HomeMy WebLinkAbout13596-zFORM NO. 4
TOWN OF 8OUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Seuthold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25688
Date: 04/29/98
THIS CERTIFIES that the building ADDITION
Location of Property: 405 PRIVATE ROAD #15
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 15 Block 9
ORIENT
(HAMLET)
Lot 3.4
Subdivision Filed Map No. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 26, 1984 pursuant to which
Building Permit No. 13596-Z dated NOVEMBER 30, 1984
was issued, and conforms to all of the requirements of the applicable
provisions of the l~w. The occupancy for which this certificate is issued
is DECK ADDITION TO EXISTING ONE FAMILY DWELLING (MAIN HOUSE) AS
APPLIED FOR.
The certificate is issued to DOUGLAS MORRIS
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
ing Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25689
Date: 04/29/98
THIS CERTIFIES that the building ADDITION
Location of Property: 405 PRIVATE ROAD #15 ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 15 Block 9 Lot 3.4
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 26, i984 pursuant to which
Building Permit No. 13596-Z dated NOVEMBER 30, 1984
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 2~D FLOOR DECK ADDITION TO EXISTING O~E FAMILY DWELLING AS APPLIED FOR
The certificate is issued to DOUGLAS MORRIS
of the aforesaid building.
(OWNER)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
//~lding Inspector
Rev. 1/81
FORM' NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NO 13596 Z Date ...~.~~-.......~....~. ............ , 19'"~'"~'
Permission is hereby granted~t~; f
~~...~..~..~..., ..... .~.. .......
........ iii...i .....
ot premises located ot ....J...~..~f~.~..~.~.~..'~.....J.[.~..'~....g~....~f]/~,~......~,... ......... .,(~).~ ...............
County Tax Mop No. 1000 Section ...... .~./...~.. ....... Block ..................... Lot No...i~.....~.e..~...
pursuant ,o application doted .... .~...~~L,......~:....~. ........... , 19.?..~...., and approved by
Building Inspector.
Fee $...~, .~,...,,....'~.. · .....
Rev. 6/30/80
Form No. 6
TOWN HALL
765-1802
APR
APPLICATION FOR CERTIFICATE OF OCCUPANCY L
~LUG.
A. This application must be filled in by typewriter OR ink and submitted to
inspector with the following: for new building or new use:
1. F~nal 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 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 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.
B. 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 Occnpaney 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
Alterations to dwelling $25.00, Swq~qng pool $25.00, Accessory huildi~g~25.00,
~ Additions to accessory building $25.00. Businesses $50.00..
2. Certificate. of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
April 21, 1998 ..
Date ' '
tlew Construction .... X... .... Old Or Pre-existing Building .................
405 Point Rd., Orient ..........
Location of Property ............................................
House No, Street Hamlet
~ Douglas Morris ..................
Onwer or Owners of Proper~y ................................................
.9 %.4,
Map
County Tax No 1000, Section ............ Block ............. Lot..
Filed Map Lot .....
Subdivision - -
. 13596-Z ~ N/ A Builders Inc.
Permit mo ................ Date Of rermtt ................ Applicant..R..& R
N/ A .
... · ..............
~{ealth Dept. Approval .................... Underwriters Approval .........
. ..............
Planning Board Approval ....
X
Request for: Temporary Certificate .......... ,. Final Cer~icate ......... -- ~ /~__~
25.00
Fee Submitted: $ .............................
co%
For~ bio. 6
TOWN OF SOUTaOLD
BUILD I~G BEP AltlR4ENT ~
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and
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 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 1% lead.
c% 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
'3pre-existing" la~d uses:
1. Accurate survey of property showing ali property lines, streets, building and
unusual natural or topographic features.
· 2. A properly completed application and a consent to inspect s$gned by the applicant.
If a Certificate of Occ~psncy 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
Alterations to dwelling $25.00, Sw~m~ing pool $25.00, Accessory building--$~25-00,
'' Additions to accessory building $25.00. Businesses $50.00.'
2. Certificate. of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ; .~5~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
April 21, 1998
Date .............
X
~ew Construction ........... Old Or Pre-existing Building .................
405 Point Rd Orienb . .
Location of Property -
House No. Street Hamlet
pp.u.9 z..a.s' Morris -
Onwer 0w~ers of Property '
.~.~ 9 .... ~ot. :'.~ ....
Map
County Tax No 1000, Section ........... Block. · · ·'
Filed Map Lot · .....
subdivision ................................................................
13596-Z .N( A. R & R Builders Inc.
permit No ......... . . .. ... Date Of Permit. .. ..........Applicant .............................
N/ A
~{ealth Dept. Approval.......-...--.-.N/A .......... Underwriters Approval .........................
' Planning Board Approval .N/..A . .
X
Request for: Temporary Certificate ......... .. Final Certicate .........
Fee submitted: $. ?3.: ?.0 .................... '.. ................ ..... ,..
