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HomeMy WebLinkAbout16600-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24083 Date DECEMBER 14, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property. 10612 8AYVIEW RD. & 680 JACOBS LA. House No. Street Hamlet County Tax Map NO. 1000 Section 88 Block 1 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 1987 pursuant to which SOUTHOLD, N.Y. Building Permit No. 16600-Z dated NOVEMBER 5, 1987 was issued, and conforms to all of the requirements of the applicable provieion~ of the law. The occupancy for which this certificate is issued is GARAGE & DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 CHESTER M. & PARKER E. DICKERSON N/A H-047981 - DECEMBER 1, 1995 N/A Building Inspefor FOB. Bi BO. O TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUiLDiNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~16600 Z Permission is hereby granted to: .... ............ . . __ "~ , ~ ct--, ~ \~.~ i _ __n_ :, ')-' .....i .................. } ~..~..~..~.: .b~.-...:7 ................... ~.. ot premise, ~<~ed *~ ..~t~.....~.~~,.~....~.~..~.~ ....... ~. County Tax Map No. lO00 Section ...... ..(~.,,~.,~.. ...... Block ....... ..~..~ ....... Lot No....l...~., .............. pursuant to application dated ....... ~t~..~......~... .......... , 19..'~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS I 8~57633 BUREAU OF ELECTRICITY ~-- ES JOHN STREET. NEW YORK. NEW YORK 10038 Date D~C~]~ ~1t1995 Application No. onfile 107~1495/95 H 047981 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application nu tuber in the pr~mises of JAMES M,DI~SO~, 10612 BA%WIF~ ROAD, SOUTHOLD~ N.Y, in the following location; [] Basement [] Ist FI. [] 2nd FI. ~]~R/OU~ Section Block uvds exantined on NaVStaR 27 ~ 1995 and found to be in compliance with the National Electrical Code. FIXTURE OUTLETS ~ECEPTACLE$ SWITCHES SERVIC~ DISCONNECT NO OI A~D~"Y' ~("w. rom, FU".NPACE GAMOTO"'..~. RitTRE APPUN'oNCE OTHER APPARATUS: ~NO VISUAL DEFECTS: "An electrical survey has been made of the exposed electrical e~dipment in the premises indicated.' 'No obvious unsatisfacto~ condition %~as found, [JNIT HEATER ¢ MULTI.OUTLET SYSTEMS NO. OF FEET Lot EXHAUST FANS AMT. H P. DIMMERS AMT. WATTS I~612 BAYVIEW RO~D SOU%~HOLD, NY, 11971 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentlals. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 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 Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 16 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 completeJ 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 1. 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 Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00 New Construction..~. ...... Old Or Pre-existing Building ................. Location of Property.. ].~i. ~...~ ~ .~ ~ .~.~ ............. .~P.~i~l~/~. House No. Street Hamlet Onwer or Owners of Property.,C~.~.~.~.~.~.~. .... ~....~.~...~.z~.....~.~./.~.~.~..~-~..-~.., County Tax Map No 1000, Section .... ~.~· Block ....... / ....... .Lot .... fZ) ............. · Sobdivision.-2~.~- ......................... Filed Map ............ Lot ...................... Permit No .... -: .Da~e Of Permit ..... Applicant ........ Health Dept, Approval ....................... .. · Underwriters Approw~l ........................ . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~ ..... Fee~.Submitted:~0~$...~ ...... ............ ..... APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS pA~. 1 805763~ BUREAU OF ELECTRICITY ~-- 8.5 JOHN STREET, NEW YORK, NEW YORK 1003B D, te DECEMBER 01,1995 ~pplicatlon~o. onfiie 1~7~1495/95 H ~47981 THI~ CERTIFIES THAT theJol~owing location; ~ B~ement ~ Ist FI. ~ 2nd H. G~/OU~ ,Section Bilk Lot examined on ~0~ ~J ~ ~ ~ and found to be i~ complianc~ with the Na~onal Elect~cal Code. FIXTURE RECEP I [ FIXTURES [ RANGES COO~K~IN DRYERS ] FURNACE MOTORS I FUTURE APPLIANCE ~EDeRS SERV/~ DI~ONNECT. I~.OE] ..... ~ 5 MULTI-OUTLET SYSTEMS NO. OF FEET · V I C A. WG ',C,ALREC,,' ,,Z ,LOCj:. U,,'--'EEE R OTHER~PARATUS~ *NO ¥I$U,~ DE?ECT$: "Ars electrical survey ~as ~een ~ade o~ t~e e~pose~ electrical equipment in the premises indicated." "No obvious unsatisfactory condition was ~ound. 10612 BAYVIEW ROAD SOUTHOLD, NY, 11971 GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified 'by their ~edentials. (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Town Hall, 53095 Main Road P. O. Box 1179 Southo[d, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 12, 1995 Mr. Chester Dickerson 155 Nountain View Manor Torrington, CT 06790 **** THIRD 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) ** xx No 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. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 16600-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF $OUTHOLD January 23, 1990 Mr. Chester Dickerson P.O. Box 846 10120 Sound Ave. Mattituck, N.Y. 11952 Re: Building Permit ~16600-Z Premises: 14100 Main Bayview Rd. Southold, N.Y. Suff. Co. Tax Map ~1000-88-1-10 Dear Mr. Dickerson: During a review of our files, it was noted that the above building permit has expired, and a Certificate of Occupancy has not been issued. A final inspection was made on October 31, 1989 and a notice was sent with the application for C.O., requesting an Underwriters Certificate and a check in the amount of $25.00. To date we have not received these papers. According to the Code of the Town of Southold Article XXVIII 100-281 and 100-284 a building permit is needed for construction of an addition to an existing dwelling. It is unlawful to occupy a dwelling or use said addition until a Certificate of Occupancy has been issued. In order to avoid any legal action you must correct the above violation immediately. Please send the appropriate papers to this office so that we may issue the Certificate of Occupancy. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. Vincent R. Wieczorek, Ordinance Inspector VRW:gar TOWN OF SOUTFfOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TO~VN HALL SOUTttOLD, N.Y. 11971 TEL. 765-I ~02 To Whom This May Concern, We are unable to complete your CertifiCate of Occupancy because .of the foil. owing reasons., ~ An application for Certificate of Occupancy is not on file. _~ No Underwriters Certificate on file. ~/' Tile check is (outdated/not ~1-~%3~e. )~. OG /-/ No Health Dept. Approval on file. /--/ No final ins.pection bas been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # / ~ _~ .Q .~ Z Building Dept. ***/5/ No Plumber Solder Certificate on file., ( all permits involving plumbing being issued after April 1,1984 ) 765-~LSOZ BUILDING DEPT. INSPECTION INSPECTOR Examined J).~.4~.., 19'$.-/. BOARD OF HEALTH .. · , 7 . FORM NO. I SURVEY ........ TOWN OF $OUTHOLD CHEEK - BUILDING DEPARTMENT SEPTIC FORM ............. .' TOWN HALL NOTIFY SOUTHOLD, N,Y. 11971 TEL.: 765-1802 CALL ................ MAlL TO: Approved .~.~..~.., 19~..~. Permit No.}. .~..~. ~.~ .~.. Disapproved a/c ..................................... ................................ ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... !9... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 diagram which is part of this appli- cation. 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 shall he 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 t{ave 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, j0ousing code, ~3d regulations, and to admit authorized inspectors on premises and in building for necessary inspejTfioB~. [) ~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant i~ lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~~..~.t.? ~..~-,~.' .~.;i~ i i i~--i~..~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No.. ~ .............. Plumber's License No ......................... Electrician's License No ....................... ' ~ I Other Trade's License No ...................... /~ ,T~ ~&~a., ~'/0/~ .42 // .~...~. Location of land on which proposed work will be done.. .~D,~.y .~./..~..c~.. ~f.~....9(.1].~..~.o. ~.~. .... House Number Street Hamlet County Tax Map No. i000 Section ~. ~)DO..~..~-~. Block ..... /. ............ Lot.../.~. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use an?_~cup: o~posed construction: 3. Nature of work (check which applicable): New Buil Repair .............. Rem'oval ............ ~'tion ...... ~ ~ ' ! ion) 4. Estimated Cost ........ ,~.~, .c.? ~ .............. Fee ' (to 5. If dwelling, number of dwelling units.. Number of dwelling un{ts on ~ 4".; ~ ...~. If garag , nu ber of cars .................................. ':: .' ................... 6. Ifbus~ness, commerctalorm~x~doccupancy, spec~fy nature and extent of each type of'use ...' ...... 2 ........... 7. Dimensions of existing structures, if any: Front ................ Rear .............. Depth .... ............ Height Number of Stories " ~ ' · " ' ' Dimensions'of same structUre With alterations or additions Front ................. Rear .................. Dept ...................... Height .......... ~ "' · · '-'/r .... Number of Stones ...................... -- B. Dimensions of entire new const:ruction: Front.. o.Q,~/.~. ~.~... Rear ............... Depth ............... Height .... , ........... Number of Stories ......................................................... 9. Size of lot Front ,/.,~J ~.~..Z".'; ~ -Rear .... .. ............ Depth ...................... 10 Date of Purchase ~ Name of Former Owner 11. Zone or use district in ' ' ' ' which premmes are situated ..................................................... 12. Does proposed construction vi~late any zoning law, ordinance or regulation: 13. Will 10t be regraded ........ ) ........ - .. ,/. ....Will excess fill be removed from premises: Yes No 14..Name of Owner of premises ~.~ ff~."~*~-~. ~'~[.~,, ~...*'~'ACrdre~S/¢/.~.~.~..~.~.~..~. ~.. Phone No.~;~.~ .~-~.O. Name of Architect ......... i .................. Address ................... Phone No ................ Name of Contractor ~ Address Phone No 15. this property located with 300 feet of a tidal wetland? *Yes ..... No ..... yes, Southold Town Permit may be required. / PLOT DIAGRAM . : and distinctly all ~es. Give street and bloc~ numbe~ whether existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether lq STATE OF NEV,~-YO,~(//,,. ! ~.S COUNTY OF .~N.,//~./..f.~ ...... ...... ?......: ..... bei,,g d,ly sworn, deposes and sa,s that he is the a,plicant (Name of individual signing contract). above named. He is the.... ,'. ....... i .................................................................... ; (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann6r set forth in the application filed therewith. Sworn to before me this et ' .~Z ........................ day o~ .... ~'~..~2r/%~.. .......... ,19... Notaw Public ......... .'.~.'...~...~% .~/..,¢t'~C. ounty ' . ~o~1~,_47078 7.8..PI/Bt/C" 8uffolkSlat~ 0t~u~ty~¢/~ ~ ((Signatureg of apvficant)pp lerm F, ooF TI-II SECTION "4A" (turn down slob) .t i-~t ROOF;HEATHING LAYOUT F, oOF "~" SECTION "4 C" SECTION "4 B" (formed foundotion) 2184 SHEET TOTAL 4 5 CORNER DETAIL "3A" SECTIONAL GARAGE DOOR ,JAMB DETAIL SHEET TOTAL 5 CH£~T~£_~_'~_~~~E_ E. D/£K~o~ \ ,.eta/e:/00%- 1"