HomeMy WebLinkAbout16718-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19529 Date NO~EMBER 23, 1990
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 17815 SOUNDVIEW AVE.
House No. Street
County Tax Map No. 1000 Section 51 Block 01
subdivision Filed Map No.
SOUTHOLD
Hamlet
Lot 05
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JAN. 13, 1988 pursuant to which
Building Permit No. 16718Z dated JAN. 28, 1988
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 SECOND STORY ADDITION OVER EXISTING ATTACHED GARAGE.
The certificate is issued to Z. MICAH KAPLAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N057136 FEB. 10, 1989
PLUMBERS CERTIFICATION DATED JOHN E. WALTERS NOV. 19t 1990
Rev. 1/81
~0~ NO. ~
TOWN OF $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)
NO_ ]~6 ;7 i~8 Z
Permission is hereby granted to: ~
/ ' ' ' "~ ~'~'~-;;'"'i, ' ......
at premises located at ..../..Z~../.....~...~~.~ ..................................................
County Tox Map No. 1000 Section ....... · .~'.../. ......... Block ......... .~../. ....... Lot No ......... ~...-~......
pursuant to application dated /-,/~ ...................... 19 .~....c~,., ond approved by the
Building Inspector,
Fee ~ ~
Rev. 6/30/80
TOWN OF sOuTHOLD __
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEP~JlTMENT
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 o~opographic 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 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.
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.O0
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
,~ew Construction ........... Old Or Pre-existing Building...~.. ...........
~ocation ok Property...~/.2 ~...~.~c~.~.~-~)]./~.~..,.. ~. ~'~ ~ .~'~.~/.~ ...................
House No. Street Hamlet
Owners of roperty ..... ...................................
:ounty Tax Map No 1000, Section ..... ~./. ..... Block .... f. .......... Lot...~ .................
iubdivision .........................· . .. . ...,.,Filed Map ............ Lot ......................
'ermit No.../.~. Z.< ~ ..... Date Of Permit.././~/~...Applicant. ~o~'....~o.~.a~....
[ealth Dept. Approval ....................... .. . Underwriters Approval..., ................... . .
lanning Board Approval ........................
equest for: Temporary Certificate ........... Final Certicate...~... ....
TOWN OF $OUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
£OUTHOLD, N.Y. 11971
CERTIFICATION
TEL. 765-t 802
SU)G. DE~? ............
Building Permit No. i(.~ql~'~
(pleaSe print)
Plumber ~0~ ~. ~]~J~ PL~(~% ~T[,~
(pleaSe print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before me this
_~day
19~
HOtary Public, ~/~,~,
County
~otary 'Public
· LtNDAJ. COOPER
Notary Public, State of NewYorE
No. 4822563, Suffolk County
'~rm Expires Dece~nber 3
~FIELD INSPECTION COMMENTS
FOUNDATION (1st)
FOUNDATION ( 2nd )
ROUGH FRAME &
PLUMBING
N. Yo
ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
TO'tN OF SOUTHOLD
OI":PlCE OF BUILDING INSPECTOR
P.O. BOX I179
TOWN I IA LL
SOUTIIOLD, N,Y. 11971
To Whom This May Concern,
TEL. 765-180,2
We are unable r.o complete your Certificate
of Occupancy because .of the following reasons.
/? An application for Certificate of Occupancy
is not on file. C~-~
/~ No Underwriters Certificnte on file.
/..~_/~/ The check [t;(.~..t:!atcd/not on file·) 4/~3,6r~
/~/ No Ileal. th Dept. Approval on file.
/-~/ No final inspection has been made.
Please contact; ()ur office on chis matter.
Thank you for yonr cooperation.
l!u.[l(]ir;,j PermJ_t # ~ .k _7_ .J_ _~' Z
Build [n[~ Dept.
**~/~rk) Plumber Solder Certificate on file
( all permits involvi, ng plumbing being
issued after April 1,1984 )
INSPECTORS
(516) 7654802
VICTOR LESSARD, Principal
CURTIS HORTON, Senior
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, Assistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 31, 1990
Z. Micah Kaplan
17815 Soundview Ave.
Southold, N.Y. 11971
RE: B.P.16718Z Second story addition over garage
S.C.T.M. 51-01- 05
Dear Mr. Kaplan:
I am writing to you regarding the above permit which has
expired and you have not obtained a Certificate of Occupancy
for the work. On 1/23/89 a final inspection was done and the
work passed however you never filed for your Certificate of
Occupancy.
I am enclosing an application for C.O., the fee is $25.00.
