HomeMy WebLinkAbout24264-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25416
Date: 12/12/97
THIS CERTIFIES that the building ADDITION
Location of Property: 67855 CR 48
(HOUSE NO.)
County Tax Map No. 473889 Section 33
GREENPORT
STREET) (HAMLET)
Block 3 Lot 18
subdivision
Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 20, 1997 pursuant to which
Building Permit No. 24264-Z dated JULY 23, 1997
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for Qhich this certificate is issued
is ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to CORNELIA C KEOGH & BEVERLY HALLOCK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED 09/08/97
Rev. 1/81
N/A
N-439463
MICHAEL DAWSON
12/03/97
ctor
]P'OB, M NO. ft
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
N?
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
............ ...........................
County Tax Mop No. 1000 Section .... ~....~.. ........... Block ....~ ......... Lot No .......... /...~... .....
pursuant to application dated ........... ~..~....~........~...~ ....... , ,9...~..Zand approved by the
Building Inspector.
Rev. 6/30/80
FORM NO. 6
TOWN OF SOUTHOLD
Build;ng Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF
Instructions
A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec-
tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal).
3.Approval of electrical installation from Board of Fire Underwriters.
4.Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, a certificate of Code compliance from the Architect or Engineer responsible for the building.
5.Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
I. Accurate survev of p~operty showing all property lines, streets, buildings and unusual natural or
topographic features.
' 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3.Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.~0 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$ i0.O0 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O, $ 20.00
5.Updated C.O. $ 50.00 Date .... (?...~.-~.,.~ .~./ ......
/
NewConstruc%ion ..~... Old or Pre exlstm ud l
.... ~ - ' ' g8 'd'ng ............ Vacant Land .............
Location of Property .................... ~_~'7 ~'5--~ ~__~--/..~..~f,,,~/C/'C~
House No, ! Street Ham/et
C.c.
Owner or Owners of Property .Y' .~.e'. ?.~ .~...~...~..-~?..v-J.~.,, [~. ~.k[.q c. ~ .........
County Tax Map No. 1000 Section ~'~ Block '~ Lot..
Subdivision Filed Map No -- Lot No
Permit No.;~..~..~.~../.2T-Date of Permit ~.-.Z. 3. 7.~/'7
.Applicant ................. ~ .......... .~..
Health Dept. Approval ....... ~.//~. ............ Labor Dept. Approval ...... --j¥/(~, .............
Underwriters Approval ........................ Planning Board Approval ..... ~./.~C ............
Request for Temporary Certificate ..................... Final Certificate .... ~ ..............
Fee Submitted $...~.~.~'...~C-~.. ..................
Construction on above described building a.~rmit me~s a/~d.~es and regu
lations..
App cant
Rev. 10-10-78
3 ? 5/
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR,
P.O, BOX 728
TOWN HALL,
SOUTHOLD, N~Y, 11971
TEL. 765-1802
,C E ,R T I F I C,,A T I O N
Date
Building Permit No. ~.q~__.~,~Z----
OwnerLC~z~g~//a ~'0~ //~'~z~ ~f~CCO~C
(please print)
Plumber ~qtc ~ ~L -~D ~O~o~J
' < ' ' (please print), %, > ~ '
I ce~tif~ that the solde~ ~s,ed in the ~ater supply system
contains less than 2/10 of 1% lead.
Sworn~ to before me this
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 7, 1997
R&R Home Improvements & Building Inc.
P.O. Box 676
Greenport, N.Y. 11944
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
XX 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.
XX No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 24264-Z (KEOGH)
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
ENGINEERS LETTER REQUIRED REGARDING HEADERS & GIRDERS.
'k
k
/' !
,~. U'..~ ~ .......
67855 CR 48
Greenport, NY 11944-2248
July 21, 1997
CORNELIA C. KEOGH
477-0094
BLDG. DEPT.
Building Department
Town Hall
Southold, NY 11971
Re:
67855 CR 48, application for permit
Filed 6/97 by Craig Richter, R & R Bldrs.
Purpose: approx. 17' x 6'8" addition to ne cor of dwelling
I am handicapped and for the past 3 years have been unable to
avail myself of tub baths, which are the only facilities available
to me in our home.
The purpose of this small addition, which would in no way detract
from our present east sideline of the dwellinG (merely "square
off" the northeast corner thereof) is to provide me with shower
facilities and a small panty area off the kitchen.
I am aware of the workload of your department and the fact that
the staff does its utmost to issue applications in a timely manner.
We have obtained the necessary financinG and are ready to have
the work proceed, subject to obtainin~ your permit.
I would sincerely appreciate anything that can be done to expedite
the processing of this application and the issuing of the permit.
Cornelia C.
THE NEW YORK BOARD OF FIRE UNDERWRITERS :t
BUREAU)OF ELECTRICITY
r-- 85 JOHN STREET, NEW YORK, NY 10038
THIS CE~IFIES THAT
o~y t~ el~tric~ ~uipment ~ ~scd~ be~w a~ i~t~uc~ by t~ applicant ~ed on the a~e application nu tuber in t~ prem~es of
C. KE~H, 67~55 CTY, RO~ 4~, (PANTRY & BA~'H ~DIT, ), GREENPORT, ~
inthefollowlngloeation; ~ S~,ement ~ IstgL ~ 2nd FL OU~' S~Ho.33 BloOM Lot lg
~s e~aml.ed o. NOV}~I'~}ER 26,1997 a.d fou.d to be i. complia.ce ~ith the NaSo. al Electdcal Code.
flXTUlE L [ [ ' FIXTURES' r RANGES C~KING DECKS ] OVENS ]DISH WASHERS EXHAUST FANS
G,F.C.I~-2
BOX 215 /~.NN
SOtYDIOLD, NY, 119'11 Per IIGENERALMANAGER
This certificate must flat be altered in any manner; return fo the office of the Board if h~correct. Inspectors may be identified by their credentials.
