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Home My WebLink About23525-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25137 Date JULY 18, 1997 THIS CERTIFIES that the buildin~ Location of Property 1780 HENRYS LANE House No. County Tax Map No. 1000 Section 74 Subdivision ADDITION PECONIC, N.Y. Street Hamlet Block '2 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 3, 1996 pursuant to which Building Permit No. 23525-Z dated JUNE 19, 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 DECK ADDITION TO EXISTING ACCESSORY INGROUND The certificate is issued to SWIMMING POOL AS APPLIED FOR. DONALD & LONRINDA STARON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Build'ing Inspe~ FORM NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N.o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ...../.z~.../..~.~.~.....?.....~ .......... ,~ ..A.~-..~.~ ....... ~ ........ ,/.......~... ....... ,o...~:~.~.....~ ........ ~~ ......... ~.....~.,..~.....~.........~ ~..~t, cz..~.o ............................ ~ .................................................................................................. J // 's ot p~mi~e~ ~=te~ ot .................. './.Z~........./.~.. ........... ~x.. .................................. ................................... . ................................ ~.~,..~...../. .............................................................. pursuant to application dated .............. ...~...'~...~-.........'~...' .................. , 19....~..~'., and approved by the Building Inspector. ~, ~...~..~. ..... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLLCATION 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 and "pre-existing" land uses: 1. Accnrate 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 $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existin~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - , .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occhpancy - Residential $15.00, Commercial $15.00 Date ..... New Construction ........ Old Or Pre-existing Building. ~ Location of Property .... ~ ].~'~ ........ '~.C~.~. ~ .J~...~.~-,,~ . House No. ~J Street Onwer or Owners of Froperty ..... . Hamlet . ........................ iC°unty Tax Map No 1000, Section .............. Block ................ Lot .... ... ............... . Subdivision .................................... Filed Map ............ Lot ...................... Permit No ...... Date Of Permit ................ ~ppzicant ..................... Health Dept. Approval ........................ Underwriters Approva] ...................... iPlanning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... . oO Fee~Submitted.., ~C~'O~ ~"~ $ ............................ ~ :.~..~.~ .~...~.~ 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 July 11, 1997 Donald Staron 1780 Henrys Lane Peconic, N.Y. 11958 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 # 23525-Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~] I~LATION/ FRAMING [~'] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONIST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [~FI~AL [ ] FIREPLACE & CHIMNEY 765-1802 BUILDING DEPT. INSPECTION [ ~FOUNDATION 1ST [ [ ].~U~NDATION 2ND [ [ ~ FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: ~~ ROUGH PLBG. INSULATION FINAL DATE Disapproved a/¢ r FORM NO. I TOIdN OF SOUTItOLD BUILDING DEPARTHENT TO~/N IIALL SOUTHOI~, N.Y. I 197 TEl,: 765-/BO2 BOARD OF IIEM,TII ............. . . ~ SE~S 9~/.V~.^NS ~ ............ SURVEY .~...