HomeMy WebLinkAbout22994-zFORH NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26652
Date: 08/25/99
THIS CERTIFIES that the building ACCESSORY
Location of Frc~erty: 240 ORIOLE DR SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 55 Block 6 Lot 15.13
Subdivision Filed Map No. __ Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 25~ 1995 pursuant to which
Building Permit No. 22994-Z dated SEPTEMBER 6~ 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to RICHARD A & BETSY A pERKINS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. H 047056 09/20/95
PLUMBERS CERTIFICATION DATED N/A
Suing Inspect
Rev. 1/81
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
N~
BUILDING PERMIT
[THtS PERMIT MUST BE KEPT ON THE PI~EMtSES UNTIL FULL
COMPLE'IION OF THE 'W~DRK AUTHOR[ZED]
Date ........................................................... 19 ......
22994 Z
Pe~mlssion Is hereby granted to:
.... ~/~ ........... ~:a~.~.~ ............ ~ ......... ~~:~"- ...... ~, ................
at premises located at ............ ,,~,..,,,..,~. ..........................................................................
................................................................. ..................................................................
CountyTax Map No. 1000 Section .....%~ ,0~. ........ Block ........ ,.(~,. ,~. ........... Lot No ..... ../..,.~..~.../.~.. ......
pursuant to applicalion dated,,..,~.,..4~....~.,...-C'../..'~...,....~.: ........ ] 9...Y.~.',..r .., and approved bylhe
Building inspector.
Fee $..../.. ....... : ..........
Building Inspector
Rev, 6/30/80
Form No. 6
TOIgN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN
765-1802
TO'~,~; QF SO~,Ti4QL',D
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
iuspector with the following: for new building or new use:
Final survey of property with accurate location of all buildings, property lines,
streets, and unusual aatural or topographic features.
2. Final Approval from Health Dept. o[ water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
t,. Sworn statement from plumber certifying tbat the solder used in system contalss
less than 2/10 of i% lead.
5. Commercial butldin, g, industrial building, multiple residences and similar bu[].dh~gs
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site pies requirements.
For exls~tng buildings (prior to April 9, 1957) non-conforming uses, or buiidi.gs smd
"pre-existing" land uses:
1. Accurate survey o[ 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 eppl~cmut.
Ifa Certificate of Occupancy is denied, the BulIding inspector a}~all state the
reasons therefor in writing ta the applicant.
C. Fees
i. Certificate of Occupa,cy - 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 buiIding $25,O0. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm -
3. Copy of Certificate of Occnpancy - .25~
4. Updated Certificate of Occupancy - .~50.00
5. Temporary Certificate of Occupancy - Residential $~5.OO, Commercial $15.00
D~te ........................................
Sew Go~strtctfon ......... Old Or Pre-ex~sttng Bu~ld~ng .................
' Iocat~on or Property ~¢ ~/g/~
House No. Street Ha~et
.... .....................
County Tax Map No logo, Section...~ ........ Block. ~ .... Lot .~/~
Su~d ivision .................... Filed Map ............. I ..............
llealth Dept. Approval ...................... .. . . Underwriters Approval ....................... . ,
Planning Board Approval ........................
Request for: Temporary Certi[lcate ........... Final Certicate .........
~ C_- ¢~qq APPLICANT
Town Hall, 53095 Main Road
P.O. Box I179
Southold, New Yoxk 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Fax (516) 765-1823
Telephone (516) 765-1802
October 2, 1998
Mr. & Mrs. Perkins
P.O. Box 1894
Southold, New York
11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of tho 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.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22994-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
80~%~7% BUREAU OF ELECTRICITY
r~ 85 JOHN STREET. NEW YORK, NEW YORK 10038
Date ?~,.P~]~f~-E1~. 20 ~ [995 App~icatlon No. onfile [~[~0~/9~ H ~47~5
RIt. HA~D & B~SY PERKIN,:, 24~ ORIOI~ D~ SOl'HOLD, N.Y.
thefollowlng locatlon; ~ B~ement ~ Ist FL ~ 2nd FL OU~ Section Bilk Lot
SEPTE~ I2 1995
examined on ' and /ound to be in compliance with the NaHonal Electdcal Code.
