HomeMy WebLinkAbout14069-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19356 Date SEPTEMBER 12, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 300 BAY LANE (P VT. ROAD ~14}
House No. Street
County Tax Map No. 1000 Section 24 Block 2
Subdivision Filed Map No.
ORIENT~ N.Y.
Hamlet
Lot 20
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 14, 1985 pursuant to which
Building Permit No. 14069-Z dated JUNE 19~ 1985
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 FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
D. CLAEYS BAHRENBURG
lding Inspector
FO~ NO. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 ~4069 Z
Permission is hereby granted to:
...O.~ u,~,, ......................................
·
at premises located at .... ~..~ ......................................
County Tax Map No. 1000 Section ..... ...~....~'....~. ...... Block ..... ..~.....~:.. ........ Lot No ......A-~...O.. .........
pursuant to opplic~tion (k~ted ................ ~ ~ ........................ ~ , 19.~..~./.., end Qpproved by the
Building Inspector. ~~
Rev. 6/30/80
~ "'~ Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMEN~
TOWN HALL
765-1802
OUT~OLD APP ICATION FOR CERTIFICATE OF OCCUPANCY 4, ..
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.
Z. 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 tatement from plumber certifying that the solder used in system contm~ns
, 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.
2. 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.
f. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buiiding $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years $10.00
UpdaL~d Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ....
~cw Construction... Old Or Pre
......... existing Building .................
Location of Property .... ~. ~c~ ........ ~3~ ~_,~ ...C~./C
House No. Street Hamlet
')nwer or Owners of Property?.' ~x./~_~ ~..~.g~.,~-~/w/~/-~
County Tax Map No 1000, Section....~.,~. ...Block.
.... · ............. Lot....~-.. 0
SubdiVision ....... i ..... ~ ...................... Filed Map ............ Lot .............
ermit 0 O
~'ealth Dept. Approval ...... ../y'.J../~. ......... ~....~de ' '~/~ ' ......... '
'7' erwr~ters Approval .... .~f./../~. ,,
Planning Board A-hr .... · ~J' /~o- ' ' 7~ ............. !?'.'
Request for: .~emporary Certificate ........... Final Certicate ...........
Fee Submitted: $ .............................
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York ! 1971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 13, 1990
D. Claeys Bahrenburg
14 East 96th Street Apt. 14
New York, New York 10128
Re: Certificate of Occupancy's for
property at 300 Bay Lane, Orient, N.Y.
Suffolk Co. Tax Map #1000-24-2-20
Dear Mr. Bahrenburg:
Please be advised that the Certificate of Occupancy for
Building Permit %Z-14069 and #Z-16927 have been issued today and
Mr. Kenneth Strachen of MacDonald Woodworking has picked them
up. Because Mr. Strachen had applied for the building permits
and CO's, we released them to him. We return your check ~2729
in the amount of $25.00 dated Sept. 7, 1990.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Georgia Rudder, Secretary
~IEL~ INS~ECT~ON COMMENTS
FOUNDATION
FOUNDATION (2nd)
oROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
Ye
ADDITIONAL COMMENTS:
VICTOR LESSARD
EXECUTIVE ADMINISTRATOR
(516) 765-1802
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 7, 1988
Mr. D, Claeys Bahrenburg
41 Fifth Ave.
New York, N.Y. 10016
Re: Building Permit #14069Z (deck)
Building Permit #14751Z (pool)
At: Suffolk Co. Tax #1000-024-2-20
300 Bay Ave., Orient, N.Y.
Dear Mr. Bahrenburg:
This letter is to advise you that the above
permits have expired.
Permit #14069Z for the deck addition can be
resolved by a final inspection of the deck and ap-
plying for a Certificate of Occupancy immediately.
Permit #14751Z has expired and a new permit
must be applied for before work can be started on
the swimming pool.
Thank you for your cooperation in clearing up
this matter.
VRW:hdv
Yours truly,
Vincent R. ~/ieczorek
Building Inspector
765-1802
BUILDING DEPT.
.INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ]/~SULATION
[ ] FRAMING F~__~
REMARKS= ~/~/~..//~,~ '~
~FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined ........ ! .....
.~ ........ Permit No.)..~.~.~.~..~.
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
[,~LDG. DEPL
Received ........... ,19.. ·
Date ...~..~./.'~. ........... I9~..~'.
