HomeMy WebLinkAbout23460-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OG~umANCY
No Z-24418 Date JUNE 11, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 1580 NORTH BAYVIEW ROAD
House No. Street
County Tax Map NO. 1000 Section 70 Block 12
Subdivision Filed Map No.
SOu'£~OLD NY
Hamlet
Lot 34
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 6, 1996 .pursuant to which
Building Permit No. 23460-Z dated MAY 21, 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 AN "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to
DONALD ALBINSON & ORS.
(owner's)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/A
N/A
N/A
Rev. 1/81
~/i~ding I~spector
FORM NO.3
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALl.
$OUTHOLD, N.Y.
N_O
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED]
Date ..................... ~Z, ......................... 19..~..~.,.
23480 'Z
Permission Is hereby granted to:
....... .......
.... ~ ...... ~..~r ............. ~ ......... ~~.....~.. ............................................
County Tax Map No. 1000 Sectio,......,~.....~.'. ............ Block ......... ../'..~.. .......... Lot No. ......~.~.... ...............
pursuant to application dated ......../~......~ ....... ~. ............................. 19....2.~.,..., and approved bythe
Building Inspector.
FeeS..?~ ........
Rev, 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
~kPPLICATION 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 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 Appzopal of completed site plan requirements.
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 Building - $100.00
3. Copy o[ Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .... ~¥.~.J~ ..........................
Deck (1974)
New Construction ........... Old Or Pre-existing Building .................
Location of Property J~P NPr~D PPYYJ?~[~'~PPJ.,. ~PP$b°3~
House No. / Street Hamlet
- DonaqdAlbinson and ElizabethAlbinson, WilliamAlbinson and Ch[ijy!~]~i~?~
Onwer or Owners of ~roperty .....................................................
County Tax Map No 1000, Section..~q .......... Block .... ? ........... Lot ...... ~. ...............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No ................ Date Of Permit ................ Applicant .............................
Uealth Dept. Approval .......................... Underwriters Approval .........................
Plaaning Board Approval ........................
Request for: Temporary Certificat~ ........... Final Certic~/~/.
Fee Submitted: $...2~.00... ~.~.0~, ~,
P.O. 80X 706 .....
CUTCHOGUE, L,.,
APPLICANT
U6 I ~
CI)I)I&
I 011^1. C()IIIII&tl I'.~:
%\
EXHIBIT
A
BLDG, OEP[
TOWN 01~ SOUTHOLD
/'
BLDG. DEPT.
TOWN OF SOUTHOt. D
Disapproved a/c ........ ........ ' ....
BOARD OF IIEALTIt
FORMNO. 1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVSY
BUILDING DEPARTMENT CIIECK
TOWN HALL SEPTIC FOlt,'l
$OUTHOLD, N.Y. 11971
TEL.; 765-1803
· (B/a'ildj~ h/Il(peeler)
APPLICATION FOR BUILDING PERMIT
t:OTl FY:
CALL
HAIL TO:
Date . .M.a.y..6., ....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to tile Building Inspector, with
sets of plans, accurate plot plan to ~cale. Fee according to schedule.
b. Plot plan showing location.of lot and of buildings on premises, relationship to adjoining premises or publ/c st?eel
or areas, and giving a det.'filed description of layout of property must be drawn on the diagram which is part of tbis appl
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 permi
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 Occupanc:
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issua,~e o a)Building Permit pursuant to th,
Building Zone Ordinance of the T6wn of Southold, Suffolk County, New York./m&.cr {er applicable Laws, Ordinances o
Regulations, for the construction 0f buildings, additions or alterations, or for/~'l~v,~l~ ,r d~emolition as herein described
'File applicant agrees to comply with all applicable laws ordinances, building/c~dd.~', .~(o ~code, and regu at OhS, a ~d t~
admit authorized inspectors on premises and in building for necessary inspec¢'~.¢¢// /-
-" ~ (Signature 6~applicant, or name, if.0 corporation)
Gary rlanner u isen as Attorney TOt .
Donald Alb:inson and William Albinson
(Mailing address of applicant)
P. O. Box 706, Cutchogue, NY 11935
State whether applicant is owner,: lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..... &!;toroey. for, .ow0er,s ....... .....................................................................
N~me of owner of premises .D°n.a!d..A!b.i.n.spn..a.n.d.E.1 j .za..b~.t.h .A.l.b!n.s.o.n, .W. iJ !i.a.m.A.l.bj .ns. qn' .an.d..Ch.r.i.s.t!n.e' .Al.b.i.n.s?. ...........
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ....... ~ ..................
PI m~ber s License No ..... ~ ........ ......... :
Electrician's License No.
Other Tr, de s L~cense No. i
Location of land on which proposed work will be done ..................................................
1580 North Bayview Road: Sou. th'o. ld.
llouse Number : Street Hamlet
C ty p N tli 70 12 ' L 3.4
ouu Tax [,.la o. 1000Sec.on .. .......... .... Block .................. et. .. ...............