FIXTURE FIXTURES RANGES OVENS EXHAUST
1 i
DRYERS TIME CLOCKS DIMMERS
S E R V I
OTHER APPARATUS:
SWI~ING FOOL- 1
TtHE CLOCKS-AI4P. 40~1
G.F,C,I-t
+{SWI~f/NG P~L) This certificate
covers oompliance at the date of
i~spectJo~ only. Because of unusual
~vironments it is advis~le to
bare freq%%~nt tes~/~d or r~pairs
made by a quaJified i~erson.
<,'< Coht.'.nued oD Paq,TM- 2 >>>
GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials,
COPY FOR BUILDING DEPARTME~T Tt'~'~$ CQ~¥ OF C,~CTfF~ A'~"E a,'~'JaT/',lOT BE ALTERFr~ IN a~v ~a~m~=m
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
SS JOHN STREET, NEW YORK, NEW YORK I003S
THIS CE~IFIE~ THAT
RICHARD & BETSY PERKINS, 240 ORIOLE DRIVE, SOUTHOLD~ N.Y,
~s examin~ on ~ EPT~ER 12,1995 and found to be in compliance with the NaMonal Electrical Code,
Lot
FIXTURE FIXTURES RANGES OVENS I DISH WASHERS [ EXHAUST FAF
DRYERS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
S E R V I C
NO OF CC. COND
PER ~'
NO OF HI-LEG
AWG,
OF HILEG
NO OF NEUTRALS
24_~ ORIOLE DRI\~
SOUTHOLD, NY, 1.1971 GENERAL MANAOER
rhis certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials,
FIE1,D 1NSPgCYION REPOR][ DA'I'I~ ~ ~ ~-
FOUNI)AI' ION (IS'T)
F R^~-IR
SUBDIVISION- MAP OF
O~ ~ ~,/h ,~
N. 88' 57" $0' E. ~.o'
"IiMMEDIATE
ENCLOSE POOL TO
UPON COI~
~BEFORE
LOT
ORIOLE
ELEVA l-IONS ARE REFERENCED T'O AN
ASSUMED DA TUM.
LOT
AREA
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
DRIVE
The waler supply and s~
~yslems for Ihls res/den
lo lhe ~tandard$ of The
Oep~rlmenl of Healft~ $~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNr)ATION 1ST
[ ] FOUNr)ATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ] iNSULATION
[ ~NAL
[ ] FIREPLACE & CHIMNEY
DATE
765-1802
BUILDING DEPT.
iNSPECTION
[ ] FRAMING [~ FINAL
[ ] FIREPI. ACE& CHIMNEY
DATE '
I NSPECTO~ ~,/,.~
Examined ...... ?/~. .....
Approved .... .~./~ ......
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT..
TOWN HALL
SQUTHOLD, N.Y. 11971
TEL.: 765-1802
., 19?F
., 19~.~. Pe;mit No..)..~.~. ?..¢..--~-.
Disapproved a/c '
BOARD OF }{EALTH
SETS OF PLANS . :
u~vE~ ......... '.22
JCIIEcK ...............
SEPTIC FORH
TO:
, (Buildin~ Inspector)
APPLICATION FOR BUILDING' PERM IT
AU~ '2 5 f995
Date . ...2-. .......... ,
INSTRUCTIONS
a. Tiffs apl~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector,
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public
or areas, and giving a detailed description of layout of property must be drawn on tl~e diagram which is part of this
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
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 Occt
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant
Building Zone Ordinance of the Town of South61d, Suffolk County, New York, and other applicable Laws, Ordinm
Regulations, for the constraction of buildings, additions'or alterations, or for removal or demolition, as herein des,
The apphcant agrees to comply with all applicable law¢, ordinances, building code, housing code, and regulations,;
admit authorized ~nspectors premises and in building
on f°r ne°essary inspecti°nsff~a~p~'t~ ~Z~ i~7'e
(Mailing address of applicant) /(7(~ ~/
State whether ~nt is owner, lessee, agent, architect, engineer, generai contrac~tor, electrician, plumber or bt
,'~,-*,~,~,g 4./5~T57 I~NRHllv5 . ........
