HomeMy WebLinkAbout16273-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z-I6369 Date November 5, 1987
SUN ROOM ADDITION
THIS CERTIFIES that the building ................................................
'.-, '-~-'- }' ~'Toca+~onor°ro~er*- 1050 Trumans Path East Marion, New York
House IVo. E;treet Harniet
,..u~, ,.yrS-"n+- Tax L,~v~a~ No. 1000 Section 03 I . .Block I 2 .Lot 5. I
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
July 22, 1987 16273 z
...................... pursuant to which Building Permit No ......................
dated Ju 1 y 27, 1987 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 .........
SUN ROOM ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to WILLIAM & PATRICIA BRENNAN
..................... /oho'o;, g4glr' o igxx ...................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO P E N D I N G
N/A
PLUMBERS CERTIFICATION DATED:
~u~i~'~s ector
Rev. 1/81
FOB~ NO. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 16273 z
Permission is hereby granted to:~ .
..... ....~.....*....L~..?x ...........................................
.........
..................................................................
at premises Iocate~l at .../..P..~.-~......~.'~~...~...).....~ ....... . .~......'~'...~.......~... ~ ..........
County Tax Mop No. 1000 Section ....... ..~...~.~. ...... Block ....... .J.....~-.. ....... Lot No .....~./..,I ...........
pursuant to application dated ........ ...~..~.....~....'~... ................. , 19..'~..'L, and approved by the
/e
Building Inspector.
Fee $..~. ..................
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 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. 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 featu res.
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: Additions $25,00
1, Certificate of occupancv New Dwelling,S25.00, Accessory,~10.00 Business $50.00
2. Certificate ofoccupancy on pre-existing dwelling $ 5 0.0 0
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..........................
NewConstruction ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property /.J.~,~ .~-~ /9,~,},~ ~ .~.:
House No. , .~ Street Hamlet
Owner or Owners of Property
County Tax Map No. 1000 Section ....~..~/. ....... Block ..... / D-. Lot. .~.~.,./.
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ...~ '~-¢ ~
Rev, 10-10-78
¢o -?_
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
$OUTHOLD, 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.
check islo ,tdated l l
/5/ 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 Permit # / ~ ~ ~ 3 Z /e~z~L~ '-
Building Dept.
***/5/ NO Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
Occupancy or use ts dnlawful without a Certificate
of Occupancy. Clear up this matter as soon as posslb]e
so that legal action does not have to be taken.
Thank you for your prompt a~tention.
UNDATION ( ls t )
UNDATION (2nd)
UGH FRAME &
PLUMBING
SULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
Z
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [,~INAL
REMARKS:
DATE
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
/
FOUNDATION 2ND [/]~NSULATION
[ ] FRAMING
REMARKS:
FINAL
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
ROUGH PLBG.
INSULATION
DATE
INSPECTO~
HENRY P. SMITH, President
JOHN M. BREDEMEYER, Vice-Pres.
PHILLIP J. GOUBEAUD
ALBERT KRUPSKI, JR.
ELLEN ~1. LARSEN
BOARD OF
TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
July 29, 1987
TELEPHONE
'~6~, 1892
Mr. Charles E. Thorp
P. O. Box 679
Greenport, New York
11944
Re: William & Patricia Brennen
Dear Mr. Thorp:
The following action was taken by the Board of Town Trustees during
their regular meeting held on July 27, 1987 regarding the above matter.
WHEREAS, the Board members have personally viewed and are familiar with
the premises in question and the surrounding area, and
WHEREAS, the Board considered all the documentation submitted concerning
this request, and
WHEREAS, the Board made the following findings of.fact:
1. By this request appellant requests permission to construct a 16' x9"
x 12~ addition to an existing residence.
2. The property is located at 1050 Trumans Path, East Marion.
3. The project will not affect the health, safety or general welfare of the
people of the Town,
NOW THEREFORE BE IT
RESOLVED that Charles E. Tho~p on behalf of William and Patricfa Brennen
Be and Hereby is Granted a Waiver of the Wetland Ordinance as aforementioned
and all in accordance with the plan submitted with the application dated
June 4, 1987.
Please be advised that there is a $25.00 fee for the waiver which is
now due .and payable. Please return to the building Dept. for a determination
on the need of any othe town permits that may be required for this project.
Very truly yours,
Henry P. Smith, President
Board o£ Town Trustees
HPS:ip
Board of Town Trdstees - Charles E. Thorp on behalf of William & Patricia Brennen
Page 2.
Commissioner ~enry G. Williams, D.E.C., Albany
Stephen Mars,i Army Corps of Engineers
Thomas Hart, ICoastal Management
Conser ration zA dvisory Council
Bldg. Dept.~
Board of Appeals
File
Examined · ..~..~.
