HomeMy WebLinkAbout24180-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26976
Date: 03/10/00
THIS CERTIFIES that the building ADDITIONS
Location of Property: 1975 CEDAR DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 77 Block 1 Lot 26
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 14, 1997 pursuant to which
Building Permit No. 24180-Z dated JUNE 11, 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 ADDITION~ DECK ADDITION & FRONT ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to BRIAN & CATHY CAMPBELL
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N-475472 12/28/98
N/A
uthor~zed Sig~ture
FO~ NO. 9
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 2i180 Z Dote ..................... ./../. .................... ,
...... ~~ ...... ~.:..Y.'. ...............
..m~~~,;~.~v:..~.~..~.~~...~..~
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~, p~e~,,, ,=o,.d o, ....... /..fiZZY. ....................................
cou,~, 'to× Mo~, ~o. ,ooo S.ct,on .......... ~:.F.. .... B,o,:k ......... ./ .......... ,or ~o...,Z~ .............
pursuant to opplicotion dated .............. ~.....~.~...~... ............. , I9.~)....~., and opproved by the
Building Inspector.
· .............
Rev, 6/30/80
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. Thi~ application must be filled in by typewriter OR ink and submitted to the buildin
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, muitiple residences anB similar buildi
and installations, a certificate of Code Compliance from archite~r engineer
responsible for the building. ~//~i,,~
6. Submit Planning Board Approval of completed site plan requir~z'/~'~'%~/<z..-~ ~
B. For existing buildings (prior to ~ril 9, 1957) non-conforming ~u~s, or'l~u~ings a
'!pre-existing" land uses: '~ ~. '.~J.- i '?"~
1. Accurate survey of property showing all property lines,x- ~s~e~?f b~lding~
unusual natural or topographic features. ~<~J/~". C
2. A properly completed application and a consent to inspect si~'e~ by tl
If a Certificate of Occupancy is denied, the Building Inspec~[~shall
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling
Alterations to dwelling $25.00, Sw~r~ming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $100.00
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 ~ 1~ [q-~-~- ....
New Construction ........... Old Or.Pre-existing Building. ~ ...... · .........
Location of Property. 1.~.~5 ..... ~.~...~.~. ~.: ..... [~. 0~.~ ~.~ ...................
House No. Street Hamlet
..................
Onwer or Owners of Property ........... .
Subdivision . . Filed Map Lot .......
Permit No~.~lJ.~.~...~...Date Of Permit ................ Applicant .........................
Health Dept Approval Underwriters Approval ........
Planning Board Approval
Request for: Temporary Certificate ........... Final ~rticate.~ ........
Fee Submitted: $. : .................... .'.'.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 22, 1999
Brian & Cathy Campbell
1975 Cedar Dr.
Southold, New York 11971
To Whom This May Concern:
We are unable to complete your Certificate
because of the following reasons:
XX An application for Certificate
not on file. (Enclosed)
No Underwriters Certificate on
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)o
BUILDING PERMIT # 24180-Z
Please contact our office on this matter.
cooperation.
of Occupancy
of Occupancy is
file.
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 (516) 765-1823
Telephone (516) 765-1802
MARCH 8, 2000
2ND NOTIFICATION
BRIAN & CATHY CAMPBELL
1975 CEDAR DR.
SOUTHOLD, N.Y. 11971
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. $25.00.
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24180-Z *
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
*THE ABOVE BUILDING PERMIT HAS EXPIRED.IT IS UNLAWFUL TO OCCUPY
OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN
ISSUED. TO AVOID A VIOLATION BEING ISSUED, PLEASE APPLY FOR THE
C.O. SO THAT WE MAY CLEAR UP THIS MATTER.
t~ ~J ALe_
GP~c-v~,~--e.~O "~ec~$ ~ct~fL L~ ,,K.~~''
DEPT.
,?"' ':"
i~ooP
/ I~ TO. Ut, SOUTBOLD
BUILDING DEPARTI4ENT
TO. HALL
/997 . s0o~0~, ~.~. ~ ~9~
............................. . ... .
' ~u2t~R BUILDING PE~IT
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK ......... , ................
SEPTIC FOE14 ...................
......................
~IL TO~.~q2.5 ..............
....... ~.r...~.~...~.. .....
..... .~.~ ~.c~ ~x,.. ~..~...
