HomeMy WebLinkAbout24358-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, NoY.
CERTIFICATE OF OCCUPANCY
No: Z-26632
Date: 08/17/99
THIS CERTIFIES that the building ADDITION
Location of Property: 225 WOOD LA
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 43 Block 4
Subdivision
Filed Map No. __ Lot No. --
GREENPORT
(HAMLET)
Lot 25.2
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 8~ 1997 pursuant to which
Building Permit No. 24358-Z dated SEPTEMBER 17, 1997
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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to FRANCIS X & ELLENJANE C. KELLY~ JR.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
Building Inspec~J
TO¥/N OP SOU'rl*IOLD
BUILDIN~ D~PARTMENT
TOWN I*I~LL
SOUTHOLD, N. Y.
N?
BUILDING PERMIT
fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
24358 Z Dote ...... .~./..~.. ................... , ,9.~..~..
Permission is hereby gron. t4d t9: ~ / ~ / / .~
........ ..~..~.~ .~...~...~...././..Y... .~..~ ........
,o ~~......~.~...~._._~..~....~.,~~..~
.................................................................................................................................
at premises Iocoted at ................................
4/3 // ' .-.,~.~ *')
County Tax Map No. 1000 Section ...... Z__~ ........ Bilk ........ ~ .......... Lot No ..... ~..~.~
Building Insp~tor,
........... ~~ .
~fi~i~"i'~ ............
/
Rev. 6/30/80
BLDG. DEPT,
TOWN OF SOUTHOLD .--~
APPLICATION FOR CERTIFICATE O~ OCCUPANCY
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
Au
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 ail buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water suppiy 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 i% 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'~pre-existing" land uses:
i. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed applicatJiOn and a consent to inspect signed by the applicant.
If a Certificata 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~ - $t00.00
3. Copy of Certificate of Occupancy - ~ .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ...Z~.~9~.~.~ ......................
New Construction ........... Old Or Pre-existing Building .................
Location of Property .... ~.~-.~....0~O0. ~- ............ .~.~r~A~pflyT.. . ......../I~.~. f. .............. . . . .
House No. Street H~mlet
Onwer or Owners of Property...~f~9~r~ ~ ~-~7..~.P~ .~ .~. ~fW~J%L~,~...~.~Z~.~ ...............
County Tax Map No i000, Section.~.~.~,QP. .... Block..0~,OQ ....... Lot..~.?v~...Z0.~ ........
Subdivision................ .................. . . Filed Map ............ Lot ......................
Permit No..%~.%~....Date Of Permit ................ Applicant.?.°~%-w}~.$.~'.~.~; .......
Health Dept. Approval .......................... Unde~riters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
............................ :
c q · ..............
Town HaH, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 9, 1999
Mr. Francis Kelly
17 Pine Street
Huntington, NY 11743-4246
RE: 225 Wood Lane, Greenport.
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 # 24358-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FRAMING [ ~FINAL~/~,~..~
[ ] FIREPlACE&CHIMNEY .
REMARKS. ~ ~ ~Z~--~~
INSPECTOR ~~'~"/,~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [/]~/SULATION
[ ] FRAMING [C-*~ FINAL
[ ] FIREPL~ CHIMNEY
REMARKS:t~ ~
P.O. Box 55 · Peconic, N.Y. 11958
(516) 765-1119
'¸%
./ Iq -o',
1
P.O. Box 55 · Peconic, N.Y. 11958
(516) 765-1119
· FORH NO.
SOUTHOLD, N.Y. ]1971
TEL: 765-1802
Disal~t ovid a/c ................................
.
7
ildi~ Inspector)
APPLI~[ATION FOR BUILIIING PERHIT
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
NOTIFY:
I~IAIL TO: ....................
'Date ................ ,19 ....
a. This application mast be completely filled in by ~pe~riCer or in
3 sets of pla~, accurate plot plan to scale. Fee according to schedule.
b. PloC pla~ sho~in8 locatiou of lot and of buildings on praises, relationship to adjoining In-~ises or public
streets or areas, and givlu~ a detailed descripCiou of layout of p~o~erty must be dr~ on C[~ diagram ~hich is part of
thl, s applicatiom
c. The ~ork covered by this application my not be cc~enced before issuance of Building Permit.
d. Upon approval of this appllcatioa, the Building Inspector will issue a Building Permit to the applicant. Such
e. No hiildiu~ shall be occupied or reed iu ~hole or ia part for an~ pm-po~ ~hatever until a Certi[icate of
Occt~ancy shall have beet granted by the lhilding Inspector.
APPLICATI(It IS ~/~ to I:he Building l)epammuC for the ia of a l~fildlug Pemit pursuant to the
Building Zoae Ordinance of the Tc~u of Seuthold, Su/folk Camry, I~t York, and other applicable I~s, Ordimmces'or
Re~lacioas, for the construction of buildings, additions or alteratic~s, or f~r rea~val or de~litioa, as herein
described, lhe applicant agrees to ca,ply wi~h all applicable la~s, ordlr~ces, building code, housing code, and
regulations, a~d ~o adult au~horiz~l inspectors ou premises and in building for necessary inspectious.