COPY FOR' BUiLDING'DEPARTMENT. q~HIS coPY~ OF CER'~IF[CA]~E MUST NOT BE 'ALTERED 1N ANY MANNER.
765-1802
BUILDING DEPT.
INSPECTION
[ ~FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
765-1802
BUILDING DEPT.
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] FIREPLACE & CHIMNEY
INSPECTION
I~~OUG/
REMARKS:
[ ] FINAL
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
] F~DATIONlST [ ] ROUGHPLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACE & CHIMNEY
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ]FRAMING
[ ] INS.~JL-ATION
[ ~'"~1NAL
[ ] FIREPLACE & CHIMNEY
INSPECTOR
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~eOUTHOLD, N.Y, 11971
BOARD O~ nm= ....
3 SETS OF PLANS ............
SURVEY .....................
CHECK ......................
SEPTIC FORM ..., .............
TEL.: 765-1802
- '~/72 ~ MAIL TO;
Examined ...... Z/.~.~4..., 19 g. / , ~, _~ .-
Ap.roved ....... "3 ..... , ~./~,~o ........... ~ . ~- ............
(
APPLICATIO~FOR BUILDING PERMIT
NOTIFY //
7. 2 .....
INSTRUCTIONS
a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of l&yout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work,
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department 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 3emoval or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Sigrlature o~ applicant, or name, if ~ corporanon)
~ . (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder.
Name of owner of premises
(tis on the tax ro~l or latest deed)
If a~licant is ~orp~a~on, signature of duly authorized officer.
..........
Builder's License No... l ~ ~ ~ 1.. ~ ........
Plumber's License No. ~[g~¢. ~.W ........
Electrician's License No. ~.
Other Trade's License No ...... ~. ..........
1. Location of land on which proposed work will be done ...................................................
House Number Street Hamlet
County Tax Map No. 1000 Section ..... 33 ........
Subdivision ................ (~'aifi~) ................ Filed Map No ............... Lot ...............
2. State existing use and occupancy of premises an~ intended use and occnpancy of proposed construction:
~- ~ ~ ~ o~y ...... t .~-~)7...~e,;&~ ....., ..............................
b. Intended use and occupancy ....... · ..................................
,~, Nature of work (check which plicable): New Building Addition r,..~ Alteration
4. Estimate'd Cost./.,...~ .'~ ~ ~ , ~ ............ Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling u
If garage, number of cars ......
6. If business, commercial or mixed
7. Dimensions of existing structures
Height .... ~;.~. ....
..... 1 ..... Number of dwelling units on each floor,.,.. J ...........
5. specify nature and extent of each type of use ........ ~".., .~ ....
Front ..... .-~..; ..... Rear .... ,~ ....... Depth .'.. ~ ?,- ......
HeighL,....l. Of. ....
9. Size of lot: Front ...~.. ,~..
10. Date of Purchase ........
11. Zone or use district in which
12., Does proposed comt?uc~ion violate
13. Will lot be regrlided ....... ~.o,.
14. Name of Owner of premises [{~-.*,~
Locate clearly and distinctly all
property lines,
interior or comer lot,
Dimensions of ~am{l?tmcture with additions: Front ..... 3 ........... Rear .... ~,o.
Depth ...... .......... .. ..... ......... N mber ofSto es ........ , .....
Dimensions of entire new construe Front ..... ; Rear .... O .......... Depth .., .I.'7..'~ .....
of Storie~,.. ........ ~ ...........................................
·,. Rear ...................... Depth .......... .. ..........
......... Name of Former Owner ............................
~ted ............ ~ .......................................
law, ordinance or regulation: , .~.. ...........................
............... Will excess f'fll be removed fro~ premises: . Yes
.. Address 67 .~.~}-,..~.~ ..e~..,~.~pPhone No .............. ...~.
Name of Architect ................ Address ............ ,,. ,,... Phone No ................
Name of Contractor . ~,~. ~ ........ Address ~ .O..}l*.r~ ~7.l,./.~, ~.. :. Phone No...~/."7.'{
15.Is this property located within 300 feet of a t~d~wetland? *YES..,~,.
ilf yes, Southold Town Tr~tstees .Permit may be required.
PLOT DIAGRAM
whether ex{sting or proposed, and. indicate all set-back dimensions from
r or description according to deed, and showy street names and indicate whether
STATE OF NEW I¢ORI~/) ./] ,. ~ ' ~'.
COUNTY O~'a.
eisthe ............................... · .......
(ContraCtor, ~gent, ~a~; ;,ffic;~,'et;.) ......................
of said owner or owne~, ~d is duly authorized to_~?rform or have perfomed the ~aid work and to m~e and file this
application; that all statements contaned m this app,lication are true to the best of his knowledge and behef; and that the
work will be perfo~ed in t~e m~ner set forth in the[application filed therewith.
Sworn to before me, his~,
...... ..... .......
Nota~ Pubhc ...... County
' ~ JAN~ E. ~k~
Note~ Public, StYe ~ ~ ~ ......
No. ~31~9, Surfak Coun~ ~ ' .