HomeMy WebLinkAbout13375-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No .... z.-~1.5.7.8. I.~. Date ..,.M.a.y. 22, 1987
THIS CERTIFIES that the building., .~.d.d./. [ ./.o.n...~..a. 1. C..e.r.af./. 9.n' .C.o...op.e.. ,f.a?,/. 1..y, .d?.e 11 iug
Location of Property ...5..7.8.7.5...Cg.u.n.c.y' .R.o.a. ,d, !/J, 8, ....... 9.r.e. qn. p.o.r.~. ~..~...~.: ..........
House No. Street Hamlet
County Tax Map No. ]000 Section .... 4.. 4. ...... Block .... 2. .......... Lot .... 8. ............
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Pemlit heretofore filed in this office dated
.A~u..g .u.s t 22, I 984 pursuant to which Building Permit No. 1337.5 z
dated August 27, 1984 wasissued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
ADDITION & ALTERATION TO ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to AGNES E. & MELANIE L. FREESE
(owner, l~IeToYr ~X X
of the aforesaid building.
Suffolk County Department of Health Approval N / A
UNDERWRITERS CERTIFICATE NO N 8 0 8 7 9 8
PLUMBERS CERTIFICATION DATED: N/A
uilding Inspector
Rev. 1/81
TOWN OF SO~334OLD
~UILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
N°.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to: * ~. -- I
...~...~~..,..~......~........... ............... ~ ...........................................................
,~,~,=~ ~ s~,5.~.~ ....... ~.' ~... ~x ..... .~~~ ........
.................... ~ ............... ~~ ........
~o~,~ ~ ~o. ~ooo ~,o~ ........ ~2 ........ ~,~ ....... X ......... ~o~,o ........ .~ ............
8uildln~
~ ,.g.~.:..~ ......
" ' [;7 .........................
Rev. 6/30/80
FORM ND. 6
TOWN OF SOUTHOLD
Building Department
Town Hell
Southold0 N,Y, 11971
76.5- ]802
TOW-N-6¢~BbTHOLO ._
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR Ink, and submitted .~ ~=====~a to the Building Inspec*
tar with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property Ilnes, streets, and unu~al
natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4..C. ommcrcial bui[dings, Industrial .buildings, Multiple R. esidences a.nd similar bu.~ldings and installa- tions, a certificate of Code comphance 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 p,zoperty showtng all property lines, streets, bulldlngs 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 New D~ell[n.~.$25.00, 'Acce.~eory ..$10.00 Bun,,es: $50.00
2. Certificate 0f occupancy on pre-existing dwo,lling ~ 50, O0
3. Copy of certificate of occupancy $ 5.00~ ove~ 5 ~ea~a ~10.00
5.Uodatod q.O. $ 50.00 Date...~...l..~ .......
6. hlteratlon $25.00
NewConutruction...... O[dorPfe.ex~st~gBu~[d~n~ ............ Vacsn~Land ........... ..
House No. Street Ha,nle~
lO00 .... ....... .... ......... ...........
' ' ' Filed Map No Lot No
Subdwls~an ..........................................................
Pormit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ c~..~" ~
Construction on above described building and4zermlt meets all applicable c(~/an,~ regulat.io,~s./2~,2
~0
Co~ 137~1
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000314 BUREAU OF ELECTRICITY '
~ [v~* ].1~, 1~)87 B$ JOHN STREET, NEW YORK, NEW YORK 1OO~8
..,~ ~..,,~.,,o.~o.o.~,,~ 4v~7/87 N 808798
THIS CERTIFIES THAT
o~y the electricol equipment ~ ~scribed below and int~dac~ ~y t~ ~pl~t ~ o~ t~e s~ ep~cat~on ~mber in the premises of
in lhe followlng Ioeatlon; ~ B~.ment ~ Ist Fl. ~ 2nd FI. .%etlon Bl~?k Lot
~s examined o~ ~ s ~ ~ ~ and found to be ~n compliance with the ~eqt~irement s of this Board.
FIXTURE FIXTURES RAN~S O~EN$ DISH WASHERS EXHAUST FANS
~T~TS SWITCHES FLUORESCENT ,
6
DRYERS
E R V I C
NO, O~ CC COND
PER ~
A, WG
O~ CC, COND,
NO. OF HI-LEG
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
To Who~ 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.)
