HomeMy WebLinkAbout16434-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
OffKce of the BuKldKng Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z189t0
Date MARCH 22~ 1990
THIS CERTIFIES that the buildKng.
Location of Propert~ 7130 MAIN ROAD
House No.
County Tax Map No. 1000 SectKon 031
REPAIR TO PORCH
EAST MARION
Street Hamlet
Block 06 Lot 06
SubdivKslon FKled Map No. Lot No.
conforms substantKally to the ApplKcatKon for BulldKng PermKt heretofore
filed in this offKce dated SEPT. 3, 1987 pursuant to which
Building PermKt No. 16434Z dated SEPT. 7r 1987
was zssued, and conforms to all of the requirements of the applKcable
provisions of the law. The occupancy for which thKs certKficate Ks
issued Ks REPAIR EXISTING PORCH ON EXISTING ONE FAMILY DW~TJ.ING.
The certzfzcate Ks zssued to
(owner)
of the aforesaKd buKldlng.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
WILLIAM AND DOROTHY WAGNER
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, No Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
16434
Permission is hereby granted to:
............................ ~. ........... .~ ............. 3 ............. _ ~
~...~~:..~_~..: ....... ~ ......... : .............................. :;:...._.. .............. ~ ........................
~t ~m,~s ,~o,e~ ot ...~.:..~..........~... e-~.: ..... .~ ...... :~~ ..............
County Tax Mop No. I000 Section ...... .~.....~..~ ..... Block ...... ..1~...?. ....... Lot No ..... ..~t~. .....
to application dated ... ~..~.~~..~ ........ , 19.~,.~., and approved by the
pursuant
Building Inspector.
Fee $ ~,~,.,'/
Building Inspector
Rev 6/30/80
TO~N OF SOUTEOL~
SOUTUOLB. MEW YORK
765 -- 1802
APPLICATION FOR CERTIFIEATE OF OCCUPANCY
NEW COMSTRUCTYON %'/ .OLD OR PRE-EXISTING BUILDING .... VACANT LAND...
~op~7.-. 2-L%.% .... -~. ........
HOUSE NO. STREET HAMLET
~ooo sc~ioa ..~./... ~oc~ ..~. .... Lot
Subdivision ...................... Filed Map . Loc ..
Pe~mi: No. / ~%.%~. Date of Permit .. . Licaa: ...........
Health Dept. Approval .................. Umderwriters Approval ..............
PIa~mimg Soard Approval ................
Request for Temporary Certificage ....... Final Certificate .........
Fee Submitted:
APPLICANT.
10/14/88
BLDG DEPT
TOWN OF SOUTHOLD
FORM NO. 6
TOWN OF SOUT~IOLD
BU ILDIN~ DEPARTMENT
TO~4N IIALL
7~5- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
This application must be filed in typewriter OR ink and submitted to the Builihg
Inspector with the following; for new buildings or new use:
]. Final survey of property with accurate location of all buildings, property llnes,
streets, and unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage-disposal(S-9 rom).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that solder used in system contains less
than 2/10 of IZ lead.
~. Commercial buildings, industrial buildings, multiple residences and similar.
buildings and installations, a certificate of code compliance from the Architect
or Engineer responsible for the building.
Submit Planning Board Approval of completed site plau requirements.
B. For existing buildings (Prior to April 9, 1957~ non-conforming uses, or buildfu]gs
and "pre-existing" land uses:
I. Accurate survey of property showing all property lines, streets, buildings and
unusual natural or topographic features.
2. A properly completed application, a consent to inspect signed by the applicant
and a certified abstract of title issued by a title company which shall
show single and separate ownership of the entire lot prior to April 9, ]957°
If a Certificate of Occupancy is denied, the Bnildlng Inspector shall state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent info~mation required to prepare a certificate.
For Vacant LaDd Certificate of Occupancy:
1o Am application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, ]957 shall also acc~pany
the applicatiom. If a Certificate of Occupnucy is denied, the Building I~.~pector
shall state the reasons therefor in ~rritiog to the applicant.
D. FEES:
I.
CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swim~ing Pool, $25.00. Accessory building $25.00
Addition to Accessory buildings, $25.00 - Businesses $50.00.
2. Certificate of Occupancy om pre-existing dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Certificate of Occupancy - $20.00
5. Updated Certificate of Occupancy - $50.00
6. Temporary Certifica£e of Occupancy -$15.00 Residential
Commercial
10/14/88
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
Town Hall, 53095 Man Road
P O Box 1179
Southold, New York 11971
January 30, 1990
Mr. William Wagner
7130 Main Road
East Marion, N.Y.
Re: B.P. #16434Z dated Sept. 7, 1987
Repair existing porch on d~elling
Dear Mr. Wagner:
I am writing to you regarding the above Building Permit.
Every permit requires a Certificate of Occupancy.
The contractor has been notified on 10/7/87 and 7/26/88
of what is necessary to obtain the Certificate of Occupancy.
Please resolve this matter as it is necessary to have a
C.O. for the work done. I am enclosing an application. Please
fill it out and return it along with a check for $25.00. Thank
you for your attention to this matter.
Secretary
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOK
P.O. BOX 728
TOWN IIALL
SOUTHOLD, 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.
/~/ The check is(outdated/~ot on fi
/~/ 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 #
Building Dept.
***/~/ No Plumber Solder Certificate on file.
all permits involving plumbing being
issued after April 1,1984 )
Occupancy or usc is unlawful wtthout
of Occupancy. Clear up this mat ter
so that legal action does not have to be
Thank you for your prompt ,it tent
FOUNDATION
{1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
ADDITI
COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
REMARKS:
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ~I~NAL
DATE
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION
FRAMING
INSULATION
[~FINAL
REMARKS:
DATE
Examlned~&~'e~ '-[. , 19g.'1.
