HomeMy WebLinkAbout24755-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26709 Date: 09/27/99
THIS CERTIFIES that the building ACCESSORY
Location of Property: 225 MARION LA EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 8 Lot 12.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5, 1998 pursuant to which
Building Permit No. 24755-Z dated MARCH 9, 1998
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 ACCESSORY STORAGE SHED IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to SUSAN E LONG
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Ins ctor
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26708 Date: 09/27/99
THIS CERTIFIES that the building ALTERATION
Location of Property: 225 MARION LA EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 8 Lot 12.4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5, 1998 pursuant to which
Building Permit No. 24755-Z dated MARCH 9, 1998
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 INSTALLATION OF TWO SKYLIGHTS IN AN EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to SUSAN E LONG
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
-&L'41
Building In#6ector
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. 24755 Z Date MARCH 9 , 1998
Permission is hereby granted to:
SUSAN E LONG
PO BOX 46
EAST MARION,NY 11939
for
CONSTRUCT TWO SKYLIGHTS IN A SINGLE FAMILY DWELLING AND AN
ACCESSORY STORAGE SHED IN THE REQUIRED REAR YARD A APPLIED FOR.
at premises located at 225 MARION LA EAST MARION
County Tax Map No. 473889 Section 031 Block 0008 Lot No. 012 . 004
pursuant to application dated MARCH 5 1998 and approved by the
Building Inspector.
Fee $ 110 . 00
Two Certificates of
Occupancy required. ,^^^
BuildiV/nYfgIn/spec r
ORIGINAL
Rev. 2/19/98
► s 97
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1 p ? 41999 765-1802
BLDG.IDT
TOWN 0+=SOUTIOLD � APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OR ink and submitted to the buildir
inspector with the following: for new building or new use:
1 . Final survey of .property with accurate location of all buildings, property linee
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 buildi
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
� . Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings <
'.'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 applicar
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 Buildine - $100.00
3. Copy of Certificate of Occupancy - 25G.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.000, Commercial $15.00
/ Date . .d"/ gb/c. 1 . . . . . . . . . . . . . . . . . . . . . . . .
New Construction. . .✓. . . .. . Old Or Pre-existing Building. . . ... . . ... . . .
��AA C L4 _ n
Location of Property. . 9iGZ.�. . . . . . 1':w�•1*�Q,� . . ��4•1--- •. - • • • • . • •�Y�gJ'i4�• " "
House No.. M4. Street Hamlet
Onwer or Owners of Property.. d.Q$ . . .. . . . . . . . . . . . ... . . . . . . . . . . . . . . . .
County Tax Map No 1000, Section. . . . . . . . . . .Block. .. . :�. . . . . . . . . .Lot. . . . . . . . . . .
Subdivision. . . . .ly�Jg . . . . . . . . . . . . . . . . . . . . . . . .Fileed Map. 4N,.. . . . .Lot. ./4/"4 . . . . . . . . . .
Permit No. vZ.V 5" .. .Date Of Permit. 0.111.7a. . . . .Applicant'SIZA� 41/ . 1Z.� .�ON-a • -
Health Dept. Approval. . . . . ./.q.fl . . . . . . . . . . . . . .Underwriters Approval. ./.`�`/�t. . . . . . . . . . . . .
Planning Board Approval. . . . . . .[.7.( . . . . . . . . . . . . /
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. Ll. . . . . . - -
Fee Submitted: $. . . ,5-61
. . . . . . . . . . . . . .
Q,1P 1 10 - `� APPANT
LI
o��gOFFOC,�-cOG
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y x
Town Hall,53095 Main Road
P.O.Box 1179 Fax(516)765-1823
Southold,New York 11971-0959 O1 �a Telephone(516)765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 18, 1999
Susan Long
P.O. Box 46
East Marion, NY 11939
NOTE: Two Certificates of Occupancy reguired.
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
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 # 24755-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.
[ ]
FJYUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS:
DATE S 3 �� INSPECTOR /
M-1802
BUILDING DEPT.
INSPECTION
j ] FOUN=ATION
IST [ ] ROUGH PLBG.
[ ] FO 2ND [ ) INSULATION
[ FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
�j
REMARKS: Cc
- -%
IVDATE --21 /—';�9iNSPECTOR
O
j 1
7GS-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ATION
[ ] FRAMING INAL
[ ] FIREPLA C IMNEY
REMARKS
DATE /t INSPECTO
rEBRUAP`1 Xg - 199 $ SUSAN C. LaNC
aa5 MARI6N DANE
EAST MARMN N, 11939
I DDo -31 -
$Ay AVENuE
• ACCES.56R9 surA6E SMED gXl2
. V) SKV LIGHTS
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" iF SPLIT RAIL FENCE y
pW CLUNG DECK
D$IVEWAY I
PROPOSER 8XIa
• STORAGE SIiEl) ' �I
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k sP IT >?A►L FENCE
INSIDE PPOPERT`I LINE 5 SE�I3AC►�
kK" T of WAy
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ATR.1 n1
N ��
A Z- I R),DN
EAST MARIDN
fr,6p-nsEt� # ? XfMl ST6 R AG F-
V A W�llk
4
IFNCA5-'--D
FKONT VIEW (TO-TA
A If XF It FLoog, SIDE '4 1 EA!
