Loading...
HomeMy WebLinkAbout23647-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25194 Date AUGUST 11, 1997 THIS CERTIFIES that the building ACCESSORY Location of Property 1655 OLD FARM ROAD ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 26 Block 4 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 9, 1996 pursuant to which Building Permit No. 23647-Z dated AUGUST 26, 1996 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 ACCESSORY STRUCTURE IN REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to ELIZABETH THOMPSON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A .� ` //Bui ing fnspector Rev. 1/81 WORK NO TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N° 23647 Z Date .... .. . ...... ........��................ 19../ka Permission is hereby granted to•�� .. .... L ....� t Gyres .. ..... ............................. A.7 ... .. . . z ,..... 7 ...../3a ...............Y.....!S ...Y......./.... ........................ ' ....�-G..... atp mises located at ..................10-0............. .. ...... ... ..... ................... ................................................................/.. .. ..1�.�. .. .............. ................................................................................ .f. .c •► . -.............................................. County Tax Map No. 1000 Section .......s ....... lock ...1...4...1.1. Lot No. .-I................ pursuant to application dated ............................. ... .... ..... 19AP, and approved by the Building Inspector. Fee s. 'v.. ...... ...... `%...... .. ...... .. ............... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT O 0 vY TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC roDCz , 3011 A. This application must be filled in by typewriter OR ink and submitted to 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. 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-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - .25V, 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . New Construction. . Al. . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property. .Lo'r? . . M. . . . . . . . . . . . . . . . . . . . . . . .©F.A.ITvT.. . . . . . . . . . . . . . House No. Street Hamlet Onwer or Owners of Property.. !.?!1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . County Tax Map No 1000, Section. . . 40. . . . . . . . .Block. . . .14 . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Subdivision. . f.A' KN. . .*rrpf�7 . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . .. . . . . . . . . . . . . Permit No.�?7. e4 1 :Z. . . . .Date Of Permit. ?S?:A. 21(:. . . .Applicant.1�N.Z:I .-6i-a 9PC'ON. . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . . . . . . . . . Fee Submitted: $. . . . . . . . . . . . . . . . . . . . . . . . . . It . . . . . . . g. . . . . . . . . . . . . . . (Y,Q . s32s 7 APPLICANT o��s�FFO�,�cOG Town Hall, 53095 Main Road y Z Fax(516)765-1823 P. 0. Box 1179 �y • Telephone (516)765-1802 Southold, New York 11971 X01 � dao OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 29, 1997 Elizabeth Thompson 270 Lafyaette St. #1303 New York, N.Y. 10012 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 # 23647-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. I N:;1'R( HUN Rl,l'Ull 1 1)A 11'. COMMENTS--- -- --� FOUNDATION ( 1.`;'1') FOUNDATION (2ND) tzROM'11 F RAMI? & I 0 PlAlMll1 NC _ I fUMLAT I UN PER N. Y . ;TnTr I�,NI�.RRY COM? _ i P I rJnl. \ - U ADDITIONAL (.UM ON S- . ........ .. r l \` h. L p �•3 s / � 0 4 G ;r 4 Ao* '. �G ��!V .`� \ 'fit•lw • -- c_ y "7r U L,K- GO .