HomeMy WebLinkAbout24365-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-27295
Date: 09/07/00
T~IS (~E~TIFIEB that the buildi~ ALTERATION
L~cation of P~y: 880 F~U ~
(HOUSE NO.) (ST~ET) (~ET)
~ty T~ ~p No. 473889 ~ion 121 Bl~k 7 ~ 11
~ivisim Fil~ ~p No. __ ~ No. __
conforms substantially to the Application for Building Pe~it heretofore
fll~ ~ ~ offi~ ~t~ AUGUST 14, 1997 ~su~t to ~ich
~i1~{~ ~t No. 24365-Z ~t~ SEPTEMBER 18, 1997
was issued, and conforms to all of the retirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
l~ ~TE~TION TO EXISTING TWO C~ G~GE (NEW GI~ER SYSTEM FOR ~
EXISTIN~ O~ F~ILY D~LLING AS APPLIED FOR.
The certificate is issued to FRANK J & KAP~N E MELE
(OWNER)
of the aforesaid building.
muF~-~LK (]O~T~ D~PA~T~ENT OF ~ar.TH ~PPRO%r~L
pLr~H~ ~IFI~ATION D~
N/A
N/A
N/A
t~ized ~ignature
Rev. 1/81
FORM NO. ~
TO~H OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~.o ~,~s z Do,...~ ....... ../..~. ................ , ,,.~?
Re~, 6/30/80
BU~-LD [NC D EFARTiffENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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" ~nd uses:
i. 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-existinR Buildinm - $I00.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00
Date ..... ~.~. ~ ..........................
New ConstruCtion ........... Old Or Pre-existing Building...~.%-- ........... ..'
F'~O v ~. ' .
~oe=ion of ~rope=y ............ .'ff~m..~ .... ..~i .... ~.~.~.~L,..~.¥ ...........
House No. Street Hamlet
outer or o ers of .. ............. . .. .. ... · --
County Tax Map No i000, Section .... I.a.t ...... ~loe~ ....... -1. ........ ~ot...]~ ...............
. Subdivision .~.~..~¢ .~....' ............................ 3.~. .........
......... Filed Map Lot .....
Permit No..~-~.~ Date Of Permit .~. ~jn~D Applicant...~.~-~?).-~-~- -..
Health Dept. Approval .......................... derwriters Approval ....................
Planning Board Approval ........................ /
Request for: Temporary Certificate ........... Final Certicate .......... .~....
APPLICANT
lall, 53095 Main Road
P.O, Box 1179
old, New York 11971~0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Fax (516) 765-1823
Telephone (516) 765-1802
July 14, 2000
Frank & Helen Mele
880 Farmveu Rd.
Mattltuck, NY 11952
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 # 24365-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMIHG
[ ] ROUGH PLBG.
[ ] INfLaTIoN
[/.~ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION I ST
[ ] ~,OUNDATION 2,ND
[ ] ROUGH PLBG.
[ ] INSULATION
] FINAL
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FORH NO. I
TO~/N OF SOUTIIOLD
BUILDING DEPART14ENT
TO~IN IIAI.L
SOUTt]OLD, N.Y. 1197 I
TEL: 765-1802
f PLICATION FOR BUILDING PER,lIT
INSTRUCTIONS
BOARD OF IlEAI.Tl! ...............
3 SETS OF PLANS ...............
SURVEY ........................
CNECK .........................
SEPTIC FORH ...................
NOTIFY: ~/ ~
CALL ........ ~..~.~. ~'~.~ ~
HAIL TO: ....................
'Date ................ ,19 ....
a. This application ns~st be cc~Pletely filled in by type~iter or in i~ ~ ~tt~ to the ~lildi~ Ins~or v.
3 ~[s of plus, ~[e ploc pl~ to ~le. F~ a~i~ to
b. Plot pl~ ~i~ l~ti~ of lo~ ~ of ~ildi~s ~ ~i~s, ~la~i~ip to ~jolnlng pr~i~s or ~llc
s~s or areas~ ~ givi~ a ~ail~ &~rip[i~ of last o~ ~r~ mst ~ dr~ m ~he di~ ~id~ is ~rr of
fl~is a~l icati~.
~. ~ ~k ~ ~ ~id: li~ti~ ~ ~t ~ ~ ~fore isle of ~ildi~ Pemit.
