HomeMy WebLinkAbout23481-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25684
Date: 04/24/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 38785 MAIN RD EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 15 Block 8 Lot 1.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 10, 1996 pursuant to which
Building Permit No. 23481-Z dated JUNE 6, 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 ACCESSORY PLAYHOUSE AND SWING SET AS APPLIED FOR.
The certificate is issued to DANIEL L FISCHER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
"//~ldin~/inspector
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25683
Date: 04/24/98
THIS CERTIFIES that the building
Location of Property: 38785 MAIN RD
(HOUSE NO.)
County Tax Map No. 473889 Section 15
Subdivision Filed Map No. __
ALTERATION
EAST MARION
(STREET) (HAMLET)
Block 8 Lot 1.1
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 10, 1996 pursuant to which
Building Permit No. 23481-Z dated JUNE 6, 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 REPLACE EXISTING COVERED PORCH AND ALTER GARAGE TO FAMILY ROOM IN
EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to DANIEL L FISCHER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N 451194 04/22/98
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
FO~,e NO. 0
TOWN OF SOU'J3.1OLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Rev. 6/30/80
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Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION 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 Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings amd
Ppre-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, Sw~ming pool $25.00, Accessory building $25.00,
'" Additions to accessory building $25.00. Businesses $50.00..
2, Certificate. of Occupancy on Pre-existinR Buildin~ - $I00.00
3. Copy pf Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Construction ........ Old ur ~r~-ex~sti%g Building. ~.. 'k' ..... LA~ .......
Location
of
Property.
House No. Street Hamle~
County Tax Map No 1000, Section .... J ....... Block ..... ~ .......... ho[ ................
Subdivisiom ........I ......................... :..Filed Map ............ Lo~ ................ f~ ....
Permit
No
Date
Of
Permit..
Underwriters Approval .......
Approval ..................
Health Dept - --
Planning Board Approval .
Request for: Temporary Certificate .......... .. Final Certicate..~. ........
Form No. 6
TOWN OF SOUTHOLD
BUILDING 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 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 Buildinm - $100.00
3. Copy pf Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential ~15.~0, Co~ercial $15.00
ate ....
New Construction ........... Old Or Pre-~isti. ng Building .................
oc t on of ..... ......... . ..............
House No. Street Hamlet
Onwer
or
Connty T~ ~p ~o lOOO, Section...,~. ........ ~l ............. ............
Filed Map Lot -- · ~''
Subdivision ........
Fermit ................ Bate of pe it. .
Approval Underwriters Approval · ·
Health Dept ...........................
Planning Board Approval ........................
./
Request for: Temporary Certificate ........... Final Certicate.~.. .......
Fee Su mitre .............................
1~0~ NO. 0
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-~N? 2130J Z Doto ....'~../.4.~ .......................................... , ~.Z'.,,~
...... ~...~ ............................................
premises I~eted et..~..~.0.~2 ........ 5([:.,...,....~/~/ ...%~5 ...................................................................
· ..~ ....... ~ ......................... ~...:...~.~...:~:~ .................................................................................
'~ ~"~"::'"":~:':::::~"::::~:':"~:;"~:"'":.'~':'~': ..........
~:~ ":. . ........................................
pursuant to application dated ........................................................ , 19 ........ , ond approved by the
Building Inspector,
~e, $.../../.~.,.~
Rev. 6130/80
FOUNDATION (1st)
FOUNDATION
2nd)
<
ROUGH FRAME &
.?LUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL
COMMENTS:
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
September 27, 1995
Mr. Daniel Fischer
38785 Main Road
Orient, NY 11957
Re: Building Permit #21304-Z
Premises: 38785 Main Road, Orient
Suff. Co. Tax Map #1000-15-8-1.1
During a review of our
building permit has expired,
never been issued.
files it was noted that the above
and a Certificate of Occupancy has
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Thomas J. Fisher
Senior Building Inspector
NEW YORI'
~ . 8~, NEW
THIS CERTIFI~R THA~
only the electric~uip~t ~s ~ri~d ~eim a~ ln~ro~uc~
~ Ist FI.
