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HomeMy WebLinkAbout26983-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27638 Date: 04/27/01 THIS CERTIFIES that the building ADDITION Location of Property: 550 BAY AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 144 Block 5 Lot 11 Subdivision Filed Map No. - Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 4, 2000 pursuant to which Building Permit No. 26983-Z dated DECEMBER 20, 2000 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 NEW ROOF OVER EXISTING ENTRY AS APPLIED FOR. The certificate is issued to JOAN R TECHET (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A a />,"norixed Signature Rev. 1/81 FORM NO. 3 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) PERMIT NO. 26983 Z Date DECEMBER 20, 2000 Permission is hereby granted to : JOAN R TECHET PO BOX 1397 RICHMOND VA, 23218 for CONSTRUCTION OF A NEW ROOF OVER EXISTING ENTRY AS APPLIED FOR. at premises located at 550 BAY AVE MATTITUCK County Tax Map No. 473889 Section 144 Block 0005 Lot No. 011 pursuant to application dated DECEMBER 4 , 2000 and approved by the Building Inspector. Fee $ 75 . 00 Author ' ed Sign ure ORIGINAL Rev. 2/19/98 Form No. 6 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT WAR 2, 2 2001 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+r.the following: for• new- building _or" new use 1. Final survey of property with " curate `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 12 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: 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. C. 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. 29. Certificate of Occupancy on Pre-existing Building - $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 Date . . .5 ? 41. . . . . . . . . . . . . . . . . . .. . . . . . . . . New Construction. .. . . . . Old Or Pre-existing Building. . . . . . . . . . . /�� Location of Property. . . o . . . . . . ... . . . .. . :} .6uk.. . . . . . . . . .. .1 f �)"LI Gdk.. . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. f.S? . . . . . . . . . . . . . . . . y'7 38 �-;/ oo�Y County Tax Map No / 11000, Section. . ..11. .. . . .. Block. . . . . . . . . . . . . . . .Lot. . . . © . . . . . . . . . . . Subdivision n( '! !� .. . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No.Q Co 9&3.� .{Da�te Of Permit. . Ia ��/f�. .Applicant� ���}.. . .. .��.�•v Health Dept. Approval. . . .J.[). . . . . . . . . . . . .. . .Underwriters Approval. . .J:/. . . . . . . . . . . . . . . . . . . Planning Board Approval. ,3. . . . . . . . . . . . . .. . . . . . Request for: Temporary Certificate. . . . . . . . . .;Final Certicate. . . . . . . . . . . n e� r Fee Submitted: $.Gt V... . . . . . . . . . . . cx�, 543 SS . � . APPLICANT �o�OgUfFO(,�coG o s� Town Hall,53095 Main Road Fax(631)765-1823 P.O.Box 1179 O Telephone(631)765-1802 Southold,New York 11971-0959 y�/�l �aO� BUILDING DEPARTMENT TOWN OF SOUTHOLD April 9, 2001 JOAN R. TECHET P.O. BOX 1397 RICHMOND, VA 23218 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 . ) $25.00 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 # 26983-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 LATION [ ] FRAMING [ FINAL [ ] FIREPLACE A CHIMNEY REMARKS: lam, � ,DATE 3 w INSPECTOR FIELD NSPECTION REPORT DATE COMMENTS II JI 04 II �I H FOUNDATION OST) n _ Z cl FOUNDATION (2ND) I� ---�� cn Ay, Iii II I�— II O vl ROUGH FRAME 6 PLUMBING ii ii O ii II II INSULATION PER N. Y. H N STATE ENERGY n �---it CODE it o I� u FINAL N ADDITIONAL COMMENTS: �I O r-� O z 9� r j ro H BOARD OF IIEALTH . . . . . . . . . . . . . . . FORM NO. 1 .13 SETS OF PLANS . . . . . . . . : . . . . . . TOWN OF 50u'ruom) SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN iIALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765- 1802 NOTIFY: CALI. . . . . . . . lixanined. ...'