HomeMy WebLinkAbout15679-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
U~KTIFICATE OF OCCUPANCY
No Z--23930
Date
O~TOBER 5r 1995
THIS CERTIFIES that the buildin~
Location of Property 7130 MAIN ROAD
House No. Street
County Tax Map No. i000 Section 31 Block 6 Lot
Subdivision Filed Map No. Lot No.
ACCESSORY
EAST MARION NY
Hamlet
6
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 3~ 1987 pursuant to which
Building Permit No. 15679-Z dated FEBRUARY 11, 1987
was ~ssued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is REPLACE AN EXISTING A~SSORY BUILDING AS APPLIED FOR.
The certificate ~s ~ssued to
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. H047117
PLUMBERS CERTIFICATION DATED
WILLIAM & DOR(~£~I WAGNER
N/A
SEPTEMBER 26f 1995
N/A
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 15679 Z
Permission ~s hereby granted to:
,. ,~~'"~~ ..... ~.,, ........... ~..,.....~.....~.:7.. .....
at premises ~ocoted ot ....,.~,../,.~ ........~..~...~ ............ ~gm~,,.?.~.:..~~ .....
County Tax Map No. 1000 Section ........ ~:~...~.~ .... Block ....... .~....~. ..... Lot No ..... ..~,.I,~ .....
pursuant to application dated .~ .~t, ............. , 19.~.., and approved by the
Building Inspector.
Rev. 6/30/80
JUN t 8
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-I802
~PLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled mn 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 Underwrmters.
4. Sworn statement from plumber certifying that the solder used zn system contains
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installatzons, a certificate of Code Compliance from architect or engmneer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
3. For existing buildings (prior to Aprml 9, 1957) non-conforming uses, or buildings and
pre-existing" land uses:
1. Accurate survey of property showmng all property lmnes, streets, bumldzng and
unusual natural or topographic features.
2. A properly completed application and a consent to Inspect smgned by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applzcant.
3. Fees
Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory bulldlng $25.00,
Additions to accessory bullding $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 Cert%flcat~ of Occupancy - Residential $15.00, Commercial $I5.00
~- Date .... .~..~ f/~.. Kf~.~
Old ' ~ .............
aw Constr~ction. . Or Pre-existiog Building ................. ' .....
)cation of Property ................... . ....
House No. ' ......... · ... . .......
Street Hamlet
~wer or Owners of Property...~.~:.%.~.%.~...~e~.k~..' ..........
,unty No ooo, Sectlo,...A< ........ ...... ........ t ..
bdivision ............ . ..............
......... Filed Map
7' , ............ .........
rmit No ........
....... , ....... Date 0f'Permzt ......... Appllcan~
alth Dept Approval
· ' ...................... Underwriters Approval
aoning Board Approval ................
quest for: Temporary Certificate ........... Final Certlcate .....
~ Submitted: $.. .
~. ~ :.t_ '~,~"~-~ .-. ·
Town Hail, 53095 Ma~n Road
P O Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 15, 1995
Mr. William Wagner
P.O. Box 21 ,
East Harion, NY 11939
***** SECOND NOTICE *****
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed) **
7o Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
iNo Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 15679-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
- ACCORDING TO THE CODE OF THE TOWN OF SOUTHOI/), IT IS
UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A
CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED.
INSPECTORS
(516) 765-1802
VICTOR LESSARD, Przncipal
CURTIS HORTON, Semo~
VINCENT R. V~IECZOREK, Ordxnance
ROBERT FISHER, Asststant Ftre
Bmld~ng Inspectors I
THOMAS FISHER
GARY FISH
OFFICE OF BUILDING INSPECTOR
TOVv-N OF SOUTHOLD
October 16, 1992
SCOTT L. HARRIS, Supermsor
Southold Town Hall
P O Box 1179, 53095 Matn Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Mr. William Wagner
P.O. Box 21
East Marion, N.Y.
11939
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.
The check is not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 15679-Z (ACCY)
Please con~act our office on th~s matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
Thank you for
o
Z
.<
Z
m
OUNDATION ( 1 s t)
OUNDATION (2nd)
OUGH FRAME &
PLUMBING
NSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
Examined
Approved ~F~
Disapproved a/c . .
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.' 765-1802
,i9 7
, 19~ ~ Permit No. J ~o~ ~ ~:
Received .......... ,19.
