Loading...
HomeMy WebLinkAbout15664-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z-19836 CERTIFICATE OF OCCUPANCY Date APRIL 4r 1991 THIS CERTIFIES that the building. ADDITIONS Location of Property 1345 WILLOW TERRACE LANE House No. Street County Tax Map No. 1000 Section 26 Block 2 Subdivision Filed Map No. ORIENTz N.Y. Hamlet Lot 29 ~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this offmce dated JANUARY 27~ 1987 pursuant to which Bumldlng Permit No. 15664-Z dated FEBRUARY 5r 1987 was Issued, and.conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is mssued is FIRST & SECOND STORY DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate ms issued to of the aforesamd building. MORGEN THOMSEN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 //Bum~dlng Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .... ~..~.....~.:..~~ ................ ...z~./.~." ....... ~.....~..'...~ ............. ...G:.~..~.....~..,..~.,....!.,...~...~..~.., .... to .~...~.~..~..'.~.~..~....~.~........~~....~. .... ~.....~......7~:~.~.~..,..'' :~...¥~...~..: ....... ,~ .., ~ . _ %--;-, J V~ 0,,,e~,,e, ,oco,~ o,.Z...~.~......~.~......~.~.~.'....,.~., ........ ..~~.. County Tax Map No. 1000 Section ....,,(~,....~....(~. ..... Block ........ ~.....~'..... Lot No ..., .~-....~ ........ pursuont ,o opplication doted .....~.~~........~...~ ........... , 19.~.~., ond ~pproved by the Building Inspector. Building 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 buildzng inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildzngs, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-d~sposal(S-9 form). 3. Approval of electrical installation from Board of F~re 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 buildzng, multiple residences and ~imzlar 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 bumldingsl (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property l~nes, streets, buzlding 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 den~ed, 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 buildmng $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Bulldlng - $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 ..YX?Zv.[ ....................... .... ... . New Construction ........... Old Or Pre-existing Building ................. Location of Property.../.~..~.. House No. Street Hamlet Onwer or Owners of Property ............................................... .... ..... .. · · .. County Tax Map No 1000, Section ...... --:.-. ..... Block ..... -v .......... Lot ...................... Subdiviszon..?. !.&.g?.?. ......~. ~.~..~..~ ..... ~..~--. ........... Filed Map...~.?.0..~...Lot... ~. .............. Permit No ......... .. ... . Date Of Permit .......... ... ... . . ~ .................................. · Health Dept. Approval .......... Underwriters Approval ....... Planning Board Approval . .. Request for: Temporary Certificate ........... Final Certzcate ........... Fee Submitted: $ ...................... ...... .............. ¢ o I A P CAiVr OUNDATION ( 1 s t) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL/ ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ J IN/SULATION FRAMING [ ]/~FINAL REMARKS: DATE INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Asmstant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L HARRIS, Superwsor SouthoId Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 March 25, 1991 Morgen Thomsen 1345 Willow Terrace La. Orient, N.Y. Re: B.P. %15664Z first & second story deck addition Dear Mr. Thomsen: I am writing to you regarding the above permit. This permit has expired and have never called for any inspections. A certificate Of occupancy is required. Please call our office to arrange to clear up this matter. Thank you for your prompt attention to this. You are in violation of the Code of the Town of Southold. Yours truly, Secretary _L :.:,!~,..~..;;,:;~j.~_~. BOARD OF HEALTH ''~'~';.J~':~O'~n~C~u~A. 3 SETS OF PLANS , -,- ~ ~a~:~,~ ~i~ FORM NO. 1 SURVEY EI'[iV~E~ ~H ~WN~ OF SOUTHOLD CHECK ~ILDiNGDEPARTMENT SEPTIC FORM TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL MAIL TO: isapproved a/c ..................................... ............................. "' .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ts of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing loc~tion of lot and of buildings on premises, relationship to adjoining premises or public streets · areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. 