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HomeMy WebLinkAbout10577-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF Of~u~ANCY No E-24448 Date JUNE 19, 1996 THIS CERTIFIES that the building ADDITION Location of Property 2175 PINE NECK ROAD House No. Street County Tax Map No. 1000 Section 70 Block 5 Subdivision Filed Map No. SOUTHOLDv N.Y. Hamlet Lot 48 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 5, 1980 pursuant to which Building Permit No. 10577-Z dated MARCH 5, 1990 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 2ND FLOOR ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to LOIS L. DUNNE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A PENDING - APRIL 11, 1996 Rev. 1/81 - /B~/' ' i/n~spector FOlt~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10577 Z Permission is hereby granted to: ...... .,JO.5'J:~ .P..~ ....... P.. ....... ~.~.~.~..~-. ................ ........ ~ ...... ,u..~ ...... ~......~.....,Jt~..~.~........P.....~,'-^~*- [~~~ ~ ............... ~.L..7._¢;. ....... .~../...~..¢. ...... ~/~.~.~....:/¢t.A ~ St)~' r~ t Z) ro .......... ~.~.~ ........ T...q. ....... ~ ...... t~.~l~: ......... ~...~..~..~.t~,~ ......... ~t4~..~t./.~,~,¢,- ............................ at premises located at ............... ,~..L.'~..,.,el'. ...... .~./.~.~/'.~. ........ /~..~.E.~. ....... ~.~..,~1,.~ ......................... .................................................................... ~./2.u .Z./:J.o..L.~, ............................................................. pursuant to application dated ..................................... J~/.t~..~.(......, 19~.O., and approved by the Building Inspector. Fee $.../..~ ............... Building Inspector Fo~m No. 5 TOWN OF SOUTHOLD BUILDING DEP ART~EET TOWN HALL 765-I802 APPLICATION FOR CERTIFICATE OF A. Thzs apptzcation must be fzlled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: t. Final survey of property with accurate locatzon of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% 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 requzrements. B. For existing buildings (prior to April 9, 1957) ~on-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 applicatzon and a consent to inspect si~aed 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. Certifzcate of Occupancy on Pre-existinE Buildin¢ - $100.00 3. Copy of Certzfmcate of Occupancy - $20~00 ' 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residentzat $i5.00, Commercial $15.00 Date ..~...~.r.[?.~.~. ................... New Construction ........... Old Or Fr~-existing Buildinj~.-- ......... '. ocation of Froparty... 2:.W ....... ........ iiii. & ..... House No. Street Hamlet Onwer or Owners of Froperty ............. .~ ...................................... County Tax Map No 1000, Section .............. Block ................ Lot ...................... Subdivision .................................... Filed Map ............ Lot ...................... Permit No. 10~.~.7. ....... Date Of Permit ........ Applicant. .. : ......... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ..................... .. . taquest for: Temporary Certificate ........... Final Certicata ........... Fee Submitted: $ ............................. ' APPLICANT Town Hall, 53095 Mare Road P O. Box1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 7,55-18~02 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 28, 1996 Ms. Lois Dunne Pine Neck Road Southold, NY 11971 Re: Building Permit #'s 7585-Z, Premises: 2175 Pine Neck Road, Suff. Co. Tax Map #1000-70-5-48 9135-Z & 10577-Z Southold During a review of our files it was noted that the above building permits have expired, and Certificate of Occupancies have never been issued. According to the Code of the Town of $outhold, Article XXVIII 100-284, it is unlawful to occupy or use a 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. Gary J. Fish Building Inspector GJF:cmt (Cert. Mail) ,FZ,,or.. j o ,'~ Ts I~" / ~ . o/c I,O o, L L ~ ' O44;r/,,,,/ B ' 3' X V' ;: 6CC J , CY APP~©V*~D AS NOT~ DATE''~/'~ BP NOTI~ BU~LD~-~G ~T~ 765-1802 9 AM m~ 4 ~M FOLLOWfNG ~F,S. _~ 1. FOUNDATION - ~/O FOR POURED CONCRETE 2. ROUGH - FRAM[N~ & PLU,', 3. INSULATION LET[ F~.R C, O ON SHALL ~ OF THE STATE CONSTRUCTI~EN CODES. NOT RESPONSIB~o ii ,./ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] I/NSULATION [ ~/~FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE FO~M lqO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....................... ..?,Z.~, 19 .~...? Approved ........................... /...~.~....., J~ Permit No ................................... Disapproved o/c .......................................................................................... ~~. (Building Inspector) Application No. /0-~GJ-77 APPLICATION FOR BUILDING PERMIT Date ........................... ~..~....'......, 19..