—T6 I S r 14re ONTSJK
Xy il
9�(x ROOF,
FL60K Pl-AH
SUSAN E. Lb/VG ?KOPDSn * 1=EBRVARS a8. 1998
9LA5 MARIM LANE 2NSTALL Twn -3b 10 36 to
EAST MARIDN , NS 11935 SI�SuLDbNE 5KY LIGHTS
SCALE - YY = !
EXISTING PROPOSED
30`z 30'� SkY ll6HT'
So�AR PANELS
41
REAR VIEW
Exl STM
ER
S Gw ER
TRAP y
PECK AREA
SUSAN E. LONG -RoPt1SED : ff-BRUARy ag, 199 $
2.a5 MARIbI`l LANE INSTALL Two 3t x3e
EAST MARIAN, NJ 11939 ZNSULDDME Sky LIGHTS
SCALE: Yy'r= 1t
SCTM # Iado -31 - 8- Ia.
FRONT VIEW
PROPOSED
30"X 3D" SKy �IGHT
R•5
€ i
�� ° LI I
hOAku Of itkALT11
POW No. i J SETS Or PLAt15 . . . . , . , . . ,
TOuVN OFSOUTHOLU 5ORVEY . . . . . . . . . . . . . . . . . . .
t3UILbIN(; UEPAt1TMENT CHECK . . . . . . . .
roWN HALL st i Ttc routs . . . . . . . . . . . . .
soUTHoLt), N.Y. 11971
> l sUSAW F- , kOAiG
�j,Q� tEL.: 765-iB02 nUTth9 .
ixaiitthed . , / ,�! CALL . .Y 77:0a7Y . . . . . , .
HAIL TO '
1pptoved . . . . hetntit No. . �.�JJ �'°4
19 . . ; 8o X • [ �, , . , , .
Eps,r ,MEFR I.L
Asdpptovedd/c . : . . . . . . . . . . . . . . . . . . . qty (IR39�oo��
.� .� . . . . ' . . . .(Iluildir�tspector) �
6r64tly� i hh ArIoN hop HUfLbfrJahEaMlt
13 d
1U. 5 im I bake AAKCR, . .5 . . . . . ., 19`1 ;
1
aLr>G. _. INSTRUCTIONS
'
TOWN OF SOUTU[tHr.ULD -
d. Tlds appiledtion must a completely filled ih by typewtitef of in Ink and submitted to the Building Inspector, with 3
it or plans, dccUtdte plot plan td scale. Fee According to schedule.
b. Plot pldn diowhig location of lot and of buildhigs oil pfennlses, teiatiotlslup to adjoining premises of public streets
r dfeds, and giving d detailed description of layout of property htust be drawn on the diagram which is part of this appli-
itloti:
b. The ttrofk coveted by tills dpplicdilon hrdy not be commenced before Issuance of Building Permit.
d. Upon approval of tills application, fire Building Inspector will Issued d Building Permit to the applicant. Such permit
At be kept on the pfernises available for inspection thtougltout the work.
i
eNo,building shall be occupied or Used in whole or in part for any purpose wilatever until a Certificate of Occupancy
A 'iave been granted by the Building Inspector.
APPLICATION 1S ItrRbbY MAbE to the Building Departmeht tot the Issuance of a Building Permit pursuant to the
tilding Zone Otdinance of the Town of Southold, Suffolk County, New Xotk,:and other applicable Laws, Ordinances of
.9Uldtioh9, tot file constrdctioti of buildings, additions or alterations, of for removal of dernolitlon, as herein described,
td dppllcdnt agrees to comply With all applicable laws, ordinances, building code, housin code, and regulations, and to
'tnit dU(hotized Inspectors on premises and in building tot necessary tspections.
. . . . . . . . . . . . . . . . .
(Signature of applicant, or nay e'if a corporation)
P-C) • Box J4(
PA:5-.r. . MAR.i4 N.r . N y . . . , 11933.- PQY4O .
(Mailing address of applicant)
ate whether applicant is owner; lessee, agent, architect, engineer, general colittactor, electrician, plumber or builder.
. . . . . . . . . . . . .aw N ,1;_& . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
lnid ofofteborptetnises-. . . S.Us. t . . . .O-N
(as on the tax toil or latest deed)
dppilcant is d cofpotatlon, signature of duly authorized officer.
1V)A. . . . . . . . . . . . . . . . . . . . .
(Name dtnd titie of corporate offfcet)
builder's License No. . . . . .N,/fit. . , . . . • . . . , , • , ,
Pluutbet's License No. , , , , h1A . . . . . . . . . . . . . . .
tleciticidn's License No. : . .Iy./�. . . . . . . . . . . . . . .