· ilq91
a. Ibis application mst 1~ c~pletely filled in by typewriter or in ink and ~itt~ to ~e ldldi~ In~tor wi~
3 ~ts of plus, ~ate plot pl~ to ~ale. F~ ~c~i~ to ~le.
b. ~ot pla ~ l~atlm of lot ~ of ~ildi~ ~ ~s, mlati~shlp to ~jolni~ ~i~s or ~lic
struts or ama, ~ givi~ a &tail~ &~ripti~ of l~t of ~r~ ~t ~ dr~ ~ ~ dia~m ~i~ is ~rt of
~is a~li~tim.
c. ~ ~ ~ ~ ~is ~licati~ ~ mt ~ ~ ~fom is~ of ~ildi~ Pe~t.
d. ~ a~al of ~is ~li~ti~, ~ ~ildi~ In~ctor x~ll is~ a ~ildi~ ~mit to t~ ~li~t. ~
~ ~all ~ kept ~ ~ ~s ~ailable f~ in~ti~ ~t ~ ~rk.
e. ~ ~ildi~ ~11 ~ ~i~ ~ ~ in &le ~ in ~rt ~r ~ ~ ~atmr mtil a ~ifi~te of
~ ~1 ~ ~n gmt~ ~ ~ ~ildi~ In~tor.
~I~ IS ~i ~ to t~ ~ildiE ~nt f~ ~e isle of a ~ildi~ Pe~t ~t to t~
~ildi~ ~ ~i~e of ~ T~ of ~ld, ~folk ~, ~ Yo~, ~ o~er ~li~le ~, ~i~es',or
~lati~s, f~ t~ ~st~ti~ of ~ildi~s, ~iti~s ~ alterati~s, ~ for ~al or ~litim, ~ ~min
~ri~. ~ ~li~t ~s to ~ly ~th all ~li~ble 1~, ~di~es, ~ildi~ c~, ~i~ c~, ~
~lati~s, ~ to ~t ~i~ i~tors ~ ~s ~ in ~ildi~or ~es~ i~ti~s.
(Si~mof~cmt, or m, ifa~ ti~)
(~ili~ ~ss of ~li~t)
State ~a~ether applicant is ~ner, lessee, agent, architect, engineer, general contractor, eleetrici~, plt~ber or builder.
............ ~.oo..N..~.c_ ............................................... ;~ .................. ~ ....... , ...........
.... .... .............. ...... cam.p!.. (.1 ..........
(as on the tax roll or latest deed)
AP~ROV£D l~ NOTE~
If applicant is a corporation, signature Of ~aly authori,~i o£fi~r. ~ATE:~----/'~ ------ ~,//~"/".~. #~
......................................................... ' UNDERWRITERS CERIEICA,~.i~ DEPOT AT
(Name and title of corporate officer) ~00]~) 765-1802 9 AM 1D 4 PM FOR TNE
FOLLOWING INSPE~IONS:
OCCUPANCY O~ ~. FOUNDATION ~0 REQUIRED
~H~=s ~[ce~ ~ .......................... FOR POURED CONCRETE
~ITHOUT CErTiFICATE ~. :~su~ON
gl~t~ic~s L~ ~ ...................... 4. FINAL ,- CONSTRUCTION MUST
~ ~s L[c~ ~ ..........
ALL CONSTRUCTION SHALL
..... I F~.. I..~ .... ~. ~.1. J.~. x .... ~ ~.~ ~ .~ ......... ~.~. ~. x. I. t~... ~5~t - -N~. - 8t~P~gtSL~ · -F~
~ ~r Strut E~ O~ CONSTRUCTION ERRORS
~ ~ ~ m. ~ ~d~ ....~.'~ ...... sl~ ......... ~ ....... ~t .........~.~..
(~)
2.State ~st]~ ~ ~ ~ o~ ~s ~ inte~ ~ ~ ~ of ~
...... ............................. ............ : ....
Pz~h~re of ~oek (cl~ck ddch apl licable):
-- 'I~pair ............ Ren~rcat ..............
I~ l~filding .......... ~ldition ../.~.. .... Alteration ..........
