HomeMy WebLinkAbout12168-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southcld, N.Y.
C~RTIFICATE OF OC~PANCY
NO Z-23038 Date JUNE 14, 1994
THIS CERTIFIES that the building ADDITION
Location of Property. 220 BROADWATERS ROAD CUT~HO~UE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 104 Block 10 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 8, 1983 ~ursuant to which
Building Permit No. 12168-Z dated Fa%R~H 2, 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 BEDROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ANDREW J. CA'LIN & WIFE
N/A
H--041307 -- J~NE 13, 1994
N/A
/- Jild~ng ins~ector
Rev. 1/81
BUILDING
SOUTHO~D, N.
(THIS PERMIT MUST BE KE~PT ON ~THE ~l~El
COMPLETION OF THE WORK AUTHORIZED)·
112168
Pe~issi~n is hereby granted ~t~/
at ~)remi~s located
~nty Tax Map No. 1000 Section
pU~uant to application dated . .............
~e~ $......: ..................
1994
P.O. ~ BOX 1179 :
'~ Southold~ New York 11971
~ttn: Tom Fisher
Re: 220 Broadwate~r-~Road~. aSsaU l~oint, NY
Se~ti0n I0~
Dear Mr. Fisher:
; Egclosed are ~ ~) CO~: icate ~of OccuPancy
~ppllcatlons and i - , ~.
a check for $75. 00 ~}~] accordance with our
~iscussions. ~ ' ~ ~
~tov~. Arrangements a~e be~n~ made ~O~ ~soo~ect the ~ood
Thank you for' you~ ass~stance~
[or wote~ distributing
system; piping shal~ be
o~ types K or L only
2-.
~n~pe~tor wi~h ~he,following: for n~w building or new use:
1. Final survey of property with accurate lo~ation of all buildings, propercy lines~
streets~ an4 unusual natural or topographic ~ea:ur~s.
~. Final Approval from Health Dept, of water su~p~y and sewerage-dispo~al(s-9 form).
~H~ 3, ~proval of electrical installatio~ from Board Df Fire Underwrit~s_.
4, -~or~ statement from ~lumber certifyin~ tha~ the ~older u~gd in system contains
less than 2/10 of 1% l~ad.
and installations~ a Certificate of ~od~ O~ian~e fr~ archi:eot or engineer
6. Submi~ Planning ~oard Approval of completed site ~lan requirements.
B. Fo: existing buildings (prio: ~o April 9, 1957) non-conforming uses, or buildings and
Ppre-existing" land uses~
1. Accurate,~urvey of property showina all property lines, s~ree~s, buildin~ a~
unusual natural or topographic features,
~. A properl7 ~omplated a~plica~ion and a consen~ =o inspe=~ si~n~d by the applicant.
reasons therefo~ i~ writing to th~ ~pplicant.
C. Fees
1, ~ertificata of Occupancy - New dwelling $25.00, Additions to dwellEng $25.00~
Alterations to .dwelling $25.00, Swimming pool $25.100, Aocsssory building
Additions to accessory buildim~ $2~.00. Businesses $50.00.
2. Cezt~fica=e of Occupancy on Pre-~istin~ Buildin~ - $100.00
3. Copy of C~rtificate of Occupancy - $20.00
4. Updated Certificate of Occupancy -
5, Temporary Oertificate of Occupancy - Residential $15.00, C~ercial $15.00,
SubdivisiOn .................................... Filed Map ............ Lo: ......................
Pla.nihs Board Approval..~, ~
Request for: Temporary Certificate ......... ,, Final Certicat~.. ~,..,.
Fee Submzt~ed. $ ...................
indicated.' "No obvious
tmsatisfactery cond[t.ion ~ found.
c~/~ .~,~,~ , ~-~-'~ ./~.,~ ,~, BUILDING DEPARTMENT ,~
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 seweKage-disposal(S-9 form).
3. Approval of electrical installation from Board~of Fire Underwriters
4. worn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead.
5. Commercial 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
Vpre-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.
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-existinR Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00~
New Construction.....~..... Old Or Pre-existing Building; ................
Location of Property ........................................................................ ..
House No. Street Hamlet
Onwer or Owners of Property .................................................................
County Tax Map No 1000, Section.../~.~.. ..... Block .... /.~.i ......... Lot ............. .~. .......
Subdivision ...................................· Filed Map ............ Lot .................... ,..
Permit No Date Of Permit Applicant
' A-.
Health Dept. Approval .................... Underwriters Approval .................... ...
Planning Board Approval...~., ~ .................
Request for: Temporary Certificate. Final Certicate
Fee Submitted: $. ..--~'. ............. ... . ..
F~EL~INSFECTION
FOUNDATION
(1st)
FOUNDATION (2nd)
2 o
ROUGH FRAME &
FLUMBING
INSULATION PER N.
