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Home My WebLink About27146-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27662 Date: 05/10/01 THIS CERTIFIES that the building FIRE DAMAGE REPAIR Location of Property: 860 RABBIT LA EAST MARION (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 18 Lot 18 Subdivision Filed Map No. -- Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 9, 2001 pursuant to which Building Permit No. 27146-Z dated MARCH 15, 2001 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 FIRE DAMAGE REPAIR TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HOWARD S & VALERIE MICHELSEN (OWNER) of the aforesaid building. SUFFOLK COUNTS~DEPARTMENTOFH~J~THAPPROVD~L ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Authorized~gnatu~e 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. 27146 Z Date MARCH 15, 2001 Permission is hereby granted to: HOWARD S MICHELSEN 30 LANDING RD GLEN COVE,NY 11542 for : FIRE DAMAGE REPAIR AS APPLIED FOR at premises located at 860 County Tax Map No. 473889 Section 031 pursuant to application dated MARCH Building Inspector. RABBIT LA EAST MARION Block 0018 Lot No. 018 9, 2001 and approved by the Fee $ 75.00 ~/d Sig~ture Rev. 2/19/98 ORIGINAL APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 o2 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 instaliations, 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 Ppre-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. 2. Certificate of Occupancy on Pre-existing 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 New Construction ........... Old Or Pre existin ........... Location of Property ....... ~.~.. 'L ~ ................................ House No. Street Hamlet County Tax Map No 1000, Section ......................... Lot ................. Subdivision ......................... Filed Map ............ Lot ...................... Permit No. .Date Of Pemit. ~.~..D.% .... ApplicOn ?~.~\.~... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval .............. \/ Request for: Temporary Certificate. iiiiiiiill Final Certicate ...... V.... Fee Submitted: $..%~..: '~"~ ................... ~k~ ,] APPLICANT Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Fax (631) 765-1823 Telephone (631) 765-1802 April 26, 2001 Mr. & Mrs. Howard Michelsen 860 Rabbit Lane East Marion, N.Y. 11939 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 not on file. (Enclosed) No Underwriters Certificate on file. 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 # 27146-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, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Fax (631) 765-1823 Telephone (631) 765-1802 April 26, 2001 Mr. & Mrs. Howard Michelsen 860 Rabbit Lane East Marion, N.Y. 11939 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. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 27146-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUG~L.~a~ [ ] FOUNDATION2ND [ ] ~JL'*ATION [ ] FRAMING [~]/FINAL [ ] FIREPLACE & CHIMNEY ~ INSPECT! ROUG-"H FRAI.IE & XNSI~ION PER N. ¥. STA'I'E ENERGY CODE FINAL ADDITIONAL COMMENTS: BUILDING DEPARTM] TOWN HALL $OUTHOLD, NY 11971 TEL: 765-1802 Disapproved aJc PERMIT NO. ' ~UIJ~DIINt.i FI~KNIII AFFLICATiON you have or ne~d ~c foIlo~, before applyin~ Bo~d of Heal~ ~ ~e~ of Building Plans S~ey Check Sep~c Fo~. Trustees Contact: Mail to: Building I/srpeotor u APPLICATION FOR BUILDING PERMIT Dat~)~ [ o~ ,2o,C~/ INSTRUCTIONS a, This application MUST be completely filled in b,~ ~ypewriter or in se~ of plans, accurate plo~ pl~ to scale, Fee according to b. Plo~ plan showing lo~afion of lot and ofbufldlngZ ?'premises relationship ~o adjoining premises or pubI~c s~ee~s or areas, and wate~ays. c. The work covered by this application may not be co~enced before i~s~ce of Building Pemit. d. Upon approval of~is application, ~e Building M~pector will issue a Building P~it to the applicant. Such a pemit shall be kept on the pre~ses available for inspection t~oughogt'~e work e. No building shall be occupied or used in whole or in pa~ for any p~ose what-so-ever until a Cemificate of Occupan is issued by the Building hspector. APPLICATION IS HEREBY MADE to the Buildipg. 