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Home My WebLink About13910-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25850 Date: 07/27/98 THIS CERTIFIES that the building NEW DWELLING Location of Property: 265 LIBERTY LANE (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 79 Block 6 Subdivision Filed Map No. Lot No. SOUTHOLD Lot 9 (HAMLET) conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 17~ 1977 pursuant to which Building Permit No. 13910-Z dated MAY 3, 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 ONE FAMILY DWELLING WITH ATTACHED WOOD DECK & WOOD PORCH AS APPLIED FOR. The certificate is issued to WARREN L. & LYN KNUDSEN (OWNER) of the aforesaid building, SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 7-SO-106 07/21/98 ELECTRICAL CERTIFICATE NO, N059760 05/07/98 PLUMBERS CERTIFICATION DATED 04/15/98 H.SMITR PLUMBING & HEAT. In.p.ctor Rev. 1/81 FOII~ NO. ~l 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) N-° 13910 Z Permission is hereby granted to: ......... ..~.~ ....... ~.~...~.....~..: ...... .~..~.~.....~.:.~.: ...................... ~~.~.~.~ ~-- .................. ~ ................................. .~.~,-,~=:.~...~...~,.~:.;...; ....... ~ ............ ~..= ....... ~; ................... ot premises I~oted at ...~.....~....~.~..~......~.~ ................ County Tax Mop No. 1000 Section .... ...~..,-I,...~. ....... Block ....... .~ ........... Lot No ....... ..~.. .............. pursuant to application dated ...~.~..~.. ....... .~...'~. .............. , 19.~.,..~.., and approved by the Building Inspector. ~ee ,...L~:........~.... Building Inspector Rev. 6/30/80 FOI~M ~,TOWH BUILDING TOWN CLERK'S SOUTHOLD ~i BU ILDING ' P ;P'MiJT / ~ 1 ,,CQMPLETION OF THE WORK AUTHOAIZEi~)' is hereby granted tO: TOWN OF SOUTHOLD BUILDING DEPARTMElqT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 ~ealth Dept. of water supply and sewera§e-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ?pre-existing" land uses: 1. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a conseng 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. 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-existinK Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 May 5, 1998 Date .................... ~w Construction .... ~. ..... old Or Pre-existing Building ................. ~ Liberty Lane Sp~.tb. p.l.~ ...... cation of ~ropertv - ' ...... ' ......... ~ouse No. Street Hamlet ~wer or Owners of Property ................................................. ~unty Tax Map No 1000, Section...P3P ........ Block... ~ ............ Lot.. 9 ....... Filed Map Lot · -'' ~bdivision ................................................................ .. 13910 Z .... App£zcant .......................... ~rmit No ................ Date Of Permit ............ '- Warren L. Knudp~ Underwriters Approval ....... Approval .................. alth Dept ........... arming Board Approval ..... X quest for: Temporary Certificate .......... .. Final Certicate ........... e ~ummitte~: ~ Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 29, 1998 RE: Warren Knudsen 908 52nd St. Brooklyn, New York 11219 265 Liberty Lane, Southold, 1000-79-6-9 :nclosed zclosed To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the ~ollowing reasons: ~/ XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. ~' XX The check is (not on file.)$25.00 XX No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 13910-Z Please contact our office on this cooperation. matter. Thank you for SOUTHOLD TOWN BUILDING DEPT. * Awaiting final survey and waker tesb. I will submit when received. Ikowsld~Smith Fluml in$, Heatiu$ a els, 49200 ~N ROAD SOUTHOLD~ NY 11971 76~- 1489 765-3690 April 15. 1998 Seuthold Town Buildin9 Inspector PO Box 1179 Southold. NY 11971 Dear Building Inspector: This is to verify that in 1978. H. Smith Plumbin9 & Heatin9 Inc. did all rough plumbin~ at the residence of: Warren Knudson 265 Liberty Lane Southold. iff 11971 Ail work was done in accordance with Suffolk County and Town Codes applicable at that time. Henry Smith Jr. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 8070841 BUREAU OF ELECTRICITY ~- 40 FULTON STREET, NEW YORK, NY 10038 Date ~¥ 07,1998 Application No. on file 15941998/98 H 059760 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises WARREN L. KNUDSEN, 265 LIBERTY LANE, SOUTHOLD, NY in the following location/ [] Basement [] let FI. [] 2nd Fl. OUT Section Block Lot was examined on APRIL 28,1998 and found to be in compliance with the National Electrical Code. $E~¥1Cl5 Dt$CONUtCl I NO. O~I ~ . _ METER - V I C E ENTIRE PREMISES- 1 ~NO VISUAL DEFECTS: "An electrical survey has been made of the exposed elec%rical equipment in the premises indicated." "No obvious unsatisfactory condition ~as found. 908 52ND STREET BROOKLYN, NY, 11219 GENERAL MANAGER this certificate m~ not be altered In any manner; tatum to the office of the Board If incorrect Ins"ecf ..... ..P~_r-,~l~l. ....... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New Yo~k 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD Fax (516) 765-1823 Telephone (516) 765-1802 April 29, 1998 Warren Knudsen 908 52nd St. Brooklyn, New York 11219 RE: 265 Liberty Lane, Southold, 1000-79-6-9 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XXThe check is (not on file.)$25.00 XXNo Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 13910-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 March 27, 1998 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD Warren L. Knudsen 908 52nd St. Brooklyn, New York 11219 Re: Building Permit # 13910-Z NEW DWELLING Premises: 265 Liberty Lane, Southold Suff. Co. Tax Map #1000-79-6-9 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. ~;1 E L~ INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL / // ADD IT ION ~.?_..~NTS: SUFFOLK COUNTY DEPARt"MEN1' OP HEALTH SERVICES PROCEDURE & REQUIREMENTS FOR RESIDENTIAL CONSTRUCTION Application for Approval to Construct The following procedure is to be followed for the approval to construct a water supply facility and a sewage disposal system on individual lots. 1. If the lot is part of an old filed map (prior to January 1,1960),or If the plot is not part of any subdivision map, and Involves private sewage disposal, thai1 thefollowing procedure Is to be followed: ....... A. Submlt three (3} copies of a plot survey (up to and including 11"x17') by a licensed surveyor containing the following Information: 1. The applicant's, or responsible representative's~ name, address and telephone number clearly printed or typed. 2. The following statement signed by the applicant - "The water supply and sewage disposal systetns for this residence will conform to the standards of the Suffolk County Department of Health Services". 3. Lot location, dimensions, map name and number, and lot number (if applicable). 4. Location of all surface waters within 300' of the applicant's lot. 5. Elevations of all corners and center-line street elevations at property corners. 6. PropOsed dwelling and any existing dwellings within a 100' radius o! the property. (Indicate dwelling or vacant}. Indicate the source of domestic water for these dwellings (well or public water). 7. Indicate distance and location of the nearest public water main. 8. Test hole data showing soil conditions to a depth of 17' or to ground water, and lot elevation at test hole site. B. If the Io! is not part of any subdivision map, then submit information (e.g., deed or chain of title on tha~t specific lot) demonstrating~lm31 - ~ 1, 1970. If-th-e lot Is not single and separate before this date, supply an overlay map, by a licensed surveyor, or the total contiguous property owned by the applicant or seller as of January 1, 1970. 2. If the lot being built upon is part of a subdivision map approved by the Suffolk County Department of Health Services after January 1, 1960, and Involves a private sewage disposal system, submit three (3) copies of a survey by a licensed surveyor.contai~ing Items I through ?,.~r=gr.~Rb~.~,. ............... 3. If the lot is not part of any subdivision map and is to be served by public water and public sewers, submit three (3) copies of a survey by a licensed surveyor containing Items I through 7, Paragraph A. 4. If the lot being built upon is part of a subdivlslcm map approved by the Suffolk CoU'hfY Department of. Health Services after January 1,1960, and is to be served by public water and public sewers, submit two (2) completed copies of Form S-19e. 5. FEES - Each application is to accompanied by a certified check, money order or business check, payable to the Suffolk County Department of Health Services, according to the following schedule for lots requiring: a. Public water and