~. INSTRUCTIONS a. Th~s 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 ofproperty must be drawn or~ the diagram which is port of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Ul~on approval of this application, the Building Inspector will issue a Building Permit fo 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, N~w 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 buildings for necessary inspechons. ~ / ~jig~atu/e/of applicant, or,~r{am_e,/?f a corporati~) ( dress of appicant} ' If applicant is a corporate, signature of duly autho~'r''''''/x' ............................................. (Name and title of corporate officer) Builder s [4cerise No ........................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Zrade's License No..,~. ............................ . ................. oZ.~.,~ ,- -- -.~...~(~'. ~ .~..~.~ 1 Location of land on wh.ch proposed wo~,k w,HI be dome. M~p N ,....~...~..~/....~ .... I~ot N .~...0....O.. .... ,. -· Street and Number. ~../..2...~ .¢~/.:~ .................. ~..C~...4,:.1. .~. .... ..~::~.~ .................. M~icipality 2. State existing use and occupancy of premises and iptended use and occupancy of,~proposed ~:ogstruction: o Exisiting use and occupancy ..... ~'% l ~.]...1~.....~......~)....~,,. ..... ...~.~...~..!.....iZ~..~........~..j~...~.~..~..'i . ,, ) ..):.~.?...(....~. ............ b Intended use and occupancy ............................................................................................................................... 3. Nature of work (check which applicable). New Building,. ................. Add'to ..... ~terat'o ............... ark ...... ,,~ ........ Repair ................ ~. Removal ................... Demolition .................... Other W ........................................... ~ . o~ ' ~ (Description) 4. Estimated Cost C ~.....C?....~.!. ,O, ..., -~,-. ....................... ':...Fee ....................... ~.~,, .~., · ....................................... , (to be paid on filing this applicatj..~) 5 If dwelliqg, number of dwell'lng units.........,.............~ ..... Number of dwelling units on each floor ....~.i. ................... If ggrage, number of cars ...., ........................................................................................................................................ 6. If business, commercial or 'mixed occupancy, spec~f,,v nature end extents) each type of use ...... ,~...,~ ............. 7. Dimensions of ex.sting structures, if any' Front ..... ,~..~....'.~., ........... Rear .,.~....~... ..................... Depth ...~..,..~-. ......... ¢~f Number of Stoiies Z ..~..~ Height ................. ;';fructure w,th a,terot, ' ............... PZi? ....... .... ..... ........... Dimensions of sam ' ' : ........................................................... Depth ....... f~....,~., ............... Height ......... ..~.../. ............ Number of Stories ...... ~ ............. 8 Dimensions of entire new construchon Front ................... ~ ................ Rear ............................ Depth ........................ Height .................... Numbe'r of Stories ..................................................................................................................... 9. Size of lot: Front ............ /...C) O .............................. Rear ,.../.,...(?.....Cfi?. .............. ._...~..... Depth .4~....~, .~'/~..., ............ ,0. Date of Purchase ~....~....'~.,~..~....,....'Z7.....7~...~.( ............... Name of Former Owner/f, .7~.~.~:~.',,~.....:~..~./"1'~.'.i~.~..... ,1. Zone or use district in which premises are situated .......................................... 12· Does proposed construction Violate any zoning law, ordinance or regulation:'" 13. Will'lot be regraded ..... ~...~..~.. .......... Wilkexcess fill be removed from premises: ( ) Yes ( 14. Name of Owner of premises ...~..]~.~....g..~...~..~..~......~.....~...-Address ..~.~'.~...'.'~..; .......... Phon* N~.I...Y..~..~..~ Nome of Architect ~t' ....... i ........... ~:h.....~'~ ....................... Address ................................ Phon, No ....................... Name of Contracto/~J~X,.y~..../.~.~.....~.~./x(...~.....~......~...l Address ..,~.~"~:~....~ ...... Phone , PLOT DIAGRAM Locate clearly and d~stmctly all bu.ldmgs whether ex~stmg or proposed, and indicate all set-back d~mensmns from property lines· Give street and b!ock number or description according to deed, and show 'street names and indicate whether i~terior or cmner lot STATE OF NEW ~pRI<~ ~ l~ c S COUNTY, OF .~:~..~' .... (N~e of individual si~ning contrace) above named. duly sworn, deposes and soys that he is the applicant He is the ...................................... , ........................................................................................................................................ (Contractor, ~t~nt, c~t~el~te-~f~cGii e'|%.-~- 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 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 fo~h in the application filed therewith. Swor~ to before me this -- ' ...... o, ...................... . Notaw Pub ic, .,~-.f~-~ .......... Coun~ .~....(Z.:.....~~ ................ .~ ~ ~ /~ ~ / ~ [] (Signature ot applicant) '~JA~Y I~UBLIC, S~a~e of New Yor~ ,&, ALBERT A. SACCO aN, GORDON K, ~1,,/~ I -- '~~ --'