HomeMy WebLinkAbout14715-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Tow~ Hal!
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20513
Date JANUARY 31~ 1992
THIS CERTIFIES that the building
Location of Property 705 FOXHOLLOW RD.
House No.
County T~x Map No. 1000 Section 106
ACCESSORY
& 485 RACOON RD.
Street
MATTITUCK,NY
Hamlet
Block 10 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 25~ 1986 pursuant to which
Building Permit No. 14715-Z dated M~CH 31, 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 ACCESSORY INGROUND SWIMMING POOL~ FENCE & DECK AROUND POOL
AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
ROBERT & ANNE SHANK
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-745997 - APRIL 22~ 1986
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
PORI~ NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20514
Date JANUARY 31~ 1992
THIS CERTIFIES that the building. ADDITION
Location of Property 705 FOX HOLLOW RD. & 485 RACCOON RD. MATTITUCK~ NY
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 10 Lot 9
Subdiuision Filed Map No. Lot No.
conforms substantially to tile Application for Building Permit heretofore
filed in this office dated ~ARCH 25, 1986 pursuant to which
Building Permit No. 14715-Z dated MARCH 31, 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 DECK ADDITION TO EXISTING ONE F~iIL¥ DW~.I~INGAS BUILT
The certificate is issued to ROBERT & ANN SHANK
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
u~ld~ng-Inspe~tor
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20515
Date JANUARY 31~ 1992
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 705 FOXIROLLOW RD & 485 RACCOON RD. ~2tTTI~JCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 106 Block 10 Lot 9
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 25~ 1986 pursuant to which
Building Permit No. 14715-Z dated MARCH 31, 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 ACCESSORY TREE HOUSE IN REAR YARD AS BUILT.
The certificate is issued to ROBERT & ANN SHANK
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
s/A
Building Ynspecter
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALt.
SOUTHOLD, N. Y.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No. 14715 Z
County Tax Map No. 1000 Section .... ~....O....~. .......... Block ...... .~..?.. ........ Lot No.....~. .................
pursuant to application dated .......~.~?~....~..~.'~.. ................. , 19..~....~., and approved by the
f~uiJding inspector.
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTIIOLD
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 ~oard 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, 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 completed site plan requirements.
B. 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
onusual 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 Iespector shall state the
reasons therefor in writing to the applicant.
C.' 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 Building - $I00.00
3.Copy of Certificate of Occupancy - $5·00 over 5 years - $10.00
Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15·00
':o~ Constrsction ........... ~ld ~ ~-~xisting Building .......... ~] ... .
,.oea,o of ropert ....... ·
)a~er or O~ners of Property ..... ..J~.(~)~...~'.l./-~..~].~..' k~.O~!..~. ................. , .... '
,ouety Tax Map No 1000 Section
' ........ Block
ubdivision ............ . . . .
. ........ ...........
erm£t ~o..o .. . ate m t .............. Applicant. . . .~-~ ...........
calth Dept, Approval .......................... Undert4riters Approval ..........
!aneing Board Approval .....................
:qnest for: Temporary Certificate ........... Final Certicate ...........
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTNENT
TOWN UALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This.application must he 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 I% 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 completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
Pre-exlstzng" 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.
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 Pre-existing Building - $I00.00
3.. Copy of Certificate of Occupaacy - $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 ...... ~ .... ~d Or Pre-e~is~ino Bull-' [ ~ ' .....................
,.ocation of ..... ......
1Iouse No.~ - 'I'~ ''~''~ ..........
, ' t~ ( ! . Astfce~ Hamlet
,ewer or Oweers of ?roperty ...... ¥'O' ...................... . .....
,ounty Tax Map No 1000, Section...l.~.~ ...... Block ..... la ........ Lot....~ .................
ermit No... ~ ~ -- ' '"''"'~% ............
....... ' ' ' ........... ~..App ican f -C...
ealLh Dept. Approval ....................
.... ' · Underwriters Approval .....................
laonlng Board ApProval ...................
)quest for: Temporary Certificate ......... Final Ccrticate
'e Submitted: $ .......
THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY
~ 85 JOHN STREET, NEW YORK. NEW YORK 10038
O. te ~prLi 22~ 1986 Jppl~catlon ~o. on/il~ 394159/~6
· .,s c..~m,.s ~.~ N 745997
only the electrical equipment as described belo~ and ~ntroduced by the applicant named on the able application nun~ber in the premises of
in the followin~ loc~tio.; ~ ~asement ~ Ist Fl. ~ 2nd FL O~t~
Section Block Lot
was exatnlaed on
Apr&l, 1] ~ 19~6 and found to be in cotnpliance with the requirements of this Board,
FIXTURE FIXTURES ~ RANGES
OUTLETS SWITCHES OVENS
DRYERS FURNACE MOTORS
EXHAUST FANq
APPLIANCE FEEDERS TIME CLOCK.~ UNIT HEATER MULTI~OUTLE DIMMERS
SYSTEMS
NO. OF FEET
OF NEUTRAL
d'~dy ~l'umJ,i.Lo
SBNIq~I. MANA~I~R
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified ~y their
!8 COPY
Form No. 6
TOWN OF SOUTNOLD
BUILDING DEPARTNENT
TOWN IIALL
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 i% 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 completed site plan requirements.
d. 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.
C.~ 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 Euilding - $100.00
3.Copy of Certificaue 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 ........ ~.~ O,~ld ~ Pre-exi~ng Buildin~ ..J ..J.. ~/' ' ..... . ......
usc ~oC...~ ~ .- S[ree~ ' /,
3ewer or Owsers of Property...']~¢.~.~.l.J~.'..~ .~.p,.~
.dusty Tax Map No lO00. Section...{*(~. ....... Block ..... [0 ......... :et .... ?~
ubdivision .................
14. . ......
ermit No,.. .. .Date m t ................Applicant.
ealth Dept. Approval ....
Underwriters Approval ................
!.tuning Hoard ApProwll ...................
:quest for: Temporary Certificate ........... Final Ccrticate ...........
'e Submitted: $ ........................... m---~/~ ~ '
05;3" .' .... .... 5"
FIELD INS~ECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
?LUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FOP~M NO. $
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
TO Robert & Anne Shank
(owner or authorized agent of owner)
Raccoon Road.
Mattztuck, N.Y. /
(address of owner or authorized agent of owner)
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance
Chap. 100
Other Applicable Laws, Ordinances'or Regulations ............................................
1) Swimming pool is not enclosed complying to
at premises hereinafter described in that ..oode .....
(state character of violation)
permits for deck addition and ~lay. house. 4) Building permit for p. ool and fence expired.
5) No Certificate of Occupancy for pool or deck. It is illegal to use pool or deck
without a C.O.
in violation of ART. III I00-30C(2A), ART. XI-100-llg.i, ART.XIV lO0-14l & I00-144.
(State section or paragraph of applicable law, ordinance or regulation)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned forthwith on or before the II~lgl)ZATgL¥
day of l~y
...................................................... , 19...8..8..
The premises to which this ORDER TO REMEDY VIOLATION refers are situated at
705 Fox Hollow & 485 Raccoon Rd., Mattituck
.,S.u.f..f..°..1..k....C..°..:...T..a.,x...~'!.!.0..0..0. Z.].0..6. Z..!g3~ .................... County of Suffolk, New York.
Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law
may constitute an offense punishable by fine or imprisonment or both.
.... .......
VINCENT R. WIECZOREK
8
OVO~I '
Examined..¥~ 0~..~.. ~ ~.., 19.~.~.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 76§-1802
Approve~l . .~ .c~..~...~. I.., 19~k.. Permit No. ! .~..'~1..%'7 .~..
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERIVIIT
Rec
Date .............. ,19 .~..(
INSTRUCTIONS
~.. .:. ..~. , ~. ..........
a. Thi~,~aplSl~tgtt,~ Must be completely filled in by typewriter or in ink and submitted to the Bmldmg Inspegtor, with 3
sets of plmls~ ~,c~r~Jefl,,1.o,t plan,to scale. Fee accordmg to schedule.
b. PlOt~p~ah;~O~ l~fi~t~0n OLlot' and of~fild~gs on premises, relationship to adjoining premises or pubic streets
or areas~ ~v~}t~ Oe~l~d, description o~ laE~t of property must be drawn on the diagram which is pa~ of this app,-
cat,on. ~ ~ ~
c. T~k ~over~4 ~y ~th!s app!~cafion may not be commenced before ~ssuance of Bufld~ng Permit.
d Up~a~ro~aLpf ~gis ap~l{ca~iSn the Building Inspector will issued a Build~g Pemit to the app~c~t. Such permit
shall be ke~l'~o:n, t~.~m~ses available for mspect~on throughout the work.
e. No bu~dmg shall be occupied or used m whole or ~n part for any purpose whatever until a Cemficate of Occup~cy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a B~lding Pemit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or
Regulations, for the construction of build~gs, additions or alterations, or for removal or demolition, as heroin described.
The applicant a~, to comply with all appficable laws, ordinances, bu~d~g code, housing code, and regulations, and to
admit author~O~$~Nrs on premises and ~ build~g for necessaw inspections.
