HomeMy WebLinkAbout23262-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24916 Date MARCH 5, 1997
THIS CERTIFIES that the building REPAIR
Location of Propert~ 4633 STILLWATER AVE.
House No. Street
County Tax Map NO. 1000 Section 137 Block 3
Subdivision Filed Map No.
CUTCHOGUE, N.Y.
Hamlet
Lot 6
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 14, 1996 .pursuant to which
Building Permit No. 23262-Z dated FEBRUARY 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 REPAIR EXISTING WORKSHOP AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
VINCENT ANNABEL & ORS.
N~A
N/A
FOgM NO.3
TOWN OF SOUTHOLD
BUILDING D~:pARTMENT
TOWN HALL
$OUTHOLO, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED]
Date FEBRUARY 27 t 19.9..6. .......
23262 Z
Permission is hereby granted to:
VIItCERT AI~NABEL
4300 STILLWATER AVE.
CUTC~OGUE, NY 11935
REPAIR TO EXISTItlG WORKSHOP AS APPLIED FOR.
at premises located at ......... .4..6..3...3....S.TILLWATER AVE..NJ.~....,...C...U..T..C..H..O..G..U..E. .....................
Court, Tax Map No. 1000 Section ........ !}J ............ Block ......... } ............... Lot No ........... .6. ................
pursuant to applicaflon dated FEBRUARY 14, 19....9..6. ......... and approved by the
Building Inspector.
F ^ 35 00
ee ~ ......... ," ...............
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATIOM 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/I0 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. 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 of Certificate of Occupancy - , .25~,
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Location of Property ...... · ............ ,'~f~..".~¢(~..~ ...................... ~~
House No. Street
CountyNe 1000, .... ..... .. .... ............
Subdivision .................................... Filed Map ............ Lot .......................
Permit Xo..~.~. ~.~.¥.Date Of permit.~.~/~.~-.?.~-...Applicant- ~ ~'~'' ....
Health Dept. Approval .... ~.~.. J ............... Underwriters Approval...~/~.-~. ................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ............................. f~~~ ' ' ' ~/ ~ /~_~.JJ ,
Coz
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
March 3, 1997
Vincent Annabel
4300 Stillwater Avenue
Cuthogue, NY 11935
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
XX
not on file. (Enclosed)
No Underwriters Certificate on file.
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 # 23262-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
I'*(EI.I) I~I~pI'~(.;L'JOI~I J*,l~[~()l{*l' D^'I't'~
I~()ll(;ll I"l~^~'ll~ &
I FISIII.AT 101'1 I'EI~
STATE
COI)I~
F I~l^l.
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATIONlST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ]/U~ULATION
[ [~] FINAL
[
REMARKS:
] FIREPLACE & CHIMNEY
INSPECTOR
FEB I ~. 1996
FORH NO. I
TO~N OF SOUTltOLD
BUILDING DEPARTHENT
TOI4N HALL
SOUTtIOLD, N.Y. 1197 I
TEL: 765- 1802
BOARD OF HEALTIt ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORt4 ...................
NOTIFY:
CALl ...................
NAIL TO: ............
APPLICATION FOR BUILDING PERHIT
INSTRUCTIONS
a. Ibis application must be completely [illed ia by typewriter or ia ink and ~itt~ to
3 ~ts of plus, ~ate plo~ pl~ m ~ale. F~ ~co~i~ to s~le.
b. Plot pl~ ~i~ l~ti~ of lot ~ of ~ildi~s ~ ~s, ~laci~ip to ~jolnlng ~s or ~lic
struts or areas, ~ givi~ a ~tail~ ~ripti~ of l~t of ~rt~ ~st ~ dr~ ~ ~ di~ ~i~ is ~rt of
this ~li~ti~.
e. ~ ~rk ~ ~ ~is ~lieati~ ~ ~t be ~ ~fo~e isle of ~ildi,g Pe~it.
d. U~ ~al o~ ~is ~li~ti~, t~ ~ilfli~ In--tar will is~ a ~ildi~ ~t to the ~lleat. ~d~
~t ~all ~ kept ~ fl~ ~s ~ailable for in~ti~
e. ~ ~ildi~ ~all ~ ~i~ ~ ~ in ~ole
~ ~1 h~ ~n ~at~l ~ ~ ~ildi~ I~tor.
a.I~ I~ l~ ~ to t~ ~ildi~ ~r~nt for ~ isle of a ~ildi~ Pemit ~nt to the
~lnti~s, f~ t~ ~st~ti~ of ~ilgi~s, ~iti~s or alterati~s, ~ f~ ~ or ~liti~, as ~in
(~ri~. ~ ~lie~t ~s to ~ly with all ~lieable 1~, o~i~en, ~ildi~
..............