/~/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter°
Thank you for your cooperation. ·
J3uilding Permit # ~ ~..~.. 3_~ ___~ ~fZ (~_ ~g~¢/L~e~\
· **/_--/ NO Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
MUIRFIELD CONTRACTING, INC.
P. O. Box 27
GARDEN CITY, NEW YORK 11530
TO
(516) 742-8124
WE ARE SENDING YOU ~,,Attached [] under separate cover
via
[] Shop drawings [] Prints [] Plans
~3 Copy of letter [] Change order []
[] Samples
the following items:
[] Specifications
COPIES DATE NO. DESCRIPTION
THESE ARE TRANSMIT]rED as checked below:
E] For approval
E~ For your use
E] As requested
E~ For review and comment []
ID FOR BIDS DUE
[] Approved as submitted []'Resubmit
[] Approved as noted [] Submit
[] Returned for corrections [] Return
copies for approval
copies for distribution
corrected prints
19
[] PRINTS RETURNI~D AFTER LOAN TO US
REMARKS
COPY TO
~'1 E ~.D INSI~ECTION COM~EN2S # ~
FOUNDATION {~st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION
PER N.
STATE ENERGY
CODE
ADDITIONAL COMMENTS:
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
1'.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL, 7(;5.18o2
Thi.~ i~ to hdv{ne you that the job under buildln8'
permit no. 3375Z issued to Agnes
FreeZe
on 8/27/84 for ' Addition is completed and
a f~-7~]'--f-~'p--c-~-tion ha~; ('-- ) has not ( X ) been done.
An Underwriters Certificate is needed.
f. order to complete thi~ file,
n Certificate of Occupancy be issued. Please ~ill ou~ the
enclosed ferm, return same to the above office wi~h a check
for ~25.00paynbl~ to tho Town of Sou~hold, Pleas~ {nd[cate
to Whom the Certificate of Occupancy
arrange with this office for an i~spectlon (la~e
Occupnncy Or USO i,q nnlawfnl without a Cert£ficate~o£
Otc,panty. i'iease, help ,s to cleo~ up th~ matter so thet
I. ega[ action do'es not have to be taken, '%
Thank you for yo.r prompt attention.
Very truly you/~,
Victor Lessard
Executive Administrator
VL:gar
C'llC 1 ·
Memorandum from....
BUll.DING INSPECTOR'S OFFICE
TOWN OF SOUTHOLD
TOWN g-[ALL, SOUTHOLD, N. Y. 11971
765-1802
April 15, 1987
Ms. Freese:
We have been unable to reach Mr. Farley
to set up an appointment to inspect the addition
of your house.
Would you kindly have Mr. Farley get
in touch with this office so that we may make
the necessary arrangements.
Thank you.
Southold Town Building Dept.
Georgia Rudder, Secretary
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
. .~5 ~ x..~..q.~ .........................
· ~-,¥~e.~..u...,-I,..t/.~.9.q .......
PLEASE TAKE NOTICE that your application dated ... ~...//. ........... ,19.
for pe~mit to C~.~.
Location o f Property ,. ....
County Tax Map No. 1000 Section .. ~Z,.q ?J ...... Block ... ~ .%- ....... Lot ...'~ ..........
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the following grounds. ~.~ .~..~. )..e~. 7
..... ~ .......................... q..~..~.~....6~..)):
· ~% . ~ '~ ..~
....~....~...~....u.,.,M;. ~ ~.4.. ..~>m...~.~ .¢..o.~...g...
)17. ~-
Building Inspector
RV 1/80
FORM NO. 1
TOWN OF SOUTHOLD
BUI LDI~JG DEPARTMENT
TOWN HALL
.. SOUTHOLD, H.Y. 11971
· TEL.: 765-1803
Id. .
appro T..~..~1.., 199 .q. Permit No. ,/ .~.g-~'~
Di.~approvcd a/c ; .
Application No; '
(Building Inspector) ~
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled ist by ttypewriter or in ink and submitted in trlplicat¢ to the
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 p~mtses or public s
or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part ~his
cation.
c. The work covered by this application may not b~ commenced before issuance of Building Pe~tt.
d. Upon apprc'.'al of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such p
shall be kepi on the premises available for inspection throughont the work.
e. No buildia~ shall be occupied or used in whole or in pa~ for any purpose whatever until a Certffieat~ of Oecu~
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MA DE to th~ Building Department for th~ issuance of a Building Pe~tt pursuant t
Building Zone Ordinance of the Town ~f Soutbold, Suffolk County, New York, and uther applicable Laws, Ordinam
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, ~ herein desc:
T~e applicant agrees to comply with all applicable laws, ordinances, building cod~, housing cod~, ~d regulations,
admit authorized inspectors on premises and in buildings for nec~s~ inspections.