sewers b. Public Water and private sanitary systems (cesspools) c. Private well and sanitary systems for lots over 20,000 square feet in area d. Private well and sanitary systems for lots under 20,000 square feet in area $25.00 $6O.O0 $90.00 $140.00 6. NOTE: Permit valid for one (1) year from date of approval. Application must then be reflled with appropriate fee. FOR INSTRUCTIONS FOR FINAL APPROVAL OF CONSTRUCTED SYSTEMS, SEE OVER S-17 February1,1976 inst~u~c, tlor~s .f0rFin'l?AP"~r°val of Constructed Systems A. In those cases where there Is an !ndl~idual.sewage.dlsposal system, the following must be submitted: 1. The applicant must.submit a survey In quadrupll.~ate (up to.and Including 11"x17') of thesubject property show ng the f~llowlng: ~ 8. The lot rlocatlon andidlmenslons . · · b. The lot number(s) a~td the name of the subdivision, If applicable. c. The final elevations of the lot. d. The exact location ~f the private well and the water service line, If applicable. (at least two ; dimensions measure~d from the corners of the building). ' . . e. The exact location Qf the public water service line, If applicable. fl The exact location of the septic tank and leaching pool(s), Glvetwo dimensions from the building corners to both the Septic tank and leaching pool(s). ~ 2. The applicant must submit a certificate from ihe seWage~dlsposal installer attesting that the system has been installed according to the criteria of the Suffolk County Department of.Health Services. 3. ~The applicant must submit a water analysis and a well driller's certificate when applicable. .4. The survey must haveia c ear area at least 2"x4" for the DePartment's approvai stamp. B. In those cases where public water and public sewers are utilized by the dweillng, the applicant is to submit three (3) copies of I~orm. S-9. These forms should be.duly executed by the Suffolk County ~Department of Environmental Control, as It pertains to the.sewer connection, prior to submission to this Department. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION l ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [P~'~NAL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [~J'~AL [ ]FIREPLACE & CHIMNEY . . . ' . , :~7~. $OUTHOLD, N, Y. ~~ ~,~ ?? ,roved ...................}~ ......... (.&..., 19.~.Z. Pemit No ..................................... ~/,~¢ 3pproved a/c ~:~U~~ .~ ....................... z;z;~'~ ............................ APPLICATION FOR BUILDING PERMIT / D~,~ ............................ ~ ............ , ~.ZZ....th I NSTROCTIONS a, This applioation must be completely filled in b~ Wpewrit~r or in ink and submitted in triplioate to the Building Inspector, with~ sets of plans, a~ourate plot plan to s~ale. Fee a~oordin~ to s~hedule. b. Plot plan showin] Iooation of lot and of buildin]s on premises, relationship to adjo[nin] premises or publio streets or areas, and dn~ ~ detailed description of layout of properW must be drawn on diagram whiCh is part of this application. ~. The work oovered b~ this application ma~ not be commenced before issuanoe of Buildin~ Permit. d. Upon approval of this application, the Buildin] Inspeotor will issue a Buildin~ Permit to the applicant. Suoh permit,shall be kept on ~ premi[es available for inspeotion throu]hout the work. e. No buildin~ shall be oo~upied or used in whole or in part for any purpose whatever until a Oertifioate of O~eupanoy shall have bee~ ]nte~ bv the Buildin~ Inspector. APPLIOATION IS HEREBY MADE to the Buildin~ Department for the issuanoe of a Buildin~ Permit pursuant to the Buildin~ Zone dinanoe of the Town of Southold, 8uffolN Oounty, New York, and other applicable Laws, Ordinanoes or Regulations, for the ~onstruotion of ildin~, additions or alterations, or for removal or demolition, as herein desoribed. The applicant a]rees to ¢omply with all applicable laws. Jinan~es, building code, housin~ code, and regulations, and to admit authorized inspeotors on premises and in buildings for neeessar~ inspeotions. ~Si~natum of a~plic~nt, .......... ................... (Address of applicant) te whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~.~.~.~.d~ ................................................................................................... ~ of owne~ of p.em~s.s .... ~?~..~.~Z~ ......... ~~ ...... ~.~~...~ ............................ :pplicant is a corporate, signature of duly authorized officer. ...... .................. t~ame and title of corporate officer) ~uildor's kicens~ ~o ......................................................... ~ /O o ~ ~ ~lumber% kicense ~o .................. .~ .................................... /4. ~ _ /~- ~l~ctrician's kiconse ~o ......... ~. .................... Other lrade's kicense ~o ................................................... ~ ~ r~ koeation of land on which proposed work will be done. Map ~o ............................................... kot ~o ......................... Street and ~umber ....... ~ ........... ~. .~ ....... , ........ ; ....................... G.?~.~ ..... Munieipaliw State oxistin~ use and oeeupancg of premisos and intonded use and occupancg of proposed construction: a. fixist[n~ use and occupaneg .................................................................................................................................... b. ~ Intended use and occupancy ..... ~.~.~.~ ........................................................................................... 3. Nat'u~e;'Of ~vork (check which applicable): New Building ..................... Addition ..................... Alteration..,, ...... ,...:, Repair ......................... RemovaI ......................... Demolition ........................ Other Work {Description) 4. Estimated Cost ..... ,4. t.,! ............. = ...................... Fee ....... : ................................................................................. : (to be paid on filing this application) 5. if dwelling, number of dwe I ng!'units ...... ,~.. ....... Number of dwelling units on each floor ...../. ................................... If garage, number of cars ......... ~ ............................................... 6. If business, commercial or mixe'd occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ..................................... ~ ..................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ...................................... ....... Height ......................................... Number of Stories ........................................ 8. Dimensions of entire new consiruction: Front ...... ..-47....(?. ........... Rear ....... ..~..~.. .............. Depth ....~¢~.. ...................... Height .......... .~c~. ..................... ; ............ Numbe of Stories ......... /. .............................................................................. 10, Date of Purchase ........ ,/,¢,,,~,,,V',,,~, ............... Name of Former Owner ....... ,~.,,.d~( f4, ....................................................... 1 i, Zone or use district in which premises are s~tuated ........ ,~,,,.~,~,; ................................................................................ 12. Does proposed construction violate any zomng law, ordinance or regulation...Z~..O. ................... ~; .......................... 13. Will lot be regraded ......... Z<'..q..? ............... Will excess fill be removed from premises: [ ] Ye .{~,.~ [ ] No (Address) (Phone No.) Name of Architect ................. ~ .................................................................................................................................... , (Address) (Phone No.) {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 wheth- er interior or corner lot. STATE OF NEW YORK, COUNTY OF ........................................... ! .......... : (Name of individual sig~ing contract/ He is the ...... ..~...~..~..~....-. ......... .~.~,¢~..g,~...~..../~ .............................................................................................................................................. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly a~thorized to perform or have performed the said work and to make and file this application; that al statements contained in this application ~re true to the best of his knowledge an.~l belief; and that the work will be~r/f~.r~§Nthe manna set forth in the application filed therewith. (Signature olappacant] ....................... // SURVEY OF PROPERTY '~':°'~'~ A T BA YVIEW AREA = 16,355 sq ft. BLDG. DEPT. TQWN QF SQUTHOLD ANY AL TER4 TION OR ,~DITION TO Tt~ SURVEY 18 A ~T A~ ~, ~C~ ~~ E, ALL ~r~ar~aLL~U~a ~ 8i~ · ~~v~. ~~c~ ~ JUL 06199 Dept. Of Heat~ Se~' s SO~ 1197l ~ Of Wastewater Mgmt~ ~.$. LIC. NO. 49618 98 - 195