HomeMy WebLinkAbout23008-zFORM NO. 4
TOWN OF SOUTHOLD
SUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OC~umANCY
No Z-23881
Date SEPTEMBER 18, 1995
THIS CERTIFIES that the building ALTERATION
Location of Property 6760 GT. pECONIC BAY BLVD. LAUREL~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 126 Block 11 Lot 3.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated S~PTEMBER 11~ 1995 pursuant to which
Building PermLt No. 23008-Z dated SEPTEMBER 12~ 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 ALT~uiATION TO EXISTING GARAGE "AS BUILT" AS AgPLIED
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
DOROTHY C. GRANNEMAN
N/A
PENDING - SEPTEMBER 11, 1995
N/A
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y.
N.° 23008 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLE11ON OF THE WORK AUTHORIZED)
Permission Is hereby granted to:
· c.
~.~i~...~,......~.......~x ...... .M ..............................
.~..~mi.~..,.:.~..~/.:..z~..~.~ ........... ~ ...... .,.~,
g~..~ ....... ~......~.~~.'~ ....... ~.......~......~.,r.~z.:~ ........
,,,~.....,,,~...~..4,.~ ....... ..~....x.: ........................................................................................................
CountyTax Map No. 1000 Section ..,. ,/..'~,...~.. ......... Block ....... .././.. ............. Lot No, ......~'..:..Z .............
pursuant to application dated .......~,,~.. ,.~,.' ........ ~. ~.. ....................... 19,,,,,...9..~..., and approved by the
Building Inspector,
Fee $.,,,~:.,.?~.. ......
Rev. 6~30~80
TOt. IN OF SOUTHOLD
BUILDING DEFARTHENT
TOWN HALL
765-!802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OK ink and submitted to the building
inspector with the followi,g: for new building or oew use:
i. 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.
&. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead-
S. Commercial building, industrial building, multiple residences and similar buildings
and install~tions, 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:
i. 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 insoect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in ~riting to the applicant·
C- Fees
1. Certificate of Occupancy - New dt~elling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building 525,00,
Additions to accessory building 525.00. Businesses~_550.00.
2.
Certificate
of
Occupancy on Pre-existinz Buildin~ ~-.,$~.0~0~0.~..
3. Copy of Certificate of Occupancy - $20.00
&. Updated Qertificate of Occupancy - $50.00
5. Iemporary Certificate of Occupancy - Residential $15.00.~ Commercial 515.00
Date .... ...........
New Construction ........... Old .~Or Pre-ex~st~ng Building ..... .,~ .........
9nwer or Owners of Properti,.-,.-.~-...'~-,"".~,?/?/,7 ..... .~.'....~..~...'~.'9.."~., .~..~'?..~..~'1, .....................
:oun~ ~.'n~ ~.,p ~o ~000, Soctio,,...g&.~ ...... B.t,,ci~..../J. .......... ~o~....~ ..................
~ubdivision .................................... F:ilcd Mnp ............ Lot ......................
,ermit No ................ Da, per. it ................ ......
iienlLh Dept, Approval .......................... Undet-~¢riters Approval .........................
'ianning Bonrd Approv~li ........................
:~equesc for'. Temporary Certificate ........... Fin;~l Certicate .... ~ .....
Tee Submitted: 5 .............................
Stype Brothers Real Estate, Inc.
MAIN ROAD, MATTITUCK, NEW YORK 11952
(516) 298-8760 FAX (516) 298-5779
"'" '-'~L-'~'~-''' - -- .... ' ..............
September 11, 1995
Town of Southold
Building Department
Main Road
Southold, NY 11971
Attention: Gary Fish, Building Dept.
Re: C.O. on Granneman workshop/garage
SCTM# 1000-126-11-3
Dear Mr. Fish:
Enclosed is our check in the amount of $25.00 to cover the fee for a
Certificate of Occupancy on the above noted structure.
Sorry for the confusion, and thanks for all your help.
Regards, ,, ./-~ ~_
Maffgery M. Walker
MMW:btf
Enc.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
t%~622~ mUREAU OF ELECTRICITY
~- 85 JOHN STREET, NEW YORK, NEW YORK 100.38
Date SEPT~R ~ 5 1 ~ ~ ~ ~ppli~ut;on No.
THIS CEEIFIES THAT
~,~ ~R~T~ ~, 6~6~ PECONIC BAY BL~.,
VISU~ DEFECTS~ "An e]ectric~
has been made o~ the ex~osed
el,~trJc~ e~ipm~st in the
[,l~m~ses i~dicated." "No obvi, o~s
unsatisfactory condition was
DOROTW£ GRANND~N
lO! PAi~: A~JENUE
C/O KEIJfI DRYE & W. ESGS
NEW YORK, NY, ],O17~
COPY FOR BUILDING DEPARTMEr,~T T;~S CC?~~' CF C~Fi'C:~l~ 3-% ~fi ?::~$7 ~JO'~; B~-2 ALTE~SD 151 ANY ~',,qANNER.
PAGE 03
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ~NAL
REMARKS:
] FIREPLACE & CHIMNEY
DATE
FORM NO. 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT'.