Approved~.~o-~ .'~ , 19%.3
Disapproved a/c
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
8OUTHOLD, N Y. 11971
TEL.. 765-1803
Permit No
(Building Inspector)
APPLICATION FOR BUILDING PERM IT
INSTRUCTIONS
Received ........... ,19.
Date ¢ , lib-?.
a. This apphcatlon must be completely filled m by typewriter or in mk and submitted to the Buddmg Inspector, wltl
sets of plans, accurate plot plan to scale Fee acco~ng to schedule.
b. Plot plan showing location of lot and o~',/~4~gl,~n prem~ies, relationship to adjoining premises or pubhc sim
or areas, and glvmg a detailed description ogllay~f q[,']~ihtSortM ~t be drawn on the dmgmm which ~s pa~ of this ap
c The work covered by ~s a¢~~ ~e~a~ed before ,ssu~ce of Building Permit.
' d. Upon approval of m~s a~5~ ~~t6r will issued a Budd~g Pe~it to the applicmt Such per~
shah be kept on the premises ~'[~t~qut the work.
~ e. No bu~g shall b~ ~e~[~t for any purpose whatever until a Ce~fficate of Occupm
sh~ have been granted by ~g ~s~
~PLICATION IS HERE~~~D~p~ment for the issuance of a Bmldmg Pem,t pumuant to
Bufld~ng Zone Ordinance of the ~bffS~ Suffolk County, New York, ~d other ~pphCable Laws. Ord~ce-
Regulahons, for the constmct~on~t~d~,~dttions or alterations, or for remov~ or demohbon, as hereto descnb
The apphcant agrees to comply with~ ~app~cable laws, ord~n~ces, bufldmg code, housing code, and regulations, and
admit authored mspectom on prem~.~hd m budd~g for necessa~ inspections
.
(Signature of apphcant, or name, ff a ~rporation)
....... ...............
......... .......................
(ma~i~ng address off
State whether apphcant ~s owner, lessee, agent, architect, en~neer, general contractor, electrical, plumber or bud,
...........
Nme of owner of premises ~~ ff~O~
s on the tax ~oll or d
If apphcant ~s a corporation, s~gnature of duly authorized officer F~[' ~ ' ~=
(Name and title of corporate officer)
Builder's License No ..
Plumber's License No ..
Electrician's License No
Other Trade's License No
Location of land on which proposed work will be done
ttouse Number Street
Hamlet
County Tax Map No I000 Section
· Block ~ .. . Lot.
2
Subdivision Filed Map No Lot
(Nalne)
State existing use and occupancy of premises and intended use and occupancy of proposed construction
a Existing use and occupancy ~ /~ ,~e_~.~. - ~ -~ ~_. ......
b Intended use and occupancy .. ~ ~ ...
3. Nature of work (check which applicable) New Budding ..... Additmn ........ Alteration ........
Repmr . ./ .... Removal .... Demohtmn .......... Other Work .........
(Description)
4. Estimated Cost ~".o.~.O ~. ~..'~ .......... Fee ..........................
(to be paid on filing this application)
/
5. If dwelling, number of dwelhng units. .~//f.,'9 .... Number of dwelling units on each floor .............
If garage, number of cars ........ ~/.~f ............................................
6 If business, commercial or mixed occupancy, specify nature and extent of each type of use ..............
7 Dimensions of existing structures, if any Front .~ o. ~ . Rear .......... Depth .............
Height ........ Number of Stones ......................
Dunensions of same structure with alterations or additions Front .......... Rear .............
Depth ........ Height .... Number of Stones .............
8. Dtmensions of entire new constructton. Front . . ).o ~. . Rear ......... Depth ...........
Height ...... Number of Stones .............................
9 Size of lot Front ..... Rear .............. Depth ..............
10. Date of Purchase ............ Name of FormerO~ ................
11. Zone or use dmtnct in which premises are situated .... ~..- ] . -~...
12. Does proposed construction violate any zoning law, ordinance or regulation . .~. ..................
13. Will lot be regraded .... ~f,~ ....... Will excess fill be removed from premises Yes No
14 Name of Owner of premises ~,',,~,g~ g-~,r~ Address ............ Phone No
Name of Architect .......................... / Address .................. Phone No
Name of Contractor .............. Address ...... ..... Phone No ..........
15. Is this property located with:tnt00 feet of a tidal wetland? * Yes ..... No ...~..
· If yes, Southold Tom Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and d~stmctly all bu~dmgs, whether existing or proposed, and indicate all set-back dnnensions from
property lmes Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot
z"- .... 7 --'
;TATE OF NEW YORK,
'OUNTY OF ~ . S S
(Name of lndlwdual s~gning contract)
bore named.
being duly sworn, deposes and say~t~al he is the applicant
(Contractor, agent, corporate officer, etc.) , t~.___,_~ ....
f smd owner or owners, and is duly authorized to perform or have performed the sa~d ~otU ~l~F.~6a_:~_ak~e_~,d.,file this
)phcatlon; that all statements contained m this application are true to the best of his knox~ledg~e~'hn~dr~i~'~, and that the
ork will be performed m the manner set forth m the apphcation filed therewith.
worn to before me this
.. · .. dayof.,~...p,~-~,~,dx~d--*..,
19
9tary Public ............ ~~... County
(Signatur~of applicant)
Note UNDAJ. COOPER
. r~o_482.25~3, Surfak Cou_nty,
.erin ~.Xprres De~eember 3'/, 1E~...~