Othet Trade's License No. . . IIJA . . . . . . . . . . . . . .
Location of land ort wihich proposed wotk will be done. . . . . . . . . . . . .. . . . . , . . . . . . . . . . . , . . . . . .
a5. . . .MAR.IAN. JAN.E,t , . , , FRST. . M ARlhl . . , , . . , . . . . . . . . . . . . . . . . . . . . . I .
House Number Street
County Tax Map No. 1000 Section , . . .a�. . . . . . . . . . . . block , , .?� . . . . . . . . . . . . . Lot YTi,.Rl. . . 1a2.:
§lrbdivisloit . . . . . . . . .1l/A. . (Nanine) . . . . . . . . . . . . . . . riled Map No. . , /y/h. . . . . . . Lot . .N/h . . . . . .
Slate existing Use and occupancy or ptenrfses and intended use and occupancy of proposed construction:
d, Existing use and occupancy . EA.M lAq— : . .R L b F—.M. O�
b. mol
Intended use find Ut;cupancy . .:5.K.1 .Q.4 .H•7:5. ,CWP AIM N!
VV els
3, Notate of work (check wlileh applicable): New Building .,?�, . . . : , , Addition . . . . . . . . . . Alteration
. . . . . . , . beihblltldh .. . . . . . . .
. . . . Outer 14o4k , , ,
d, Pstitnated Cost (Description)
) S . . . . . . . . . . . . . . . . . . . { 1 Pee . . . . . . . . .
(to be paid on filing tills application)
$t It dwelling, number of dwelling u its',, . ,NIA. , , , , . , . , Number of dwelling units oil elicit flout . .
If gatnge, hutribeF br cats �f
i, If business, cbmMetclal of mixed occovincy, specify natyte and extent of each a of use
1, bitnensidus or existing structure's, if h Profit . .(OA .. . Depth
. . . . . . . .
lief Int s hear . la4. . , , , . . . . . bcpth . .3 : . . . . . . ,
g • . . • . , . Nulnbet df Stories . . ( yz,
biifiensions of Barn structure with alterations of ad itions: wont
bepth . , . . . . . . s}. . . 1160,11t . . . . ,�iQa�. . . . . . . . . . Number of Stories . . .4�,4 . . .
1, bhnettsionl of en)ire hew construction: wont . . , , . . Rear , JPZ1 . Depth
I. , $'
Height . : . .la. . . . . , Number Of Stories . . .6vl A . , �}�,�5561 �( , ST,RV.CT.0 K!
Size of lot: rtont . . . . A93,.0.� '
i. bate or PUtchase . . Relit . . . , t !� . . . . . . . . . ,
. . . . . , .<9 2011. . . . . . . . . . . . . . Nance of Fortier Owner
4 Zbtte of use district lit which ptenilses ate situated , . , .%F,5,l,q MN TlAxA , , , , , , , , , , , , , ,
!. boes ptoposed cohsttuctioin vioiat oily zoning law, ordinance of teglihilion: . . .M). . . . . . . . . .
Will
lot be regraded 4 i,
• Will excess fill be removed front prenrisesl Yes No
Name of owner of ptehtises SUS lei. �, , 1vb t ,G, , Addtess N1.49 k1. . ./,.t4.1}1: . . . phone No. y7.9: ,;7,
Maine of Architect . . . . . . . . . A„ Address . , .N�/t.
S � . Picone No. .
Name of Contractor . . Address . • . . . • . . . . phone No. . . . . . . . . . . . . • .
, ie this ptopetty Within 300 feet of d tidal wetland? *yes• , , No, , . . . . . , .
If yeti SoUtltold Towdl,'PrUstees Permit may be teyuired:
PLOT DIAGRAM
Locate clearly and distinctly all buil Ings, whether existing of proposed, and.indicate all set-back dimensions front
operty lines. Give street and block hutnlet bt descrlptioit accotdhtg to deed, and show stree
IeNot of cornet lot. t haines and Indicate whether
SI-E ATTAC-H MEWrS ,
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�CESSORy 8 �X Int S-TO RA6S SNED
tfEOrw
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UNTYor .5u.FF0.1,1,. . . s.s
SV:$ °tti1 • ,>~ : • )rb N w. . . . . . . . . . . . being duly swotn, deposes and says that he is the applicant
(Name at Individual signing contract)
�ti hattted. I
lite . . . . . . . .Q !? N QF,. . . . . . ,
(Cotttractot, agedt, corpotate officet, etc.)
aid btvitef or owners, and is duly authorized to perform or have petfotihed the sold work and to snake and file this
icalioh; that ail 'statements contained lit this application are iHic to the best of lilt knowledge and belief;and that the
k will be performed 1n tine iriahnet set forth ht lite application filed thetewith,
hi to berate the this
dayo.f. 199$
•� . , : � : County
Valk
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Canmwbn aw,.a, pplicanU
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