HomeMy WebLinkAbout22974-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OC~umANCY
No Z-24183 Date
FEBRUARY 26~ 1996
THIS CERTIFIES that the buildin~ ADDITION
Location of Property 1255 WEST COVE ROAD
House NO. Street
County Tax Map No. 1000 Section 111 Block 3
Subdivision Filed Map No.
CUTCHOGUE ~ N.Y.
Hamlet
Lot 13
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 14~ 1995 pursuant to which
Building Permit No. 22974-Z dated AUGUST 28; 1995
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 DECK ADDITION TO EXISTING ONE FAI~ILY DWELLING AS APPLIED FOR
The certificate is issued to BARATI~EFI~%N
(owner)
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
//Building Inep.ctor
FORM NO.3
TOWN OF SOUTHOU)
BUILDING DEPARTMENT
TOWN HAU,
$OUTHOLD, N.Y.
Ne 22974 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF '[HE WORK AUTHORIZED)
Date
Permi~on is hereby granted to:
Coun'IyTax Map No. 10,DO Section ................ ./..//... Block .................... ,,~,,~, Lot No ....................
pursuant fo application dated ..... ~L,,,,~'Y..4,~,,2~,,, ,, ,,, ,/,,,,-:~,, ................................. and approved by,he
Building Inspector,
~ee ~.,..2.~.:.,~ ......
Rev, 6/30/80
Form
TO~ ~L ::0!i FEB ~31gg6 ~i
765-1802 -~ ~''~
APPLICATION FOR CERTIFICATE OF OCCUPANCY ~WN OF ~O.~J~*~O~ ~
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 Realth 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
qpre-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 ~o 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 Buildin~ - $i00.00
3. Copy of Certificate of Occupancy - $20~00
4. Updated Certificate of Occupancy - $50.00
Temporary Certificate of Occupancy - Residential $15.00, Cemmercial $15.00
New Construction ........... Old Or Pre-existing Building .................
ty ~.~.~3~. .~7~f ~ ~
Location of Proper .................
House No. Street Hamlet
Onwer or O=ers. .. . ......... .................. . .
County Tax Map No 1000, Section...~/ ......... Block...~?. .......... Lot.../.? ................
Subdivision Filed Map Lot ...............
Permit No. ~.~. ~.~..y-. .... Date Of Permit..~.~:/r.~:...Applicant.~¢.<~... ~.~. '~.
Health Dept Approval Underwriters Approval .........
Planning Board Approval .............
Request for: Temporary Certificate ........... Final Certicate ...........
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New Yo~k 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 26, 1995
John W. Reichert, Inc.
P.O. Box 1862
Southold, NY 11971
Re: Marion Mcall (S. Trefman)
Prem: 1255 West Cove Road, Cutchogue
To Whom This Kay 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 # 22974-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] I~.ATION
FRAMING [~INAL
REMARKS:
DATE
3. Nature of wink (check which applicable): New Building . } ........ Addition .......... Mteration . .../~'7; ....
Repair .............. Removal .............. De~nolition .... : ~ ...... Other Work ..............
4.
Estimated Cost
(to be paid on fiting"this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ...............
· If garage, mnnber of cars .......................................................................
6. If business, commercial or mixed occupancy, specify nature aud extent of.eactk.type of use ....................
7. Dinteasions of exihting structures, ii' any: Frontn ......... ~ .... Rear .............. ,5; Depth ..... ~. .......
}leight ....... /J.. ......Nnmber of Stories ..... i(./.l......... .......... i ....................
Dimensions of same structure with alteratious or additions: Front ................. Rear .................
Depth ....................... lleigl,~t .......... ~ ........ ~.. Number ~ Stories ...........
8. Dimensions of entire new construction: Front ....... ,1~. ': ....; Rear ..... :-,%.." ...... Depth .....
lleight ............... Number of Stories ........................................................
9. Size of lot: Front ......... , ............ Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner .............................
I 1. Zone or use district in wlficb premises are situated .....................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ... ~.' .O. .........................
13. Will lot be regraded ....... ; .................... Will excess fill be removed froth premises: Yes No
Name of Architi~ct ........................... Address ................... Phone No ................
i.s this property within 300 feet of a tidal wetland? *Yes ........ No..
*~If yes, Southold Town Trustees Permit may be required.
-. PLOT DIAG IL~M
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block nmnber or description according to deed, and show street names and indicate whether
interior or corner lot.
t5.
APPROVED AS NOTED
NOTtFY BUILDING o~pART~ENT- AT
~65-1802 9 AM TO 4 PM FOR THE
FOLLO~NG IN~PEO~ON~:
1. FOUNDATION - ~0 REQUIRED
FOR POURED CONCR~E
. 2. ROUGH - FRAMING & PLUMBING
3. INSU~TION
4. FINAL. - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION 5HALL MEET
THE RE~UIREMENT~ OF THE N.Y.
STATE CONSTRUCTION & ~N~R~Y
CODE~. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERROR8
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
CTATE OF NEW YO21K~ . S S
:OUNT¥'? ..... ...._ . .
.. .~ ~.~...~..... (f.~ (~. ~ . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
bore na[l~cd.
le is the ~~~ ' '
(Con tractor, agent, cor'porate officer, etc.)