OF FIRE UNDERWRITERS
BUREAU OF= ELECTRICITY
YORK '10038
fil~ 0~6~8~92/92
;pplication number ih t/~e premises of
Block Lot
FIXTURES
FLUORESCENT
DISH WASHERS
NO. OF
2/0
1/0^'w'°'
275 TONN H~RBOR l,~
This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspecto~ may be identified by their credentials.
OF: CERTIFICATE MUST NOT r~_, AI~TERED IN ANY MANNER.
~0~r NO. ~
TO~VN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHOAIZED}
N~_ 19152 Z
Permission is hereby granted to:
..... .~..~..~....~..~..
to
pursuant
Building
Map
C) i~'~ Block ....... ..O... ~ ... Lot No...J ....................
doted 'ii ....... ~}, ~....~ ............. , 19..~...~.., and approved by the
Building Inspector
Rev. 6/30/80
£4'00~
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~/O/N
,./
.i,
THE OF
~ 40 FULTON STREET, NEW YORK, NY 10038
~ APRIL 22,~998 ~c~. ~o. o.~1~ 15863298/98 N 451194
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the ~ove applica~n number is in the premises of
D~/EL FES~R~ 38785
in the following locaaon; ~ Basement ~ 1st Fl. ~ 2nd Fl. OUT Secaon Block Lot
was examined on ~RI~ 09, ~99~ and found to be in compliance with the Naaonal Electrical Code.
FIXTURE ~ECEPiAC!.ESI FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS I ~['dO~SCEm OrHB~
DRYERS
SYSTEMS
NO, OF FEET
E R V I C
OTHER APPAR~US:
*NO VISUAL D~FEDTS~ "An electrical
sul-vey has been made of the exposed
electrical equipment in the
premises indicated." "No obvious
unsatisfactory condition was found.
GENERAL MANAGER
This certificate muff not be altered In any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. ,
PAUL R, BURNS
PO BOX 1061
SOUTHOLD, NY, 11971-G932
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST~NOT BE ALTERED iN ANY MANNER.
'" ~ BOARD OF HEAL,T,H ............
f~ 3 sETS OF PLAdS ............
' IIVJI III .................. ...
I1~11 ~ ~ ~ ~111 ~o~ OF ~OUTHOLD ClI~C~....... ' ..
~~OLD EL: 7G5-180~ CAgL
, ~- ~?Z~ _ . . .........
Examincd..~.~ .... , lP~ ~ HAIL TO: _ _ . ''
. . ...........
..................................... ..........
(BoNding Inspector)
APPLICATION FOR BUILDING PERMIT
Date .. [ ........... ·
INSTRUCTIONS
a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building IhSPector, with
sets of plans, accurate plot plan to scale. Fee aCCording to schedule.
b. Plot plan sho~ving location of lot and of bulldogs on premises, relationship to adje/nlng prcm~ or public streets
or areas, and aiv~g a det~led descriptio~ of l~yout of property must be drawn on thc diagram which~ of t~s
' ca~on.
c. Thc work covered by tMs application may not be commenced before issuance oi BuUding Pe~i~ - '
d. Upon approval of this application, the Building Inspector will issued a ~uilding Pc~it to thc app~ Such pe~it
sh:ll be kept on the premises ava~able for inspection throu~out the Work.
e. No build~ shall be occupied or used in whole or in part for any purpose whatever until a Cc~fi~ of Occup~cy
shall have been 8r~ted by ~e BulldOg Inspector.
APPLICA~oN IS HEREBY MADE to thc Build~ DepOnent for the ' , · · · '
~jle.apph,can~ agrees to COmply with all appiicabI~ laws. ordinan~.~ ~..aJ;.. _'~ ? o[ dcmo~,~on. = ~,.m des~bed.
aumlt authorized ~s~ect . .~; ..... ~ :_ ~..:,~- ~ _ .... .~a=~= u au, ~gusln~ cOQ and ~Ilons. and to
(Mailing address of applic=t)
State wh~ther applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder.
........... ~.
(as on thc tax roll or latest deed)
If applicant is a co~oration, ~ignature or duly authorized officer.
· State existing ose and Occupancy of premises and intendcd use and occnpancy of proposed constructio~ · --
a. Existing usc and occupancy ;..
b. Intended use and occupancy
Plumber's License No. ~'
Elcctrkian's Hcensc No. ~ ~ ~
Other Tradek ~cense No ......................
