Loading...
HomeMy WebLinkAbout12910-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15551 Date April 2, 1987 THIS CERTIFIES that the building ...P.o. ,o .1. ,...f .e .n.c. e.: .d .c.c. k.: ......................... Location of Property . 14905 MAIN ROAD EAST MARION House No. Street Ham/et County Tax Map No. 1000 Section 023 .Block 1 . .Lot 2.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Feb. 28, 1984 , pursuant to which Building Permit No. 12910Z dated . .g.a.r.c.h...6.,.. ! .9 .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 ......... .... D.e. 9.k' .a.d..d.~.t.%o. 9..w. 5. t..h..s.w.i..m.m.i.n.g., pool and fence. The certificate is issued to CHARLES S. GILL I SP IE ..................... io¥.'o; gV :, Yct ..................... of the aforesaid building. Suffolk County Department of Health Approval Iq/A UNDERWRITERS CERTIFICATE NO. . Iq647889 ,lune 14, 1986 PLUMBERS CERTIFICATION DATED: N/A ........ Building Inspector Rev. 1/81 FORM NO. 2 TOWN O~: $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) 1291O Z Permission is hereby granted to:/~ . 4 ,--, ~ .~.~.~2.~L ............ ..~.~. ...... .Lmn..l ...... ,o ..... o, premises located at ....!..~....~..?....~.......~..c~.,~..?....~. ........ ...~.~..~.~.~. .................. County Tax Map No. 1000 Section ..... ..~...~'....~. ..... Block ......... I ............ Lot No. ~......~' ~ pursuant to application dated ....~.~.~/~....~...~.. .............. , 19.~...~.., and approved by the Building Inspector. Rev. 6/30/80 l~'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICIT~ ~., ,,:, 85 JOHN STREET, NEW YORK, NEW YORK 1003~8 ..re ~'~ -~'~ ]'~'~ ..,..c..o,,No.o,,/.e ~,:L~'U/8~ N 647889 THIS CERTIFIES THAT : only the electrical equipment as described below and ~ntroduced by the applicant named on the abo~e application number in the premlses of ~ax'les b. G.tili-~&~ie: ~iu ~4 1~. drive o~ c~u~w~y, in the followlng location; [] Basement was exa~nined on [] lstFL FIXTURE I FIXTURES 7 .L I 7 [] 2nd FI. (J~%(~ Section Block Lot and found to be in co.tpliance with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS TIME CLOCKS SERVICE DISCONNECT S E R V I ; C NO, O~ CC COHO, pER ~' OF CC COpl0. NO OF HI-LEG OF HI-LEO NO OF NEUTRALS A. WG OF NEUTRAL OTHER APPARATUS: 1-G.F.C.I. &"gJ~L~G POOL; This certificate covers cc~liance mt o~ unusual enviror~nents it is advisable to have ~requen~ test ~ud/or repcAr~ qu~li£1ed person. This certificate must not be altered in any manner~ return to the office of the Board if ihcorrect. DEPARTMENT. THIS I GENERAL MANAGER ~ ~r~ Per ? // may be identified by their creflentials. MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This ie to ndvlse you that the job under building parfait no. 12910Z iseued to Charles Gillispie on 3/6/84 for Addition is completed and ;] final inspection has ~ ) has not ( x ) been done. [n order to complete this file, it is necessary that ;~ Certificate of Occupancy be issued. Please fill out the enclosed form, retnrn same to the above office with a check for $25.00 payable to the Towa of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupnncy or nsc ia unlawful without a Certificate of Occupnncy. l'lense he{p ns to clear up thi~a matter so that legal action does not have to be taken. Thank you for yonr prompt attention. Very truly y~, Victor Lessard Executive Admlnistra~or VL:gar oriel. YORK STATE DEPAP~MEI~f OF Et~VI?~)N.~-~NTAL CONSEI~VATION ~g~ato~ Affairs Unit .......... Bldg. 40, SU~Y--~om ~,~ ........... Stony ~0~ ~ ~794 .................. (516) 751-7900 A review hae been made of your proposal to: ~,~ /~ ~ New York State Department of Environmental Conservation has found the . parcel ~ project to be: Greater than 300' from inventoried tidal wetlands. · Landward of a substantial man-made structure greater than 100' in length constructed prior 'tO September 20, 19~7. ~Landward of 10' contour elevation above mean see level on a gradual, ural elope. · Landward of topographical crest of bluff, cliff or dune in excess of 10 feet in elevation above mean sea level. '----. Therefore, 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 ]~risdiction pursuant to this act. However, any additional work or modifications to the project may require a permit. It ia your responsibility to notify this office, in writing, if such additional work of medifications are contemplated. Very truly yours, /~ Danie 1 J, ~Larkin Reglonal Supervisor of P-" gulatory Affa/rs DJL:RNT:cz FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 Instructions This application must bo filled in typewriter OR Ink. and submitted ~a ~ 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 unu~al natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-($-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. 