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HomeMy WebLinkAbout14064-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. ZI5643 Date April 14, 1987 THIS CERTIFIES that the building .... .O.n.e...f.a.m.i. 1..y..d.w..e .1.1.i.n..g.. .................... · 980 Stars Road East Marion Location of Property ................................................. House NO. ' ..... '~'t/e~[ ' ' ' Ham/et County Tax Map No. 1000 Section ...0.3. [ ...... Block 04. .... Lot 4 Subdivision Soundcrest Woods Filed Map No. .5.315. LotNo. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated J u n e 1 I, 1985 pursuant to which Building Permit No. 14 06.4 z dated ...J.u.n..e..1.9.:..1.9.8. 5. ........... 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 ......... One family dwelling, attached 1 car garage. The certificate is issued to ERICK AND JANET HEINS ..................... io'a;n'o;', ~;~ 'fffffffff~'~& ~'/ ..................... of the aforesaid building. Suffolk County Department of Health Approval 85 - S O- 8 2 Ap r · 3, 1987 UNDERWRITERS CERTIFICATE NO ............. N 783/*.23.. J~e c o..1. [,. ·1·9.~t 6 ........... PLUMBERS CERTIFICATION DATED: March 24, I987 Building Inspector Rev. 1/81 FO]II,~ NO. e~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF TNE WORK AUTHORIZED) NB 14064 Z Date Permission is hereby granted to: ......~......~..~ ...... ..e...:......~..~ .............. ~~~.,..x~,?....:~ ........... ~-~ ............ .~.......:....~ ............... ,. ............... , ........... at premises located at ..~ ....... .~,~....~.~ ........... ...a~......Q~.....~........~.~ ...................... pursuant to application dated ........ ...~..~.....~.~ ...................... , 19..~...~..'~ and approved by the Building Inspector. Fee $ ................... Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF $OUTHOLD 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 ink, and submitted i ~ to the Building Inspec- tor with 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 similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10,00 o.o. $ o.oo 5.Updated C.C. $ 50.00 Date ................. NewC°ns truc~i°n ...... Cid or Pre-existing Building ............ Vacant Land ............. Location 0f Property ~'~ House No. Street Ham/et Owner or Owners of Property .~C~.. ~. ~L'~'. ............................... County Tax Map No. 1000 Section ...~.;k ....... Block .... ~. ......... Lot..~. ........... S~bdivisio,~..~..~'. .......... Filed Map No. ~Jl~.Lot No..~ ........... ........... , Perm[tNo ~0~ Date of Permit ~l ~ l ..... App icant~..~..~.~ ............. Health Dept. Approval .. ''~. ................... Labor Dept. Approval .................... , .... Unde~ritersApprova~ I~J~ ~ Planning Board Approval ..... Request for Temporary Certificate ..................... Final Cerdf cate ..................... FeeSubmitted$~¢~¢ Oo ~ ~'~ Construction on above described building an.~oer,~.~.~ym77 all applicfible codes and regulations. App.cant. .................................. Rev. 10-10-78 'I~LD'~S~'ECTION FOUNDATION (lst) COMMENTS FOUNDATION (2nd) ~ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: lOOlO?:~ T H E THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003B Appl,~.,,o. ~o. o.J.e ~m~3~/~ N 783473 in the foltowing locatloq~ ~. Base.lent~ ~ only the electrical eqtt,pment as described below and introduced by the applicant named on the above application number in the premlses of A¥ic I{eins, Sts~ Road, E~st ~arion~ 1st FI. ~ 2,,d ~T, ~ect~on Block and found to be in contpliance u, ith the requlrett*ents qf this Board, FIXTURE OUTLETS SWITCHES FIXTURES DRYERS FURNACE MOTORS SERVICE DISCONNECT S V I NO. OF CC COND A W G. NO OF HI.LEG ~ RANGE~e ] iPECIAL REC'PT OF HI-LEG OTHER ~PPARATU$: Lot EXHAUST FANS DIMMERS · 4/0 -t-G.F.C.I. t-~ao~, Detector~ C~S Electric Box 215 Southold, N.Y. 119'71 Lic. 578E GENERAL MANAGER ' 11 Per' This certificate must not be altered in any manner; return to the office of the Board if incqrrect, inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTJFICA~.,E ~UST~OT BE ALTERED IN ANY MANNER. ,TEL. 765-! 802 ' TOWN oF sO oz,v OFFICE' OF BUILDING IN,$PECTOR P.O. BOX 728: : ~ TOWN HALL SOUTHOLD N.Y, 11971 Building Permit ~,~ I certify that ~he,:,,$0~der'used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) NO' to befor~ ,day o -Notary Public TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 7654802 July 13, 1987 Janet Heins 870 Stars Road East Marion, N.Y. 11939 Bear Mrs. Reins~ This letter is a follow up to our con- versatio~ on Friday regarding your house num- ber. If you will please mail me your original Certificate of Occupancy I will make the nec- essary changes. Thank you for your cooperation and under- standing in this matter. Yours truly, Secretary TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL SOUTHOLD, N.Y. 11971 TEL. 76S-1802 This is to advise you that the job u. nder building permit no. 13530Z issued to Nancy Radmzn on __3_1/9/84 for Accessory is completed and a final inspection }las ( ) has not ( x ) been done. ~n order to complete this file, it is necessary that ;1 Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.OOpaynble to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this offlco for an inspection date Ocenpnecy or use i.q unlawful without a Certificate of Occupancy. Please. he]p ns to clear up thfa matter so that legal action does not have to be taken. ~ Thank you for yot~r prompt attention. Vet! truly~, Victor Lessard Executive Administrator VL:gar 765-18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE. 765-X802 BUILDING DEPT. INSPECTION [ ] FRAMING [ ] FINAL / DATE INSPECTOR 7GS-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION SST [ ] ROUGH PLBG. ~/] FOUNDATION 2ND [ ] INSULATION ~ [ ]FRAMING [ ]FINAL REMARKS: _~__~G ~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.._.