HomeMy WebLinkAbout14498-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-23328 Date
NOVEMBER 4, 1994
THIS CERTIFIES that the building MODULAR DWELLING
Location of Property 65400 COUNTY ROAD ~48 ~RE~EPORT, N.Y.
House No. Street Hamlet
county Tax Map No. 1000 Section 40 Block 3 Lot 10.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated 1/10/86 & 9/11/87 pursuant to which
1449B-Z &
Building Permit No. 16456-Z dated 1/10/86 & 9/11/87
was issued, and conforms to all of the requirements of the applicable
provisions cf the law. The occupancy for which this certificate is
issued is ONE FAMILY ~ODULAR DWELLING WITH HANDI-CAPPED RAMP *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ESTATE OF DANIEL ~. ~ONKLIN
N/A
N-001922 - JANUARY 7, 1988
N/A
*THIS UPDATES CO Z-16603 DATED 1/21/1988 & CO Z-17730 DATED 1/31/89
/ v'- Z Bu ing'
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-17730
Date JANUARY 31~ 1989
THIS CERTIFIES that the buildin~
Location of Property 65400 NORTH ROAD
House No.
County Tax Map No. 10Q0 Section 840
Subdivision
ADDITION
Street
Block 03
Filed Map No.
GREENPORT~ NEW YORK
Hamlet
Lot
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JANUARY 9~ 1986 pursuant to which
Building Permit No. 14498-Z dated JANUARY 10g 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 HANDI-CAPPED RAMP TO EXISTING ONE FAMILY DWELLING
DANIEL G. CONKLIN
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
Building Inspector
IB'OR~ NO. ~
TOWN OF SOUTHOLD
BUILDIZ~G DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 14498 Z
Permission is hereby granted to:
.....~...~....~:.~,..J.L~.zl ......
,o
_ ~'1_ 'n '"T',,,...O0.' f_v_n ' , fi L v - I
~... ~..._¢.~.....c~_~.:,~, ~ ..c~.~ ............................... : ......................
· ..-/...._ ...... ."l'" '" ..... ~" ....... '" ' ~"
at premises located at ...~..~.:.~.~..~......~..~....~ ......... ..~..~ ...................
County Tax Map No. 1000 Section .... ..~....~..0.. ........ Block ...... ..~..~ ....... Lot No....L..~.. .............
Building Inspector.
Fee $,.,.~,,?. ............
approved by the
Building Inspector
Rev. 6/30/80
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~t~ ~ppl~ati~ No. on flle
THIS CE~IFI~ ~T
,. ,~/~o.~, ~~s~9~~_________ ~ ,. r~. ~ ~ r,. .~.o. s,~
~ examin~ ~ =nd~nd to ~ in com~innce with the r~ui~ments o~ th~ ~.
04~'YERS KJRNAC~ MOTORS ~JTUIII AI~UANCE ~ TIMICAOCliS I/NITHIA~IS ~ ~RS
NO O~ lint
~BIVI{~ DISCONNECT
JOHN AVONA
P,O. BOX 12
SHELTER ISLAND, NY, 11964
This certificate must not be altered in any monner; return to the office of the Board if incorrect. Im~:N~ors may be identified by t~ ir crmtentials.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
........ -.-. A~P~ICAT[0R P0[ C[[TI~ZCA~ OF 0CCU~ANC¥
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:
i. Final survey of property with accurate location o.~ all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supplyiand 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 1% 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:
i. Accurate survey of property showing ali property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applzcant.
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,
klterations 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 Buildinz - $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.OO
Date
New Construction ........... Old Or Pre-existing Buildin¢.&',~f~,~t~z
LOcation of Property .... ~'~...~ ~ ¢~.~/
House No. Stree~ Hamlet
Onwer or Owners of Property.. ~Z~..~..~ff~ ~ ~,.~.~' .
County Tax Map No 1000, Section.~ ......... Block..~ ........... Lot..~/~..~.~. .........
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Pe~it ................ Applicant .............................
Health Dept. Approval .......................... Unde~eriters Approval .........................
Planning Board Approw~l ........................
Fee Submitted. $ ....................
' .......... .....................
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE .................
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........
65400
Location of Property ..... North Road Greenport, New York
HOUSE NO. STREET HAMLET
Owner or Owners of Property ...~ANIEL CONKLIN
County Tax Map No. 1000 Section 40 Block ~. Lot . l0
Subdivision ....................... Filed Map ........ Lot ..........
Permit No.I~ ..... Date of Permit 1/10/86 .Applicaat WM. CONWAY
Health Dept. Approval .................. Underwriters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate .......
