Loading...
HomeMy WebLinkAbout15186-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19926 Date MAY 21~ 1991 THIS CERTIFIES that the bu~ld~n~ Location of Property 8~Q, BRAY AVE. House No. County Tax Map No. 1000 Section i26 Stlbdlvlslon ADDITION MATTITUCK~ N.Y. Street Block 1 Lot Filed Map No. Lot No. Hamlet 15 conforms substantially to the Application for Building Permit heretofore f~led in th~s office dated AUGUST 11~ 1986 . pursuant to which Building Permit No. I5186-Z dated A~GUST 18~ 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING The certificate ms issued to FREDERICK & MARY MILNER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING 5/20/1991 PLUMBERS CERTIFICATION DATED MAY 9~ 1991 - FRED MILNER ~~J ' ~g~Inspector Rev. 1/81 FO]B3J NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING P ER~,~ IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) counw Tox Mop No ~000 Se~,,on ..l ,~ .~ . ~,~ ...... /. ........... Lot No. /.~......~... Bul~ Inspector. Rev 6/30/80 Form No. 6 TOSUN OF SOUTI~LD 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 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-dzsposal(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 i% lead. 5. Commercial building, industrial building, multmple residences and similar buildings and installations, a certificate of Code Complmance from architect or engineer responsible for the building. 6. Submit Flannlng Board Approval of completed site plan requirements. For existing bumldlngs (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 applzcant. 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 building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Ftc-existing Bulld3ng - $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 ../.. .............. ... .. .. . ~ew Construction ...... . Old Or Pre-exist~ng Building .............. Location of Property..~;u~s~©. ~;[ ..... %~"~''' ~--Street ........ ' '~'~'f~ ..... ~g~ ............. )nwer or Owners of Property..~.~.~...¥...~-~.~...~.~'~.-' ......................... . -. . ... ]ounty Tax Map No 1000, Section ..... /..3%..(-3. .... Block ........ .~/. ..... Lot ........ ~. .......... ;ubdlvision Filed Map Lot . . {ealth Dept. Approval .................... Underwriters Approval ............... 'lanning Board Approval ........... equeStee Submitted: for: Temperates...h~o,.~.~--Certificate. o~ ....... ........ ,.. F~nal Corticate . .... . .... ............ i TOWN OF SOUTt~OLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-! 802 CERTIFICATION Owner ~-~ ~t %!q%Q~ (please prlnt) Plumber S~ ...... (please print ) I certlfy that the solder used in the water contains less than 2/10 of 1% lead. supply system (pXumber's sxgnature} $~to befor~ ~ ..~ ~ --day of , ~lotary Public, ~~County Notary Publlc INSPECTORS (516) 765-1802 VICTOR LESSARD, Pnnclpal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 March 15, 1991 Mr. & Mrs. Milner 600 Bray Ave Laurel, N.Y. 11948 Re: B.P. 15186Z ADDITION TO DWELLING Date of Permit Aug. 18, 1986 Dear Mr. & Mrs. Milner: I am writing to you regarding the above Building Permit. This permit expired in February 1988. You have never obtained a Certificate of Occupancy. This is now in violation of the Code of the Town of $outhold. The last inspection you had was 11/6/86 for the insulation and you passed. However you never called for a final inspection. Please contact our office regarding this permit. Thank you. Yours truly, Secretary ~iELD FOUNDATION FOUNDATION 2. ROUGH FRAME & (1st) (2nd) PLUMBING ~U~RN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7GS-'1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PI.BG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ]FINAL REMARKS: .~,/-/',.~//~/~// /~ 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING £ ] FINAL RE:MARKS: ~/~/~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]~,ATION FRAMING [~"'FINAL DATE INSPECTOR ,00 O~ 0 0 FORM NO 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765~1802 , me.,,,t ? D~sapproved a/c Apvhcanon No. Date .. i .... 