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HomeMy WebLinkAbout13440-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ..... .A.c. qe..s .s.o.r.y ................................ Location of Property . ~ 6.0 ................ .R.o.b. J:..n.s.o.n...R.c3... .............. G..~.e.e.n.p..o?.~. .... House No. Street Hamlet County Tax Map No. 1000 Section ...0.3.4 ....... Block .. 0..5 ........... Lot .. 0..1,2 ............ Subdivision ......... X. ..................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... N.o..v.....8. ........ , 19.8.3. pursuant to which Building Permit No....1.3.4..4.0.g ............ dated .... .S.e.p. ~.e.m,b,e, ,r .... 1. ,4 .......19.8.4., 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 ......... ...... ?.o9.Z' .a The certificate is issued to ............... .C.O.~.~...S.,..~..0.~.~.I~.?..~..~..~.0.~. ............... (owner, I~F~z'Jg~o~) of the aforesaid building. Suffolk County Department of Health Approval N/R N704120 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 134i0 Z Permission is hereby granted to: ...~..o...L..~.~3 .............................................. ............................... t.v..~.-l......~.~ ...... 4. ~ ,o ..... ~.~ ...... ~....~.~..~...~....~.....~..~......~ ....... at promises ,~ated at ....~.~.~...~~....~., ........ ~.~" ............ County Tox Mop No. I000 Section ..... ...(~.....~...~, ...... Block ...... .,~..,.~.... ...... Lot No ...... .~...!.....~... ..... pursuant ,o application dated .... .~..~..~.....~ .................. 19.~....~.., and approved by the Building Inspector. Fee $..1.~....t ............ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ m......~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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, Commercial buildings, Industrial buildings, Multiple 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 p~operty 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 $15.0 0 3, Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date...~ .~77 .&...~ . ,~... .......... New Building ~ ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .4~.~. ................. ~'..c~. ~./¢~.~'..~....~..~'. .......... House No. Street Hamlet Owner or Owners of Property County Tax Map No. 1000 Section .. ~.. i~.~. ....... Block Lot. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. (.~..~.~.~. ~... Date of Permit ?~'/~.&.~....Applicant .'.~.,~¢~.~..'~.../?/¢¢~'~/..~..'~. .......... Health Dept. Approval ........................ Labor Dept. Approval ....... , ................ Underwriters Approval /1]. '~¢ .~C~ .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate Fee Submitted $ ~; ........................... Construction on above described building ~F'~it meets all,,atap, licable codes and regulations. 5 ,27o© .................. Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765~1802 TO Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /_~ An application for Certificate of Occupancy is not on file. /~/ No Underwriters Certificate on file. /7/ The check is(cu~at~not on fileo) 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. Building Dept. c ***/~/ NO Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD INSPECTION FOUNDATION (lst) FOUNDATION 2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY QODE COMMENTS FINAL ADDITIONAL COMMENTS: YORK STATg DEPARTMENT OF ENVI~ON~:~NTAL CONSEP~VATION ~gulato~ Affairs Unit Bldg. 40~ SUNY--'Roo~ ~-9 Stony ~o~' ~ '11794 ............. '-(516) 751-7900 Mr. Bob Copas 36 Fro~t St. Or~nport, N.Y. g/o Frank Messina Sept 7,198~ !~: NYSDEC Application 10-83-1568 Dear M~. Copes A review has been made of your proposal to: construct & 20 ft X 40 ft in-ground swimming pool southwest Of the existing house, Locatio~: Stlrling Creek New York State Department of Environmental Conservation has found the , parcel XXX project to be: Greater than 300' from inventoried tidal wetlands. xXX Landward of a substantial man-made structure th~ b~lWh~.~ .... ~ greater than 100' in length constructed prior to SePt~m~o, Landward of ~0' contour elevation above mean aea level on a gradual, nat- ural Slope. Landward of topographical crest of bluff, cliff or dune in excess of 10 feet in elevation above mean sea level. Tkerefore, no permit under Article 25 (Tidal WetLands of the Environmental Conservation Law) is required at this time since the current proposal is beyond State mandated ~urisdiction pursuant to this act. However, any additional work or modifications to the project may r~quire a petit. It is your responsibility to notify this office, in writing, if such additional work of modifications are contemplated. Very truly yours, FORM NO, 3 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'SOFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL RV 1/80 File No ................................ .... ?..~,. ..~: .... .:.~.&. . .... :,. PLEASE TAKE NOTICE that__your application d~ · ~ .................... ~ 7' 19 ..... ~o~m~o~on.=- .... ~/~e~ ~n.. ~a>~.. .... .... ......... ~ ...... at . '~~.:~ " Location of Property ...~: .................. ..................... House No. Strut Hamlet County Tax Map No. 1000 Section ...:, ,~ ....... Block ...... ~...., Lot,, ,'~ ....... Subdivision ..... . ........... Filed Map No ................. Lot No ..... .~ ......... is ret~ed herewith and~approved on the following grounds..~f~. ~O~,..~. . ~ Building Inspector -FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 19 '1. Permit Disapproved a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .../ ................ ]9... INSTRUCTIONS ' ///~ ;~ ~ a. This apPJlcation must be. ~ompletely filled ~n by typewriter or in ink ~nd submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according fo 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 issue a Building Permit to the applicant. Such permit shall be kept on tile 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 alter.ations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances,~ild~ co~ousing code, and regulations, and to admit authorized inspectors on premises and in buildings for necess.~sp~c~on~ .~_ '~(~'~ applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, piun~per or ouilder. Name of owner of premises . '~9 .... '~'*- '~"~< ...... >"'.al ......... ~ ...... > ........ .... : · · ' ~, ............... If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............ .O).~.f~ ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on whictLt~l~.pse~c/t~k~l~b~ c~: .~K3.~... ¢.],? .(._.,x.,~, y~r.,. ~, ..... B ..................... .., ................ ............. .................. House Number . Street Hamlet County Tax Map No. 1000 Section ....0~_.'~;_.'~..,__ ...... Bloc~..2Y..~...~. ......... Lot..~..~..~. .......... "~':~" ~ .....~ p'oOC- Subdivision .................................... /File/t Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ........................................ ~ ..... ....................... 3. Nature of work (check which applicable): New Building . ~... Addition .......... Altoratlo~ . . ~ ...... Repair .............. Removal ...... ;... Demolition ....... Other Work (Description) 4. Estimated Cost .... ~. O..o~.. Fee ................. ! ~ (to be paid on filing this application) 5. If dwelling, number of dwelling pnits ............. Number of dwelling units on 0ach floor ................ If garage, number of cars ..... i ................................................................... 6: If business, commercial or mixed occupancy, specify nature and extent of each type of use ...... : .............. 7. Dimensions of existing structures, if any: Front 3~ ~ Rear 3 ~-. 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 ............ Number of Stories Height ........................................................... 9 Size of lot: Front ~ Rear Depth Name of Former Owner 10 Date of Purchase ' ' hp6 d 11. Zone or use district in whic r mises are situate ..................................................... 12. I)oes proposed construction vio!ate any zoning law, ordinance or regulation: ...~.o. .......................... 13. Will lot be regraded ...~.~ ................... Will excess~ fill be re~oved from premises: Yes No 14. Name of Owner of premises i~ ¢..Qo.~.~ ......... Address ~.~...O~. ~'~.. '.(~..~%1~-.~'7. Phone No..' .............. Name of Architect . .~h~...~.o.~, .~? *?~. ~c-I ......... Address t.ht.~t~o ~..~'.~..~t~.~re.oPhone No.. k~qt. ~.~.~ ...... Name ~of Contractor . .~..~.q-~ ~. ~.~S ........ Addres~.~..6~...~.o.~ .~. ~..~ Phone No. fi. ~.~..~.~..~ ...... PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK. COUNTY OF... S.S Sworn to before me this ........ ....~..~ .... day ~f .... .~. ~.. County Q~~ (Signature of applicant) ............ .~{~...t~-...~5..~.~.~.t.&~t ................ being duly sworn, deposes and says that he is the applicant (Name of md~wduai s~g~mg contract) above named. , He is the ~v i (Contracto :, agen ,f~corporate officer, etc.) of said owner or owners, and is d~ly authorized to pe :form or have performed the said work and to make and file this application; that ail statements contained in this applic ~tion are true to the best of his knowledge and belief; and that the Work will be performed in the manner set forth in the a[ ~lication filed therewith.