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HomeMy WebLinkAbout15209-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy }40 Z15224 Date January 27, 1987 THIS CERTIFIES that the bmldmg .Afl d i t i.o.n ..................... Locatton of Property 3505 DELMAR DRIVE LAUREL House No Street Hamlet County Tax Map No 1000 Sectton 12 5 ...... Block . 4 ......... Lot ............ Subdtvlston ................ Fried Map No ..... Lot No ............. conforms substanttally to the Application for Braiding Permit heretofore fried in tills office dated ... Au[: .1.6,. 178.6.., .pursuanttowluchBmldtngPermttNo..I.5.2.0.9.Z. ........ dated . Au g: 28 ~ .l.9.8 .6 ..... , was msued, and conforms to all of the requirements of the apphcable prowmons of thc law The occupancy for wluch flus certificate m issued m . .Al.ter.atzo.n t.o .a.dd.fa.miI.~( .roqm., t.o.ex.i.s, ti.n.~.o, ne. f. am.i.l.y..dw, el. lin.~ The certificate m msued to J.O.HN & DIANE VIOLA ....... fo~;n'er, ~ro~ ........... of the aforesaid building Suffolk County Department of Health Approval .. N / A ............................ UNDERWRITERS CERTIFICATE NO N785444 12/23/86 PLUMBgRS CgRTIFICATION DATED: N/A Rev 1/81 FORM 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) N©. 15209 Z County Tax Map No 1000 Sect,on ...) .~'. ~..~/ .... Block ...... ~..~. ....... Lot No.....~....~( ....... pursuant to apphcatJon dated .~~ .~ :~.'~.. , .. , 199 ~., and approved by the Building Inspector Building Inspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ~nk, and submitted I~ to the Building Inspec- tor w~th the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and mmilar buddings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote plan requirements where applicable. For existing buddings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-ex,sting" land uses: 1. Accurate survey of pz~operty showing all property lines, streets, buildings and unusual natural or topographm features 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent informa- tion required to prepare a certificate, C. Fees: 1 Certfficate of occupancy $25.00 -- BUS[NESS $50.00 2. Certificate of occupancy on pre-ex~stmg dwelling $ 50.00 3 Copy of certificate of occupancy $ 5.00, over 5 years $]0[00 5 .Updated C.O. $ 50.00 Date/:c-7~(~-.~/--'/:~'.. .~ /.2/../.. NewConstruct-zon ..... Old or Pre-ex~stmg Budding ~'/ Vacant Land Location ofProperty ~..~...~.... ~,.C',/)~./q.?....',~..~,.'.~'..~. ..... Owner or Owners of Property . .'~.~..~..t~v...-;~-. [ .4~1~.~.~ ......... ~ 0 .~ .... County Tax Map Noo 1000Sect,on ..Z~.'.~.~.... Block .... ~ ....... Lot .... .~.-~, ........ Subdwm~on ......................... Fded Map No ........ Lot No ........... ... App,,cant Perm,t Noir..~ .~ Z Date of Permit ,~0. . Health Dept Approval ................... Labor Dept. Approval Underwmters Approval .................. Planmng Board Approval .................... Bequest for Temporary Certfftcate .................. Final Certificate ....................... Fee Submitted $ .... ~.--~.! .... QO A ,,cant pp . .,~ ~ ~. z~ :/~ .... ~ .~ ................. r/ /r7 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N Y 11971 January 15, 1987 TEL 765-1802 J/ l 211981 Mr. John Viola 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. )No Underwriters Certificate on file. XX)The check zs (*~v~lRg~ot on file.) $5.00 )No Health Department Approval on file. )No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # I 5 2 0 9 Z )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April 1, 1984) NOTE: As of January I, 1987 there has been an increase for Certificate of Occupancy. You are being billed under the old rate. If payment zs not received by February 15, 1987, the fee will be $25.00 for your addition to existing one family dwelling. FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING J INSULATION PER N. STATE ENERGY CODE ADDITIO~AL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 7654802 January 15, 1987 Mr. John Viola 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. ( )No Underwriters Certificate on file. ( XX)The check is (*~E~c~ot on file.) $5.00 ( )No Health Department Approval on file. ( )No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # I 5 2 0 9 Z )No Plumber Solder Certificate on file. (all permits involving plumbing being issued after April 1, 1984) NOTE: As of January I, 1987 there has been an zncrease for Certifzcate of Occupancy. You are being billed under the old rate. If payment is not received by February 15, ~987, the fee will be $25.00 for your addition to existing one family dwelling. 765-:L802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: 765-XSOZ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL [ ] FRAMING REMARKS: DATE / ~~,NSPECTOR 4~ ~///~ BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL DATE INSPECTOR I ]e~o~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ EURE^U OF E-ECTmCIT¥ [ December 23, ] ~gOHN STREET, NEW YORK. NEW YORK 10038 ~,, ~.,,,..,,o.~o,,.