STATE ENERGY
C,ODE
COMMENTS
FINAL
iONAL COMMENTS:
..'4
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(5 t6) 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
February 7, 1989
AWJ Construction Corp.
Depot Lane
Cutchogue, NY 11935
Dear Mr. Jacobs:
In order to complete the Certificate of Occupancy on the
Andrew Carlin permit (12168Z), we require a new check for $25.00
and an Underwriters Certificate. Enclosed please find your out-
dated check.
If you have any questions, please fee~l free to contact
this office at the above number.
Thank you for your cooperation in this matter.
THE BUILDING DEPT.
TOWN OF SOUTHOLD
FORM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building inspec-
tor with the following; for new buildings or new use:
I. 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 sew,er~ge disposal--{S-9 form or equal}.
3. Approval of electrical installation from Board of Fire Undbrwriters.
4. Commercial buildings, Industrial buildings, Multip!e 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 peoperty 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 $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ..
New Building ............. Old or Pre-existing Building(Z) ......... = ZVacant Land i ..........
Location of Property ~'""J~ ~>~'1~~.. ~"~ . C~>~/'"~'~/t~"'°~
House No, Street
County Tax Map No. 1000 Section ... ~(~.~. ...... BlocE ~..O ......... Lot .... ~. ..........
Subdivision., ~' .~...4::~.....~t~,~.. ,t~.t&~'l~'~' .~ .~. ,/~.... '~ ,_, ,~ ~" '/1~' ' '-'~'~'~ ' F i ledl~J ? Map No.,. !.~.~ ..... Lot No../~il~. ~ .....
ermi, ..... Date or Permitt./.. .¥..Applicant. ;O. ,. c~. ;-. ~ ,~.~,'. ..........
Health Dept. Approval ........................ Labor Dept. Approval .........................
,Underwriters Approval ........................ Planning Board Approval ..................
Request for Temporary Certificate ..... Final Certificat~
Fee Submitted $ .............................
INSPECTORS
(516) 765-1802
VICTOR LESSARD, Principal
CURTIS HORTON, Senior
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, .~ssistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
~COTT L HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
SouthoM, New York 11971
Fax (516) 7654823
Telephone (516) 765-1800
ORDER TO REMEDY VIOLATION
Date: December 18, 1990
TO: Andrew J. Carlin, (Owner)
220 Broadwaters Rd.
Cutchogue, N.Y. 11935
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance CHAP.
Other Applicable Laws, ordinances or Regulations
100
at premises hereinafter described in that BUILDING PERMIT %12168
13903-Z, 16792-Z, & ~17292 HAVE EXPIRED iAND CERTIFICATES OF
OCCUPANCY HAVE NOT BEEN ISSUED WHICH IS REQUIRED BEFORE
OCCUPANCY OR USE.
In violation of ARTICLE X]fVIII CHAP. 100-281 and 100-284.
YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the law
and remedy the conditions above mentioned IMMEDIATELY
The premises to which this ORDER TO REMEDY VIOLATION refers
are situated at: 220 BROADWATERS RD., CUTCHOGUE, COUNTY OF
SUFFOLK, NEW YORK. SUFFOLK COUNTY TAX MAP ~1000-104-10-7.
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both.
ORDINANCE INSPECTOR
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
Mr. Andrew J. Carlin
19 Greenway Terrace
Forest Hills, N.Y. 11375
Re: Building Permit ~12168-Z
Premises: 220 Broadwaters Road, Cutchogue, N.Y.
Surf. Co, Tax Map ~1000-104-10-07
Dear Mr. Carlin:
During a review of our files, it was noted that the above
building permit has expired and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold Article
XXVIII 100-281 and 100-284 a building permit is needed for
construction of additions to an existing dwelling. It is
unlawful to occupy or use said addition until a Certificate of
Occupancy has been issued.
Your final inspection was made on November 5, 1984. We had
notified your builder Mr. Jacobs on two Dc. casions (see attached
copy of correspondence) that everything Was okay for the
issuance of the Certificate of Occupancy, but that we needed an
Underwriters Certificate and a check in the amount of $25.00.
Kindly send us your check in the amount of $25.00 and a
copy of the Underwriters Certificate so that we may issue the
Certificate of Occupancy. Kindly clear ~p 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.
Vincent R, Wieczorek,
Ordinance' Inspector
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York ! 1971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 7, 1989
AWJ Construction Corp.
Depot Lane
Cutchogue, NY 11935
Dear Mr. Jacobs:
In order to complete the Certificate of Occupancy on the
Andrew Carlin permit (12168Z), we require a new check for $25.00
and an Underwriters Certificate. Enclosed please find your out-
dated check.
If you have any questions, please feel free to contact
this office at the above number.
Thank you for your cooperation in this matter.
AWJ CONSTRUCTION COl
DEPOT LANE
CUTCHOGUE, NY 11935
TO THE
Fo..
THE BUILDING DEPT.
TOWN OF SOUTHOLD
~'/L 50-791
19.
