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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)