~i~ ~all ~ ~pt'~ ~ ~s ~ilable for in~ti~ ~h~ O~e ~rk.
e. ~ ~itdi~ ~11 ~ ~i~ or ~ in ~le or in ~r~ for ~ ~ d~at~r ~til a ~rti~icate o~
~I~ IS t~lli ~ to ~ ~ilding ~r~ut For ~e is~nce of a ~ildi~ ~mi~ ~r~nt to the
~tildi~ ~ O~i~e of ~ T~ of ~ld, ~[folk ~, ~ Yo~, ~ other a~llc~le l~s, ~i~es or
~la~i~, for tim ~st~ti~ of ~ildi~s, m~i~i~s or altera~i~s, or for r~al or ~Ii[i~,.~ tmreln
~ri~. ~m a~llc~r ~ to ~Vly ~ith all a~li~ble l~s, ordi~es, ~ildi~ ~, h~si~ ca~, a~
~lati~s, ~ to ~ir ~ri~ im~tors ~ ~i~s aid in hdldi~r ~ces~ ~Ci~s.
...... ...................
(Si~ture o[ a~lic~nr, or ~, if a co~ratim)
(~ili~ ~ress o~ ~lieanr)~
State ~O~r a~li~t i~ ~r, le~, ~nt, a~d~t, e~i~r, ~ral ~tractor~ el~trlci~, plier or ~
B~ilders License No ..........................
Plumbers License No ..........................
Electricians License No ......................
1. l~caticsl of land on ~aid~ proi~sed ~0ork will be done ..........
I Ic~se limber Street Hadet
co~, t~x~,No. ,~ .~,ion ..1~.1 ........ ,~o~ ...2 .......... ~t ..Il ...........
...... ......... F,i, No ................ ,, ...............
2. State existi[g use and occopar~, of premises and intended usen a~d ocoal~m:~ of proposed construction:
,. ,,,,,, ....... .,.' " -- ...........
3.
I0.
II.
12.
13.
16.
15.
If I~mine~, ~m~rcinl or mi~nl ~Otlmt~. ~cify trot.ute anti exLen~ o~ each ty~ o~ use ......................
I)in~nsimm of existing ~tnmtu~. if any: Frnt~t ................ ~ar ............... ~plh .................
~n~ of C~Lractor ................................... ~klre~n ............................... H~xm ~ ...........
PI.OT DIA(;RAH
lot:ate clearly ar~ distinctly all Doildings, ~hetlmr existing or proposed, mxl indicate all set-I~:k dimensions
frml propert~y tines. ¢ixae street and block ra~l~er or description according to deed, and sho~ street m~raes anti indicate
xdmtlmr interior or corner lot.
OF O¢CUPAFIC~
PROVIDE :~A HR. FIRE
RATED SEPARATION TO
PART. 717,3 (f) (l) OF
N.Y. STATE BUILDING CODE.
.... .....................
APPROVED AS NOTED _
DAT~ :~I~P. ~
OTfFY BUILDING DE~ENT~Arl,
78~-~802 9 A~ ~ 4 P~THE
FOLLOWING tNSF~ON8~
1. FOUNDATION . ~0 REOUIRED
~OR POURED CONcR~
2, ROUGH - ~RA~ING ~.pLU~eiN~
~ '.NSULA~O~,
4. FINAL -, CONS~RU~ON ~UST
~E CO~ FOR C.O.
~LC .CO~STRU~ION SHALL ~
T~E REQUIREMENTS OF THE N.~
STATE CONSTRU~ON & ENERGY
CODES. N~ RESPONSIB~ FOR
DESIGN OR CONS~U~ON ERRORS
~rn, clelx~mes a~xl r, ay~ thaL lie i.q Lbe aifl>l it':mi
Ik: t., II~t .......................................................................................
//~Cz.,~rac. tor/, ap, el,t, corporate officer, etc.)
of ~;aid ~nr ¢~ntl iS ch~ly ~thorlzol to lx~rfonn or have [x~rfo[.~l the said ~rk aIxl Lo n~ike mgl file Ihi~
Ih;ti. the ~)[k will I~ ierfonl~l in Ihe II~lln~r ~t forth in the nlqflicntita~ film tl~rc~iLh.
($11;T~tture of Appl lO.mt)