HomeMy WebLinkAbout13373-zFOP~M NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF O~CUpANCY
No Z-24702 Date OCTOBER 28, 1996
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 670 FOUNDERS PATH SOUTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 64 Block 2 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 21, 1984 pursuant to which
Building Permit No. 13373-Z dated AUGUST~27, 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 ABO~E GROUND SWIPING POOL & FENCE AS APPLIED FOR.
The certificate is issued to ANITA RATHJE
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
H-052169 - OCTOBER 8, 1996
N/A
Rev. 1/81
// u:di g Inspector
lrO~' NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLLmrlON OF THE WORK AUTHORIZED)
13373 Z
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Building Inspector.
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
i. 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,
C. Fees
i. 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-existin~ Building - $100.00
3. Copy of Certificate of Occupancy - ~ .25¢.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..... .~. ~. ~. ~./../. ~.?? ....................
New Construction ........... Old 03 Pre-e~stin~Buil~ing...c~.. ....... ~... ~ / ~
Location of Property .... ~-'7..~. · · -7~-.~. .'~jC~- · · .~. .~?. ~-~?- · .~. · ............. ~/-~-.~..- 7. -/.f.~- ....
House No. Street Hamlet
Onwer or O~ners of Froperty ..............................................
County Tax Map No 1000, Section .... ¢..~( ...... Block...~ ......... Lot ..... ~./..~. ............
Subdivision .................................... Filed Map ............ Lot .....................
Permit No./..~. ?..?.~. ..... Date Of Permit .... Applicant ........
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicat~ ...........
Fee Submitted: $ ~.~.~. ~ ........
~' 5"~1-~'~ APPLICANT
THE NEW YORK BOARD OF FIRE UNDERWRITERS P~: ~.
~.~2~,~ "U.EAU OF E'ECT.,CrrV
~-- 85 JOHN STREET, NEW YORK, NY 10038
Date (~'-'~)[~ ~{ ~ ~6 Application No. o, fi~e ~2587896/96 H ~52~69
THI~ CE~IFIE$ THAT
o~y t~ el~trical equipment ~ ~scd~ be~w a~ int~uced by t~ applicant ~m~d on the a~ve appli~tlon number in the prem~es of
gN[TA RATHJE, 070
in the foBowing location; ~ Basement ~ let Fl. ~ 2nd FL OUT Section Bilk
~sexaminedon 0 ~. (t)~]~ ~ ~ 1~ ~ and found to be in compliance ~ith the N~nal Elect~cal Code.
SERVICE DISCONNECT NO. OF
OTHER APPARATUS:
EW1MHING POOL- 3.
- , - ,r, 3~! 9/27/96-1
DEP~ICA.~ RI{~HOVSD I,ETT}~R
MOULD ~ REPAIRED RECSP'.{'ACLE-1
DRYERS I FURNACE MOTORS FUTURE APPLIANCE F~EDERS
.~T K.W. OIL H.P. GAS H.P, AMT. NO. A, W, G.
s?.?"2;,'
I
NO, OF CC COND. ~C~'C~
PER ,e' OF O
MULTI-OUTLET
SYSTEMS
NO. OF F~ET
UNIT HEATERS
¢
Lot
EXHAUST FAN!
AMT H P.
DIMMERS
AM, T, WATTS
E
NO. OF HI-LEG A.W. G NO OF NEUTRALS A. W G.
OF HI-LEG OF NEUTRAL
fi~35 FOUNDERS
,SiOUTIIOLD, igY, 11971 ~EEAL ~AGEE
Per_
This ce~ificote must not be altered in any manner; return to the office of the ~ard if incorrect. Inspector~ may be identified by their credentials.
COPY FOR IT. THiS COpY~ OF NOT BE E~ED ~N ANY NANNER.
Fi~D %~SI~ECTION
FOUNDATION
COMMENTS
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
FINAL
ADDITIONAL COMMENTS:
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN IIALL
$OUTHOLD, N.Y. 11971
TEL. 765-1802
This is Co advlae you that the job under building
permit no. 13373Z issued Co Anita Kingham
on 8/27/8~ for accessory__ is completed
a final insl~tion ha~ ( ) has not ( X ) been done.
and
In order to complete this file, it is necessary that
;~ Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for $10.00 payable to the Town of $outhold. Please indicate
to Whom thc CerCiflcnte of Occupancy is to be mailed, and
arrange with thin office for an inspection date
Occupancy or ilse in t~nlawful without
Occl~pnncy. Please, help un to clear up thla
leg,al action does uot have to be taken.