Name of owner of premises 4.". u u-.,.~ ...................................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Bui~aer's License ,o...?.f.'>. ¢. #. Z-'? .........
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done ..............
.... .%.q..o. ........ ..... p..~. ! .o.z. ~.. 72 ~ .~....' ...... ~.b~,.~... 9..~4: ...... t~...q~! ......
ltouse Number Street Hamlet
Cotmty Tax Map No. lO00Section.,..' .... ~'(.......... Block 6 ' Lot. J. Ct./.2:'. .....
Subdivision ' Filed Map No. Lot
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy L
/
b. Intended use and occupancy ...............................................................
· 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........
Repair ............. Removal .............. Demolition .... : ......... Other Work .............
4. Estimated Cost ............. : ........................ Fee ...
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ..............
· If garage} number or' cars ......................................................................
6. If business, commercial or rri~.xed occupancy, specify nature and extent of each type of use ...................
7. Dimensions of existing structures, it' any: Front ............... Rear .............. Depth .............
Iteight ............... Nmnber of Stories ......................................................
Dimensions of shine structure with alterations or additions: Front ................. Rear ................
Depth ....................... Height ........... ~ ......... ... Number of Stories
8. Dimensions et' entire new construction: Front .............. : Rear ............... Depth .............
Height ............... Number of Stories ....................... :
9. Size of lot: Front Rear ...................... Depth ....................
lO. Date of Purchase .................... ' ......... Name of Former Owner ..................... : .....
11. Zone or use district in which premises are situated ...................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..............................
13. Will lot be regraded ....... ' ..................... Will excess fill be removed from premisea: Yes I'
14. Name of Owner of premises ............... , .... Address ......... .......... Phone No ..............
Name of Architect ........................... Address ................... Phone No ...............
Name of Contractor .......................... Address ................... Phone No ..............
1.5. I.s th±s property w±th±n 300 feet of: a t±dal wetland? *Yes ........ bio .........
'~If yes, Southold Town Trustees Perrait may be requ±red.
PLOT DIAGRAM
Locate clearly and distinctly ali buildings, Whether existing or proposed, an&indicate all set-back dimensions frc
property lines. Give street and block number or description according to deed, and show street names and indicate wheth
interior or corner lot.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
"IMMEDIATELY"
ENCLOSE POOLTO CODE
UPON COMPLETION
BEFORE "WATER"
UNDERWRITERS CERTIFICATE
REQUIRED,
APPROVED i~S NOTEO
DAm ~B.R.# ~
NOTIFY BUILDING DEPARIMENT AT
765-1802 9 AM TO 4 PM FOR-THE
FOLLOWING INSPECTIONS:
1. FOUNOATION - TWO REQUIRED
FOR POURED CONCRETE.
2. ROUGH - FRAMING & 'PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
STATE OF NEW YO2Rlz'b~,~ ·
... ~..~'..~ff...~.....'~...].~..~.../~.{~.4 ~ ....... ......... being duly sworn, deposes and says that he is the appltca
(Name of individual signing contract
lbove named.
(Contractor, agent, cor'porate officer, etc.)
said owner or owners, and is duly authorized to perform or have perfo~ed the said work and to m~e and file ti
~pplication; that all statements contained ~ ttds application are true to the best of his knowledge and belief; and that t
york will be perfo~ed in the manner set forth in the application filed therewith.
;worn to before me this
...................
4ota~ Public, . . .~//.~'~. ~. ~. · County ' .
· .........
~A~ ~BLlC~tate of ~;Y. ' (Sig ture of applica:
No. 472~9, Suffolk Cou~/' ..
lerm ~ir~ May 31, 19~