~.....ur~N%.... Approved .~gle'e4~..~ .~.., 19~. Permit No. ).qg..~.~ Disapproved a/c ..................................... Rece±ved ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date 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 ~ireas, 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 Bhilding Permit. d. Upon approval of this application, the Building Inspector wilt issued a Buildh~g 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 authorized inspectors on premises and in building for necessary inspections. ......... ............ (Signatt~e of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~...~.: ~J .' ./~......O/...L~... ~...~..: .(~J~/~'~.'.O~ ......... (as on the tax roll 6~ latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... ~ ............ Plumber's License No. ~ Electrician's License No... ~ ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... ............... .................... House Number Street Hamlet f County Tax Map No. 1000 Section . .O..~.[-.O.0 ..... Block ..: ~....O. 0. ....... Lot ..... '. · ./~J~. ~ ..... Subdivision...::~..~.~ ....... Filed Map No...~..~J.~'~.. .... Lot...~..~. ........ (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: h(,a. Existing use and occupancy ..... .~.~ ..................................................... b. Intended use and occupancy.. ~. ~~. ~~ ........................... 3. ' Nature of work (check which pplicable): New Building .......... Addition .......... Alteration .... Repair .., . ~ .o . Removal .............. Demolition .............. Other Work .............. ~ . (Description) timated C .~.1, .D. ~ 1D 4. Es est ........ . ........................ Fee ................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...............I Number of dwelling units on each floor ................ If garage, number of cars 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use ..................... 'm ..... pth 7. D~ ens~ons of ex~shng structures, ff any: Front ............... Rear.. ............. De ... 'ght ' ' ........... ; He~ ............... tuber of Stones .................................................... Dimensions of same structure ~vith alterations or additions: Front ................. Rear .................. Depth .................. i ' ' ' Height ......... ~..; ......... Number of Stories ...................... 8. Dimensions of entire new construction: Front ....L0.~ :.q.! ...... Rear .. tiP.{ :,.~.t~ ......Depth . .3.@~, .......... Height ............... NUmber of Stories ..... ~ ................................................. 9. Size of lot: Front .... ,I .0.(2 .t! .............Rear ....... ! .O.O.' ........... Depth . .~..O.~.: .I .q/ ......... WI0. Dare,of Purchase ......... 11. ' Zone or use district in which premises are situated .... ~LA~/~t~0 .................................. 12. Does; proposed construction vilolate any zoning law, ordinance or regulation: . Ig).¢) ........................... 13. Will lot be regraded ...... (k%~ .................... Will excess fill be removed from premises: Yes (~ 14. Name of Owner of premises ~?. Name of Architect ./5-~ .~i i i i i Address i~ ./~..t~i i Phone No ................ Name of Contractor ..... ~.% ............... Address ................... Phone No ................ 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, , S.S COUNTY {DF ................. ............................... being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) above named. 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 statements conltained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application filed therewith. Sworn to before me this ' ........', ..... ~ .......... day Of... Notary Public, ....... ~ i ~.-. h~ ,~, ,o~, County NOT,~R¥ PUBLIC, State ~ t~ewi¥orl~ ...... RODERtCK VAN TUYL. P.C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK;kCO DEPT. OE HEALTH SERVJCESi (s} ~-~ ~. ~4 ~ /~LICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APP/~O~/AL Of CONSTRUCT,ON ONLY r-- 'DATE: H.S. REF. NO. ~' - ~'~0~ APPROVED' ~ ~ 8INGLE FAMII V nl~, ~ ~'.. SUFFOLK CO, TAX MAP DESIGNATI~)N: DIST. SECT. BLOCK PCL, OWNERS ADDRESS: DEED: L?-/A TEST HOLE STAMP SEAL fl~ SUFFOLK CO. HEALTH DEPT. AppROvAL J ~. ~ t '- (/ - ~, ~-. :. THE WATER SUPPLY AND sEWAGE DI~OSAL ..... ~.2~ ~ ":~ ~ SYSTEMS FOR THIS RESIDENCE WILL 7~+~' ~ ~ I. CONFORM TO THE STANDAR~ QF THE ~- /' SUFFO.~.CO. ~PT. OF HEALTH SERVICe. , ~ t , ~ % e~ ~ / SUFFOLK COUNTY DEPT, OF HEALTH ~ ~ CONSTRUCTION ONLY ~) / ' APPROVE D: { ] ~~ ~ SUFFOLK CO, TAX MAP ~GNATION: ONLY FACILI ~ , r. ~ 3~ .... ~.. ,, LI~O LAND ~R~YORS GREEN~RT NEW YO~ .