--" DOLLARS
5'"
886
CONSTRUCTION CORP.
Depot Lane
Cutchogue,N.Y.
11935
Dear Mt. Jacobs,
In order to complete the Certificate of
Occupancy on the Andrew Cartin Permit (12168Z) ~
we require a new check. Please find enclosed
your original check for $5.00 (~886.)
We also need to schedule a final, inspect--
ion when ever will be convenient. Please contsct
our office on this matter.
Thank You,
Dorothy So Midgley
Sec. Building Dept.
76S-1802
BUILDING DEPT. ·~ !~
INSPECTION~~
[ ] FOUNDATION ZST [ ] ROUGH PLBG.'
[ ]FOUNDATION, ZND [ '1 INSULATID~
FRAMING [ ] FINAL
REMARKS:
INSPECTOR
~ FORM NO. 1
~' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .......... .~./.'?., 1973
Approved ............ ~.~.., 1 .(~... Permit No ............
Application No... (..~. f. ?....~....
Disapproved a/c .....~....~ .... z4LL ...........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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
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 inspectio~s~,
(Marling address of applicant) ! (q ~-
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..................... ...........................................................
Name of owner of premises...~...0.~....~.,... ~..~.....'~...c~..q.. ...............................
(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 ..... .~...~.. ............. :.
Plumber's License No. ~"J'"-7 ~'
Electrician's License No...~...~'.-~. ...............
Other Trade's License No ......................
I. Location of land on which proposed work will be done.
House Number Street Hamlet
County Tax Map No. 1000 Section ....... !9..%-. ..... Block ..... l.(~. .......... Lot....q .~...~ .........
Subdivision...~./~.~'/~....~'.~.~..~.g(~.... FiledMapNo...(..~.¢ ...... Lot ..[..~...~..-. ....
State exlstln u (N )
2. ' ' g se and occupancy of premisest~nd intended use and~ancy of proposed construction:
a. Existing use and occupancy ............... ~ ..... }' ..........................
b. Intended use and occupancy .... ~ ..... ~ ...... $'...*-j~. ..............................
3. Nature of work (check which applicable): New, Building .......... Addition ...... Alteration ...~ .......
Repair .............. Remov~l: ...... ' ........ Demolition .............. 0~er Work.. '(l~r~;"~ ' j''ti~n
Fe
4. Est/mated Cost .............................. e .................................
(to be paid on filing this application)
5. If dwelhng number of dwelhng umts. ·............./ Number of dwelling units on each floor ................
If garage, number of cars ...... i .....
6. If 'business, commercial or mixed 0eeupaney specify nature and extent of each type of use . . ._.._ ..........
7. Dimensions 9f existing structuresi' if any' Front ~ 2~ . Rear ~ ~ D,~.th
Height .~,~ ........... Number of Stories../..~.~.: ............................................
Dimensions of same structure with alterations or additions: Front . .~..~. .......... Rear . .~. ~. ............
Depth.. ~ ................ .:. Height.../d r Number of Stories /.
8. Dimensions of entire new construlction: Front ...2.,, ......... Rear ... ~ ."2r~.. Depth /~.~..
· e-. ' ' .....................
Height ............ Number of Stories ............................................
9. Size' of lot.' Front . l 1~. ....... .......... Rear ...7 .................. a Devth ~.].O .~..~. ~...~o. .........
10. Date of Purchase ............ ................. Name of Former Owner ~ .............
11. Zone or use district in which premises are situated ........................ : .......... ; ..~, .............
12. Does proposed construction Viola!e any zoning law, ordinance or regulation: ............. .~...~..: .........
13. ~flllot~be~,regrade~d .....A~..q3,.i'....,~.~_~.~ ......... Will exc,~s fil,l be removed from premises: Yes ~No~
14. ,name o~ owner et premises ..,~. ,a...t,r,~.~-. ....... Address .tX .or~0~..7~-te~.. Phone No..t~..~.~..E
Name of Architect ........... i ................ Address ................... Phone No _~ ~ ...' .....
Name of Contractor. ,~.~..4: .'4..r~,. '~.~. ...... ~.. Ad'dress ~>~.~.*~ .~.. ~. ~.~0ne 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 corner lot.
STATE OF NE~YOt~I~.
........ ~,..~.w..z-.V.'.../cji .-~..;Ir... ~. ~..- ..... : ....... being duly sworn, deposes and says that he is the applicant
(Name of indiviagal s~8~fing contract)
above named. · j ,
............................................................
c~ : (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 conthined in this application are true to the best of his knowledge and belief; and that the
work will be performed in the mann{r set forth in the application filed therewith.
Sworn to before me this~, '
............... 7: ...... day o~ ..... ~~..~ 19...
NotaryPublic~~.i.-'~'~ . County~-~",~'~///~7_ , .
JUO,ITH T, T'~RR¥ ................ ,~..,/~..~./. .... ~ ..............