-fAX PA Lafayette St.ELIZABETH TH t * ARCHITECT 270 Lafayee St. Suite 1303 NEW YORK, NEW YORK 10012 (212) 274-8336 E L I Z A B E T H T H O M P S O N A R C H I T E C T 270 Lafayette Street, Suite 1303 tel. 212 274-8336 New York, New York 10012 fax 212 274-9158 ap C21 q W Ht W `l au WeTZ ©0 V 4,C A t o0j / You(L FEL4-,ow I us?E'txvR� JO H M/ Sjv'pr 'D MI M`1 `!A-a)t:. I N O P-t e m T i km i STt-a T A- B(.D4 FOP- 'r1+E GFHLbt'Ns TACE F}ot�Sti I M'A'UI Se,&v Sul LbI1J j 'n"ez- Sera M�-I-f2 � 'DES'Pt� M-1 ot3�ILc.Tt eiJS I N 0>1 '3 SATS OF D&Aw I N C1 C4. W S f T9� PC.A�u Z'EP•w► r f}PPULA no7J Bc.►9rv�. Gt} I W t t.t_. 1;6' Atw Al rev- Tl+,c Kruy-T Z v-iekncp> M`14Ag p t R uT w I tom.. 8..g 10 I-c>u LF} UFoN r-kj R.CW P-,� . IM THg M E-M.M -n M E 1 P- I N 114E F t AS(— F- 61 r-e Ej ATvb T►°►K-� A- C.00 lC_ . '�Ii'E fa,*� I S U p t Aiu --, AS THS D044to iWc1S MOTE IfC omil ADD i TI oNrj, wALt- lacF M , W i W— %C %" (.rye) W 141 TE J>L jFx r Gc.r+,, Sl4re t S H&Pe Yov fZ 71 Me IN IUgw 6AjcL4#,b wA Pftoa,?c.xl dLc �vT' Saf," IT w k U T -PA4U S 1 r i AUG 91996 s BLDG.DEPT. ��nih OF S_ O THOLD X a ' %MAsS-i Ca, I: --- I QUI Z EIN f4OH FSv1J 1 Xb �— 270 I, r-A-t6trC -ST- :2 w.`f, , 1.1,`t, I00IZr I _ I I AgavE t=eaM�N4 s'-o` i-o' 2'-d a'-o` ( Z t 2 'Z74 - 1/4 _ * A7x� i Eta ,9 P.k� 2. IL" _ — — , � SI►�1 t�IJ GFS-q'I 5'r�'l Dl .ALA, ROS1s 4 RSM s I�IY� FX/ ' .. - s� Zx�S 2XlD � L Lx� �, iC FMiI.t� 4 ZSo%a ,a, Z, ,d S, o Z oOt= 1Y�ll- �R�II INS TD x - V4 \VR trc Pt. _14 LASWof . /qtr � ..�or 1,011 41 BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOL.D SURVEY. • . - - - - • . - . . . • • • • . . - • ' • - . & k 1} BUILDING DEPARTMENT CHECK t TOWN HALL. SEPTIC FORM . . . . . . . . . . . . . . . . . . . BLDG.OEpT' SOUTHOLD, N.Y. 11971 TOWN OF SOVTHO`p TEL! 765-1802 NOTIFY: CALL . . . . . . . . . . . . . . . . . . Examined... .. P9.. MAIL. TO: . . . . . . . . . . . . . . . . . . . . Approved.. .!�19 Permit No.Of C`,/ � .................................... Disapproveda/c .............................. .................................... • ildingInspector) AP)CATION FOR BUILDING PERMIT Cc Date. . . . . `1. . . . . , 19.dd l INSTRUCTIONS a. This application must be completely filled in by typewriter 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 layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application un<uy not be ccmnenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throsg)uort the work. e. No building shall be occupied or used in whole our in part for any purpose whatever until a Certificate of. Occupancy sbtal.t have been granted by the Building Inspector. APPLICATION IS H RM- MALE to the Building Department for the issuance of a Building Permit pursuant to the ItAlding 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 removal 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 I necessary in tions. ��. . . ............... '(Signature of applicant, or .. .if. a corporatism) N;`f..r (Mailing address of applicant) . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .....----Qu?N�(�. 1} r!{lT�??�'./.rP.►?T$!19r?C�TZ................................................................... Name of owner of premises ... N? :g1':'�!�THc?;�tpSo!?............................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . • . .•-.- ••••• ---•'• (Nameand titleofcorporate officer) Builders License No. ......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. .................. F!:q"..M........................... O_ P4Etj- ............................... blouse Number Street Hamlet County Tax Map No. 1000 Section ..�(V.......... Block ... ........... Lot ..�........C . Z? -3-', MEQG�D� Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ax jj el.............................................. b. Intended use, and occupancy ......5 Poh I5 ............................................................... I_ Hatore of work (dkecc wl►id► applicable): New lk)ilding X....... MIition .......... Alteration ......... .. Reixuir ............ Removal ............. I)EmoliLion ............ Other Work .................... .............. (Description) 4. Estiiiiated Cost !............... fee ............................................... (to be paid cxh filing this appl icat ion) 5. If (k)ellirgr, nxalker of daellin>!; units ............ 11ni)er of duelling mi us on each floor ................. If garage, nni)er of cars ...................................... 6. If lxhsiness, enmhercial or nixed occupancy, specify nature and extent of each type of use........ .............. 7. Dimensions of existing strictures, if any: Pront................ Rear ............... Depth ................. Ik wit ......................... Mai)er of Stories ...................... Dinhensions of sane structure with alterations or ackliLions: Front ............... Rear ............... DelAh .................... Ileiglkt .................... Maher of Stories ............... 1 t3. Diuhensians of entire new construction: Front ...6.t...... .... Rear ...6.r........ I)epti► ......... h Ileigl►t .....115................. Maiker of Stories .. ! ................ � r 9. Size of lot: PYnnt ... 160 ........... Rear .....?�.Z0.r.......... Depth ..z$�............. 10. lkhte of Purchase ...[is :............ Nuke of Former Owner � ..14!Q(Jy.................... If. 7.cxie or use district in which premises are sihiated ............................+.``.................................. 12. Does proposed constrx.tion violate any zoning law, ordinance or regulation: ..1.+;.................. 13. Will lot he regraded ....M P............. Will excess fill he ram wed from premises: YES 14_ wanes of Owner of pranises r klZ.�.�}�4Y1 ►o�?...... Address P0.. L�gE►`I ft[��T.,.�134�. Plxxne No. Z I ........ Natne of Architect ..........._�?I�' ................ Address .N. .!. �Y... I�tZ...... Z�4'ts336 PI hone No. . N:me of Contractor ...........�+' ................ A(klress ...............................I9xx)e M). ........... 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO . ,7� ,..... *IF YES, S(Al'111)(1) 'ID14N 'I1A SIM"i PEII[117' MAY I93 le p1ItIqD. PLOT DIAGRAM I<x.-ate clearly and distinctly all buildings, ul►ether existing or proposed, and indicate all set-hack dimensions frun prolxe►t:y lines. Give street and block rrni)er or description according to deed, and show street nines anxi indicate %Acether interior or corner lot. C (3 .� APPROVED AS NOTED DATE;-94Z ELP.#o;2 FEE: 1'i BV6. NOflFY BUILDING OE 765-1802 9 AM TOE FATFOLLOWING'NSPECn1ONS: FOR OCCUPANCY OR 1' FOUNDATION FOR POURED CONCRETE REQUIRED 2. ROUGH - FRAMING & PLUMBING 3.USE IS UNLAWFUL 4. FINAL anON BE COMPLE'CTEONSTRUCT1pNMDST WITHOUT CERTIFICATE '41-L CONSTRUCTION SHAD. MEET THE REQUIREMENTS OF THE N.Y. slnD: or MV Y(X(K, 9 i; CUPANCY STATE CONSTRUCTION & ENERGY NOT RESPONSIBLE FOR .......... DESIGN OR CONSTRUCTpp: pS a......... a -.................. ....being duly sworn, delx)ses arxl says that he is the, applicant: (N-ane- of individual signing ccxhLract) above mmied, Ikeis (lie .......... ..... .................................................................................. ((:ontractor, agent, corlx)raLe officer, etc.) of: said owner or oxrhkers, anxl is duly authorized to perform or have pcerfornied the said work and to make arid file this application; that al.l sLataneots contained in this alq)lication are true to the best of his knaal.edge and Ixil.ief; ahxl that the work will be performed in the manner set forth in the application filed therewith. Bourn to before nhe this .......( ........ .clay of19. .. .f� Notary Pul)li .. .. .... !".. .......... J' Notary hubllc,Stale of New lbrk (Sighk►Cure of.Al)p1icaac) No. 314898057 Ouallfied In New York County Commission Expires June 8, 19W