(Siam of ~licmt, or ~, if a co~rati~)
State ~etber applicant is c~rer, less~., agent, ard~itect, engineer, ~ral c~tract~, electricia, pl~r or ~il~r.
~ o~ ~, o~ ~ ........ ~~ ..... ~6 ...........~ ...................
(as ~ ~ t~ mi1 ~ latest d~)
applicant is a corporation, signature o£ duly ~tbori~l officer.
and title of corporate oiEicer)
Builders License No ..........................
Plumbers I icease No . . .
Electricians License No ......................
Other Trade ' s Liconse NO
I. Loeatlon o~ land on ~hiek proposed -.~ork rill be done ........... <: .................................................
.... ....................... .4 ......... x ..... , .................................................
Ilonse limber Street ,
9alxli~iaion ...................................... Filed ~ ~ ................ ~t ...............
2. $tat~ aisti~ u~ ~ ~ o[ ~i~s ~ int~ ~ ~ ~ of N~ ~stmeti~
~. ~,a~ ~ ~ ~ ..~A~:~:...~...e2'..~..~'~e~...e~a¢~~-- -"-- :~ -~-' ~" - ----- ~---~ .................
..{
i%lure q~ ~ll~ (cl~ed~ ~nidn ~pplic'e
I~pair ff~r~/~[~_. .... I~evat ..............
Es £ i,~Kc~l Cost .. (~..//~.;.. L ............
I'k.~ Ik~i hling .......... /~kli t ion .......... Alteration ..........
l)ennl i t ion ............ Other I&)~ ..................................
(I~ript i~)
(to Im ~id ~s filiag this fl~l. icati~)
its ............ tll~i~r of ~k~lling traits ~ each flor ................
If garage, aa.~i~er of ears ......................................
I}inenai~xa of ~iating atnm~rea,i if any: ~t ................ ~ar ............... ~ptb .................
I~i~t ......................... ~dmr of Stories ......................
Dinunai~a of sam slam.ire ~ith ialterati~m or ~kliLiona: Front ............... I~ar ...............
~pLh ................... '. I~i~t ] .................... Kldmr of Stories ...............
~ or u~ district in ~lid~ prmd am
~a propel c~mt~ti~ vJolat~ any ~lin
~a this p~rty within ~ f~t 6f a tic~l
PI.OT I)IAGllAH
l~x.'ate clearly end distinctly all {buildings, ~hether existing or pro~s~l, m~l i~licnte all ~t-I~k dimnsions
proi~rt'y li~s. Oi~ st~t a~l b]~k n~ccording I:o ~1, a~ dt~ street ~ms a~l i~llcate
interior or co~r
765-1802 9 AM TO 4 PM FOR THE
FOLLGW~NG ~NSPECT{ONS:
FOUNDATION . '~O REQUIRED
FOR POU~ED CONCRETE
/? / c o
]~;E REQUiREMEnTS OF THE ~
STATE CONSTRUCT{ON & ENERGY
CODES. NOT RESPONS BLE FOR
= ~~[ DESIGN O~ CONST~uCTION E.RO~S
~ ...l~ing duly ~rn, delx)~a m~l anys that he is the appli~nt
in I '
lie I.]e ............................ ,! ......................................................................
(Cz)at. factor, egent,.co~l~rate officer, etc.)
applicatio,s; that all stat'~eta contaii~l in this n[~)lieat ion are tt~ to the ImsL of his kl~l~l~e aiKI l~Jief~ alii
Ihst the ~)rk will I~ I~rfom~l in lb0 ~ma,~r ~L forth i. tho applicatinn filed
.......... .......
CLAIRE L. GL,EW
Notary Public, State of New York
No. 4879,505 { /9 ,
Qualified in Suffolk County ~(.~
Commission Expires December 8, 19-~ ~
(Sig~iture nf Applicant)