(Signature of applicant, or name, tfa corporation
' . .~,q... ~.~...L~...~.~.~q~%.~.~ ..,.
' (Mailing add.ss of applicant)
State whether applicant ~s owner, lessee, agent, architect, engiueer, general contractor, electrician, plumber or bu
Nmneofm~nerofpreunscs ..~B~.~..~: Fg~[ ~P ~ ~ . .
· . .................... ~...~.~. .~....~.~ ......
(as on the tax roll or latest deed)
......
Plumber s License No..~.~ . .~.'~..
El:ctrician's License ~o' .
Ot erTrade's hce~se No .
'" · .' ...................
......... _ ................... · · · ·
House Number Street Hamlet ~ ......... ' ....
County Tax Map No 1OO0 Section ~.
' · ............. Block ................ Lot .............
Subdivision ..................................... Filed Map No ............... Lot ............
(Name)
a. Existing use and occ,uoancv T ~ ~ 0 L ...........................
........... ~ ........ ~ ............
3. Nature o£work (check wbk!. appllcable): Ne~v Building .......... Addition .......... Alteration .......
Repair Removal D 2molit!,on Other Work
4 Estimated Cost ....... ' . . ~ ~
(to be paid on filing this application)
.~ Ifd Iii nberofd ellig nits .O.~.~ ff.A15~%'7{. Nmnberofd llingunits
· We ne, nul w n u · · · we on each floor
r Ifs ge number of cars l'~Ot0~,
If u slness, cot.lmerclal or nllxed occupancy, specify nattlre and extent of each tvne of use .. --~
7. Dimensions ofexisting structures, ifany: Front,. J ..... Bo,,,- '" .-' '~: .............
Hci,,~t ,, ,, ,,, . -- ................. Depm ............
,, ............. ,. · 9mtllm:r el ~torles .................................................
Dimensions of same strm;turi~ with alterations or additions: Front ................. Re .
D.epth ...................... Hetaht .... x, ......... ar ..............
8. Dimensions of entire new construction:"Front ........... ~ . ~,,umoer et ~tortes..~..: .............
14,,i.ht ~,,.....,.__ ~ o.. · ............ ,xear ............... Depth ...........
9. S:zo of lot: Front ....... [O.{a: . ~o~, ~ ,.,~,',' ..................... '_. ............
,-,-. .,-,- · ' ............. '" ........ '."~'~ .......... Depth ..... ~..o.O.'o .....
.. ,. . . .. · ................. r~ameoxeommrOwner ..........
I1. Lone or use msmct in which prcnllses are situated... 2 .... ':. ' ...........
~1. ?,..o. es proposed construct,on violate any zoning law ordiaance or re~,t,l~;i'~n'.' ..........................
'l~. ~,:ll lot bc re-reded . ,,,. o_: ....................................
.. ~ o . ' ...................... Will excess Illl be removed fromtnremises:
{4. ~ame et Owner or pretmses .................... Address ....... p nr~ M Yes
Name of Arclmect .... . .. . ~_-~ _ . ......... o .............
........... · '-,uureas ................... Phone No ............
Nan e of Contractor .......................... Address ................... Phone No .............
PLOT DIAGRAM '~
Locat~ clearly and distinctly all buiklings, whether existing or proposed, and. indicate all set-back dim0nsions f;
property lines. Give street and block nun, her or desert tion
;t, terior or corner lot. · P according to deed, and show street names and indicate whe~
¢-~TATI~ OF NEW YORK,
COUNTY OF
................................................ being duly sworn, deposes and that he is the
(Nanie of imlMdual signing contract) says applic:
obey.: named.
~e is the '
(Contractor, agent, corporate officer, etc.)
of said owner or own'ers, and is du y authorized to perform or have performed the gaid work and to make and file
application; that all statements contaiaed in this application are true to the best ofhls knowledge and belief; and tbzt
~ork will be performed in thc manner set forth h~ the application filed ', '
t: erewlth.
~wom to before me this
........... Z.g. or... ............ ,
.. ....... , ,. ,, A
NOT~ ~BL~, S~ ~ New York
'.'-., ..