SubdMsion ..... . ....... j ..... . Filed Map No. Lot
i(Name) ,
State "' '
exmtmg use and occupancy, of premises and intended use and occupancy of proposed construction:
I(!9.7.4) .
Exi ting d cy Deck a.s b.uilt ',
Deck as built (1974) ~.
b Intended use and occupancy . ........ '
3. Nature of work (check which applicable). New Building ......... Addition [Seek Alteration : .........
Repair .............. Removal .............. Demolition .............. ethel-Work ...............
$,5,00 00 ' (Description)
4. Estimated Cost ..... · ............................... Fee ~:
"~ (to be paid on Filing tiffs application)
5. lC dwelling, nnmber of dwelling units ............... Number of dwelling units on each floor ........
· If garage, number of cars ........................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures if any: Front ........ Rear . Depth
I Ieight ............... Number of Stories .... ' .........
Dimensions of shine structure with alteration or additions: Front
................. Rear ..........
Depth ....................... IIcight ........... . ........ ' .......
;.. Number of Stories ......................
8. Dimensions of entire new coustmction: Front ............... Rear ............... Depth ...............
~-~, ................ nmber of Stories ...............
>. Size of lot: l"ront .................... Rear ...................... Depth ........
10. Date of Pnrchase ............................. Name of Former Owner ................... '
l 1. Zone or use district in which premises are situated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation:
Will lot be regraded ....... '. .................... Will excess fill be removed from premises: Yes No
[4. Name of Owner of premises .................. Address .................. Phone No ................
Name of Architect ........................... Address ................... Phone No .................
Name of Contractor .......................... Address ................... Phone No ................
5.' I.s thi~,i~roperty within 300 feet of a tidal wetland? *Yes ........ No .......
yes, Southold Town Trustees Permit may be required. ''
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
)roperty lines· Give street and block number or description according to deed, and show street names and indicate whether
nterior or corner lot.
See attached survey of'Anthony kewandowski dated April 23, 1996 showing wood deck. as built.
Said survey being designated as Exhibit A. Upon information and believe deck was oomStructed
' in 1974.
APPROVED AS NOTED ·
DAm I :6Oa-
NOTIFY BUILDING DEPARTMENT AT
785-1802 g AM TO 4 PM FOR THE
' FOLLOWING INSPEGTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
~. INSULATION
4. FINAL - CONSTRUCTION MUST
RE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MElT
THE REQUIREM~:NTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
. DESIGN OR CONSTRUCTION ERRORS
'ATE OF NEW YORK,
)UNTY OF. SU.F.FOL ......... s.s
Gary Flanner Olsen
............................................... being duly sworu, deposes and says that he is the applicant
(Name of individual signing contract)
eve named.
is the ......... A. ~. t. o. r. n. e.y.
(Contractor. agent, corporate officer, etc.) ~ ' ..........
said owner or nwner~, ,a, nd is duly anthorized to p,c,'rform or ~ ye performed t ~e saki wm'kxand to'make and file this
~lication; that all statements contained in this application are true to tile best of his ki~/wled~e and belief, and ti at
rk will be perle.ned in thc manner set forth in the application filed therewith. ~ ~ , I thc
om to before me this~, / //
............. ..... '...day ................. /
................................. ~ounry / ~/~,
~/ LORRAINEKLOP~R ' -'~ ~ ~/ ~
.- ........... ..... .....................
Ou~lm~in Su~ol~ ~ (Signature of applic~t)
GARY FLANNER OLSEN
COUNSELLOR AT LAV, I
RO. BOX 706
MAIN ROAD · CUTCI-IOGUE, LONG ISLAND, NEW YORK ~1935 · PHONE 516-734-7666
FAX 516-734-7712
May 6, 1996
Re: Albinson to Carbone
Our File # 6002
Dear Gary:
As per our meeting of this morning, I am enclosing herewith
the following:
1. Application for Building Permit for deck as built.
2. Application for Certificate of Occupancy for deck
as built.
3. Check payable to the Southold Town Building Department
for building permit in the sum of $75.00.
4. Check payable to the Southold Town Building Department
in the sum of $25.00 for CO.
GFO:lmk
Enclosures
Very truly yours,
Gary Fish, Building Inspector
Southold Town Building Dept.
Main Road - Town Hall
Southold, NY 11971
CEMC
P 92
MAIN ROAD~;ELIC CENTER
P.O. BOX 786
· MATTffUOK, NEW YORK 11952
BUS. (s~s)
FAX ($16)
Southold Town Building Department
Attn: Gary Fish
Dem' Ga.-y,
May 6, 1996
RE: Albinson permit for de~k
In reference to the permit application filedrt~0day by Gary F, Olsen, EsR. for his client
Donald Albmson, attached please find a sl~teh of the deck with a descriptmn of
materials. Please letme know if there is an~ing I can do to help.
Sincerely,
Tom Uhlinger
An Indepertdentiy Owned and Operated Member' o! Coldwell Baflke! R~sidentiat Affiliates, [nc.