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HomeMy WebLinkAbout15570-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z18589 Date NOVEMBER 24~ 1989 THIS CERTIFIES that the building ADDITION Location of Propert~ 2150 MILL CREEK DR. SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 051 Block 06 Lot 06 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 8, 1986 pursuant to which Building Permit No. 1557UZ dated DEC. 12~ 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 F.XISTING ONE FAMILY DWELLING. The certificate is issued to LORRAINE L. & THOMAS P. CASSIDY (owner, XXX ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO.N853560 FEB. 16~ 1988 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 - / ~Building Inspector ~0~ NO. ~ TOWN OF SOUTHOLD BUILDIblG DEPARTJvtENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15570, Z County Tax Map No. 1000 Section ..... C~..S..,[ ...... Block ...... ,,,(~,,..,~, ...... Lot No ..... ..,(~,.,,.~, .......... pursuon, to epplicotion doted~....~.. ............... 19.3..(¢, ond c~pproved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUT~OLD BUILDING DEPAKTHENT TOUN ~ALL SOUT~OLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ~ OLD OR PRE-EXISTING BUILDING ...... VACANT LAND Looa~iom of Property .... .ous~ No. ooamty Ta~ ~a~ No. ,000 Section ..¥A. Blo~ ...~... Lot' ...~ ..... Subdivision ....................... Filed Map ........ Lot .......... // ~ ~ ...... ~.. Health Dept. Approval .................. Underwriters Approval Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ P~ Su~m~tt~: ~G-. ................ rev' I0/14/88 FORHNOo 6 TO~IOF SOU1110LD ~OILDING DEPARTMENT ~ TOWN HALL i 765 - ]802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted to the Building Inspector with the following! for new buildings or mew use: ]. Final !survey of property With accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health bcpt- 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 solder used in system contains less- than 2/10 of ]Z lead. 5. Co~merclal buildings, industrial buildings, multiple residences amd similar.' buildings and Installations, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land use~: 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'slngle and separat~ ownership of the entire lot prior to April 9, ]957. If a:Certificate of OccUpancy is deumed, the Build,nE Inspector shall state the reasons therefor in wrz£zng to the applzcant. 3- Date. of any housing ced~ or safety inspection of buildings or premises, or other pertinent information r~quired to prepare a certificate. C. For Vacant Land Certificate of Occupancy: ]. Am application for vacant land Certificate nf Occupancy shall be submitted, and a certified abstrac~ of title issued by a title company showing single and separate ownership of the entire 10t prior to April 9, 1957 shall also accompany the application. If a ~ertificate of Occupancy ia denied, the Building Inspector shall state the reasons! therefor in writing ~o the applicant. D. FEES: ~. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwel{ing $25.00, Swiping Pool, $25.00. Accessory building $25.00 Addition to AccessOry buildings, $25.00 - Businesses $50.00. 2. Certzfzcate of Occupancy on pre~exmstlng dwelling - $100.00. 3. Copy of Certlfmcate of Occupancy - $5.00 - over 5 years - $]0.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated C.ertificat~ of Occupancy - $50.00 6.1 Temporary Certificate of Occupancy - $25.00 Residential $50.00 Commercial °~- OUNDATION ( 1 st) OUNDATION (2nd) OUCH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE F I'N J ADDITIONAL THE NEW YORK BOARD OF FIRE UNDERWRITERS [00012:[ BUREAU OF ELECTRICITY THIS CERTIFIES THAT o~y the electrical ~uipment ~ ~scrlbed below and introduced by the applicant ~med on the a~ve application number in the premises of Thomas P. Cas~idy, 2150 We~t ~ill Creek Drive, Sou~hold, ~ in thefollowlng location; ~ Basetnent ~ Ist FL ~ 2,~d FL .Section Bt~k .Lot ~s exarnlned on attd found to be in compliance u'ith the reqttiretttents ~f this Board. FIXTURE RANGES ~KINGDECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS 12 DRYERS SYSTEMS NO. OF FEET E ITHER APPARATUS: Track lighting= 2-G.F.C.I. E R V I C NO, O~RCC,~CONO 16 feet, 4 lites A W G, JNp OF NEUTRALS A w' G' OF HI-LEG[ OF NEUTRAL Paul Burns 275 Town Harbor Lane Southold, ~/ 11971 Lic%28~~ GENERAL MAN AGj~E~ rhls certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION FRAMING [/--]'l~l NAL REMARKS: 765-Z802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~NAL ~O INSPECTOR 7654802 BUILDINq DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~FRAMING [ ] FINAL 7GS.'1802 BUILDING DEPT. INSPECTION [ ] F. OU~IDATION '"ST [ ] ROUGH PLBG. [r'~F~NDATION Z ND[] INSULATION [ ] FRAMING [ ] FINAL THOk,'~AS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1803 ~×amine~ .W'~..l.