HomeMy WebLinkAbout13996-zFORM NO. 4
ToWN OF SOUTHOLD
BUILDING DEF~LRTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22503 Date AUGUST 6~ 1993
THIS CERTIFIES that the building. ADDITION
Location of Property 1960 YOUNGS ROAD ORIENT, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 18 Block 2 Lot 37.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 24, 1985 pursuant to which
Building Permit No. 13996-Z dated JUNE 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HE~TH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ANTHONY & JOYCE SPINELLO
Rev. 1/81
~ / Buit/ding Inspector
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)
NO 13996 Z Dote ........~....~ ........................ , ]9..~..~..-''
Permission is hereby gronted to: ~-~ ,
r_~, ~\ .
.....
......
at premises located at ........................................................... .~~ ................
County Tax Map No. 1000 Section ..... ...(~...!...~. ....... Block ...... ..~....1=.. ...... Lot No.......~...~...:.~ .......
pursuant ,o application dated ......... ..~.~d,/~....~'....L'~ .................. , 19..~..'../, and approved by the
Building Inspector.
Fee $...~....: ..............
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
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 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 f~om 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
'Tpre-existing" land~¥ses:
1. Accurate survey of property showin§, all property lines, streets, building and
unusual natural~r 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.' F~es
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 - $100.00
Copy of Certificate 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
House No. Street 'Hamlet
Onwer or Owners of Property . . ~.. . 1~¢ ~
County Tax Map Ne 1000, Section ...... ! .~. ..Bloc L
Subdivision ......... Filed Map Lot
Permit No. · Of Permit ................ Applicant ..........
Health Dept. Approval ....................... ... Underwriters Approval.... ....... . . . .
Planning Board Approval ............. ~ ......
Request for: Temporary Certificate ........... Final Certicate ..........
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
August 5, 1993
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
Anthony & Joyce Spinello
42 Maple Drive
Great Neck, N.Y. 11021
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.
XX The check is not on file. $50.00 (2 CO's)
No Health Department Approval on file.
No final inspection has been made.
No Plun~ber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT 9 BP #8465Z&13996Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
~. COMMENTS
F1ELD INS[ECTION
FOUNDATION
(1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C~DE
FINAL
ADDITIONAL COMMENTS:
] i
~L
~L'"~E: ....... B'¢: _._.:____ .
,I ~%¢f~F-~U',L DING DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
FOII qWING IN~'3EC1-IONS:
1. FOU~'~mATId)N - TWO
FOR n-tuR-D CONCRETE
2. ROUC,~; ~:RAMiNG 8, pLUMBING
3. INI~lu A'~'
~. FINm~ ."'~ ~ii~'RUCTION MUST
Bt_ ~ .... ,.,- r". i(,R C.O.
~,j ~ CC~}," i' i~'T'!)}~I StlAL.L MEET
''tE RFx'' "'*~ ?'~ T-i'}'5 OF THE N.Y.
5TA-.-r C,.'""{R~;CI-tON & 7~'TRGY
CCF"F~. i,d ~I- RESP~t..~S!BL[- FOR
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved . ..~ .~...~....., 19~.ff. Permit No. ]..~.c].?.~..~...
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
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 auth°rized inspect°rs °n premises and in building f°r necessary(bs~s'~'~4_0_~ ~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Nameofownerofpremises .. ~mDL[~.k..~..OT...~?.cl.C~- .~-~'e'/t/° .........
............ ~;('a} ~)~ the~'4ax roll or 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 ............ b .~ ~¢.~.-~. .............................
............... 9 ........... ..........................................
House Number Stre"e't Hamlet
County Tax Map No. 100,OSe'cfion ....... Block Lot. ~7,'~- .........
Subdivision.. "~ i: ' (N.ame). ~ Filed Map No. Lot
2. State existing use a_n~ ~ccupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and 6~c;~:gancy'... ~....:'.~.~be )~-. g.F.... ,~.? ,~5.~ ...........................................
b intended use and &ecu ~.']'~','. ' J'C(h~ )~¢ }- ~;'}V/¢
3. Nature of work (check which applicable): New Building ..... ' ..... Addition ~ .~).~..~]~. Alteration ..........
Repair ..; ........... Ren)oval .............. Demolition .............. Other Work ...............
4. Estimarea t;ost Z2..O .............. Fee .~'..~.b. ~
~ (to be paid on filing this application)
' / 0
5. If dwelling, number of dwelling units ............... Number of dwelling units n each floor ................
If garage number of cars ' ,~ ·
6. If business, commercial or, mixed occupancy, specify nature and extent of each type of use ~..... ~'.
7. D~mensmnsofex~st~ngstructures, ffany: Front ............... Rear .............. Depth :q r. ~ ~'.' . · ·
Height Number of Stories ....... ~ .......... ' '. '" .~,.; ..
Dimensions of same structure With alterations or additions: Front ................. Rear ................
Depth i Height Number of Stories
Dimensions of entire new construction: Front ............... Rear ............... Depth .............
Height ,. Number of Stories .........
10.
Date
of
Purchase
..... ~..~.['~ .]. ~ ."/.9 ............ Name of Former Owner .... ~t./~-:t~: ................
11. Zone or use district in which premises are situated
12. Doe~ proposed construction wolate any zomng law, ordinance or regulation: ... ~'~. ..........................
13. Will lot be regraded ....... ~_.~. .................. Will excess fill ,be removed from premises: Yes
14. Name ofOwnar oCpremises .~['~.~¢e~. ~?~.~}e/]~. Address/7{O.e~.'.~$'k"./$~...~.C.. Phone No *-1~.
Name of Architect ' Address Phone No
Nam~ Of C
ontractor ........ I .................. 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 - -
"/'/~/:' ~' ~; 'of._~..~_...~'~hivi~,',:s'~~ ........ being duly sworn, deposes and says that he is the applicant
above named.
He is the .~..~...'...i ....................................................................
~ (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duiy 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 filed therewith.
Sworn to before me this
..................... day of ................ 1
Notary Public ......... ~.3~
.~5.~(., ......... County f'~ ~)~ ~--
Notary Public~ State of New York · ~.~. ~.. ', · '. · - .' , .~ ,~. . ~ · ·
No. ~o~ ~ ' t~gnature of apphcant)
Qualified in ~Vestchester Co~ ~ '
~sslon Exph,e~ March 30, 198'~