Certificate of
matter no that
Thank yo~ for yot~r prompt attention.
Very truly
Victor Lessard
Execut ~ve Administrator
VL:gnr
encl .
Town Hall, 53095 Main Road
P, O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 24, 1995
Anita Kinghan
Box 791
Founders Path
Southold, NY
11971
Re: Building Permit #13373-Z & 14189-Z
Premises: 670 Founders Path, Southold
Suff. Co. Tax Map #1000-64-2-19
During a review of our files it was noted that the above
building permit's have expired, and Certificate of Occupancies
have 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 any
construction of additions, accessory structures or new
dwellings, and it is unlawful to occupy or use said 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.
' FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
~ ! ' TEL.: 765-1803
,~×a,hin
Disapproved a/c .........................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
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 givh~g 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 bare been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Btdlding 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.
'rite applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
authorized ins ectors on p. rgt~i~es ~l~tl,in building for necessary inspecCOns.
,J ' , "? ',~ ',, i, . ~Jll . '"~'"'"'"~' '~: ....... · '"~.':'""' ....... : ......
~,s ~4,~ ,~l~b'! (S,gnature of apphcant, or ~a~e, ,fa corporat,on)
~,~ ~ o ~,~s, ~ ...... · .......... i~ahing address of applicant) r
State whether ~i ~i~ er , engineer, general contractor, electrician, plumber or builder.
_ ....... ....... ., ...... .................................
,~a,ne of owner of premises .... .(~.(~... ~ .~.,~....~.../..d~.' ~. ~~ ....................................
(as on the t~fx 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 .........................
Electrician's License No .......................
Other Trade's License No ......................
I. Location of land on which proposed workwill be done .... .~.'.~.~...~..~~..........P~A .~ .~
llouse Number Street Hamlet
County Tax Map No. 1000 Section ...... ~. ~ ........ Block ..... ~ .......... Lot..../.~ .............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... · .~..O~.......,o~v~%~. · · . . .~..~. · .Y. · .~ ....................
b. Intended use and occupancy ....................................................................
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal ............... Demolition .............. Other Work ...............
~/,_.~.,..¢~ ~ .,,~.~ (Description)
4. Lstimated Cost~ .... ~/~...'.~'. · i....~.'~.-. .........2. ....... Fee ...............
~lSdO ~ '" (to be paid on filing this application)
5. If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................
If garage number of cars
6. If business, commercial or mixeO occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ................
Height ............... Number of Stories .......................................................
Dimensions 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 .......................................................
9. Size of lot: Front ...................... Rear ...................... Depth .....................
10. Date of Purchase .......... i .................. Name of Former Owner ............................
I I. Zone or use district in which pr~mises are situated ...................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ............................. '..
13. Will lot be regraded ........ ~ ................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises d~,u~..o.~..~.... Address ................... Phone No
Name of Architect ..... X, AF ................... u Address ................... Phone No ................
Nmne of Contractor .... /..\. . ~. Address ................... Phone No ................
PLOT DIAGRAM
buildings, whether existing or proposed, an& indicate all set-back dimensions from
number or description according to deed, and show street names and indicate whether
Locate clear/y and distinctly all
property lines. Give street and block
interior or corner lot.
STATE OF~NEW YORK, "S.S
COUNTY OF ................. i
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
'1, FOUNr~ATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSLJLATION
4. FINAL CON'STRUCTIC)N MUST
BE Cr~MPI ETE FOR C. O.
ALL CONSTRUCTION SHALL MEET
THE REOUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
............................ ; .................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
lie is the ..................... i ...................................................................
(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 contained in this application ard 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
NOTARY PUBLIC, State o)
(Signature
of
applicant)
No. 470787& Suffolk Cmmty ~.~
APT '~ AS NOTED
DATE: ~B.P. ~ ) '~-,~."~
FEE: ]~BY: ~'