HomeMy WebLinkAbout23831-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25510 Date: 02/02/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 500 SEAWOOD DR SOUTHOLD
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 88 Block 2 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 12, 1996 pursuant to which
Building Permit No. 23831-Z dated NOVEMBER 27, 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 DETACHED GARAGE AS APPLIED FOR.
The certificate is issued to GEORGE F FAETH
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N414012 03/14/97
PLUMBERS CERTIFICATION DATED N/A
zL 9-
h
Bu' lding Inspector
Rev. 1/81
FORM NO. 8
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° 23831 Z Dote ./.I� .......................................... 192.
Permission is hereby Ont d t :
Ae
.:.................
to . .... .. ........ .....
. .. ................. ... . . ......... . . .. ..,..............................................
:..... .. ...
at premises located at � "'
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......................................................................��....9.................................................................... ..................
County Tax Map No. 1000 Section ........Gl...e.... Block ...... ......... Lot No. .....k.............
pursuant to application dated .... ...................................... 19... E and approved by the
Building Inspector.
af
Fee $.A1.4
, s
..................... ........ ........ . ............. ...
��..............
Buildin nspector
Rev. 6/30/80
lorm No. 6
T014N OF SOUTHOLD
3UILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. 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 17 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.
3. 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.
Fees
1 . Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool 525.00, 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 - .25-i�
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
iew Construction. . . . .. . . Old Or Pre-ex
rPre-existing Building. . . . . . . . . . . . . . . . .
.ocation of Property. . . . �QQ. . . ,nFLJOODWSVE. . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
House No. Street Hamlet
)nwer or Owners of Property. . . . . . . . . . .OE , . . eO... F�:.r.. . . . . . . . . . . .//. . . . . . . . . . . . . . .
:ounty Tax Map No 1000, Section. . . #. . . . . . . .Block. . . . . . . . . . . . . .Lot. . . . . . `e. . . . . . . . . . . . .
ubdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . .
II '�77 i
•ermit No. . .2.3831 -F,-. .Date Of Permit. . //.: —Applicant. . . . . . . . . . . . . . . . .
iealthDept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Tanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . .
request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . .� . . .
ee Submitted: $. . . . . . . 2 s.DU
"x . 5 APPLICANT
cu,-r? .,7 5 ri til I
Ole_
o
Gym
Town Hall, 53095 Main Road y Z Fax (516)765-1823
P. O. Box 1179 Telephone (516)765-1802
Southold, New York 11971
ajo� � dao
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 29 , 1998
George & Dorothy Faeth
P .O. Box 872
Southold, New York 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
fXX An application for Certificate of Occupancy is
not on file. (Enclosed)
XX 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 # 23831-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
`IrPORT DATE
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M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN ATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE S CHIMNEY
REMARKS:
DATE _INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ "] F UNDATION IST [ ] ROUGH PLBG.
[ FO NDATION 2ND [ ] INSULATION
[ FRAMINGFINAL
[ ] FIREPLACE S CHIMNEY
REMARKS:
DATE 2, INSPECTOR
THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1
1195099 BUREAU OF ELECTRICITY
F 88 JOHN STREET, NEW YORK, NY 10038
%Date MARCH 14,1997 Application No.on file 13475197!97 N 47.4012
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premixes of
GEORGE FAETH, 500 SEAWOOD DRIVE, SOUTHOLD, N.Y.
in thefollowinq location; ❑ Basement ❑ Ist FL ❑ 2nd FL GAR .Section Block Lot
was examined on MARCH 04,1997 and found to be in compliance with the National Electrical Code.
FIXTURE FCFPTACLFS FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS
SWITCHES OUTLETS INCANDESCENT FLUORESCENT I OTHER I AMi I K W. I AMT. I K W I AMT. K.W I Ami X.W. AMT. H.P.
8 J 7
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS
AMT. K.W. OIL H,P. GAS H.P AMT. NO. A.W.G. AMT. AMP. MAI. AMPS. TRANS. AMT H.P SYSTEMS AMT. WATTS
HOST FEET
SERVICE DISCONNECT NO.OF $ E __R V 1 C E
AMl AMP TYPE METER I X tW 1 0 3W 3 9 3W 3 F IW NO.OF CC COND A.W.G. NO OF HIA A.W.G NO OF NEUTRALS A'W. .
EQUIP. PER.B' OF CC.COND OF Hb LEG OF NEUTRAL
OTHER APPARATUS:
JIM SAGE F1:EC. INC, I:TC.#.3635-•E � L L
MARINE PLACE
.1REEMPORT, NY, 1.1044 GENERAL MANAGER
17.
3S 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.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
i
BOARD OF HEALTH . . . . . . . . .
FORM NO. 1 3 SETS OF PL\YS . . . . . . . . .
TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CIIECK . . . . . . . . . . . . . . . . . . •
TOWN HALL SEPTIC F0RM . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NaTIFY ;
Examined CALL
CALL
�
•, 19 •W !•MAIL TO :
Approved . . . ./. Y.�. . . . . ., 19?�. Permit No. -a 3- . . . . . . . . . . . . . . . . : :.
Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building nspector)
low �mlixsl APPLICATION FOR BUILDING PERMIT `ltq
Date . l�/ ��6. . . . . . ., 19 . . .
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 stieets
or areas, and giving a detailed description of layout 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 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 for necessary i spections.
. . . . . . . . . . . . . . . . . . . . . .
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises RaK Tll
(as on the tax roll or latest deed)
Ifapp is a torpor t' signature of duly authorized officer.
6me an'd title of corporate officer)
Builder's License No. . . �. .?.7. . Z . . . . . .
Plumber's License No.
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
I. Locatilonn of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . : . . . . . . . . . . . . . . . .
�. . . . . . . . . . . . . . . . . . . S�/ywaa00 OJ el . . . . . . . . . . . . . . . . �aTf/e cQ
. . . . . . . . . ... . . . . . . . . . . . . . . .
House Number Street Hamlet
County Tax Map No. 1000 Section . . . :Q . . . . . . . . . Block . . . . Z. . . . . . . . : . . . Lot . . . . . . . . . . . ... .:. .
Subdivision . . .S h.G�oo t�, , , , ,'f�/��S . . . . . . . . . . . Filed Map No. . a S 75 . . . . Lot . . .. . . . . . . .
(Name)
1 State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . .. . . 404/,f LC ii! .(
b. Intended use and occupancy . . . . . . . . ... . . . . . k k�<<� '� , C
3. Nature of workcheck which applicable): New Building . . .X, , , Addition . . C l/ Alteration
Repair ( moval . . . . . . • • •
. . . . . . . . . . . . . Demolition . . . . ; . . . . . . . . . Other Work . . . . . . . . . . . . . .
oc� o'
(Description)
4. Estimated Cost . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
S. If dwelling g units . , . . !t!0!!�` , , , , . Number of dwelling units on each floor . . !�/�`I , , ,
o, number of dwelling
Ifgarage,numberofcars ;'J W- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. . .
. . . . . .7. Disensions �fexistin structures, if any: Front . . . .�?,� , , , , , , , Rear 9.` Depth . .' .;.S. ".'
. ". . 'Heiht ¢ mberofStories . . . . .owe . . .
'
Dimensions of same structure with alterations or additions: Front
t � 6�. .`. . . . . . . . . Rear . .�a.`. . . . . . . . . . . . .
Depth ions o',, mire n cons,. . . Height Front
. . .�.�. . . :. . . . . . . . : . . Number of Stories . . . GN !4. . . . . .I. . . . . . . . .
8. Dimensions of entire new construction:
ruction: Front . . . . . ,b , . , , . , : Rear . . .q-g. . . . . . . . . . Depth .4l%Y . . . . . . . . .
Height .ao
rttber of Stories . . . . ...QN. , , (}No yq1.
9. Size of lot: Front . . . . . la°. . . . . . . . . . ..: . . Rear . . . . .L9°. . . . . . . . . . . . . De th . . ./, s'a% . . . . . . . . . . . . . .
10. Date of Purchase 8,x(4/ ,� �, • , , , . Name of Former Ownerj vD�rm
11. Zona or use district in which premises are situated . , , . .lekk,-f e I,r¢c ' ' ' ' ' ''�eN�•
12. Does proposed construction violate any, zoning law, ordinance or regulation: �o
13. Will lot be regraded . • NO . . Will excess fill be removed from premises: Yes
. .�
14. Name of Owner of premises !h/I�eSRr ,ear?%€.F!1RTH, ,foo °
yr y Address . SRppoyo r?R.u� , phone No. 7.65:P??;¢
Name of Architect • . . . . . . . . . . ., , , , , , , Address . Phone No.
Name of Contractor �o,,P, , ."reffc . Address a�syS /9,iv- M 9el � 3 3rj?
15. ' Is this property within 00 feet of a tidal wetland? �< • Phone Na ,
Yes. . . . . . . . No.,X. . . . . .
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and.indicate all setback dimensions from
property lines. Give street and block numberQQp�1escnption according to deed, and show street names and indicate whether
interior or corner lot, foo " NIC rd 5 , z`° ;7,k,
ayr hb
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STATE OF NE �,�_
R S.S
COUNTY O NN, ,o, /. . . .
y •signing• •�"`Y/ • being duly sworn, deposes and says that he is the licant
(Name of individual s�gng contract) pp
above named.
fie is the . :. . ... . . . . . . . . . . .
� on rac agent, corporate officer, etc.)
if said owner or owners, and is duly aI thon3Ld- orm or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief;and that the
York will be performed in the manners t forth in the application filed therewith.
;worn to before me this
l � . . . .day of. . .1 0.✓.
'otaryPu ic. . .. ! County
Nptar f'{ibiT A111a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ELIZAB . 1I ANS! Eyll.Lt (Signature of applicant)
Y w York'
fUra, 6860,Suffolk Coin. .
Tars Expires October 3T;, 190TL .
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