HomeMy WebLinkAbout13012-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Zi9507
Date NOVEMBER 14, 1990
THIS CERTIFIES that the building.
Location of Propert~ 210
House No.
County Tax Map No. 1000 Section
ACCESSORY
CUTCHOGUE
Street
110 Block 006 Lot 004
Hamlet
Subdivision RAVATONE REALTY Filed Map No. 539 Lot No. 3
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 29~ 1984 pursuant to which
Building Permit No. 13012Z dated APRIL 10, 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 ACCESSORY BUILDING IN REAR YARD.
The certificate is issued to JON AND KATHLEENLAKE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO~ N162176 NO%~IBER 2?¥ 1990
PLUMBERS CERTIFICATION DATED N/A
/ Building 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 Z19508 Date NOV. 14, 1990
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 210 GLENWOOD RD. CUTCHOGUE
House No. Street Hamlet
County Tax Map No. 1000 Section 110 Block 006 Lot 004
Subdivision RAVATONE REALTY Filed Map No. 539 Lot No. 3
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 10~ 1984 pursuant to which
Building Permit No. I30t3Z dated APRIL 10~ 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 2ND STORY ADDITION TO EXISTING ONE FAMILY DWELLING.
The certificate is issued to JON AND KATHLEEN LAKE (owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N658598 SEPT. 6~ 1984
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
l~OJl, llJ NO, Jl
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
COJ~APLETION OF THE WORK AUTHORIZED)
N? 130i2 Z
Permission is hereby granted to:
.... ....... ............................
.... ~,,~.~ ...... ~;~,.,~ ...................... ~,~. ,~ ~
..... ~ ......... ~. ....... [l....q...~..~. .....
..i~.~......~.~ ........ ...... ~ .................
~'o
.~.! o .~..~.. ~ ........... ~
at premises located at .................. ~ .............. ~.~ ...........
County Tax Map No. 1000 Section ...... .I..(,..O. .......... Block ........ ~ ........... Lot No ....... ~ ..............
pursuant to application dated ..... ...~.~...~..........~....~ ................. , 19.~...~.., and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PEPJVilT MUST BE KEPT ON THE PREMISES UNTIL FULL
CO/VIPLETION OF THE WORK AUTHORIZED)
N? 13013 Z
Permission is hereby granted {o: ~ {~
..... ;~.1.~.....~.....~.....~.....~....~ ........................
.............. ~: ............. ~., ........ ; ..................... ,
~o..~~.~ ...... ~.E....~.....~.~.~....~~.~ ............
....................................................
County Tax Map No. 1000 Section ..... !.J...~. ........... Block ........ .~ ........... Lot No ........Lf ...............
pursuon, ,o epplicotion dGted .... ....~..~.~....~.~ ................. , 10.~.~, ol3d opproved by the
Building Inspector,
Fee $...~,~;..~.~. .....
IBuilding 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 tha 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 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 requirements.
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 Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
Fees
i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swinnning pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50,00,
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15,00, Commercial $15.00
Date .......... /.././~..../~...~. ...............
~ew Construction ...... ...,.,~Old Or P/e-existing Build,~ng~ ...............
~ocation of Property.~.~f-~.%.~'2~-'--~'~-/.~.... ~ House No. Street/'
)nwer or Owners of Property..q~t~..~.. .........................
:ounty Tax Map No 1000, Section .... /./.~ ...... Block ...... ~ ........ Lot ..... ~ ..............
~,ubdivision ........................~.._... ~ . ~. ,,7//~Fi~ Xap...~..~-~.~..Lot .....
................ pp icant...
ealth Dept. Approval.. ............. .. . ,, ,... . .Underwriters Approval..,~~./.~..~
lanning Board Approval ........................
equest for: Temp?~ry Certificate .........., Final Certicate ....
ee Submitted: $ .... ~. ....................
.................
.... ~PLICA-NT
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/i0 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:
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 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-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ....................................
qew Construction ...... ~)f21,?~rZD-existing Building.., ...... [ ....... ././. ~..,~...~C~..
~ocation of Property..-'....~J-f?~5?. :.~-~Cr,~F... ~.....~~~. ...................
House No. Street~ Hamlet
)nwer or Owners of Pro ertl, ~/// ~ ~~ ~/~"~- ' '
:ounty Tax Map No 1000, Section..././..~. ..... Block ...... ~. ....... Lot ....... ~ ............
;ubdivision .................................... Filed Map....~$...'~.~. ..................... Lot . . .
'ermit No./~.~./~..~..Date Of Permit../..~.~Z~..~...Applicant... ~,,~. ..... :~..~ .....
[ealth Dept. Approval .......................... Underwriters Approval ..........
'lanning Board Approval ........................
equest for: Temporary Certificate ........... Final Certicate ...........
ee Submitted: $ ........................
. ..........................
FIELD IN.S PECT~IV
FOUNDATION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
C,ODE
COMMENTS
FINAL
ADDITIONAL COMME~ITS:
ADDITIONAL COMMENTS:
FOUNDATION {1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
3.
INSULATION ?ER N. Y.
STATE ENERGY
FINAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [~'] ROUGH PLBG.
[ ] FOUNDATION 2ND
\/
~[~] FRAMING
INSULATION
[ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
765..'1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.'
[ ] FOUNDATION :)ND [ ] INSULATION
FRAMING
REMARKS:
DATE
INSPECTOR
7G5-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN ItALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under buildlng
permit no. 13013Z issued to Jori Lake
on ~0/84 for Addition 'is complet'ed and
a final inspeetlon has ( ) has not ( x ) bee. done.
~n order to complete this file, it is necessary that
Certificate of Occupaucy be issued. Please fill out the
enclosed form, return same to the above office with a check
fo$25.00 payable to the Tows of Southold. Please indicate
Whom the Certificate of Occupancy is to be mailed, and
~rrange with this office for an inspection date
Occnpnncy or use is unlawful withoOt a Certificate of
Occupancy. Plea~;e help us to clenr np this mntter so that
legal action does not have to be. taken.
Thank you for yonr prompt attention.
Very truly y~,
Victor Lessard
Executive Administrator
VI,: ga r
cncl .
TOWN OF SOUTHOLD
OI':FICE OF BUILDING INSPECTOR
ILO. BOX I179
TOWN IIALL
SOUTIIOLD, N.Y. 11971
November 5, 1990
Jon T. Lake
210 glenwood Road
Cutchogue, N.Y. 11935
TEL. 765-180,2
To Whom This May Concern,
We are unable r.o complete your Certificate
of Occupancy because .of the following reasons.
/~/ An application for Certificate of Occupancy
is :lot on file. (ENCLOSED)
/--_///blo Underwritcrs Certificate on file.
/..~The check [:;(qXliXR~LRl(~/not on file.) $50.00
2 CO's required @ $25.00
/i~/ blo Ileal. th Dept. Approval on file. each.
/-~/ No final inspection has been made.
P]ease contact ()ur office on this matter.
Thank you for your cooperation.
lluLl(]~ng PermJ. t t! I 3 O I 2 Z
I 3 0 I 3 Z
Building Dept.
*.~/_--/ Ho Plumber Uoldc~: Certificate on file.
( all permits involving plumbing being
.i'ssucd after April 1,1984