,f said owner or owners, and is duly anthorized to perform or have performed the said work and to make and file this
pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
~ork will be perfo~ed iu th~er set forth in the application filed therewith. '
.worn to before me this ~ ~
..............
lota~ Pnblic, . . .~~. ~~County ~ /2 ~ ' ,~
V NOTAN~T, RY P C; State of N .... Y ...... ; ' ~ .......................... n ' '
Term E~ires May 3~. ~ 9~ ,' '
Exanlincd ............... , 19 . a.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT,.
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c ............................... ; .
B0,~RD OF tlEAL'rll .........
3 SE~'S OF PLANS .........
SURVEY ..................
CtlccK ...................
SEPTIC FORtl .............
.o~'IS¥ l
CALL .....
HAIL TO:
. (B/ZildYng Inspector)
APPLICATION FOR BUILDING PERMIT
Date ................... 19...
INSTRUCTIONS
'a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
set~ of plans, accurate plot plan to scale· Fee according to schedule.
b. Plot plan showing location of lot and of buildings on preniises, relationship to adjoining premises or public sti-eets
or ~.reas, aud giving a detailed description o[ layout of property mnst be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issnance of Building Permit.
d. Upon approval of tbls applicalion, the Building Inspector w:ill issned a Building Permit to the applicant. Such permit
shall be kept on tile premises available for inspection throngbont the work.
e. No building shall be occupied or used in whole or in part for any pnrpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bnildiug Permit pursuant to the
P, uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, m~d other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereiu described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and irt buildiug for necessary incpections.
·...'7~..~..,-z..~....o¢....~.~../.~..~'~.,<T....-Z.xr..e-. ......
(Signature of applicant, or name, if a corporation)
g .o.. ..~. .o.x. . . t?. .o.~. . . .,~.o. ~.n'/.~.~. /A , .,4,. , .~...
(Mailing address of applicant) t
State whether applicant is ownerclessee, agent, architect, engineer, general contractor, electrician, phnnber or builder.
........... ~.r~. . .~ .~. . .co.,,/z-.ze. .,e. .<. ~.4 .........................................
Name of owner of premises ....?.('?./~..Z..~?...: ......................................................
(as on tire tax roll or latest deed)
If applicator is a corporation, siguature of duly authori/.ed officer.
'ai~d and title of cort;(;rate offi~;r') .........
Builder's License No. /~3. '~3~-/' P/
Plumber s lAcense No .........................
Elect ca~sLmenseNo .......................
Other Trade's License No ......................
Location of land on which proposed work will be done. I ~- - ~, C. ~.. ~ ~¥ ,-
....... :~.i .... .., ....... . ................. ' .................. ....... -... .....
llouse Number Street Itamlet
Coun, 000 .......... /Z/ ..... mo k ........ :... ............ .....
Subdivision ' Filed ?,'lap No ............... Lot ............... (Name)
State existing use and occupancy of premises and intended ose and occupnncy of proposed construction:
a. Existing use and occupancy.. .... /~. ............... ~ -..~m.,.:,~.,~'~.,,' " ~'.~4~i~ ....................
--.. / ._. ! ._. _..,
(/<~1 / (,~'~ _/~ (~o'~ TITLE NO. ,,.~ -~ c.. Co c~ ~,,~
....
Cg'. 1o
MEASUREMENT
IN
U.S.
STANDARD
~ ~E EXISTENCE OF RIG~ OF WAYS AND/OR EASEME~S O~ HECORD, IF A~Y, NOT SHOWN ARE NOT GU~ANTEED.
THE DiMENSiONS SHOWN HEREON, FROM ~E STRUCTURES TO THE PROPER~ LINE, ARE FOR A SPECIPIC PURPOSE ONLY. THEY ALE
NOT INTENDED TO BE USED FQR ~E ERECTION OF FENCES, STRUCTURES GR ANY OTHER IMPROVEMENT.
UNAUTHORIZED ALTERATION OR ONLY COPIES FROM THE ORIGINAL GUARANTEES INDICATED HEREON SHALL RUN ONLY TO
THE PERSON FOR WHOM THE SURVEY IS PREPARED
AD~ITION TO A SURVEY MAP GEARING OF THIS SURVEY MARKED WI~ AN AND ON HIS BEHALF TO THE TITLE COMPANY
A LICENSDD ~ND SURVEYOR'S SEAL OHIGINAL OF THE LAND SURVEY- GOVERNMENTAL AGENCY AND LENDING NST TUT ON
ISAVIOLA~ONOFSEC~ON7209, SUB. OR'G EMBOSSED SEAL SHALL BE LISTED HEREON AND TO THE ASSIGNEES OF THE
DIVISION 2, OF TH~ NEW YORK STAT~ CONSIDERED TO BE VALID TRUE LEND ~G N~ITUTION.
EDUCATION LAW. COPIES. GUARANTEES ARE NOT TRANBFERABLE TO ADDI-
TIONAL INSTITUTIONS OR SUBSEQUENT OWNERS.
DATE
~-o~-~
LAND SURVEYORS~ GUARANTEED TO
W~STCH EST[ R OFFIC~ ~ ~:~ C O U NTY
POUND RIDGE, NY P.O* BOX
LONG ISLAND OEFh :~ ~ ~TCHE.~T~R AVE,
TELE~HOiJE, ~30-54~.~1Z4