~.., l~ .~>. Approv~t ~. )..~ 19~.~. Permit No..~ .~.~.~.~.').t..-~... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... 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 be 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 untii-a Certificate of Occupancy shall have been granted by the Bnilding 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i~pee/tions, f/~.,/- ~0 ·..~.x(.~2~.. ~.. V.':~?~ ................. '~ (Sign~ature[/(~)-~/,~° f applicaz~t~21136,~ -~ 't~ ~ation).~, ...... .. ./. /.?.7./. ....... . ., .-rS.~ .... '.:.:.) ...... ~y'.' t. ~:. ~ ... (ma~l~ng address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ]~.0¥"x'~ 'F mC- ~.P.t-~c~ ~q_ ~,. G~'9 (d.~ ................ ('as ;'n i~e ;ax ;o'1{ ;; ilt;;t' j;~d)'l ................. If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) Builder's License No .... .~"..~'[ .~. ................ Plumber's License No .... i.~. ~... II ............ Electrician's License No ....................... Other Trade's License No ...................... Location of land on winch proposed work will be done .................................................. ........ ~./~ ...... ~. .~.,Jt 5:~. ~.c;.o.~. ~. ~ ~'~-: (~ House Number Street Hamlet County "Fax Map No. 1000 Section . .~. Il .T. ~...-~..~.. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................. .......... :est~e,,¢ ........................... b. Intended use and occupancy ~..A~.~ 3. Nature of work (check which applicable): New Building .......... Addition ......... Alteration ....... t... Repair .............. Removal .............. Demolition ........... i.. Other Work ....... , ........ (Description) 4. Estimated Cost. ~.~..~. ?f.. r .......... Fee .......... i ................... ........ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. Number of dwelling un . on each floor ................ If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each tyv~ of use ..................... 7. Dimensions of existing structures, if any: Front ..... 3,.~. ...... Rear ... ~..~.*] ...... Depth . .~.~. '. ....... Height Number of Stories .~-.. Dimensions of same structure with alterations or additions: Front .~. ~ : Rear ...3.. 7__ a. DD~mPtehnsi~ni3;~;ntirenf~o~truct~o%~:ghFtront 5.~.'...: "l~irN. Um'b~-rz°tf~t°nes'~p't~";-/3~l'-~'¥F/." :9~ Sizeoflot Front /.~P~. Rear ,~>o ! ' . Danfh /.5~ 0 ' .............. i t0:. Date of urchase .... ~ .....(J'. (~ .~... Name of Former Owner 12. Does proposed construction violate any zonine law, ordinance or regulation' '~,/~,i ' ' ' ' ' 13. Will lot be regraded ...~. ~ .............. ~ · · .c,' Will excess fill be removed from premises' Yes Name of Architect ........................... Address ............ ' .... [... Phone No ................ Name of Contractor ' . ........ Address ................... Phone No ................ 15. Is this property located withinl~00 feet of a tidal wetland? * Yes ..... No ~... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to' deed, and show street names and indicate whether interior or corner lot. .STATE OF NEW YORK, individu tact) ab6ve named. being duly sworn, depos~es and says that he is the applicant He is the .............................................................. . ........................... (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 statoments contained in this application am true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................ ~7. ...... day of ..... .~..~.... 3/otary Public,..~-~r._~,~,.~..,.1.,. .................. C0un ' NOTARY PUBLIC, State of New York ......... : .... No, 470~'878, Suffolk Term F,hires March 30, 19 ~// i (Signathre of applicant) OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE :: ©OOLIPANCY ~ ~ublng ~ u~ for water diatributlng ~YStem; Piping shall be ~ ~1 ~or L onl~ PLUMBER cERTIFICATION ON LEAD CONTENT BEFORE Cf'RTIFICATE OF occuPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. APPROVED AS FEE: ~' ~ ~y. NOTI~ BUILDING ~EPARTMENT AT 76~1~2 9 A~ ro ~ PM FOR THE FOLLOWING rX ~'