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HomeMy WebLinkAbout22815-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall 8outhold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26651 Date: 08/25/99 THIS CERTIFIES that the building ALTERATION Location of Property: 240 ORIOLE DR (HOUSE NO.) (STREET) County Tax Map No. 473889 Section 55 Block 6 SOUTHOLD (HAMLET) Lot 15.13 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 8, 1995 pursuant to which Building Permit No. 22815-Z dated JUNE 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 SECOND FLOOR RENOVATION TO AN EXISTING ONE FAMILY DWELLING 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 061631 10/05/98 PLUMBERS CERTIFICATION DATED 08/25/99 PERFECTION PLUMBING Buil~g Inspect~ Rev. 1/81 FORM TOWN OF $OUTHOLD BUILOING DEPAR'(MENT TOWN HAU. SOUTHOLD, N.Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] cate ..................... ~.~? ............................. 22815 Z Permission Is hereby granted to: ........ ./~........./~ .................................................... .... ~j~..-~.. ........ ~.,...... ./.~/,.... to . . . ~ ~.~.z-~. ............. ~. .~. . . ........... ,~,~m. . . . . . ./. . . ~. .~. . . . . . .~ .............. ~ .......... ~ .... ~ ~. ............... ~ .......... ~.,. '.~ ............ ~.,~.~. ~ ..................... ...... z~.. .~....~.~......~.~.~ ....................... ~ ..................................... ~ ........................ Coun~yTax Map No. 1000 Section .......,-.~-.,~... ........... Block ...... ~.~. .......... Lot No ........ ,-r~.P~"~"/'-~. ..... ~-~ -~... 19.,,..~...~. and approved bythe pursuant to application dated ...................... i .................... Building Inspector. ~ee S.~ ....... /~" Buildrng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOI~ BU1LDiNG DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAi 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: 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 so]der used in system contains less than 2/10 of 1% lead. 5. Commercial buildin~g, industrial building, multiple residences and similsr buildh~gs and installations, a certificate of Code Compliance from architect or engineer respousible for the building. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior Lo April 9, 1957) non-conforming uses, or buildings sad "pre-existing" land uses: 1. Accurate survey of property showing al3. property lines, streets, building and unusual natural or topographic features.. 2. A properly completed application and a consent to inspect signed by the 8pplicant. 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 dwe].ling $25.00, Additions to dweiling $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 Buildfn~ - $100.OO 3. Copy of Certificate of Occupancy - .25~ 4. Updated Certificate of Occupancy - .~50.OO 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......... 2/~./~. ...................... New Coustruction ........... Old Or Pre-existing Building../.. ............ Itouse No. Street Hamlet Ouwe or Owee s of Property .... .................................. .i~.. ~o=. .f. I~, County Tax Map No 1000, Section ...... Block .............. Lot ..... 3. ............. sub, division ...... ........... Filed Map .... .... .ot ....... ............. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Final e Reqsest for: Temporary Certificate ........... C rticate ........... Fee Snbmitted: $~ ~-~ ~ ........................... I . ' '' .~~/~/~ ~-~ ~ ~¢ APPLICANT TOWN OF $OUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 ToWN llALI, $OUTIIOLD, N.Y. 11971 CERTIFICATION TEL, 765-1802 Date :. I certify tba% tile solder used in the water supply system contains ].ess than 2/10 of 1% lead. S~,;orn %o before me %his No%~ry Public ~ ..... County NO. o, rG_, ..... ~ ExOke~ Aort ~, ~ (plumber'S signature) FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION (IST) Il II FOUNDATION ROUGH FRAPIE & Il PLW/4BING I' INSULATION Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516)765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD 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 the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) XX 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. XX No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22815-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING [ ]FINAL [ ] FIREP~A~HI~MN~Y ~ REMARKS~ DATE ~J~ INSPECTO/~. ,.~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ~INAL [ ] FIREPLACE & CHIMNEY REMARKS: (~/~j C <::2. DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] R~GN PLBG. [ ~/INSULATION [ ] FINAL FIREPLACE & CHIMNEY DATE THE NEW YORK BOARD OF FIRE UNDERWRITERS 80?2829 .U. AU OF E. CT.,C, Y ~-- 40 FULTON STREET, NEW YORK~ NY 10038 Date OCTOBF~R 05,1998 Application No. on file 16876098/98 H 061631 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application nutnber is in the premises of RICI~h/ID PERKINS, 240 ORIOLE DRIVE, SOUTHOLD in the following location; [] Basement [] 1st FL [] 2nd Fl. Section Block Lot was examined on ~PT~[B~R 29,1998 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS FLUORESCENT OTHER 8 DRYERS S E R V I C NO. OE CC COND. A W, G, NO. OF RI-LEG A, W.G. NO OF NEUTRALS A.W. G, PER ffi OF CC. COND. OF RI-LI~G O~ NEUTRAL OTHER APPARATUS: PADDLE FAN-1 P. O. BOX 1894 SOUTHOLD, NY, 11971 GENERAL MANAGER 11 This certificete must not be elfered in eny manner; return fo the office of the Board if incorrect. Inspectors mey be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE AL~TERED IN ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ' APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY ........ SEPTIC FORH ............. NOTI~Y~ CALL ................... HAIL TO: Date .............. 19 . INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 publ/c sfi, eets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by tkis 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 permit 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 Occupancy shall have been granted bY the Building Inspector. ' APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South61d, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code-;~ngir~gulations, and to admit authorized inspectors on premises and in building, for necessary inspecti°ns"'~/'//~/~'~/~' ~ --' . (Signature* ------of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generaJ 'contractor, electrician, plumber or builder. Name of owner of premises .......... ~. .... ~.~/.~!m,l .............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ' ; ( ,Name and title of corporate officer) Builder s License No ................. ~.../~.... , . Plumber s Lmense No .......... ~ ....... Electrician's License No.. ~.,~C ..... : ..... Other Trade's License No .,C .................... 1. Location of land on which proposed work will be done ................................. } ................ ...... . ?.o. ....... , ........... /o/¢. . . . i...' ......... .......... ' ............... House Number Street Hamlet Cotmty Tax Map No. 1000 Section ....'.~. ......... Block ...~ .......... i... Lot.../??/,3. ........... Subdivision ...... .~/~./~o./~.' fZ....~..~,oaJ3 ............ Filed Map No .... .~?. {/ ....... Lot .... (Name) 2: State existing use and occupancy of pr~mises and intended use and occupancy of proPosed construciion: a. Existing use and occupancy ........ L~.~....,f~/.~.~c.~ ................................................. b. Intended use and occupancy ........... ;'. ........ ' ........................ .. ................ · 3. Nature of work (check which a'pPlicable~, xT~. ~.n,~'~ · . . ~ ~ ~. ,,'-'* ~'"~"-',,,~ .......... ~,aaltlon .......... ~teration ...~;~. '.. ~epar .............. XemovaI .............. Demolition .... : ......... Other Work ......... 4. ~is~mate est ....... ~ .......................... Fee ... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units . ~ / N mb fd lli If ga numb rof I ............. u ere we ng units on each floor .............. . rage, e cars .... , .... ~ · 6. If business, commercial or mi,x~d occupancy, specify nature and extent of,each type of use ...... ~ ............ 7. Dimensions of existing structures, if any: Front... Height ............... Number of Stories ..... ~ ............... ' ...................... ~...' ..... " .~ ..... D~ensions of shine structure with alterations or additions: Front Rear ~. ...... Depth . ' .... -; HeiSt -, .', ~;~;-; .,.. Number of Stories... ~ .... . ........ 8. Dimensions of entire new construction: Front..~ ...... : Rear ............... Depth ............... ,Height ............... .Nu~be~ of Stories ........ ~ ~>v ........... Size of lot: Front.. {a~, ~o ' ,~, Date of Purchase ~ ..... ... Depth . . . '~ ...... i ......... ' ......... ~ameoreomerowner . ~ . . .. Zone or use district ~n which pr~mises are situated .......................... Does proposed construction v~ghte any zoning law ordinance or regulation' . Will 10t be regraded ~/~- . . .,, ..... ' ' ' , ,' ........ / ......... ~. · ...... ~'I?'1 ' '1, 'J ' .~., ...... Wlll excess HII De removea trom premises' ~¢ Yes No ,, · -/ ........ r ..... ~.. auaress ...r.o.. ~l~q ~..~ Phone ~n /d_~o3~ · n~e of Architect ~ -~ ' ................. :. · · .... ~ 72 ................ aaaress ................ Phone No . . . Nme of Contractor 9.~ /,v a~ .... ' ' ' _, ,. ' ............ I9 this property within 300 feet of a tidal wetland? *Yes ........ No. ~ .... · If yes, Southold Town Trustees Permit may be required. ' I' ... , PLOTDIAG~ Locate clearly ~d distinctly ~1 [build~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from deed, and show street nines and indicate whether 10. 11. 12. '13. 14. property lines. Give street and ' ' · block number or description according to interior or corner lot. (Name of individual signinl~ contract) above named. being duly sworn, deposes and says that he is the applicant '5 He is the . .~ ................. (Contractor ............................................... agent cor'porate officer etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true tO the best of his knowledge and belief; and that the work will be performed in the manner s6t forth in the application flied therewith. Sworn to before me this ~ .................. .~d £ I . . ~ , No'tary Pu'blic,' ~~ ........ ' ..... ' ' ' ' '