 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 ~>.t~ August 31~ 1984 ~p. lic.tlo.;vo o,,yll~ 253049-84 · N 657945 THIS CERTIFIES THAT Marlor~ J. LaTorre~ Lake Dr. SoutholdF in the following location; ~ Basement ~ 1st Fl. FIXTURE OUTLETS SWITCHES 8 8 FIXTURES INCANDESCENT FLUORESCENT 8 DRYERS [] 2nd Fl. Section Block Lot and found to be in compliat~ce with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET OTHER APPARATUS: R V I C E CC. COND, OF HI-LE~ ---1 smoke detector--- 8' track lites--- AWG OF NEUTRAL Tow~ }talbot Lane ; ~/~ SouUhold~N,Y. 11971 lic .~82E GENERAL MANAGER , ; Per This certificate must not be altered in any manner; return ~o the office of the Board if ~nco~rect. Inspectors may be identified by thei¢ credentials. CQP~FOR BUILDING DEPARTMENT. TH S COPY O~ C~ F C~ ~U~[~T BE~TERED ~ ANY MANNER ~IEL~ INSPECTION cOMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-180:3 Examined...~..~."~.... ~ .... , I~...~. Approved .........'.~.~,'. .... .~.., 19~..~. Permit No.~. ?,.~."~..~..'~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ., 197.3. 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 all applicable laws, ordinances, building code, housing code, and regulation_s, and to admit authorized inspectors on premises and in building for necessary inspectioms. (Signature of applicant, or name, if a corporation) .l.t. ./.3. : . . . :.,.;. . .& . . . 5 .4. 3 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ..~..t')..~ .ex..~.?<....J-~..c~.'.~.O..F.C.~.' .............................................. (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..~..O./).~..l~.O.'.~. ......... Plumber's License No. ~~:~.$7/.ai'. Electrician's License No..~..0,~-.....~..6,7..~~ .~. ...... Other Trade's License No ...................... Location of land on which proposed work will be done...~..~.k~-.'~... (! '(/'~' 't'' '/~' '~'~ .~..O.Q.S.~.O..(~....~' ........ ........................................................ ....... ....... House Number Street Hamlet !. County Tax Map No. I000 Section..O..~..0. ........... Block ..~....~ ......... Lot ..... ~..~.' ....... Subdivision..~. +.c~.~..~..~. .... ¢ .~.c~..~-7..~.. ........ FiledMapNo..6~.[ ........ Lot .... .~t/ ........ (Name) State existing use and occupancy of premises and intended nee and occupancy of proposed construction: a. Existing use and occupancy ! b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition ............ Other Work ............... ~..,5 '-/'/./ ~' 000 (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, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurbs, if any: Front ............... Rear .............. Depth ............... lteight ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front Rear Depth ................... ... Height ...................... Number of Stories ...................... 8. Dimensions of entire new ' ' Front ......... ., ..... Rear ....... Depth constructmn: ....................... Height Number of Stories 9. Size of lot: Front .......... ............ Rear ...................... Depth ...................... 10. Date of Purchase .'~/..t&/.~.. ~.l.).l. Ct .~ .......... Name of Former Owner ~ (.~2.~ .r>. ~.~ .z_,/. 2)¢ 11. Zone Or use district in which premises are situated ...................................... !. ............ 12. Does proposed construction vio'late any zoning law, ordinance or regulation: . ~..o ........................... 13. Will lot be regraded ..... .~(.~ .......... .-:-: .......Will ex.ces~ 1~11 be removed from premises: ~Yes No 14. Name of Owner of premises L-:dD. zIe-//e-. ~ ! .o. rf.~. Address ./--.~.~. p.r.'t.~.~. ......... Phone No..~..~. ?.&.g. ~. ~... Name of Architect . .~.~o..e.e~9. ?. ~..~.Jg?..~ ........ Address ./~..q~.;q ~.o..at.~ ...... Phone No.. lqame of Contractor · .~.OOfi..g~. · ~..~.~ ('.% ..... Address ,~;~ .,~.~.. ~ .r. Li/..~..' 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 blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NI~R~,/ (-~ ., . ..... ~... ~. i.~ ..'7..~_~;Z~'g.:q/..~ being duly sworn, deposes and says that he is the applicant (Name ........ of individual s"-"" ' ighing contract) above named. He is the s. (Contractor, agent, corporate officer, etc.) aid owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this /application. that all statements contained in this application are true to the best of-hla knowledge and belief; add that the work will h{ iSerformed in the manner set forth in the application filed therewith. ~ Sworn to before me this Notary Public ......... ~ ..... ~_... County ./f7 '-~"~,/~ S~_k .~upj~/, "~' (Signature of apphcant) 4 ' ~ If copper tubing is used for wat®.~d, isiributing system; p,pmg shall be of types K or L only "Alteration of this Document e~cept ' by an Architect or Licensed Profes. Sional Erll~ineer, iS illegal": Sedtion 72i~'_'), Subdivision 2~ N.Y. State Education L;aw~ Nchitect and £n~inee~s Sea[ a~G $!.~netu[e on}y g~ for initial use of dr~in$: Ch:o~, ~lterafl0~s er re · Vi~ons to ~r r~se of dr~;TnSs'W~h-,: , v~ ~al ~d Si~ure on A~q~OVED AS NOTED FEE:;~C"I~' ,Y: Y, QL. NOTI~ ~ILDING DEPARTMENT AT 7654802' ~AM TO 4 PM FOR THE ~ FOLLOW]~ IN~ECTIONS: ~. FOU~D~ION - ~O REQUIRED FOR P~RED CONCRETE 2, ROUG~- ~AM~NG & PLUMBING 3. INSULATIO~' 4. FINAL - C~N~TRU~I~N MUST BE C~PL~E [~ C. O, ~ ALL CON'RUCTION SHALE ME~ THE RE~U[REME~ OF T~ N. STATE CON'RUCTION & ENEE~ CODES· NOT RESPONSIBLE DESIGN ~ ~T~I~ ALBERT A.,, 'SACCO GOEDON K: AHLERS 1546,55 L (¢-,,'T~) .