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HomeMy WebLinkAbout23206-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Nall Southold, N.Y. u~KTIFICATE OF OCCUPANCY No Z-24267 Date APRIL 8~ 1996 THIS CERTIFIES that the buildin~ REPAIR Location of Property 540 FRANKLINVI?~.~ RD. LAURELf NEW House NO. Street Hamlet County Tax Map No. 1000 Section 125 Block 3 Lot 1.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 26~ 1995 pursuant to which Building Permit No. 23206-Z dated JANUARY 4~ 1996 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate ie issued is STRU~ruIu%L REPAIR TO FLOORS & GIRDER SUPPORTS IN EXISTING ON~ FAMILY DWI~AING AS APPLIED FOR. The certificate is issued to FI~EDA ~UES'£~R & ORS. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL INSPECTION CERT. PLUMBERS CERTIFICATION DATED Rev. 1/81 ~10B6~ - ~c~ ~3~ ~996 Building Inspecto~ FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HN.L SOUTHOLD, N.Y. N~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL COMPLETION OF THE WORK AUTHORIZED) Date ..~', .............................................. 23206 Z CounlyTaxMap No. 1C,00 Section ...... ~,,',,,~,,~.... Block .......... ,~ ......... Lot No, ..../..~..,~... .............. pursuant to application dated ,.,,,,,E~¢¢~-,,, ,~...~. .................................19..~ ,~,,,,,,,, and approved bythe Building Inspector, Ee~ $.~.~.... .... .................... /Building Inspector Rev, 6/30/80 ~. ~. APPLICATION FOR CERTIFICATE OF OCCUPANCY T~O~:SO~'M~) -- TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 Ao 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: I. Final survey of prcperty 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. 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 i. 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, A~ditions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $IOO.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~.~/~.f~.,! ........................ New Construction .......... Old Or Pre-existing Building. F~ ................ Location of Propertyl..~.~C~ ......... ~.~.Ylk~.~l~--..~ ........ ~ ~ ........... House No.-- ~,/CY~%)~ . -~_' ~ _, ~Ha~et Onwer or Owners of Property .~~r.~,~Z~ .~ .~'~. ~O~S~ r.+~ ~$, ...... County T~ Map No 1000, Section.,~ ....... Block..a ............ Lot.2~.~ ................ Subdivision .................................... Filed Map ............ Lot ...................... Permit No~.~.~ .~-....Date Of Permit..(/.~-l~.~- ..... ApplicantD~D.~¥~g'. ..... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~ ...... Fee Submitted: $ .~..~. ~ ~.~ .................... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Tefephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 2, 1996 Ms. Nancy Kormendl Box 403 540 Franklinville Road Laurel, NY 11948 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) 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 # 23206-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. IEL]5% INSPECTION REPORT DATE COFRKENTS 'OUNDATI ON (]ST) NSULATION PER N. Y. STATE ENERGY CODE -'OUNDATI ON (2ND) ~ou~ Fm~,m & II 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMI~NG J.~JI. ATION FINAL [ ] FIREPILACE & CHIMNEY RI'MA.KS". ,/~/~/~. /~S~¢.~' ~/'/~, / ' //- (516) 286-6642 ELECTRICAL INSPECTION SERVICE, INC. 375 DUNTON AVENUE EASTPATCHOGUE, NEWYORK 11772 ___ 1CIB64 Data 3-],3-96 APPLICATION No, ON FILE ADDRESS: 520 Franklintown Road ISSUED TO: Hr. F,. KOJZmendl VILLAGE.L Laur el TOWN: INTRODUCED BY R~ne H~acock LIC. NO.__ o~_3~___- was examined on 3-1 3-9 6 and found to be in compliance with the National Electrical Code. LOCATION XX BASE. XX 1st. 2nd 3rd Attic Pool OUTSIDR, RES. DE'[. GARAGE HOT TUB FIXTURE RECEPTACLES SWITCHES G.F. C, I. DIMMERS FANS AIR. COND. 6 4 6 1 DISHWASHER DRYER CLOTHES WASH, GAR. DtSP, RANGE t OVEN t SMK. DET. FURNACE OIL GAS CIR, MOTORS BELL TRAN, SERVICE DISCONNECT 1 150 OH Service Change President This certificate must not be altered in any manner. InspeFtors may be identified by their credentials. ~..~'"'""~-~'"'"'~'~WN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL4 765-1803 ...... ,,o. . bisapproved aJc ................................... ................................ ' ' . (Bulling ln~etor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS · 3 SI&TS OF PLANS "CHECK SEPTIC FOItH CALL .......... ~ ...... II^IL TO: Date ,. ~' 19 f a. ' Tiffs application must be completely filled iu by typewriter or iii iuk and submitted to the Buildhlg luspector, witl sets oJ' plans, accurate plot plan to scale. Fee accordiug to schedule. b. Plot plan sbowblg location of lot and of buildings ou premises, relationship to adjoining premises or public stre or areas, and givhlg a detailed descriptiou of layout of property must be drawn on the diagram which ts part of this ap catiou. c. The work covered by lmd~ applicaUou Illay ltot be couuneuced before Issuance of ~uJldhlg Penuit. d. Upon approval of this application, the Buildiug Inspcc{or will issued a Building Penni[ to the applicant. Such per~ shall be kept on the premises available for Inspection throughout rite work, e. No bulldlug ~ball be occupied or used tn whole or in part for any purpose whatever until a Certificate of Occupm shall have been granted by the Building Inspector. APPLICATION IS IIEP, EBY MADE to tile Buildhlg Department for the issuance of a Building Permit pursuant to Buildlug Zone Ordinance of the Town of Sou[hold, Suffolk County, New York, mid oilier applicable Laws, Ordinance: Regulations, for the cons[mc[ion of buildings, additions or alterations, or for removal or demolition, as herein descrik The applicant agrees to comply with all applicable laws, ordinauces, building code, bousiug code, and regulations, ant admit attthorized Inspectors ou premises and in buildiug for neees, sary fnspectious. (Sil~%re of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicaut is owner, lessee, agent, architect, engineer, geueral contractor, electrician, plulnber or buih · ©up. .e c,z rT. .................................................................. a,neo, ............ ............. I[ applicant isa corporation, signature or duly authorized officer. '~w~ ~ (Name and title of corporate officer) Builder's License No .................... Ph,,,,ber's License No ....... ;., Eleclncm I s License No ........ Other Trade's Ligm~se No .... ',, ...... COMPLE~ FO~ C,O, CONSTrUCTiON SMALL CONSTRUCTION & ENERG~ Location of land on which proposed work will be doue ............ ::"-;37;$.. · N¢Fr..~E$PONBIB~:E · .r~ ....... ........................ 1, ..... ............. I louse Number St reel Hamlet CouutyTHxMapNo. 1000Sect{om, .. ock ......... ~.,,~.. Lei ..... < ...... Subdivision ..................................... Filed Map No ............... Lot ........... (Name) State ex{sting use and occupancy of premises cud {uteJ:ded uso and occupancy of proposed consiru~fion: a. Existing use and occupancy . .~e.~j~<.< .................. ~ ....................... ~ .... b. lJ)Jo{)ded Use and occupancy ~ .................. ~.~,,-~., , 3. Nature ofwo~rk (check which applicable): Ne~ Bnilding .......... Addition .......... Alteration .......... Repair . .~... ......... Reinoval .............. Demolition .............. Ofllar Work ............... 4. Eslimated Cost .... 0 ....................... . ........ Fee ...................................... (to be paid on filing tills application) 5. If dwelling, nnmber of dwelling nnils ... ~. .......... Number of dwelling units oil cecil floor ................ lf garage, numberof cars ,, ................................. ~ ..................... , ........... ,.. 6. If bnsiness, commercial or mixed occupancy, specify natnre and extent of each typ~ of use ................... ?. Dimensions ot~xlst!~g~tmctures, 11' ally: Front. ~ ,-,'~.~ ....... Rear ...."~i ....... Depth. ,~.0,~ ......... Dimensions of satori'structure with alterations or additious: Front ...-~.'¢../~.-.~. ...... Rear ........ Depth ...................... lleight ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ..... r.~/'.¢~:~... Rear ............... Depth ............... lleigbt ............... Number of Stories . .., .................................................... 9. Size eliot: Front ...................... Rear ...................... Depth ...................... 10 Date of Purchase . Name of Fenner Owner I I. Zoue or nsc district in which premises are situated ..................................................... 12. Does proposed constrnctlon violate any zoning law, ordinance or regulation: . ¢¢.~.KA .......................... 13. Wilt lot be regraded ......................... .... Wilt excess till be removed from premises: Yea No 14. Name of Owner of premises .................... Address ................... Phone No ............ - Name of Architect ......... ~; ............. Address ................... Phone No Ns,ne of Contractor. ~¢',,~',~...A. ?~.¢. ........... Address ..... , ........... ?hone No ........... 15. £¢ Ellis property within 300 feet of a tidal wetland? ~Yos ..... ~.. N~.., ,~F~...' ~I[ yes, $outhold Town Trusteee Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. THE rFATE OF NEW Yo. rdL . ~ ~C ct.. ~~z [ ..................... being duly sworn, deposes and says that lie ia the applicant ~ (Name of indtvldnal signing contract) bow named. ~lg IS ......................................................................................... (Contractor, agent, corporale officer, etc.) ~f attid owner or owners, and ia duly authorized to perform or bare performed the sam work and to make and file tbls pplicadon; that all statements contained in fids application are trne to the best of his knowledge and belief; ami that the york will be performed in tho maker set forth in lhe application filed fimrewitb. ;~om to before me this ' / sco , ~. 472~89, Suffolk 6ou~ Term ~ May 3~. 18~ ~ (Signatnre of appltc;mt)