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 unusaa~ natural or topographic features. ' 'o 2. Sworn statement of owner or previous owner as to use, occupancy and cond~t~ n 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. Certiflcate of occupancy New Dwelling. S25.00. Acce.~.~ory :$10.00 2. Certificate gl ~ccupancy on pre-existing dwelling ~ 50.00 3. Copy of cemficate of occupancy $ 5.'00. eve: 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Uodated ~.0. $ 50.00 Date .......................... 6. hlterat~on $25.00 New C on s t ~ u c ~ i on Old or Pre existing Building Vacant Land . ' Location of Proper~ .~.:/..,.~.'./'*tQ~ ........ .................. House No. Street Ha/n/et Owner or Owners of Property ......... * ......................... County Tax Map No. 1000 Section ...~.~ ........ Block...~. .......... Lot. ~..~,~ ..... · ' ' Filed Map No Lot No Subdivision .......................................................... Permit No. J ~.~[/.~. ;~... Date of Permll. ~3././~/?/;./.?,..Applicant ........ ~]~ Labor Dept Approval Health Dept. Approval ............................................ ~ ~ ~.~ Planning Board Approval Unde~riters Approval.... ................. : .................. Request for Temporary Certificate ..................... Final Certificate Fee Submitted $ ~,/~ ~ Construction on above described building and ~rmjt me~ts all/~applicable, codos and regulations. 10.10,78 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE FIELD ~NSF~CTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ._ADDI__T_IONAL COMMENTS: ~ ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined... &..U. .... .... Disapproved a/c ..................................... Received .... ?. . ,19 · (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 19... IN STRUCTION S a. Tins 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. .... C~ :~o~/~ ~ ~J.-4~-~ ~I .~.. (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. ...(~g~.~4 .~....©P..~. ~ cT~ ~ ...... ~ 8 .~. ~.,:~.~ .~... Co..~>: ~ .................................. Nmne of owner of premises ...Q.l: ..,- ........................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... ~/.~.'3i. ~ {Q ..C<~.. ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............................... .~ .................. House Number Street Hmnlet County Tax Map No. I000 Section ..... .~). ~-. a. ..... Block ....... C>. 1 ........ Lot ..... ~ ~.. ~ ...... Subdivision. ,~..~., .~..,t~ .~ .......... Filed Map No ............... Lot..~..~t .......... (Name2~' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...d¢.4..r.'~e;/y ~..r' ' 3. Nature of work (check which applicable): New Building ...,A. .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ ~ ~_ (Description) 4. Estimated Cost . Z¢/_J-~D.I ..... F I]0 ' '- (to be paid on filing this application) 5 If dwelling number et~ dwelling Cnits - - Number of dwelling units on each floor If garage number of cars *-'-~ 6. If business commercial or mixed occupancy, specify nature and extent of each type of use ...%-7 ................ 7. Dimensions of existing strueture~, if any: Front ............... Rear .............. Depth ............. Height ............... Number of Stories.. ....................................................... Dimensions of same structure wi~h 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 ' Name of Former Owner 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ... ,/~J~ ...................... 13. Will lot be regraded ..... ,~.i ........ , ........... Will excess fill be removed from premises: (Y~ No 14. Name of Owner of premises C_/-J~t~. ~tll~..t.'~... Address .B?d,.t~./k.~... d,R'. ~ot-,). Phone No./nC2.-2.'. &~7..c/... Name of Architect .......... ~ ................. Address ................... Phone No ................ Name of Contractor .~_~097/J~F.'.>.P*.o~.~ ........ Address . .~.%o, bla~..l'~. ....... Phone No. ~.C/.~..-,_h/.~.~ .... PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. T WON MUST c,_,A STATE OF NEW YORK, COUNTY OF ................. , , ........... : ...... :..~.' .................. being duly sworn, deposes and says that he is the applicant (Name of individual signlng contract) above named. He is the.. i ....... .~.~. .... .~2c)~'J (~4 .~.---...Or'~.. ............................................ , ........... (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 are 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 befor~e me this . · ' ......... · .~. · ./~ .......day/o~...~..~ I i · ..... ,i,.,..F , ' Id... applicant) ~': I Poo/- ° I /-/o oL% L ISLAND" /