~ ,~ ?~X~%, . ........ :. ~.- ................ ~ ................
~F~ ,~ ,~ ,~ -, (Signature of applicant, or name~ a corporation)
~"<]5~?:~' ~9~ ~ ~.~7 (~c &.z...~ :~..t.~.~'~
· .. ~ (Mailing address of applicant)
State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder.
......... f~g~...q¢~g ............................................................
Name of owner of premises ...... ~O.~... ~.~ ..........................................
(as on the tax roi1 or latest deed)
authorized ......... officer.
Builder's License No ......... /.C? ..............
Plumber's License No .........................
Electrician's License No. 14/O
Other Trade's License No ......................
Location of land on which proposed work will be done. lq~)~,~~- ,x ,~ ~'~OX ~-~\kKS~''-~(~ Ixk~o
· .//t.g ..... 1L4c..o.o.~... 12o.~s0., ...... fo.~. ~ ~.. ~.~ ~.; ........ l~.~727.'~..'.~/~....tV.. ~.. .......
House Nmnber Street Hamlet
County Tax Map No. 1000 Section ...~ .0...~. ......... Block .... .I..(~. .......... Lot.. ~ ..............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .......... .~..~./J~..Z'a.~.?.d.~.&. .......................................... ..
b. Intended use and occupancy ......... /~ .~fl. (.~...Z~. i~../.~. './'- ...........................................
3. Nature of work (check which applicable): New Building ' Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition . ~... Other Work .........
~..~..~(~. ~ 5tolr~c P**~'~ DlsC. lcr ?Z-"~ctJ~ (Description)
4. Estimated Cost ................................ Fee .......... , ............................
tto be prod on fihng this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................
If garage, number of cars ............................................ i ............................
6. If business, commerciai or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions ofexisting structures, ifany: Front ............... Rear .............. 'Depth ...............
Height Number of Stories 1
Dimensions of same structure with alterations or additions: Front ............ ~ ..... Rear .......... ........
Depth Height Number of iStories
8. Dimensions of entire new construction: Front ............... Rear ........ ! ....... Depth .
Height ................ Nu~nber of Stories ........ . .........
9. Size oflot: Front ..... 1o~,.~'. ........... Rear..:::~.';~::i::::: ~)~,~ ',~.'.~,i'~i.,~. .......
10. Date of Purchase ............................. Name of Former Owner .~.. ,C'. ~.,. j.~.c, .(-~,/2t'~ .......
11. Zone or use district in which premises are situated ....................... i ............
12. Does proposed construction violate any zoning law, ordinance or regulatim~: i... i.. ~.~)i i i ..... ii i~i. iii
13. Will lot be regraded ........ ,.~..6~ ................ Will excess fill be removed from premises' ~ No
14. NameofOwnerofpremises-../..~..to~-.T~...~../f.~..~ Address ~//~..(..T?.cg¢i~.~'.PhoneNo' .
Name of Architect .... 2 ...................... Address
Name 0f Contractor . ./~. ~lC.f{-{,, f. o~...~'~/~..~.,, .~., Address~?~. ............... ~t~./fy. ~.q~.../7~.i ..../~PhonePh°ne NoN°.,~.~: .~ ....... ./~.o. ~...~" '
PLOT DIAGRAM I
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.
OCCUPANCY OR
USE IS UNLAWFUL
WffHOUT CERTIFICATE
OF OCCUPANCY
APPROVED AS NOTED
o ,BY: -
NOTIFY BUll. DING DEPARTMENT AT
765-1802 9 jA~ TO 4 PM ~R THE
FOU.,OW~NG INdirECTIONS:
1 FOUN[3A'r ON ~0 ~EQUIRED
FO ~ POLI~-O CONCRETE
2 ~()t ~r. ,'~ ~,:?~AM!N~ ~ PLUMBING
[:;F ,-C,h~ ~,~ ~ }'UR C,O,
STATE CONSTRUCt ON & ENERGY
CODES NOT! RE,S,~.,.PO.N~qBLE FOR
STATE OF NEW YORK, ' ,%,(:~i~ O~ C¢)NSTRt,~C'I'I~,~'~ =RRORS,
s.s ' e
.................. /
....... ~: ~f.~ · .~ ............. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ~ ~'
(Contractor, agent, corporate officer, etc.) ~
of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this
application~ that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
work will be perfomed in the m~ner set forth in the application filed therewith.
Swom to before me this
$ota, Public, ...2~..~.. ~.. County~ ~
~ ~h',~2 ................... ~ ....... ~i~a~;;; ;pplic' ' ' 'ant";