HomeMy WebLinkAbout12600-zPORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N,Y.
Certificate Of Occupancy
No. Z-16530 Date December 22, 1987
THIS CERTlFIES that the building Construct Deck Addition
Location of Property 2320 Yennecott Drive Southold, New York
House No. Street Hamlet
County Tax Map No. 1000 Section ....0.5.5 ...... Block 04 .Lot 033
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
September 2, ! 983 pursuant to which Building Permit No. ! 2600 z
dated............................September I5, 1983 . wasissued, 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 JOHN C. ROSS
..................... id~;n'o'r,'~seTe~l:~¢7~' .....................
of the aforesaid building.
Suffolk County Department of Health Approval .... N / A
UNDERWRITERS CERTIFICATE NO ..... N / A
N/A
PLUMBERS CERTIFICATION DATED:
Building Inspector
Rev. 1/81
FO~tM 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)
12600 Z
Permission is hereby granted to:
..~.~,...~ ...... ~..~,.~ ...............
....... ~.~..~; ......................................
...... ~..~.-~L~..~..~:.~.:~. ..................
...................................
at premises located at .~...~,~,..c~..o..O........~~.~..-.~.~it)...%~)..~;~¢...~~ ......
County Tax Map No. 1000 Section .... .?.,.~..~...~.~. ....... Block ....... .,~....~ ....... Lot No......~.....~..~.~ .........
pursuant to application doted ...... ..~~,~........'~... ........ , 19..~.,,~, and approved by the
Building Inspector.
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - ]802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ,-, Jama,.=m to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate location of alt buildings, property lines, streets, and unu~al
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 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 Neu I)welling.$25.00, 'Accessory tS10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50. O0
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00 ~ l ~?
5.U~dated C.O. $ 50.00 Date ...~3 .... ~.1. ,.].~ .....
6. hlteration $25.00
New C on s t P u c % i on ...... Old or Pre-existing Building ~. ......... Vacant Land .............
Location of Property .................. ' .....................................
House No. Street Hamlet
Owner or Owners of Property ~,~ ~ .';.
County Tax Map No. 1000 Section .............. Block ............... Lot ................
Subdivision ............................
Permit No ........... Date of Permit.. ....
Health Dept. Approval ...................
Filed Map No Lot No . ..
Applicant
~..
.... 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.
.............................
R~v. 10.10.78
Co 1&55o
FIELD INSPECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
~ODE
ADDITIONAL COMMENTS:
TOW OF 50UTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
· town HALL
SOUTHOLD, N.Y. ! 1971
TEL. 765-! 802
Thls is to advise you that the Job under building
permit no, ~ issued to John Ross .......
on _.~/~ff~.83 .... for A._~d~.~J~og .. , is completed and
a final inspection has ( ) bas not '( ~ ) been done.
rn order to complete thla file,'it'is necessary that
;, Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a cheek
for $25.00 payable to the Town of $outhold. Please indicate
to ~hom tho Certificate of Oecupdney i~ to be mailed~ nnd
arrange with tills office for an inspection date
Occupancy or uae in unlawful without a Certificate of
Occupancy. Please. help tls to clear up this: matter so that
legal action does not havo to be taken,
Thank y¢)u for your prompt attention.
Very truly y~,
Victor Lussard
Executive Administrator
VL:gar
enc{.
TOWN OF SOUTiIOLD
OI.I'ICF OI.' BUILDING INSPF. C¥OI~,
I'.O. BOX 728
TOWN IIA LL
SOU FIIOLD, N.Y. 11971
November 27, 1987
TEL. 765-1807
Mr. Jobn C. Ross
Box 560
Southold, New York
11971
complete your Certificate
?f tile following reasons.
' / Ail ,,I'~¢1 i,:;lt, i. rm for Certificate of Occupancy
/x/ :i,> Iind,:t',;rit,~,~.5 Cc'~tificahe on file.
/x'/ 'lbo (,hock i:;(ouLd,lted/~x~i~gB Returned herewith, plea:
send new check in the amount of $25.00
/ / ~:~, ~(:n'[lh Dept. Approval on file.
/ -/ l'.,~ fin,~l Jnsi)(,cf.ion has been made.
ihlJ ]dj r/q
1'],,,~.,,, conlact, our office on this matter.
for your cooperation.
l'[umbor So]der Certificate on file.
all p(~rluit.~; involving plumbing being
J.r~s~ed ,~fter April 1,1984 )
~ 0cc,qwmcy or use is unlaw[ul without a Certificate of Occupancy.
('.l(,;lr up Ibis; matter as soon as possible sO that legal action does not
h;tvo £o I)e
Thank ymt.
TOWN OF SOUTIIOLD
OFFICE OF I~UILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
We are unable to complete your certificate
of Occupancy because ~of the following reasons.
/Z/ An application for Certificate of Occupancy
is not on file.
_~- No Underwriters Certificate on file.
/Z/ The check is(outdated/not on file.)
/Z/ No Health Dept. Approval on file.