Location of land on which proposed work will be done; '
ouse Nun her Street .........................
'- Hmnlet ' *'
Coumy Tax M ~ N ~ 1000 ~ rio ~ff. ' ' '
................ Lot.
u v on .............................. ~ ...... Eilcd Map No.
(Name) .............. Lot ...............
Tennis Court ~ ....... Accessory ~u£Zd/.ng .......... ~e,ce ...... · Oc~~. .~/~ o*~... _~..
Estimazed Cost ~0o 0, ~
.I (to be paid on filing this application)
If dwelling, nmnber of dwclling unit~ . / ~
......... ; .... Number of dwelling units on each Floor .............
If garage, number of cars ........ i ..........................................................
Ir business, commercial or mixed ocFupancy, x~ccify nature and extent of each type of us~ .............
H~ight ....... ~.~ ..... Numhcr?f Stories . . .~ .............................................
Dimension~ of same st~ctur= wit~ alterations or additions: Front . .~ ¢0~ ~f~-'. Rear ........... '
Depth ...................... HeiSt ....................... Numbor of Stones ....................
Dimensions of entire new construct{on: Front..~o~dd..qi. Rear ............... Devth .......
Size of lot: Front ......... ~ ........ Roar ......... Depth ~.e~ ~...
Date of Pure~ase ~ .............
i ia 7"i?d Li&;i'a .... S m= or o = Ow= ....... ..........
Zone orus~ distric vhic r i r ~ .~g<~ ..........................
~,~es proposed Construction violat~ any zoning law, ordinance or regulation' ~ .............
Wmiotb= g =a a · .' · '
~, .. + ................ Wdl exceos~ll be remove~ from prem~aes:
~m= orO,~n=r orpremises ~AO~a~ d.T~ec~<~f~ddresx ~ ~TZ. ~r/eo. L'.. Phone No ~rd.q~..~ ..
N~eof Architect ........ i --- ,
15.Is thzs property locate~d ~ithln ~00 feet of a .tidal uetland~ ~lgS .... ~O~.
~If yes, Southold ~oun ~runtees Permit may be required.
PLOT DIAG~M
I.
Locate cle~ly ~d distNetly ~I buRd~gs, whether ~xisting or propos=d, ~d. indicat~ ~1 set-back a~tnsions from
prope~y Enos. Giw street ~d b~ock number or description accord~g to deed, ~d show street n~es and ~di~
int~Nor or comer tot.
STATE OF NEW YORK,
COUNTY OF.. .
.............................. ' ................ being duly deposes and says that he is tho applicant
(Name of individual signidg contract) ... sworn,
above nam'ed.
He is lite '
; (Contractor, agent, corporate officcr, etc.)
of said owner or owners, and is dulyiauthorized to pe.rform or/lave performed the said Xvork and to maize and file this
aPplication; that all statements contaified in this application are true to tile best of Iris knowledge and belief; and that the
Work will be perlbrmed in the manner ~ct forth in the application filed therewith. /,
Sworn to before me this j .'~
No, 4707878, ~tf~k G~m~-., (~Jgflatur~ of applicant)
BOARD OF IIEALTI1
FO~S .o ~ s~'rs O~f~.A~s ~ ..........
BUll. DING DEPAR~ENT CIIECK .~ ......................
,O,~NO~...~. ~9~
TEL: 765-1802 NOTIFY: .
/ ~ ~n. ~o= ....................
....................................................
..................................
~PPLI~TIO~ FOR B~ILDI~G ~E~IT
a. ~his application namt be cmpletely filled in Ir] typewriter or in ink and anhnittad to tim lkdlding Inspector with
3 sets of plans, accurate plot plan to seale. Fee according to schedule.
' h. Plot plan abowing location of lot and of beildings on premises, relatiom~ship to adjoining premises or public
streets or areas, and giving a /~ailed description of layont of property namt be drawn on the diagr~n ~hlab is part of
this application.
c. llm ~ork covered by this application n~y not be ccramneed before issuance of Building Pennlt.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
pemit shall be kept ¢m the premises a~ailable for inspection thrcnghont the work.
e. No building shall be occupied or used in whole or in part for any parpoee whatever until a Certificate of
Occupancy shall have hean granted by the Building Inspector.