We have your Underwriters Certificate on file, however we need
a Plumbers Certificate. Your prompt attention to this will be
appreciated. The code of the Town of Southold requires that a
Certificate of Occupancy be obtained for all Building Permits.
c.c. Charles Thompson
Yours truly,
Secretary
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND ~~NSULATION
FRAMING [ ] FINAL
INSPECTO~/__~
76S-~802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST ~ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[~/]/FRAMING [ ] FINAL
,REMARKS:
/
THE NEW YORK BOARD OF FIRE UNDERWRITERS P~'~' ~
I 0{~'i ~'!~, BUBEAU OF EL.ECTBICITY
~ 85 JOHN STREET, NEW YORK. NEW YORK 10038
Date ~'K}~{I~¥ ] 0, I q;~ Application No. onfile ~0fi~/~ N 0~t ~
THIS CE~I~I~ THAT
~y t~ ~t~ ~u~t ~ ~ ~ ~ int~U~ ~ t~ ~t ~ ~ the a~ ~t~ numar ~ t~ ~ o~
~ exam~ on .~N{~RY ~9~ and found to be in compliance with ~e r~ui~ment~ of th~ ~rd.
DIW~IIS FUIINAC~ MOTORS ~ AI~IJANCI I TIM CLOCKS UNIT HIATII~ M~LTI-O~RIT D~
SYST~4S
I~Cl D~CONNICT $ I R V I C
This certificate must not be oltered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their cmdm,~lls.
COPY FO~ BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT ANY MANNER.
,row. o ,sou om
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
~(Build~ Inspector)
APPLICATION FOR BUILDING PERMIT
Application No ..................
Date ...~.~..../.Ky,., 19c~.&
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 dia~am which is part of this appli-
cation.
c. Th~ 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. Suc~h..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 buildings for necessary inspections.
(Signature of applicant, or ffr~me, if a corporation)
......
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engSneer, general contractor, electrician, plumber or builder.
Name of owner of premises .... .~.. x~.,'.c .c~ ]~../. ~.?/vA ~ .................... ' ......................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Bnilder's License No ..... /r~ 2 (:~../.~..~. ....
Plumber's LicenseNo .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
.... ./.7 l ........ c. .... .c ....... ,2 /. . ¥. . .................... :.
. House Number Street Hamlet
County Tax Map No. 1000 Section .... .~./ .......... Block ...... ./. .......... Lot..',ffl ..............
Subdivision ..................................... Filed 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 .... c52. J. ¢ .... ~,~ z ...//...¢,%:~.~2 ~¢.~ ........................... '..
b. Intended use and occupancy .. ~ ./. . ]. C. . . vm / . .. ]F.. g ,Y. ; C,~ C ~, ..........................
10.
11.
12.
13.
14.
Nature'0f work (check which applicable): New Building .......... Addition.. ~ ..... Alteration ...... ,...
Repair . .. RemoVal .......... Demolition ....... Other g/ork..
$ o,.o.o ................ Fee ....................
Estimated Cost .... "~' -- ~ (to be paid on filing this.'.a~g~t~n)
If dwelling, number of dwelling Units ............ Number of dwelling units on each floor ................
If garage, number of cars ...... ! ..................................................................
If business, commercial or mixed occupancy, specify nature and extent of each ty. pe of use ........... t ...........
..... / 0 ? ' o~'''' ...
D~mens~ons of exxstmg structure~, ffany: Front .... 5tO. ........ Rear ., 5~. .......... Depth . Lt( .....
Height ...~. 6? ........ Number of Stories ..... 2., ................................................
Dimensions of same structure with alterations or additions: Front ..... y.O~. ........ Rear .... Y.O ./. .........
Depth .. ~'. (~..~ .......... ,.. Height .... ,~, 2~ f. ............ Number of Stories ..... ~ ..............
Dimensions of entire new constr¢ction: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
Size of lot: Front ..... ,Z(~O./.I ........... Rear .. ff. Oo.' ............... Depth . ..2, x'.c~../ ..............
Date of Purchase ........... ! .................. Name o,f Former Owner..... ...C~¢r~'~'.o./.e,~' ...........
Zone or use district in which premises are situated ..... F. cz, c/.*~ ~/ra.// ..................................
Does proposed construction violate any zoning law, ordinance or regulation: ................................
Will lot be regraded ......... ; ................... Will excess fill be removed fret9 premises: Yes No
Name of Owner of premises :2../~d~..Ad~of~,r~.. Address ~o~.o~q .~.2~/c .do,~JdPhone No..
Nmne of Architect .......... i ................. Address ................... Phone No ................
Name of Contractor ..C,g~ ~ ia&. 7~0 ~/a~co..v~. .... Address .~//.~/~ ~c. ff~z'eov,~l~'. Phone No.. ~. ~'~..~ &2/.~..
PLOT DIAGRAM
Locate clearly and distinctly all i buildings, whether existing or proposed, and, indicate all set-back dimensions from
pro~ei~t:t lines. Give street and block: mmber or description according to deed, and show street names and indicate whether
i~tterior or corner lot.
STATE OF NEW YORK, S.S
COUNTY OF .................
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signJing contract)
above named.
He is the ....................................................................... .k ................
(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 conthined 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 before me this I
............... t~ ...... day o~.......k~0.c~., ........ , 19..~.
NOTARY PUBLIC, State of ~w Yel'k
~ No. 47078?8, Suffolk County~ ............
term Expires March 30,19.-Lg./ '(Signature of applicant)