Dem~lit ion ............ Other ~/ork !Description)
(to be paid tm filing this application)
5. If &~elling, rfl~tmr of d~ellin onits ............ l~tmr of &mlllng tmlts ~ ead~ fl~r ................
6. 1~ Imai~msa, ~mrcial or mi~ ~pa~y, spaci~ mture a~ ~ten[ o[ each ty~ of u~ ..... ; ................
· ~ o~ Ar~dt~t ~reaa ~ ~
~ of C~tractor ~klress ~ ~
PI.OT DIAGRAH
f~ pretty li~s. gi~ st~t fl~ bl~k mmfmr or ~scripti~ flcco~ing Lo I~, a~ ~1~ street ~8 ami i~licate
~dmtber interior or eo~r lot. I
¢
(~m of i~id~t signing cont"ract~
~1~ is the ..........................
(C~Eractor, agent, ]cor~rate officer~ etc.)
o~ said ~r or t~rs,' nr~l i8 duty i~thoriz~l to i~rfona or h~e l~r~k~rn~ tbe ~id ~rk m~l to rake ami file thi~
alq~ltcaEton; that ail 8EarphonEs contrail in this a[~l ~eat~<m are tn~ to the bent of his k~x~l~ m~ bel4ef; n~l
time the ~rk ~ill I~ I~rFou~ tl~e ~mm~r ~t forth in the a~lieati~ fil~ tbe~i~.
...... .......
~ta~' ~l)lic' z / ~' ' ~ ~ t~
/ / ROBE~I.I~.~ (Sl.mla~e c~ Applicant)
~m ~r. M~ 31, ~
765-1802
BUILDING DEPT,
INSPECTION
FOUNDATION 1ST [_ ~JGH PLBG.
FOUNDATION 2ND iv] INSULATION
FRAMING
REMARKS:,
[ ] FINAL
765-3,802
BUILDING DEPT.
INSPECTION
[ ~FOUNDATION 1ST [ ] ROUGH PLBG,
./
[ ~'] FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING [ ]FINAL
] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ _] ~~LBG.
[ ] FOUNDATION 2ND [~--]-INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLA~.~& CHIMNEY
REMARKS: ~ ~ ,__~~~:~_
INSPECT~~-~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY ~,
DAT,~ ~/~/~//~ INSPECTO~~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ .] RO~JGH/PLBG.
[~"'INSULATION
[~] ~U~NDATION 2ND
[~FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
INSPEC~
765-1802
BUILDING DEPT.
/~ INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS~_
765-1802
BUILDING DEPT.
1ST [ ] ROUGH PLBG.
INDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
[ ] FIREPLACE& CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG~G~
[[ ]]:OR~NM~ION 2ND ~LATION
[ ] FIREPLACE & CHIMNEY.
DAT ,INSPE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDA~IST [ ] ROUGH PLBG.
[ ! F~N~DATION 2ND [ ] INSULATION
[ ,~]/FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY ,
765-1802
BUILDING DEPT.
INSPECTION
[ F~~OUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
REMARKS: /~,~~
] INSULATION
] FINAL
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND/*) [ ]/~SULATION
[ ] FRAMING ///_~j [~/~
FINAL
[ ] FIREPLACE & CHIMNE_Y
THE NEW YORK BOARD OF FIRE UNDERWRITERS P^G~ z
lo~.~1 aU.EAU oF ELECTR,C,TY
., ~ 40 FULTON STREET, NEW YORK, NY 10038
' Date '' DECEIVER 28,1998 Application No. on file 14984597/97 31 475472
THIS CERTIFIES THAT
only the electrical equipment as described below and Introduced by the applicant named on the above application number is in the premises of
BRIAN C.~BELL, I975 CEDAR DRIVE, SOUTHOLD~ ~
in the following location; [] Basement [] 1st FL
was examtned on DECEI'~ER 21,1998
[] 2nd Fl. Section Block
and found to be in compliance with the National Electrical Code.
FIXTURE RECEPTACLES FIXTURES RANGES COOKING DECKS OVENS
OUTLETS FLUOREECENT OTHER
3 5
Lot
DRYERS
SYSTEMS
E R V I C
PER ffi
NO, OF HI-LEG
NO, OF NEUTRALS
PAUL R. BURNS
PO BOX iO61
SOUTHOI~, NY, 11971-0932
LIC,#3897
GENERAL MANAGER
11
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, i
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT SE ALTERED IN ANY MANNER.
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