HomeMy WebLinkAbout26703-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-27874 Date: 08/14/01
THIS CERTIFIES that the building ADDITION
Location of Property: 55 SOUTH VIEW DR ORIENT
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 13 Block 3 Lot 12 .1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 7, 2000 pursuant to which
Building Permit No. 26703-Z dated AUGUST 7, 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 PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CHERYL TORTORIELLO
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N 112020 01/26/90
PLUMBERS CERTIFICATION DATED N/A
1
Authorized Signa re
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. 26703 Z Date AUGUST 7, 2000
Permission is hereby granted to:
SUZANNE M EGAN
316 WEST 22ND ST
NEW YORK,NY 10011
for
CONSTRUCT OF PORCH ADDITION TO AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP#16105-Z .
at premises located at 55 SOUTH VIEW DR ORIENT
County Tax Map No. 473889 Section 013 Block 0003 Lot No. 012 . 001
pursuant to application dated AUGUST 7, 2000 and approved by the
Building Inspector.
Fee $ 75.00
u o iz Signature
ORIGINAL
Rev. 2/19/98
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1.802
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 buildinj
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 use or buildings an(
•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.conseut 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 Building - $100.00
3. Copy of Certificate of Occupancy - i24%0
4. Updated Certificate of Occupancy - $50.00
5. Temporary 'Certificate of Occupancy - Residential $1 .00 Commercial $15.00
Date .....� /27.. .. . . . . . .. . .. . . . .. . ... . . . . . . . .
New Construction. . ..... . Old Or Pre-exi ti -Building. .
•/ 1
Location of Property. .. ...... S.`... 1 � �. • • ...
. . . .. .. . .. . ...... ..
' House No. Street .Hamlet. . . . .. . . .
Onwer or. Owners of Property. .... . . . . ... . ... . . ... . ... ... .. .. :.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . b..�. . . . . .Block. . , . . . .). .. .. . .Lot. . .�:�:' J . . . . . . . . .
Subdivision. . .. . .
.4 . . . . . . . . .. . . .4 . . . . . . . . . .Filed Map. . . . . . . . .I . . .Lot. . . . . . . . . . . . . . . . . .
Permit No. . R�.� .�3. . .Date Of Permit. �. .. ... .Applicant. . . . : . . . . . . . . . . . . . . . . . . .
.
Health Dept. Approval. . . . . . . . . . . . . . . 4. 4 . . .. Underwriters Approval. . ... . . . . . . . . . . . . . . . . .
Planning Board Approval. .. . .. . . . . . . ... . . .. .. . . . ..
Request for: Temporary Certificate. .. .. . . . . . . Final Certicate. . . . :: . . . . .
iee Submitted: $. .. . . . . . .. . . . . . .. . . . . . :
�y 0 : . . . . . . . . . . . . . . . .: . . . . . . :. . . . . . . . .•. . . . ... . . . . .
RZ
THE NEW YORK BOARD OF FIRE UNDERWRITERS' PAGE 1
1t3Ut�i.. i BUREAU OF ELECTRICITY
F— 85 JOHN STREI�-#'. NEW YORK, NEW YORK 10038
Date JANUARY 26, 1.990 Apoication No.on file 49307287/87 R 112020
THIS CERTIFIES THAT 1 , ,
only the electrical equipment as described beb>iIend introduced by the applicant named on the above application number in the premises of
SUSAN ELAN, SOUTH V[EW DRIVE, ORili*-r, N.Y.
in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl. t7t.t l' Section Block Lot
was examined on '1ANff ARYL e 1 a°lC) and found to be in compliance with the requirerpents of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS I DISH WASHERS EX HAU ANS
OUTLETS RECEPTACLES: SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P.
r DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS
OIL H.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. I AMPS. TRANS. AMT. H:P. NO.Of-FESYSTEMS-- AMT. WATTS
ET
SERVICE DISCONNECT NO.OF S E R V I C E
AMT. AMP. TYPE METER 1-92 W �,3W 3 B 3W 3,B'IW NO.OF CC.COND. A.W.G. NO.OF HIAEG A•W.G. NO.OF NEUTRALS A.W.G.
EQUIP. PER% OF CC.COND. OF HIAEG OF NEUTRAL
OTHER APPARATUS:
WIRING FOR SCREENED PORCH ONIN-A,
PAUL R. BURNT
775 TOWN HARBOR BANE
SOUTHOLD, NY, 1.,19 71 G�ERAL AGER
Per
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAWIER.
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PL
[ ] FOUNDATION 2ND [ ] INS U ION ..
[ ] FRAMING FINAL
[ ] FIREPLACE & IMNEY
REMARKS:
- Z
DATEz � INSPECTOR
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH P G.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING [ INAL
[ ] FIREPLACE 8 CHIMNEY
REMARKS:
DATE CO INSPECTOR. � i
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FORK N0. s
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° 16105 z Date .......I-A... ..2: ............. .. 19.Ez
Permission is hereby granted to.
..... 1-�?::�. ..... .-............................
......0...... '�!- :'....t�.:`�.:...�.!.9.s:-1...............
:: .. . s, ,.. ' . .. ...a-h.. :............ .0
• •�...ic
at premises located at
..............®. .:y'.. �.5.. ..` .•..�� �
County Tax Map No. 1000 Section ......V�.......... Block ....�.A ....... Lot No. ..
pursuant to application dated .......... .Ji!!..`.`s4...�'.:..................... 1911, and approved by the
Building Inspector.
Fee $. :... .......
Y .............................................
Building Inspector
Rev. 6/30/80
J ...w.
FORM NO. 1 ^
COMWA
wow*Wr
TOWN OF SOUTHOLD Drpil
BUILDING DEPARTMENT 2719
TOWN HALL J:M
r�G
SOUTHOLD, N.Y. 11971 `''s
TEL.: 765-1802 TOWN OF SOUTHOLD
Examined
Examined . . ,R.+�!►�t.'?*�+ . ., AT Received . . . . . . . .. ..� 1 9 . . .
Approved . . .1.4. 1 _;-X% 19 7 Permit No.
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date . .2,1 i . . . . . . . . . . ., 190y
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 authorized inspectors on premises and.in building for necessary inspections.
(Signature of applicant, or name, if acorlporation)
. . . . . . . . � . . . . . . . . . . . . . . . . . . . .
(mailing address o� applicant) . . . . . . .
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elect kian, plumber or builder.
��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . . . . . t. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(as on the tax 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. Loc ion of land on which proposed work will1 be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
�, , , So vTy ✓�l` ✓. . �P�.! d�'. . .'r 11.['�ti..�r ref. . '0<A50 . . .�.�- •— . . . . . . . . . . . . . . . . . . .
House Number Street Hamlet
County Tax Map No. 1000 Section . . . .�7. . . . . . . . . . . Block . .3. . . . . . . . . . . . . . . Lot . . /.?-_ . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . . . . .1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Intended use and occupancy . . . . .. . . . . . . . . . . . . . . . . . . . . .
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