19 : (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Ttus application must be completely filled m by typewriter or in tnk and submitted to the Building Inspector, w~th: sets of plans, accurate plot plan to scale. Fee according to schedule b Plot plan showing location of lot and of buildings on premises, relatmnshlp to adjoimng premises or public street or areas, and giving a detmled description of layout of property must be drawn on the d~agmm whmh ~s part of this appl cation. c The work covered by ,bas apphcatlon may not be commenced before issuance of Burring Permit d Upon approval of this appbcat~on, the Bmld~ng Inspector will issued a Building Permit to the apphcant Such penni shall be kept on the premises available for inspect,on throughout the work e. No bufldmg shall be occupied or used ~n whole or m part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmlding Permit pursuant to th Bmkhng Zone Ordinance of the Town of Sou,hold, Suffolk County, New York, and other applicable Laws, Ordhaances c Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as hereto describe, The apphcant agrees to comply w~th all appbcable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and m burring for necessary~ _l~C~,O]S~[ ~,\' ( (Signature of applicant, or name, if a corporation) (Mmhng address of apphcant) State whether apphcant ~s owner, le..ssee agent, architect, engineer, general contractor, electrician, plumber or buflde, Name of owner of premises '. ' ' '- t~s on If apphcant ~s a corporatmn, s~gnature of duly authorized officer (Name and title of corporate officer) Budder's L~cense No ~az~..; the tax roll or latest deed) Plumber's License No Electrician's L~cense No c~.rmz.4_J Other Trade's License No 1 Location of land on which proposed work wdl be done 2 House Number Street County Tax Map No I000 Section { '. -.- I ~ I ~ Block Subdivision ~ ~ c 7'/'L;/ -' (Name) Hamlet / rot. Filed Map No Lot State existing use and occupancy of premises and intended .u~se and occupancy of proposed construction a Existing use and occupancy -~r ......... b Intended use and occupancy 3. Nature of work (check which applicable) New Building Repmr Removal 4. EstnnatedCost .~.; ............ o ..... Demohhon If dwelling, number of dwelling units ..... If garage, number of cam ........... Addition ~./ ... Alteration · Other Work (Descnphon) Fee .. (to be paid on ~ing this application) Number of dwelling umts on each floor ........... 6. If business, commercial or m~xed occupancy, specify natu~re and extent of each typ, e of use ........ ,.., ..... 7 D~rnenslons of exCtlng structures, if any' Front ., Rear ~..' Depth ........ Height . Number of Stones t ...... Dm~enslons of same structure with alterations or addlttons Front . . Rear ...: ........ Depth : -. Height . [~ . ....... Number of Stones..~[...;..4 ...... 8 Dmaenslons of entire new construction Front .~ ..... Rear .......... Depth ..... Height ..... Number of Stones ...... '....'-' 9 S~ze of lot Front -..t .... Rear ...... Depth ........ 10 Date of Purchase '.~,~ ....... ~_Name of Former Qwner ....................... 11. Zoneorused~stnctlnwhlchprem~sesaresltuated. ~... '..,~ :' .\ ...... 12 Does proposed construction.violate any zoning law, ordinance or regulation' . ............................ 13 Will lot be regraded [ ~ ~ _~ Will excess fril be removed fr,om premises' Yes 14. Name of Owner of premises ~',~[~ ~' ", ~ ' -' ~ . Address .... ; .......... Phone No ............ Name of Architect ' . Address Phone No. Name of Contractor ...... Address .. Phone No.. / PLOT DIAGRAM Locate clearly and distinctly all buddmgs, whether existing or proposed, and, indicate all set-back dnnenslons fron property hnes Give street and block number or descnptnon according to deed, and show street names and mdmate whethe interior or corner lot STATE OF NEW YORK, S.S ..,c, : . ~'""~,. being duly sworn, deposes and says that he as the apphcan (Name of individual signing contract) above named ,.~/He th ' (Contractor, agent, corporate officer, etc ) of smd owner or owne~, ~d is duly au~onzed to perfom or have peffo~ed the smd work and to m~e ~d file th~ apphcatmn, that fll statements contmned m th~s apphcatmn am true to the best of h~s ~owledge and behef; ~d that th work will be performed ~n the m~ner set forth m ~e apphcat~on fried ~erew~th Sworn to before me thru ..... '. (S~atu~ of app~can