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c '
3 SETS OF PLANS
SURVEY
SEPTIC FORH
CALL
H^fL TO:
(Bu~dih/g Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Ttffs apl~llcation 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 preniises, relationship to adjoining premises or public s~
or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this ~
cation.
c. The work covered by tiffs application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building hrspector will issued a Building Permit to the applicant. Such p~
shall be kept on the prenffses 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 Occup
sbalI have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant t,
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinanc
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descr
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, a~
admit authorized inspectors on premises and in. ~t ln.s~cnons,~-.,-- .~'~~
building for necessary in cfions
-- (Signature of a.l~plican~//Sr Joanke, if a corporation)
.o. ? .<. . ,w,. :' z , W. . ,,,
(Mailing address of applicant)
applicant is owner, lessee~------~ architect, engineer, generai contractor, electrician, plumber or
State
whether
but
................................... ' .................................. AS
Nameofownerofpremiscs
Cas on the tax roll or la~.fi~UiLDING' DEPARJ'MENT-AT
If applicant is a corporation, signature of duly authorifed officer.
765-1602 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRtr I ~:
2. ROUGH - FRAMING & PLUMBING
8. INSULAllON
4. FINAL - CONSTRUCTION MUST
BE COMPL~ ~'- FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERROR~
(Name and title of corporate officer)
~uilder's License No... ':~:) ................ t~ttBERWRIT£R$ CERTIFTC~TE
.... It ~ REQUIRED
Plumoer s License rqo .... ~ ....................
Electrician s,License No.. ''~''/ '''~' ''~ .... .......
Other Trade s License No..j~ .................
Location of land on which proposed work w !! ~ done.
................... ....... .... ..... .....
Itouse Number Street tlamlet
County Tax Map No. 1000 Section ' /'~ ~ Block / ? ' Lot . .'~.. ...........
.,
Subdivision Filed Map No ............... Lot ............ (Name)
state existing use and occupancy of pre nises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .......
............... ..... .4' ~ e:.... .. /..>
· /'.) Z~ Z.,
...... . .L~...b..r'../:--...:C.,?. o...~. ...................... ..................
b. lntended use and occupancy
3. Nature of work (check which applicable): New Building .......... Addition Alteration
Repair .............. Removal .............. Demolition .... : ......... Other Work ...............
.,~.~.. " ' t/ _ · o ~ (Description)
4. Estimated Cost ... q oa ' .............. 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 of cars ..... ,(...~.."FTC..: ..........................................................
6. If business, commercial or mixed occupancy, specify nature and extent of.each tgpe of rise
· - · ' /' I ............ F TM .....
7. Dunensmns ol existing structures if any: Front .... Z~- ......... Rear ./.¢. .......... Depth . .o?.~. ..........
tteight. ./. ............ Number of Stories ..... ';?.~...~-~-~.. ...........................................
Dimensions of shine structure with alterations or additions: Front .../.¢..: ......... Rear ..
Depth . .'~ ?..' ..... Height ....... ~.,. ......... ... Number of Stones...
8. Dimensions of entire new cpnstruction: Front . ./~?..~'-,t'.~-~. e'e--,.; Rear..¢ ....... ,, ..... Depth ...............
Height ............... Number of Stories .6~..:'F~..{..f..~.:/.. /..?.~..o'/.;o.,"/.).
9. S,ze of lot: Front ..... ..qg.~/, ..,. ......... Rear... gl./. ............... Depth
10. Date of Purchase .... t/?. ~ .o.~/.~. 7. ..... ......... Name of Former Owner .... ~"~..c? .~,.~.r'~ ....... : ~ .~."...
1 1. Zone or use district in which premises are situated... ~;.e..r.: ....................... ~...
12. Does proposed construction violate any zoning law, ordina~ce or regulation: ...A~.~o ..................... 7~...
13. Wttl lot be regraded ....... .5,~'~..,.: · · ~ .......... W~ll excess fill l~e removed fr~l:n pre~..n~,sl~ ~,~ No
14. Name of Owner of premises ~.:/.o~o.~.~ .~/?<,,.~O.*.,.p.,r.,1Address ~'.o~....J~.~-~ .% .~.d.,-..'.~:z~,,~Phon'~Nb~.~'.~k~.~/~..'
Name of Architect ..... ~.~.q,O. .............. Address .2~'. · ."AB .......... Phone No ................
Name of Contractor .... d~)qo.<.'..<-C''. .............. Address ~,.'~'~,.' .-d~. +.d.~.d"..~</,f4F~. Phone No ............ ' ....
15.' Is this property within 300 feet of a tidal wetland? *Yes..'~.' .... No .........
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
'qTATEOF NEW YORK ...S.S
~OUNTy OF ...... ~ ~ .: ........
........ .; 2. ..... ~ ..... '..' ................ . ......... being duly sworn, depose~ and says that he is the applicant
~" (~Nam'dof individul~l signing contract)
~bove named..
le is the ..... . ........................... ' ......................................... '... ............
" (Contractor, agent, cor¢orate officer, etc.)
f said owser or owners, ~d is duly anthofized to perform or have perfo~ed the said work and to m~e and file this
pplication; that all statements contained ~ this application are true tO the best of his ~owledge and belief; and that the
.,ork w~l be perfomed in the m~ne.r set forth in the application filed therewith.
worn to before me this
/
' ..... .... .'" ....... ...........
T~rm ~xpires Juno 1~, 19~