~,,~osT/~ N 785444 THIS CERTIFIES THAT Hr. Viola, Delmar Dr., o~ Pccon~c Bay Blvd. ~ matzre], N.Y. 7 10 ~ 9 ~ 7 OTHER APPARATUS E R V I C E Gary Doroski 425 }fonsell Lnne Cutc}'ofue N.Y., tic. ~'7941-E Gr~IE~AL MANAG~ This certtfrcate must not be altered m ~ny mc~nner, return to tBe o~{~ce of t~e Board d ~ncorrect inspectors may be ~dentdmd by their credenhals COPY FOR 1½UILDING DEPARTMENT TH~S COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER Examined Approved .(~. 0~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL F~OUTHOLD, N.Y. 11971 TEL.. 765-1802 ,19'~t'0 , 19~b Penmt No I ~'.~O~ ~ D~sapproved a/c (Budding Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19.. IN ST RUCTION S a. Tlus apphcanon must be completely filled m by typewriter or ~n ink and submitted to the Budding Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showing locatmn of lot and of buildings on premmes, relatmnslup to adjoining premises or pubhc stree or areas, and giving a detmled descnptmn of layout of property must be drawn on the dmgram whmh as part of thls app cat~on. c. The work covered by flus apphcatlon may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this apphcatmn, the Budding Inspector will msued a Budding Permit to the applicant. Such perm shall be kept on the premises available for mspecbon throughout ~1~ work e No budding shall be occupied or used m whole or m part for any purpose whatever untd a Cemficate of Occupant shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldlng Permit pursuant to tl Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulatmns, for the construchon of buddings, add,irons or alterahons, or for removal or demollbon, as hereto describe The applicant agrees to comply w~th all apphcable laws, ordinances, budding ~ode, housing code, and regulations, and . admit authorized inspectors on premises and m budding for necessarytfltspe_cb~ ~ , (S~gnature of apphcant~ or name, if a corporabon) (Mmhng address of applicant) I I ~ ~ ~ State whether apphcant ~s owner, lessee, agent, architect, en~neer, general contractor, electncmn, plumber or buflde ........ Name of owner of premises ~, k lit ~. 1~> [ ~ .................... (as on the tax roll or latest deed) If applicant ~s a corporation, signature of duly authorized officer (Name and htle of corporate officer) Builder's License No . . Plumber's License No~ ~ g~--~--~{-~-~ Electnman's License No Other Trade's License No 1 Location of land on which proposed work will be done ttouse Number Street County Tax Map No 1000 Secbon } ~ ~' Subd~wslon (Name) Block .~'~ . ·. Filed Map No · Lot. . ~'~. Lot. State existing use and occupancy of premises and intended use and occupancy of proposed construcbon a Existing use and Occupancy ~"~ } g ~.~---~O~. ' .l~ ~. 3 Nature of work (check which applicable) New Bufl&ng ..... Addition . .. Alteration ~ Repair ... Removal ...... Demolition ...... Other Work ........ 4. EstunatedCost~.~.~.t>Q.- .............. Fee/ ,3'-~, ('~(? (Description) " (to be paid on filing th~s apphcat~on) 5. If dwelling, number of dwelhng units ....... Number of dwelling units on each floor .............. If garage, number of cars .......... 6 If lousiness, commercial or mixed occupancy, specify nature and extent of each type of use ................ 7 D~menslons of existing structures, if any Front ../q t> .. Rear to t> . Depth . Z,~. .. Height ~ ... N~mberofStorles. l~z- '' . ...iii'.. ii ......... ' Dimensions of same structure with alterations or additions Front . . ~ ..... Rear .... .-" ........ Depth .. ~ ...... Height . , ~ ..... Number of Stones ................ -' 8, Dimensions of entire new construction Front ~5~.*~. ,~-; ...... Rear .,, ,~ ,e ....... Depth , .~, .~Xt~.., .~ ...... Height "- .. . Number of Stones ...... : ............................. 10 Date of Purchase ... [~;/7_~... . . . ..Nd ormerOwner . ¢ .ty~..~--~. .... 1 I. Zone or use dtstnct in which premises are situated .................................. 12 Does proposed constructl?~n~olate any zoning law, ordinance or regulation .. ~..~ ...................... 13. Wall lot be regraded ~-~ ..... ~ ..... Will excess f'fllbe removed fzom preamses ,~. Yes ,~ No 14 Name of Owner of premises ~t2[c [',) .~ .t,o.~.,/4 . Address 'a~6-q5 ~ .~.}4'U~.~d. ?, .ICl~o~"-e No..~'Y.~.. ~../.;7. Name of Architect ...... Address t?~4fi, P! ~*' .e-~-w.. . . Phone No. Name ofContractor~-~r~..g .~. i¥~51 .~i.' i. i Address p:D,, ~3.q'- ...... Phone No. 7~5(i ~i"$i<~ i i PLOT DIAGRAM Locate clearly and distinctly all bufldmgs, whether exl lcate all set-back dunenslons from property hnes Give street and block number or descnption accordmg to deed, and show street names and indicate whether interior or comer lot. /_ ,,/J~ t ~ STATE OF NEW YORK, COUNTY OF Al S.S (Name of individual signing contract) above named '[ 27t be)g d~l~5o~rrn, He is the ............................ (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly anthonzed to perform or have performed the said work and to make and ~e this application, that all statements contained m this apphcation are true to the best of his knowledge and belief, and that the work will be performed in the manner set forth m the application filed therewith. Sworn to before me this .......... , :. ' Notary Public, . . . . ~.- ........ .. , 19£.6 .. County--~ ~ ' ,5: .3. ........ (Signature of applicant)