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ~/3 . , 19~
'; , t%, 'fo' i ,!,..tOtnt~N~.TRUCTIONS
a. T~s apphcaQon must,o¢~c~plete~F~ by Wpewnter or in ~nk and submitted to the Budding Inspector, ~t~
sets of plus, acc~ate plot pl~.~ Seale. F~c~brdmg to schedule
b. Plot pl~ shqwmg locanon of lot ah~ of bmldmgs on premises, relatmnship to adjommg premises or pubhc stre
or ~eas, and g~v~g'i d%tmle~t~h ~*f layout of property must be drawn on the dmgmm which is pa~ of thru ap,
c. The work covered by t~s apphcatzon may not be commenced before zssu~ce of Budding Permit
d Upon approval of thzs apphcahon, the Bmldzng Inspector wall zssued a Bufldmg Pe~zt to the apphc~t Such pen
~all be kept on the premmes avaEable for mspect~on ~rou~out the work
e No bufldmg shall be occCp~ed or used zn whole or ~n p~t for any purpose whatever untd a Cemficate of Occupar
shall have been grated by ~e Buildmg ~spector
~PLICATION IS HEREBY MADE to the Bmldmg Dep~tment for the zssuance of a Bmld~ng Pemzt pu~uant to ~
Bml&ng Zone Ordmance of the To~ of Southold, Suffolk County, New York, ~d other apphcable Laws, O~m~ces
Regulatmns, for the constmctzop of buddmgs, addzaons or alterations, or for removal or demohQon, as here~n descdb
~e apphcant agrees to mmply;wzth all apphcab]e laws, or&nances, bufldmg code, houmng code, and regulatmns, ~zd
admzt authomed mspectom on ptemmes ~d m buddmg for necessa~ znspechons.
(Si,nature of apphcant, or ~ame, if a corporatmn)
....... ~. ~. ~...Eq V.~..~.~ ..................
(mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build.
Name of owner of premises ~JtA- t- ,,9r~. ,,5d,'9-C-.~/,-~--,~. ..........
(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 /, 9 . 3 ?.6, .//
Plumber's License No
Electrician's License No
Other Trade's License No.. .
2
Location of land on which proposed work will be done
House Number Street
County Tax Map No 1000 Section ~ [
Block
Hamlet
.. Lot
/'///~T. Filed Map No Lot
Subdivision (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy 7- ~ ?- ~-~ ~- zg{>~'/t~ ~7 .~ / $ 7'/.~7~ C,- J' r 9 ~..
b Intendeduseandoccupancy 5'F/,'.~? ../Or~.. ~..ff..~.t.)t.e..~.../¥.-,~.". ,-X./~..:-.~...
-~'--- ~I'..L [::TTE DQtVE'
N. 5~ 13 50 F_
Z
98.26
1%o
,.-. Po53- /~.
C =,.,.,"-, ..... ' I U)
1
COUNTY
3. Nature of work (check which applicable) New Budding .Nk AddlBon ...... Alteration ....
Repair
' ~/ :2 (Descnptmn)
.... Removal .......... Demolmon 'k ....... Other Work ............
4 Estimated Cost . . .~.~P,.~ ............. Fee .~.~ .................
(to be pad on fihng th~s apphcatmn)
5. If dwelhng, number of dwelhng units__. ~/~ ...... Number of dwelhng units on each floor
If g~age, number of c~s ..... ~ .........
6.
If bus~ness, commercml or m~xed occupancy, specify nature and extent of each type of use . ~ ..........
7. D~ensmns of exmtmg structures, ff any Front ....... Rear ......... Depth ...........
Height N~ber of Stones ~, . ? ~ .~ ~ .....
D~ens~ons of same structure w~ alteratmns or additions Front / ~ .~ ~ . . Rear
Depth lq ......... He~t . /.~ Number of Stones . . I .. . tX .......
8 D~ensmns of entire new construction Front /.~ ~ ~ Rear ' ~' ~
.... ~.~ ....... Depth ./~... % .....
Height .1.7 ' . .. Number of Stones . ~. { ..................................
9. Size of lot Front y~ ~,~o~ ............... Depth ..................
10 Date of Purchase ....... Nme of Foyer Owner ...................
11 Zoneoruse&stnctmwhichprem~sesaresltuated. .~y~ ~~rf~.~ ................
12. Does proposed constructmn violate any zomng law, ordinance or regulation .. W.o .................
13. Will lot be regraded ...... ~ ...... Will excess fill be removed from premises' Yes
14 N~eofOwnerofprem~ses~{~~ ~Address. ~r~.~. PhoneNo ........
Nme of Architect ............. Address .............. Phone No ..........
Nme of Contractor .~[~. ~r.~.~c~ ~. Address ........... Phone No
__.
15. Is this property located withinl00 feet of a t~dal wetland? * Yes . . No ~ . · If yes, Southold To~ Trustees Permit ~y ~ re~ired.~
Locate cle~ly ~d dmtmctly ~ bufldmgs, whefller existing or proposed, m~d, md~cate ~ set-back d~ens~ons from
prope~y hnes. Gtve street ~d block number or descnptmn according to deed, ~d show steer nines and md~cate whether
mtenor or corner lot
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
ITATEOFN W~(/~)~i OccuPANCY
:OUNTY OF.: ~ ! . $ S
bore named.
being duly svt~om; deposes
and says?hat h~:
~}~e apphcant
[e is the .................... ~.. ,~.,,.. .. · .~7~'N, ·. ..................................
'( XC. ractor, co.orate off, cer. etc.)
f smd owner or owne~, ~d ~s duly ~med to ~rfom or have perfomcd the aid work ~d to m~e ~d file ~s
~phca~on; that ~1 statements contained m lh~s apphcatmn are tree to the best of hm ~owledge and belief, and that the
ork will be perfo~ed in the m~ner set for~ m the apphcation filed ~erew~th
worn to before me this
ot~ubhc, ~ . %/~ . . ~ County ~
.~~ ~ <$ff~ature of apphc~t)