APPLICATICtt IS l~[~f MAtE to the l~dlding Department for the issuance of a Building Pemit pursuant to the
Building Zone Ordinance of the Town of Sonthold, &fffolk Cxamty, New York, and other applicable Laws, Ordinances or
llegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein
described, alto applicant agrees to conply with ail applicable la~s, ordinances, building code, housing code, and
.... .................
(Signature of applicant, or nam, if a corporation)
(NaHing address of appllcant)
State whether applicant is o~er, les~e, agent, arddtact, engineer, general contractor, electrician, plmber or builder.
......... d~ .~.¢../, ......
.ises ......... ..................... ........
(as on the tax roll or latest deed) ' '
If applicant is a corlxrration, signature of duly antt~orized officer.
(Nm~ and title of corporate officer)
Plurrbers License No ..........................
Electricians IAcenae No..~.~...~. ~.....~'. ......
Other Trede'~ License NO .....................
I. Lacation o[ lard on ddch propa.~t ~ork will I~ done ..............................................................
~ 'r~ mp ~. ,~ ~i~ ..... /~ ....... ',,~k ..~ .......... ,~ ...d,.d: ........
~ivisi~ . . Fil~ ~ ~ ........ l~t ...............
(~)
2. State existi~ u~ a~ ~ of pr~i~s ~ inte~ u~ ~ ~ of p~ ust~ction:
a. ~isting ,~ a~ ~ ..... ~.(~.~. .~.'. .~.df(~..qX~ ...............................
b. Intem~ ~ ~ ~c~y ~a~ ~
3.
lO.
ii.
13,
15.
· Den) ition'('../.~Z?~?~g'-/¢'.. Oiimr
............ ............
~l.i,~llal ~ . ~.~ ............... ~a ...................... Vi ........................
&~llins, ~nli~r of (kmllil~ uai~s......../ .... l~i~r of &~lling units ~l each fl~r . ...............
garage, ~l*i~r of cars ......................................
I~mhmss, c~m~rcial or mi~l ~m]Im[~y, s~cif7 ~ture a[~l exEenE of eacl tylm o~ u~ ......................
r ~ ....
I)iueimiom cfi ~isEing atr~Lurefl, ie any: ~ri~L ................
t~i~,~ ~ .................... a.,i~ o~ SL,,,-i~ .~: ..................
I~plh .................... I~i~lE .................... Rlll~r og Stories ...............
~i~ ,,~ ~o. ~,~ .~-0. ............. ~.~ ...~.q.~ .......... ~p,, .~~ ......
Z'
7~ or u~ district in ~dd~ p[anisea are ai~at~l
I~a pro[x)~l ~ml r~ti(m violate an] ~ming h~ ()~di[~e
~ill lot I~ ferried .................... Wilt e~eaa
............................ ; ................. 1~ ~. ..
~.~ el: ,~.,~,,~,.o~ 9~ 0,~/~,~ ~,~,, ..~ ......................... ~,o,~ ..........
..................................
this p~rty ~itllin ~ll f~t of a titht i~tla~17 ~ ~1~ .......... ~ ~ .........
PLOT I)IAGRAH
Iix:ate clear'iF aixl distinctly all Imiidiags, ~d~etJmr exisl:Jeg or proposed,
Prou pr()perty li~es. Give strl.~at mai blc~zk Ix~tmr or descriptitm according to de
~d~etlmr interior er coruer lot.
s~l ip~licate att set-lmck dineasions
M, m~l shoe street nines'taxi ir~licate
as alxl says that lie ia tile appl iCalil.
^ppi '.enl. }
,'~2nt Io before#~d this
........ ....
~ [.: Y~LENE O. HORNE
; NOtaff Publio, Slate of New York
,' , No 4951364
Ik; i8 the ...~. ................................................................... i ............................ ~ (Cz) LracLtr~ abe ~ (orxrUe offlte , el.( )
apldicaL~ that all statamnta conL'ai~xal in this flpplit.ation ere t'rl~ to lite I~;l: of his ktx~l~ge
Ilmt Lite ~)[k will. I~ l~r~onl~l in the ,ureter sec forth in tile appl ica[ion fil~l[tlm~iLh.