HomeMy WebLinkAbout24231-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No g-25266
Date SEPTEMBER 15, 1997
THIS CERTIFIES that the buildin~
Location of Property 880 FAP/4VEU ROAD
House No.
County Tax Map No. 1000 Section 121
Subdivision
ADDITION
MATTITUCK, N.Y.
Street Hamlet
Block 7 Lot 11
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J~NE 10, 1997 pursuant to which
Building Permit No. 24231-Z dated JULY 7, 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 EXISTING OWE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to FRANK & KAP~NMELE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
Rev. 1/81
l~w.~e NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BIJILD~NG FERJ~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 2~231 Z Do,e ..........~...~... ...................... , ,~.~..
Permission is hereby granted to~ .
.... ~~....~...:.../.....z/..ff..?
co,,.~ To× Mop No. ,ooo Sec,,on ...~...4_/. .... B,~ ......... ~ ....... Lot No...//.. .................
pursuant to application dated ......... ~..~....~.. ................. , 19ff...~, and approved by the
Building Inspe~ ~'
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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 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 c6mpleted site plan requirements.
For existing buildings (prior to April 9, t957) non-conforming uses, or buildings and
Vpre-existing" land uses:
1. Accurate survey of property showing ail 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 Buildin~ - $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
New Construction ........... Old Or Pre-existing Building ...... ~ ........
Location of F operty ..... ..... .... ..... .... ............
House No. Street Hamlet
Onwer or Owners of Property ............................................. .. .. .. · · ·
County Tax Map No i000, Section ..... I..~.% .Block.. '-~ .Lot ....
Subdivision ......................... ---. .......... Filed Map ...... ~.~ .... Lot ....... ....
No..~.k~.~.~.'.~..~...Date Of Permit ............... Applicant .... E~...~-~- t-~/~''~
Permit
Health Dept. Approval .......................... Underwriters Approval] ........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ .~.~..: .0..0. .............
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
September 5, 1997
Fax (516) 765-1823
Telephone (516) 765-1802
Karen S. Mele
880 Farmveu Rd.
Mattituck,N.Y. 11952
To Whom This May Concern:
We
because
XX
XX
are unable to complete your Certificate of Occupancy
of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24231-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
1)~ I'¥: LiUIIIII~IITIi
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ~NSULATION.
[~'] FINAL ~/~~~
]65..1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] INSULATION
[ ]FRAMING [~INAL ~/-~__~/)
[ ]FIREPLACE & CHIMNEY
REMARKS:
FOPJ4 NO. I
TOWN OF SOUTHOLO
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y* 1}97l
TEL: 765-1802
Disapproved ale ..................................
.................. .................
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORH ..... ,~,~ ..........
NOTIFY:
........ ..............
........................ .d..T~.&...
Date ................ ,19 ....
a. This appllcatlon most be completely filled in by typ~cclter or in ink and sul~itted to the P~fildlng Inspecto~ with
3 ~sets of plans, ancorate plot plan to seale. Fee according to schedule.
b. Plot plan sho~ng leeatlon of lot and of buildlngs on pr~tise$, relationship to adjoining premises or peblle
sitters or areas, and giving a detailed deserlption of layout of property mst be dra~n on the diagran x~hich is pert of
this application.
c. The ~ork covered by this application may not be ecnraeseed before issuasee of Building Pemit.
d. Upon approval of this application, the P~ilding Inspector x.;ill issue a Building Pennit to the appllc~t. Soch
permit shall be kept on the premises available for inspection throughout the ~ork.
e. No building shall be occupied or used in V/hole or in pert for any purpose ~haeever until a C~rtiflcate of
Oecupeney shall bave been grated by the MiMing Inspector.
APPLICATION IS l~Rmff ~ to the Building Depeth,ent 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 renaval or denDlltloa, as herein
described. ~he appllc~at agrees to ccmply ~ith all applicable laws, ordinances, building code, h(~lsing code, and
regulations, and to admit authorized inspectors on prendses and in beildlng for necessary inspe32..tlons.
(Signature of applieant,^or nam, if a corporation)
(Mailing address of applic~t)
State ~bether applicant is o~a~r, lessee, agent, architect, engineer, general contractor, electrician, pl.t~ber or builder.
...... i;;',; or ................
·
If applicant is a corporation, signature of duly anthorl~ed officer. FEE:.
NOTIFY BUILDINQ DEPJ~t~ AT
(Nam and title of corporate officer) 0CC~PANCY O~
USE IS ~JNLAWFUL
Builders License No ..........................
Plt~nbers License No ......................... .
Electricians License NO ......................
Other Trade's License No .....................
WI~rNOUI' CE~'I"ffICAI'E
OF OCCUPANCY
765-1802 9 AM 10 4 PM FOR THE
FOLLOWING INSPECTIONS:
~. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2, ROUGH - FRAMING & PLUMBING
3, :NSU~TION
4: FF~L CONSTRUCTION MUST
BE COMPLETE FOR C.O,
ALL CONSTRUCTION¢SHALL MEET
?i4~ REQUIREMENTS OF THE
I. Location of land on ~hlch lmvl~*~t ~ork wll 1 be done ........................... ~.T~IE..CO~g~TR[~C]~ON..&. -E~RGY
~i , A. J, t ~ CODES~"NOT RESPONSIB~ FOR
... ~ ...... ~ v.~ .~ ...... ~ ~ ............... g~ ff,~.~ ......... n~
~ ~r St~t ~et
~ty T~ ~ ~. ~ ~U~ .12.U.OO .... m~k ..QQ-QO... ~t
(~)
2. State ~stlg ~ ~ <~ of ~s ~ int~ u~ ~ <~ of ~ ~st~cti<:
a. ~sti~ ~ ~ ~ .............................................................................
.... .............. .........
3.
6.
7.
I0.
Il.
12.
13.
"14.
Nzllnre of ~olk (cl~ck ~hich apl!licable): 'l~c~ Ikdhling .......... A~klition .......... Alteral ion ..........
~ (l~ripLi~)
If Imaitmns, ~ureial or mi~l ~qm~y, n~ci~ ~aLure n~l extent: of each ty~ of u~ ......................
Din~nsi~s of ~isting 8tnmtur~a, if mW: I~t ........... ; .... ~ar ............... ~pth .................
I)inanai~a of ~m stricture wi'Lb alterati~m or ~gMitlons: Front ............... ~nr ...............
r~m or u~' dial. rleL in ~deh p~r~ni~8 nze nit~t~l ..............................................................
~a prOl~] c~mtnmciim violhte any ~dng
~*m oF Arddteer . ............ [ ....................... ~klren8 .............................. H~t~ ~ ...............
~mn of (~tractor .' .......................................
/
I=rc~u propelty lima. Oi~e $trc-~t ar~l
M~etlmr interior or corner lot.
block I~mdmr or descripti~a m:co~xling to d~l, and ~1~ street ~mn mai i~lleate
G9 ' I £~
g
of ~u?d (~r or ~ra, m~l i8 duly *~jt.horir~l Lo l~r form o~ have l~rforn~d the 8aid ~rk atgJ to n~lke mM file this
dlq)l ICatl(~l, that all fltalalents e¢~IOiT~I Tn I.hts alq)] teal ion ate tn~ Lo the Imat: of his k~l~ll~ m~ l~.l.]ef: al~l
that the ~)rk wilt I~ l~rfou~l iu thq uumt~r ~t fort.h in tim appl.lcatlon fi l~l tl~r~ith.
Fk~orn I.o .[~.~re m~ tilts
' (Sigl~al:ure of ApplieanL)