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'cons/ruction of bv,/Id!ngs, additions, or'alterations o~-fo~ reino~'al DJ demolition as herein described. The applicant agrees to ooi'aply With all applicable laws, ordinand?s, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.~ OCCUPANCY OR USE IS UNLAWFUL .,. (Signature of applicant or name, if a corporation) WITHOUT CERTIFICATE " ga OF OCCUPANCY .,, ~ (Mailing address of applican0 State,whether applicant is owner, lessee, agent, architect, ~ngineer, general contractor, electrician, plumber or builder ", APPROVED A~ NOTED ' ~..~r BUILDING D£P~I'M~T AT (as ? the tax roll or latest, , _ . ?S8 1802 9 AM TO 4 P'M FeR '~, ' ' - , , ,. FOLLOWING INSPECl'ION$t " If applicant is a corp.orapon, mgnaturc of duly authorized officer ~. FOUNDATION · TWO REQUIRED /~of ". ' FOR POUREDCONCRETE (Name and tiff corporate officer) ,, . . ~; ROUGH, FRAMING & PLUMBING ~. INSULAllON ' ' "-"~ (~so~) ~c. c,c.-~,, nNAL -CO.STRUCnO. MUST Builders Lmense No. ~TC:V' ~J I[]~.M .-- ,-- BE COMPLETE FOR C,O, Plumbers License lq"o. tV/C) ALL CONSTRU,¢TION SHALL MEET THE REGUIRt-~MENTS OF THE ~t/~ : ' STATE CONSTRUCTION & ENERGY Electricians Licensc No, ' CODES. NOT RESPONSIBLE FOR Other Trade's Licen~e No. L~AId~P-~ [. ~-(~kc&~,r-- '~t~, ltt~,O~I~TltlilI~.DNERRORS 1. Lo_cation of land on which prop. o.sed .work will b~ dope: ~e-,~b,b,+ ko.,ne. -'.' ,' House Number Street Hamlet , , ~m mO ~ ~"~-~:.'~ -,Iris' ~ ;':'(" {Y;~';;; l 0 County Tax Map No. 1000 Section ','~/'* / B ' ! ~"- Block ,...c,;',~qL:~! :'"" :' ''~ Subdivision Filed Map No. Lot (Name) .~,.,. ~^~,~.g, w,o ~,~u o~uupuacy oz premlse, s.~lfl Intended use ~d a, Ex~stmg use ~d oce~p~y ,,., ,~/~ ..... oecup~oy of proposed cons~ction: b, ~tended use ~d occup~c~, /~ (check which apglicable): New Building Ad~tion . Alteration L Nature~k ' ' ] ' Repair Removal Demolition" O~er Work' L Estimate~ Co~ ~; ~0 0 Fee If dwelling, number of dwelling ~nits ~/~ (to be paid on filing this application) if garage, a~ber of cars. ~ Number of dwelling units on each floor If business, commercial or mixed >ccup~cy, specify nature ~d extent of each t~e of use... DimensionSHeight ~/o°f~xisting stmct~eumberif~Y: Frontof Stories~f~ ~ ~/~ Re~ ~f~ . Dep~ Dimensions of same structure Mth alterations or additions: Front M/~ Rear Height .. M/~ ~umber of 8tortes_.. Rear ... 0. ate or Purchase otFom,r Omer 1, Zone or use district in which prern~ses are situated ~ 2 2, Does proposed construction vio[at~/a~Y zoning Iaw, ordinance or regulation:. ~ ~ Name ofOontractor~M ~ 0~ Ad~es~70 k~ ~ Phone ~' 5. Is this property withiB 100 feet of~ tidal wetl~d? *YES ~/~ NO 6. Provide su~ey, to scale, with acetate fo~datlon pl~ ~d dist~ces to prope~y ~n[~}~1 ~ 7, If elevation at ny point on prope~ zs at 10 feet or below, must provide topo~aphical data on sumey. TATE OF ~ being duly sworn, deposes and says that (s)he is the applicant , Agent, Corporate Officer, etc.) '~ed to perform or have performed the said work and to make and file this application; tion are true to th ' e best ofh~s knowledge and behef; and that the Work will be ~cation filed therewith. Signature of Applicant BORN MASON CONTRACTOR Steven Born 770 Leeward Drive Southold, NY 11971 765-3303