~ .................... CBECI(-.4~ ....................... SEPTIC FORM ................... NOTJ FY: MAIl. TO; .................... APPLICATION FOR BUI1.DING PERNIT INSTRUCTIONS a. lids application n~mt be co pletely filled in by type~rlter or in ink and m~hMtted to the I~dldiug Inspector xdl' 3 ~ts of plea, ~rate plot plan .o ~ale. F~ accordi~ to b. PIoE plan ~ l~a~ Of lot ~ of ~ldz~s ~ ~8, relationship ~o ~joini~ pr~i~s or ~llc struts or areas, a~ givi~ a (~tai~ ~ripci~ o[ l~t of pro~r~ ~sC ~ dr~ ~ rim dia~ ~id~ in ~rt of A~.IC~.(~ IS 1~ ~ to ~ ~fildi[~ ~r~nt for the issue of a ~dldi~ Pe~ ~r~nt to the ~laCi~s, for t~ ~stneti~ o~ t~dldi~s, ~iti~s ~ atterations, or for ~al or ~mlition, as tmreln re~lations, a~ to ~it ~t~ri~ ins~tors on prmi~s aed in {Si~mre o[ a~llcanr, or ~ if a co~rarlm) (~aiti~ ~r~s o~ applicant) l{ ~' State ~Smtlmr ~licanc is ~r, l~s~, a~n~, ardd~t, engi~r, ge~ral contractor, el~rrician, plm~r or Imilder. (~s ~ tim t~ ~tt or latest d~) (~ a~ title o[ co.rate Pliers Licen~ ~ ......... ................. El~trici~s Licon~ ~ ..... ; ................. 2. State ~istlng u~ aM <~ of ~mi~s aM inte~xu~ a~ ~cu~my of p~[~ const~ction: . .... .... .................................... 't. P~flure o£ ~ozk (dmck ~d('Ji al~dlcnble): N~ I~Jihling .......... ~kliLion .......... A1, Ler~L'io~ .;' .. I~1~J ~ ............ 1~1 ............. 1~1 ilion ............ Oilier ~rk ................... ..... ~ ......... 6. [it in,itel (~ ................... ice ................................... , ........... (Io I~ ~id (m [Jlhlg lh[~ ~. [~ ([~]JJflg~ i[lll~[ o[ (~llh~ IlrtJLs ............ tl~ff~r of (~11 in~ t~lJl'~ (~ each ~1(~ ................ 6. If Ixisi~ss, ~m~rcJal or mJ~l ~q~r~y, s~c[[7 m~ture ar~ extent of each ty~ o~ u~ ...................... ~. l)ln~nsiam o~ exlsri~ S[ll~itli'~a, J~ any: [~-(~1{: ................ l~ar ............... [~pL[~ ................. l~J~l~ ......................... ~d~r o~ Stories ...................... llln~nsi~s of sam sin~m~e uith altera~J(xm or aHJLions: Fron~ ............... ~ar ............... l~pLh .................... I~i~lt .................... ~t~r of 5~orles ............... 8. l)[.~msi~ls of enLi~e i~e c~sl:n~l:kx~: F~cx~t ................ I~a~ ............... l~pth ....... ~ ...... ......................... ~(.or te~ ..................... ........ ..... .......................... 12. l~s prOl~a~l camt. n~:ti(m violete any xxxiing I~. ordil~m~se or re~tslati~: ...~.~. ................ i3. ~ill lot i~ regr~l .................... ~ill e~ess fill I~ r~ ~ in'~ni~s: ~S 14. ~s of ~r of p~ni~s ........................... ~klress .............................. ~ ~ ............... ~ of Ar~dtecL .................................... ~klress .............................. ~ ~ ....... ? ....... 15. ls this pml~rt~ within ~ [~r o~ a ti{~l ~ln~d? a ~1~ .......... ~ .~ ..... PI.OT DIAGRAH l~caLe clearly aid dlsl:|ncl:ly all I~dldi~q;s, ~hether exisl, ing or pml~l, alxl itxlicate atl set-l~k dimn~ions [-ro~l prol~rl-y liras. Give s~t m~l bilk t~d~r or (~scripti~ acco~]Jng I:o (~(I, a~l d~ atreet ~t~s m~l ialicat'e ..behql duly .,~rn, says that ho {.q tim applica.t lk: i:; t.he C_~..4.. ((~mLraetor, nge,t, corpOraLe o~Ficer, etc.) oF ~;aid ~er or ~r~, nl~l i~ duly ~n~LhorJ~ Lo Imrfom or have l~rforn~d (be Bald ~rk a~gl to nwke a~J file this IhaL the ~}rk will I~ i~rforn~l ie Ihe ,u,,~r 8et I~th in the aUplication fil~l ....... ~)t.ary l~lbl ~..~ C~tRE L. GL,~ N~a~ Public. State of New York No. 4879505 Qualified in Suffolk Coun~ 19 Commission Expires December 8, ($ |?jlal tire of Appl ica, t) 81 ,@ ob 8~ I~