Fee Submitted:
Final Certificate
XX
rev. 10/14/88
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
January 25, 1989
Mr. Daniel Conklin
65400 North Road
Greenport, New York 11944
Re: Building Permit 914498-Z
Tax Map ~1000-40-3-10
Dear Mr. Conklin:
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.
According to the Code of the Town of Southold Article XIV,
100-141 and 100-144 a building permit is needed for construction
of an addition to an existing dwelling. It is unlawful to occupy
a dwelling until a Certificate of Occupancy has been issued.
Your final inspection has been made. Please fill .out the
enclosed application for Certificate of Occupancy and return to
this office with a check for $25.00. This building permit is
for the Handi-Capped rail.
In order to avoid any legal action, you must correct this
violation immediately.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
VRW:gar
encl.
Vincent R. Wieczorek
Ordinance Inspector
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN liALL
SOUTIIOLD, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
Wa are unable to complete your Certificate
of Occupancy because ~of the following reasons.
/_~ An application for Certificate of Occupancy
is not on file. ~~
/--/ No Underwriters Certificate on file.
/~/ Tile check is(outdated/not on file.)
/~/ No }]ealth Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on
Thank you for your cooperation.
Building Permit
Building Dept.
this matter.
bio Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
? 1E~D ~NSI ECTION
FOUNDATION
(1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
?LUMBING
INSULATION FERN. Y.
STATE ENERGY
COMi~ENTS
CODE
ADDITIONAL COMMENTS
FORM NO. 1
TOWN OF SOUTHOLO
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N,Y. 11971
TEL,: 765-1802
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 until a Certificate of Occupancy
shall have 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, housing code, and regulations, and to
admit autkotized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Name of owner of premises . .~.q..r~.tlt ]..~.O.,9 ./~. !l.b .......................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No... ~. 1 .~....~'~.~ ..........
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Locationoflandonwhichproposedworkwillbedone..~.~....~...~..~.C.~.'.j ......................
.................................. .- ........... b. p.o.<t ..................
ltouse Number Street Hamlet
County Tax Map No. 1000 Section ...~.0. -Block ..~... ............. Lot./~. ..............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exis'ting use.and occupancy . ~.{~5/.¢..-.~.?.~).l/. ~3.o.~.e~.. "
b. Intended use and occupancy . . ./7.d..d ..... .fT..O~..C.' .C.e-.5.~ ..........- ................................
:3. Nature of work (check which applicable): New Building dditio" ... .. Alteration ..........
Repair .............. Removal ...... : ....... Demolition ........... i.. Other Work ...............
~'~f'.r-) : (Description)
4. Estimated Cost .................................... --~.~ff.~. Fee ..... .... ' ....:...
· ~ ('to be ~aid on filing this application)
5. If dwelling, number of dwelling units ................ Number o f dwelling unit~ on each floor ................
If garage, number of cars ............................................ i ...........................
6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use .....................
~ 7.' Dimensions of existing structures, if any: Front ............... Rear ....... ~ ...... Depth ...............
Height ...... .' ........ Number of Stories ............................ 2 ............................
Dimensions of same structure with alterations or additions: Front ............ i .... Rear ..................
Depth ..... ~ ................ Height ...................... Number of Stories ........ .~ .............
8. Dimensions of entire new construction Front ,,P67 . Rear : Danih
aright . ...~. 1, .......... Number of Stories ..................... ~.. '. ........................
9. Size of lot: Front ...................... Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner . ~ ...........................
1 1. Zone or use district in which premises are situated .............. : .......... ~ ...........................
12. Does proposed construction violate any zoning law, ordinance or regulation: .~q.c/j ...........................
13. Will lot be regraded .... .~... ~ ....... ~. ............ Will excess fill be removed from premises:__ ~Yes _
i4. Name of Owner of premises ~[)q~r~)e-I..t~oxl.kt,.N.... Address /gPT.~..~ .~. ...... Phone No. '.~..7.~(= .O..[g.O.~,....
Name of Architect ........................... Address '
Name of Contractor..~tl[tq,.~,o :~,o~q.c~. . Address i .Z.'4 1 i' rhone No ....... .....
· ...... . Phone No.. ~..6,..~..~ ~ .~-?=.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indlcate 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,
COUNTY OF ................. S.S
................................................. being duly sworn, deposes
(Name of individual signing contract)
above named.
and says that he is the applicant
He is the .............................................................. ~ ...........................
(Contractor, agent, corporate officer, etc.) i
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 manner set forth in the application flied therewith.
Sworn to before me this
.............. .... .....
· HI,fi & DE rOE ...........
NOTARY PUBLIC, Stats of New York ,~, ..... (_S_i.g__lt~m~ of, applimmt)