. ....., ((����// (,, MAIL TO: . . . . . . . . . . . . . . . . . . . . AI>i,rov(YI•{Y'T.�f...:.., .Lr .lPenult: No. ........ ................................ . . . Disopproveil a/c ... ............................... ............................... .... ...................................................... inn inn . :O or Q 20Uu APPLICATION FOR BUILDING PERMIT Uu 9 Date. . . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS RUCTIONS n. 91%ijt_nlpl lcn[ion must be cx,plelely filled in by type%4riter or in h,k and submitted to the f4ub cling Tuslecl nr w 3 seta 0 . plana, accurate plot plan to scale. Fee according to scJaedule. 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 descriptio, of: layout of property mist be drm+n on the dingran which in lust of (ilia nlq,lica(io,. c. 'lbs work covered by this application may not be commoced before issuance of Building Permit. d. Upon approval of this application, time Building inspector will ismue a Building Permit to the applicant. b&xh permit shall be kept on the premises available for inspection throug1lout the work. e. No building shall be occupied or used in whole or in part for any purpose Aiatever until a Certificate of Occupancy shall have been granted by Lire Building Inspector. APP1.1cA'riON IS IEMISY MAIZE to the'Building Department for Ilia issuance of a'ikuilding'Penult pursuant to ll,e Building Zone Ordinance of the Town of Soutl,nld, Suffol% 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. 'flue applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations,,and to adait authorized inspectors on premises and in building for necessary inspections. EN,V,IRQNWENT.EAST..INC......................... (Signature of applicant, or name, if a corporation) P.Q...Box..130•.BE(`QNIC••N•:Y• ................. (Mailing address of applicant) State wAmtl,er applicant is owner, lessee, agent, architect, engineer,*geceral contractor, electrician, pludrer or build GENERALl.,CONTRCTQ�3........................................:......................................... Name of owner of premises ....:dC)A 1 e CH ET' ........ ............................................................ (as on the tax roll or latest deed) 7,Aud t ration, signature of duly authorized officer. �....Bet&r.-S.••Stoubenburgh, Pres . titleof corporate officer) Builders License No. 5556..11.1............... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. location of lard on whirl, proposed work will bedond............................................................. 5 � Y....... � AE.....................nn f.TTt-r-u��. (louse Nunber StreeeAt��,,.. Iianlet . Canty Tax MapccNo. 1000 Section ...tA-4 ....... Block .....c5......... pot ....11......... Sulxlivision Filed Map No. ............... Lot .......... (Name) 2. State existing use and occupancy of premises and intended use six] occupancy of proposed construction: a. Existing use and occupancy .... 'INGI .... l4Ml.l! .... WL-(1l IJ 6.................. b. Intended use and occupancy . I /�Gl ,.....� M�V\','.....Z)W-tl,;l-:Aq. ............... u, ?. Ki( of work (d kwiddr appl,lcabNr' le); u lk,llding .......... Addition _%z......Alteration .......... te 1uir ............ ......... Dermlitla. ............ Other 1Jork . ... ... ..... .... (Description) It Estimated Cost J�p.d'.�.I� ... fee ............. A (to be paid ort filing tills application) S. if (k,ellh,g, rentor of dwelling `,,rllta�.1.�0( hir ... tkni,er of (keening units on eaci, floor ... .A.N. If garage, umber of care ...•..ii.....fY.! ... ...... ...... .. ..... If or ). Ill,.euxlanasuf exnlac(nglatn.ctlLocn,lwocy, specify nature a(xl extent of. eadn Lype of use.....!v!,:........... .. 