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
sh~ll 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 td 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 autliorized inspectors on premises and in building for necessary inspections.
..... ' ' ;a'tio' O orno ....
(Signature of applicant, or name, if a o p ' )
/ (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .... ' '~"' ' ' '(as ~}t
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 ..................................................
.3..o. 0 .... cz ,. . . ...........
House ................... Number ~' ' ~ir~;i .................Hamlet
County Tax Map No. 1000 Section .~..2...~. ...... Block 2~ _ _ ~c>c ~
Subdivision ............ .~/././~. ................... Filed Map No ............... Lot ...............
/ (Name)
2. State existing use and occupancy of premises a~d intended use and occupancy of proposed construction:
a. Existing use and occupancy .... .(~..~.... .~2~...~ .............................
b. Intended use and occupancy ..... ~..~.....~-'f~...-~. ~ .... .1~..'~..~..~' '~' · ........................
3. Nature of work (check which tpplicable): New Building ..... ' ..... 'Addition..../.. .... Alteration ..........
Repair . Remoyal .............. Demolition .............. Other Work ...............
~: : (Description)
4. Estimated Cost ...... ./?/.~ .0. .................. Fee ......................................
~' (to be paid on filing this application)
5. If dwelling, number of dwellin~ units ·. f. ....... Number of dwelling units on each floor .... ./ ...........
If garage, number of cars ... ~ ....... .'~//~ ................................................
6. If business, commercial or mixled occupancy, specify nature and extent of each t e of use .. ~'~.'~.' ...' ......
7. Dimensions of e,xistlng structuTes, if any: Front... ~...o ......... Rear .... .T~.'...J~.o. Depth . .. ~ .o.
Height ... 2~ .......... Number of Stories .... ....~. ............... ~ ................................
Dimensions of same structure with alterations or additions: Front ... R~..°. .......... Rear . ~ .' ............
.... ~ .,~ ~ .,} ...... Number of Stories.. g .......... >....,;,..
8. Dimensions of entire new construction: Front ............... Rear ......~....'.'... Depth ../. ~..~. ~ ....
Height ../?...o. ...... . Nu. mber of Stones .../ ....................................
S~ze of lot Front ~ ~ -. .. Rear ...... ~.~ .... Depth ~- ~*
Date of Purchase ......... i ................... Name of Former Owner ...,~N-.N~... ~ ........
Zone or use district in which p?emises are situated ...... f?..../... ~/. ....................
12. Does proposed construction viblate any zoning law, ordinance or regulation: .... ~ ........................
13. Will lot be regraded ....... ~ .................. ~ill excess fill be re~oved fro~.tpremises: Yes
14. Name of Owner of premises . . ........ ~k~dress ...~.~.r. ~.~ .~..~(.~'..'~PhoneNo ..~.~..¢'~.g.-~-
Name of Architect ........ ~ .................. Address ................... Phone No ................
Name of Contractor .~., .c..&.~f.K£. ~. ~.,~g~'~¢?~. Address .~.~. t'..~..e, ag ......... Phone No. fl.~.-~...~. · · .'~..G.
10.
'11.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and bloci: number or description according to deed, and show street names and indicate whether
interior or comer lot.
STATE oF NEW YORK, S.S
COUNTY OF ................
.................... :: ...... I'. .................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
abow,· named.
He is the ..................... ....................................................................
(Contractor, agent, corporate officer, etc.)
of said ,owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this
application; that all statements conjoined 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 filed therewith.
Sworn to before me this
............... ............ 9...
Nota~ Public, ...... j. ~,../t/~..b"..~*'~'.... County
NOT~F~Y PUBLIC. S¼~ of N*w York (Signature'of applicant)
'No, 47078'18,
Teu~ Expires M~tcl~ 30, 19,~/
DATE: ~,~._B P ~-_1 SLO~ ~'"'~;~--
:FEE:': ~ u~: _' .....
:~',i[i q~ING ~ARTMENT AT
76548( 9 AM TO 4 PM FO~ THE
lNG ~b~F
1. qON ~ TWO
FOR pO J~ZD CONCRETE
_-FRAMING & PLuMBiNG
3. LAT~ON
4. FIN .. COt':'~' -~ ~ ,~ON MUST
ALL '"
])Li:Rr'MF]NTS OF THE N.Y.
CONSTRUCTION & ENERGY
NOT RESPONSIBLE FOR
OR CONSTRUCTION ERRORS.