/Z/ No final inspection has been made.
Please contact our office on
Thank you for your cooperation.
Building Permit # I 2~6 o..--0 Z
Building Dept.
***/-_1
this matter.
No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
SOUTIIOLD, N.Y, 11971
TEL. 765-1802
LI ~L ...................
~LDCL l:!'{ ':
TOWN (? ?"'
'this is to advise you that the job under building
permit no. ~ issued to .... 'JQ~i~ ROss
on __9./15~_8. _~____ for _--Ad~_d_i_tion is completed
a il. hal ].nspection ha.,; ( ) has not ( X ) been done.
and
rn order to complete thin 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 tlde Town of Souehold, Please indleate
to Whom tide Certificate of Occnpancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or uae is unlawfnl without a Certificate of
Occupancy. Please. help dis tO clear up this. matter so that
legal action does not have to be taken.
Thank you for your prompt attention,
Very truly y~,
Victor Lensard
Executive Administrator
VL:gar
encl.
BUILDING and REMODELING ROOFING end SIDING
ROBERT L. HYATT, INC.
SOUTHOLD, NEW YORK 11971
($16) 79S-3390
/89
TOWN OF SOUTHOLD
BUILDIN~ DEPAFtTME~T
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL,: 765-1803
Examined..~ '~.qv.~..r...1......,~ 19
Approved .... ~.~...}..~'.., 19~. ~. Permit No. ]..~ .6...t~....
Disapproved a/c .....................................
................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received .......... ,19...
a. Tlfis application must be completely filled in by Wpewriter 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 regulations~, and to
admit authorized inspectors on premises and in building for necessary ~cSo_~ns~7~ ,..~Z ~.~::~~ ·
~.' .~,,~. g. ~t..r...,,~.,.
(Signature of appJ~cant,/o5 r/nme, if a corporation/)
/
(Mailing address of applicant) /
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
;2}'~[ownl; ~f premises.,-~'..?~..~. "'.~.~ .............................. ~ ............
~ (as on the tax roll or latest dee )
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporat~e 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 ..................................................
.)&~ ........ .v.5 ~ ~?.o...T~.....~ ~. ~..e. ........ ~?.o. ~..~. S ..~. ~.... ~:7.: ..............
House Number Street Hamlet
County Tax Map No. 1000 Section ...... O..~.,~. ...... Block .... .~..OC. ......... Lot,, ,.0, .~., ,,~, .........
S d v sion. 7. .......... '
Filed Map No .... $.1..~..~. .... Lot ¢./. ?..~&-..~..~..
(Name)
2. State existing use and occupancy of p..remises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ZM~J ~C z_ l,,x/~
b. Intended use and occupancy .............................. ..... ' .... ............................
3. Nature of work (check which ap!blicable): New Building .......... Addition~.~., .E~./.~.. Alteration ..........
Repair .............. Removal .............. Demolition 'v ............ Other Work ...............
4. Estimated Cost .... .Z-..~..~..,..~! ................. Fee.'~.~..~/ ~..o (Description)*
~ (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 ired extent of each type of use .....................
· ' ' ' .~.~..~. ~..~fl..~. Rear Depth
7. Dimensmns of ex~stmg structure~, ff any: Front ...............................
Height ............... Number of Stories ........................................................
Dimensions of same structure wi!h alterations or additions: Front ................. Rear .................
D.epth .................... i' · Height ................ ~ .... Number of Stories .....................
8. Dimensions of entire new constr~ction: Front .,~..~. ~..~,L../t.. Rear ............... Depth ............
Height ............... Number of Stories .......................................................
9. Size of lot: Front ...........I ........... Rear ...................... Depth .....................
10. Date of Purchase ........... i .................. Name of Former Owner ............................
I 1. Zone o~' use district in which pre. mises are situated ....................................................
12. ' .....
Does proposed construcUon v!olate any zoning law, ordinance or regulation: ...............................
13. Will lot be regraded .... /~.'.0.i .... ~ ......... Will excess fill be removed from premises: Yes No
14. Name of Owner of remises J~.~.N ~5~ aaar~ ~'ovT'~ ~ t-D
...................... , . .................................... Phone Nop
Name of Architect .......... ......... ,.~ .......Address ................... Phone No ..... iii i~ ii"'
Name of Contractor ./~?.0~(~7-../~.~. ~.~.~..~. ~ Address .~,~.P.q .T~.*..t_~ ..... Phone NoYf. ·~. 3 3 o
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 corner lot.
STATE OF NEW Y~e:~K,~/.,..~ ~ e
COUNTY OF..o...'~;~-d~,'~l~..~.o --
........-~'~-"~ff~~.~'o-'-~-,r~5~~ '. .......... being duly sworn, deposes and says that he is the applicant
(Name of individual ~ contract)
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; that all statements confained 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 ~ I
Notary Public, of New Yor~
S~ate .
.o. §~-oa44ooa Suffom Count,z:.~ liia'n'ti
OOmmission- Expires March aO,