7ilr Q•-�I ,�or. ..IS-?,i. !31 . .... e, if any: Iha)t.. (l .... Rear ..C:l.l... .... f?eptb ..... I Imenai .. of arse e... . ... with Rather of Stories ,.I j2STUU�y S. Ir alterations or r Jditlons; Front ..... M. Rear }� �y ... t `'.�... 11'pill ......—S .�.'....., Ilei L• ....... .I'.r..., Mn x:rr of Stories ...... R. Dlurenalans of entire new const Hart; Front ...��'.�!`��!.. hear ...N��.,. Depth .. ��':Z Y Ieigl+t' .........1 .�....I... Nnt,er of Stories .... .. 9. Sire of lot: VronL .... 156 . .... hear .,.��1'J.a ....... ►le ei • °0 '-- x}•12. 2••-1 M. Dal of 11,rd,aae ..............1..... . N+.rne of Forner OAter �pp ,t ........ .. ................... It. Za.e or use dlatricL In wtrld, pr�enises are situated ......lT.—.7p.................................... g N-0-qCe any zo(ring ltw, ordinance or regulation; .....,N..b............. !. Ik)es proposed construction viol t:3. Will lot Ire re raded .... p ......... Will excess ,fill Ile remo�vetddffrern premises; YES Ill. Mitties of (water of praaises i� �� ...... Address r• �' �.. F;...... pix„te No.2q9—.&'.V N+n,e of Archllect .............:I N+nie of Contractor Envlrortm .... ................. Arklroae .......... Phax: No. .. 15. Is this Property within 300 fee�rt '•East•IX2es •• Aklress .1?.:0....1.9.4.P.eA4311�1......11tons No.734,-7,47,4 11958 of a tidal wetla,xlY * YES .......... N3 .......... *l!' YUS, SOl iluj1 7DUN 1 411?13S PE1341'1'MAY IRc W,Iti►►um. . PLOT DIAGRAM lactate clearly and distinctly all buildings, wi,edier existing or proposed, and Indicate all set-bade dimensions. from property linea. Give street arA block nnber or dsacript'ion according to deed, and six)w street onnea aril Indicate ulwtlwr interior or corner lot. I i SIA'iic (Xr N:W Y(XU<, (XXIItIY lX�' ,.J,Ll 0�1.t........... SS $eller„S.,, Stoutenb�(rc�h•.... ..... .....IxiuISduiYrvn, deposes and Says that be Is (Ile applA a,nt: (Nrnr (it Individual, signing contract) ulxrve ,unied, Ile ix the ..General.xbntract0 .................... .................................................. (Contractor, regent,-aP1rpornCe officer, etc.) Of xnld (mler or um,era, and In (July au iorized to Inerronn or have lierforuted the acrid work oixl to make and fl to thin appl icaLia,; LIM alt aLalenenLa contained in I.his rIppllcatiar nr'e fox to the hell' of ]its krxn+ledge and Ix}+Lief; andshut the work will Ile perronne(I in I.I,ejarrnner net forth in lie application failed therewitl,, btx)rn to be[[fore me Oils ... ..,..!....(lay of .. ? e . cr.. l9... Notary N,blic ....... . .i............... r ROBERT I.SCOTT JR. gnanture of Applicant) Notary Public,State New York Qualified in Su k County NIX.01 SC472508� 2 Term Expires May 31, t APPROVED AS NOTED DA,� taaoot� ruirm FEi� �. 'C.P.#...�b9�3 �h BY: NOTIFY BUILDING DO EkAT785-1802 4 AM Td4 P FOR 1 { FOLLOWING INSPECTIONS: t FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING NE v[ poRck£ FDO F S INSULATION C ex.Lsi !�T' b FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. _ ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, - - STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR y' _'.. Fav R DESIGN OR CONSTRUCTION ERRORS , t KtZctiErt E-ATR-( I J iE� p t1. tzM MAIN eN'Tf- occupmcy - USE to UNLAWFUL - of WlTHOUT CERTIFICA OF OCCUPANCY - j Q { � KITCHEN LIV• R'Sv(• - M. 6EP. - � f N _ 1 ASK- - covERE.n Po�cH to - -- - - - ---- N L.w {-DRCtf R <>F a .Es vd 6m t �— AL 1 Ln , x FkRGkWAc11 . SAMti NE 1 , ¢' R1NG CONCEAL.eD l.1GHT5- '" i. `. i L S- DSi✓T Lit V I N G fZo D M - �S alN TQC s — A-cttwl\Y o A�l I KI7GNl✓1 I L T > r ao I �SiTnE YT. LE.DwG) $'�" QeIL . 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Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation ??? Flood Zone: to : �