(Signature of applicant, or nam~, if a corporatlm)
~ a....~.....~... ...... ~.~.~(~...~. ~..<<.~-,'
(Mailing addm*s of' applicant)
State '~heth~ appllc~t i~ o~r, les~e, ~_mt, architect, engln~r, general contractor, electrlchm, plmt~er or lmilde
..... ~.~..~...~ ............................................................................................ .
~ o~ ~ o~ ~..~.~.~.~ ..... ~.t>. ..... .~T.~..~.~ ..... ~.~2.':~ ........................................
{a.~ on the tax roi1 or late*t
If appl~t is a corpo~iou, ~x3Un-e ofFly au~horlzed of£icer.
and title of cor~offimr)
/ ~,~ ~ ~ .... .~.~.:.~.~...-...::.~..
Pl~bers License I~o ..........................
Klectriclm~ License No
Other Trade% License No .....................
I. l~catlon of l~d on which p~o~d ~x~rk will be dor~ ..............................................................
....... ~.~..F.. ................... .~...0.0 ~.......~...: ....................... ..¢..~.~..~C ................
Bouse NL~ber St-rc~ t
~.T~. ,~ ~,.....~. ......... .~ .... .~. ......... ~ ..~.~..w.....
8ubdivl,lon .................................. .. . . Filed 1,tap I~. . Lot
2. State exi~tlng use ~1 occup~:y o[ pr~a[ses and intended use ami occupan~ of Irropo.~l eomtructlon:
,. ~t~ ~ ~ ~ .... £~.ee....~......tS..~...c.oZ .... P...~.~.c..<.~.a ........................
3. F~m,e of ~o~k (dmck ~,ifid~ applicable): ~ l~Jilding .......... addition [.~.~ Alterati~ ..........
I~[~ir ............ ~al ............. 1~1 iti~ ............ Other ~ .................. ~ ...............
~ript i~)
,,. ........ ........................................ :. ....
(Co ~ ~id ~ filing this al~licati~)
5. If &~lli~, ~imr of ~llitg imits ............ t~d~r of t~lling t~its on ead~ fl~r ................
If garage, ~i~r of ~rs ......................................
6. If I~i~ss~ ~reial or ~ ~, s~ei~ ~ture ~ ~enE of ead~ ty~ of u~ ......................
7. Din~nsi~m of ~is~i~ s~n~t~ares, if any~ ~tmt ................ ~ar ............... ~ptll
I~i~t ......................... ~n~r og Stories ......................
Di~nsi~m of ~ stn~re with alterari~s or ~itions: Front ............... ~ar ...............
~pth .................... lhi~ .................... ~mt~r of S~ories ...............
8. Diu~nsi~m of entire ~ ~sr~tion: ~t ................ ~ar ............... ~pfl~ ..............
l~i~t ......................... ~t~r ot Stories .....................
9. 5i~ of lot: ~ .................... ~ar .................... ~pth ....................
I0. ~te of ~rd~a~ ..................... ~ of Fonmr ~r
II. ~ or u~ district in d~id~ p~i~s a~ si~t~ ..............................................................
12. ~s ~o~1 ~E~ti~ vi.olace any ~i~ 1~ o~i~e or re~fla~i~ ........................
13. ~ill lot lm ~r~ .................... ~ill ~ss fill [m r~
16. ~s of ~r of ~s ........................... ~ress .............................. ~ ~ ...........
~ o~ Ard~it~t .................................... ~ress .............................. ~ ~ ...........
· ~ of C~tractor ................................... ~ress
15. Is this pm~r~y within ~ f~ of a till ~clmfl? * ~ .......... ~ ..........
PLOT DfAGRAH
locate clearly and distinctly all buildings, ~lmtlmr existing or pro~, ~ i~licate all ~t-~ dl~nsions
~ pro[~r~y li~s. Gi~ st~ ~ bl~ ~r or ~rip~i~ acco~ing to ~ ~ ~ strut ~ms ~1 i~icare
OOOUP4t~O~
...US~ IS ',~.. 0~ /
~ ~/~
..... ~. .... ~...~~ ................... ~ing ""U ~"'. 'a"~ ~ *~. ~""~ "~ i" "'~ ~,'¢ i~"~
(~ o[ i~ivid,~t signing c~Lract)
a~e
~ is the ...~~.~. ........................................................................
(~ltractor, agent, cor~rate officer, etc.)
of said ~mr or ~rs, m~] is duly ~thori~ to [~rfom or h~e i~rfo~ the ~id ~ a~l to ~ke ar~l file Ibis
a[Sfllcati~; that all state, ets cc~tab~l in this a~l icati~ are tn~ to ~te Imst of his ~[~
dmt the ~rk will I~ ~rfon~l in [he i~m~r ~t forth in ~e a~iicatkn~ fil~
~m to t~is ~ ~ V
.......... ~..'~d. o~,..ta ~ (~.--'~--:(~ 'X
APPROVED AS NOTED./_
LOWING INSF:'CTIONS:
COUNDATION TWO
~:0¢ POURED CONCR~E
..... : ~ ~4'~TRUCTION ERROF
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