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 all be kept on the premises available for inspection throughout the work. e. No building ~hall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy all 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 sliding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. m applicant agrees to comply with ali applicable laws, ordinances, bu~iing cote, ho/~ing/9ode, and regulations, and to mit authorized inspectors on premises and in building for necessary in ec ' s (Signature of applicant, or name, if a corp. oration) (Mailing address of applicant) :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................................. ame of owner of premises ..................................................... (as on the tax roll or latest deed) 'applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · Builder's License No 6.a Plumber's License No ......................... Electrician's License No ........... Other Trade's License No ...................... / e ' Location of land on which proposed work will be done~ ....... .~. ................. · ..... . ............................................................... ............. House Number .~. Str.[get~. Hamlet County Vax Map No. I000 Section .............. Block ...... . .,~...: ...... Lot ..... ~ ..~. ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and o~cupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... : ............ ~' .................... r.~ ......................... b, Inten. ded use and occupanc,' · .... · .--~.'~. · .'f~. ~ ....... f. NatUre work which applicable). New Building Addition Alteratmn of (check Repair ............ -i Removal ............ Demolition ......... Other Work ./~..¢~.. . (Description 4 Estimated Cost,. 4 00 Fee (to be paid on fihng this application) 5. If dwelhng, number of dwelling units ..... // ...... Number of dwelling units on each floor ............ If garage, number of cars ......... ~d~'.O,e~fi. ~-._.~ .......................................... 6. If business, commercial or mixed occupancy, specd'¥ nature and extent of each type of use ................. 7. Dimensions of exmtmg structures, ff any: Front ............ Rear ............. Depth ....... He~ght~,~/..~?'.~..."?...~. ~... Number of Stones ...... ~ ..................................... Dtmensions of same structure wRh alterations or addmons Front .............. Rear ............. Depth ..................... Height .......... t ........ Number of Stor/es ................ 8. Dlmensiqns of entire new construction' Front .... ~. o~,....~.. Rear ..... /. ~ .'~.... Depth .... ,4/.C©. .'. He~ght,'~/4Q~...~.x../.d. fO'. f.2./. Number of Stones ...........~ ............................... ............. Depth ............... 9. Size of lot. Front ...... ~ ..... , ......... Rear..~qa.n~ 10 Date of Purchas¢ ...~g'-,4"..,/.~/.~;~f.P. ........ ,~, eof' ormerOw, ner ...,///'~....~.~"C../~2Cx"...~.:'."fi'.~ 1 1 Zone or use dmtnct in (vhich premises are mtuated.. ~¢ ~.. t .~-4. qFl ~. ~/q / ......... 1 2. Does proposed construction v~olat, e any zoning law, ordinance or regulatmn ....... . .,'f~..~. ............. 13. W~II lot be regraded ....... .,/~..O. ................ Will excess fill be remov,e~ from premises: Yes 14 Name of Owner of premises . .,,~,4~t ...Z-.,~..o,,*/~.$..O.,D,~.. Address ~.~,.~./~...~.~.,f'4'¢.~ ~'... Phone No. Name of Architect .......................... Address ............. ~t. Phone No ......... Name of Contractor .. ~O, t. ~ e.'/....~)~,o. ~-~:/-~'.. Address ~?,~&r,.~lO~,~.. ~. ~,. Plmne No ~/.~. ?. 15. Is this property located dithin 300 feet of a tidal wetland? *Yes ~.. No .~'~. *If yes, Southold Town Trustees Permitp~rbe required. DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back d~menmons property hne$. Give street and block number or description according to deed, and show street names and mdlcate whe, interior or corner lot. STATE OF NEW,,~Y,QR~v/-- } ~_ R R cOUhq~Y OF ~ :'~ [~-S5-xt'. ~. ~ &~. -'- ~ .. .... ~ .~ .~ ~ ~ ~ .... ~ .... .~[ .~.~.~/· .. being duly sworn, deposes and says that be m the apph, ,' ~ (Name of individual signing contract) / work w~ll be performed in the m~ner set forth in the application filed therewith. Sworn to before me thru ~ ~ kt ~ ~t 19 ...~.~.~. ....... dayof...~ ,.,, ~ ..... ~7 . q~' ~1~]