Approved .....
' FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
~i}..."./ .... 19~. ?. Permit No. /.[~..~.~..~ .~v.
BOARD OF HEALTH
3 SETS O15' PLANS
SURVEY ...q-.q" ....
cnEc~ ~..~.'z' 51...
SEPTIC FORM .............
NOTIFY
CALL - ...............
MAIL TO:
Bisapproved a/c .....................................
.................................
(Buikling Inspector)
APPLICATION FOR BUtLDING PERMIT
INSTRUCTIONS
Date .. g/g.2~ ........... 19~J~].
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 buitdh~gs 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. Tile work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Bnilding 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 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 inspet}tions. .
(Sig~{athre 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.
........ C.,O Fz-D:.o..c.,PL~. ................................... ;. ...................................
N amc of owner of premises ... ~ t. / ]{ O,~g-~.. ~.r2¢;~ . .'/?(LJJ7 ~ C~ W..~..~..Z'e'.O.r;/~r'. L3 ...................... (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) .
ALI, CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No.../,~-..qg... ~..~- ........
Phnnber's License No .........................
Electrician's License No
Other Trade's License No ......................
I. Location of land on which proposed work will be done ..................................................
...... / a,5o...LT.,co,-m cto~..._~aTP~.. ,.. ~¢.s. ?...4g/..a:c ,?. ~. ~...4./..'4. ........... : .............
House Num her Street Hamlet
County Tax Map No. 1000 Section ....,~.] ............ Block ../..¢~. ............ Lot..,,.h~..*.]. ............
Subdivision ..................................... l:iled Map No ............... Lot ...............
(Name)
State existing nsc and occupancy of premises and intended nsc and occupancy of proposed construction:
a. Existing use and occupancy ...... ~(~C.]5~.. ..................... ~ .................................
b. Intended use and occupancy ..... .~14~£'1 . . .t'O.O]97~ ...............................................
3. Nai/ure of~,work (check which a~plicable): New Building .......
Repair .............. Remgval .............. Demolition .
4. Estimated Cost... ~5~..~.~.~
Fee
' ~ Alteration
dditi ~' "
......... Other Work .... ; ......
Aon)
(to be paid on filing this application)
5. If dwelling, number of dwellingiunits .............. Number of dwelling units on each floor ...............
If garage, munber of cars ......................................................................
6. If business, co mnercial or mixe,d occupancy, specify nature and extent of each type of u'se .................
7. Dimensions of existing structures, if any: Front .... , ........... Rear .............. Depth. ~ ............
igl
He ~t ............... Number of Stories ' ' ~' ' ' ; ...., .....: ........
Dimensions'of same stntcture ~/ith alterations or additions: Front ................. Rear .................
Depth ................... i · · Height ...................... Number of Stories .....................
Dimensions of entire new constp~ction: Front ............. '.. Rear ............... Depth ..............
~eight ............... Number of Stories .......... 27 .............................. ..,. ..............
9. Size of lot: Front ........ "].~, ......... '.. Rear.....'., .~'.~ ............ Depth . .~,,t(5..'.O.O. ...........
10. Date of Purchase .......... i .................. Name of Former Owner ............................
1 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 ........ r~O .................. Will excess fill be removed from premises: Yes Nc
, ,
14. Name of Owner of premises [J)~.~.~.a-tr.~o, a4. t~'eo,O~:rAddress 0 .. LeAJ~hlt~al~hone No ...............
Name of Architect ......... L ................. Address ................... Phone No ...............
Nmne of Contractor . ~b-o*'l~.."3'[q~c.t~ .......... Address /5~:. t03.rl..~.r~e-,nlgO~'~. Phone No.. 4.0.).-: I.~...5/.~....
15. Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..~..
· If yes, Southold Town Trdstees Permit may be required.
PLO~F DIAGRAM
Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all s~t-back dimensions fret
property lines. Give street and block, number or descr/ption according to deed, and show street names and indicate whethe
interior or corner lot.
STATE OF NEW YORK, S.S
COUNTY OF..' ...............
· ' ' s;" .... (~ame of individual signing contract)
above nanled. .. ~
being duly sworn, deposes and says that he is the applican
IIe 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 thi
application; tlmt all statements contained in this application are true to the best of his knowledge and belief; and that th,
work will be performed in the manfi~r set forth in the application filed therewith.
Sworn to before me this //
........ 19
.......... ~..' ~ ....... cNy o!f ....
Notary Public ' ~
· County
HELEN Ir,, DEiVOE
NOTARY PUBLIC, State of New
No. 47078711, Suffolk CouetY(70
Term Expire~ March
I
...... I~0~ ..... , ~
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