~c, 5q '>(~ '""i~i':~//u.~'~'' ........ ' ~-~
Town Hall, 53095 Main Road
P. O. Box 1179
Southotd, New Yo~, 11971
Fax (516) 765-1823
Telephone (516) 765-1802
March 25, 1998
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
Douglas Morris
1488 Laurel Hollow Rd.
Laurel Hollow, New York
11791
Re: Building Permit # 13596-Z DECK
Premises: 405 Point Rd., Orient
Suff. Co. Tax Map #1000-15-9-3.4
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 $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.
F1ELD ~NS~%CTION
FOUNDATION
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C DE
{1st)
FINAL
COM~ENTS
(2nd)
ADDITIONAL COMMENTS:
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no. 13596Z issued to Douqlas Morris
on 1/30/84 for Addition is completed
a final inspection has ( ) has not ( X ) been done.
and
In order to complete this 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 the 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.
Victor Lessard
Executive Administrator
VL:gar
enci.
765.1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING
[ ] ROUGH PLBG.
[_ ~ULATION
[ ~] FINAL
] FIREPLACE & CHIMNEY
REMARKS:
.
DATE
INSPECTOR.,
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined../~.~..~...~.q., 19~.~..
Approved ./9~..~... '.<~..., 19'~.q.. Permit No.).
Received .......... ,19...
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOB 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 regulation_s, and to
admit authorized inspectors on premises and in building for necess~iry insp,~5,tio~s2/
...... ./~.: ?:~.:~...//. ??.,.~..'.zT. :~./. ~.C.%: ......
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... t ................................................................
Name of owner of premises . . h .... ~...~.t..5: ...............................................
(as on the tax roll or latest deed)
If applicant is a corporation, signalure of duly authorized officer.
Builder's License No. ff. J.~...j~°~/~l°/d/ ~zO:~l
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..... .~. ??. ~. ~.~ ..........................
.... i. .~. ~. . . . .~<. : :.~:. . .q[ . . .~. .~. ~ ............ .o. .~.:. ...........................
House Number Street Hamlet
County Tax Map No. 1000 Section ..,.17./..5: ....... Block ....~. .............. Lot.~.. ~ '~'~
................................................... /'. ~:..Z .~.J
Subdivision (Nmne) Filed Map No. Lot .o.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... ?7..er..7. t..~..~r..~....t ..~. /
b. Intended use and occupancy *r ~--$~ J~w,t ~t ~-/
3. Nature of work (check which pplicable): New Building .......... Addition .......... Alteration ..........
Repair ... ........... , Reraoval ............ Demolition ............. Other Work .ff.~.~/..~.er.~.~..
,. ~ r & (Description)
4. Estimated Cost ~ ~O Fee. ~.'. 7.
(to be paid on filing this application)
5. If dwelling, number of dwellin~ units .... ~ ......... Number of dwelling units on each floor ...............
If garage, number of cars .... I ...................................................................
6. If business, ' ' ~
commercml or mixed occupancy, specify nature and extent of each type of use ....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
Height .... . ........... Number of Stories .. ~ ................................................... :
D~ensions of same structure With alterations or additions: Front . .~ ~. ~ ...... Rear ..................
Depth ................... [... Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ......... , ..... Rear ............... Depth ...............
Height .............. Number of Stories . ~ .
10. Date et Purchase .......... i ................... Name o[ Fomer 9.Z ......
11. Zone or use district in which p~emises are situated... ~O.~ .............. ~ / ...........................
12. Does proposed construction viqlate any zoning law, ordinance or regulationL .. {g.q ..........................
13. Will lot be regraded ........., ...~ .... Will excess fill be removed from premises: Yes
14. Nme of Owner of premises~o2~[~l.~T.~t.~... Address ................... Phone No ................
Nme of Architect ......... ~ ................ Address ..................... Phone No ...............
N~e of Contractor~.~ .~. ~ ~. Address~~ ... Phone No.
PLOT DIAGRAM
Locate cle~ly ~d dist~cfly ~ bufld~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from
property lines. Give street ~d bloc~ number or description accord~g to deed, ~d show street nines and indicate whe~er
integer or corner lot.
STATE OF NEW YORK,
COUNTY OF .................
............................. ~ .................... being duly sworn, deposes and says that he is the applicant
. (Name of individual signling contract)
above named.
He is the ...................... . ...................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dul~ 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 manne? set forth in the application filed therewith.
Sworn to b~fore me this 1
~.... '. .... : .... .~. (. i~.....day oi .... '~'~.~ .... 19 .g?
Notary Public ....-- ?~'"1~[:~1 ,{. I~[ ¥0[ ~' ~' .4-..~..x.~..... County/~~:~
NOTARY ~l r. IJC, Stale of ~0¢~ Ymk ...~.:..~..v ...... ; . . ~ ....... r.~ ................. x . .
o 471)18'18, Suffo!l< CsulltV (Signature of applicant)
Term [:xp]res/vlalck 30, 19_~,5'"