Loading...
HomeMy WebLinkAbout22797-zFOP~ NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24121 Date JANUARY 18, 1996 THIS CERTIFIES that the buildin~ Location of Propert~ 240 WIu~ ROAD House NO. County Tax Map No. 1000 Section Subdivision ACCESSORY NEW BUFFOLKw N.Y. Street Block 8 Lot Filed Map No. Lot No. Hamlet 19 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1995 pursuant to which Building Permit No. 22797-Z dated JUNE 5, 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 STORAGE SHED IN HEAR YARD 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 WILLIAM & VIOLA SUMPTER N/A N/A N/~ Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. Ne 22797 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ........ ~....5.~ ........................................ 19...~.5. .... Permission Is hereby granted to: NILLIA~4 & VIOLA SUI~TgR 240 WICKS ROAD NI~ SUFFOLK:~ NY 11956 CONSTRUCT AN ACCESSORY SHED TO CODE IN THC I~AR YARD AS APPLIED FOR. at premises located at..,....2,~.O....~. ~.g~ .s.. ?..0..~.. .................................................. ~...s,, ,T~, .~OLI~. .............. ~ Coun~Tax Map No. 1000 Section ......... !.!.0. ........... Block .......... .8. .............. Lot No ........... 1..9. ............... pursuant to application doted .......... ..1~..~... !..7.: .................................. 19.......9..5. ...... and approved by the Building Inspector. Fee $..,.3...5.:.,0..0. ........... "~uilding inspector Rev. 6/30/80 TOWN OF SOUTHO!D BUILDING D EP AP. TM~E~~r TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP~~WCY 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: t. Final survey of property with accurate location of al! buildings, property lines, 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical insta!!acion 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 cercificane 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 al! property lines, streets, building and unusual natural or topographic features. 2. A mrooer!y completed application and a consent To inspect signed by the applicant. If'a ~ertificate of Occupancy is denied, the Building inspector shall state the reasons therefor in writing ~s the applicant. C. Fees - _~.00, Additions to dwelling i. Certificate of Occupancy New dwelling Alterations Co dwelling $25.00~ Swimming pool ~25.00, Accessory building $25.00, Additions co accessory building $25.00. Businesses $50.00. o~ - ~ ~ ~ Buildin~ $100.00 2. Certificate of Occupancy on ~.e ~x_sc_n~ - 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $1~.00, Commercial $~~.00 Date ............................ ~ew Construction ........... Old Or Pre-existing Building ................. Location of Property..Z.¥.O. ' ...... .~..~7~6...~.~.. .... ~ouse No. S~reet ~anutac Onwer or O~er~ of ~roperty...~..~gal./t M..~./(.ZO.4 ^...J..~../q £/Z.g.{C. ..................... County T~. ~p No ~ooo, Section...U.e. ...... Bloc~ ...... ..~. ....... ~ot../.? ................ Subdivision .................................... Piled Map.....~. ...... Lot ...................... .... ............................. Hea!ch Dept. Approval .......................... Underwr±tars Approval ......................... ?!arming Board Approval ........................ Request for: Temporary Certificate ........... Final Car~icate ........... 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 January 11, 1996 Mr. William Sumpter 240 Wicks Road New Suffolk, NY 11956 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) 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 # 22797-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. FIELI~ INIiqPECTION REPORT DATE CONMENTS FOUNDATION (]ST) 11 FOUNDATION ( 2ND ROUGH FRANE & ~-. INSDLATION PER N. Y. STATE ENERG~ CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY ,-.,,ARKS: /~/~ [ ] ROUGH PLBG. [ ] INSULATION DATE OCCUPANCY OR USERS UNLAWFUL '~IT~O~T CERTIFICATE OF OCCUPANCY FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 ~'A TEL.: 765-1802 Approved 'i ........ , Ig~mit No .~. Disapproved a/c ................................ 2 .... · ~mlrifffig Inspector) APPLICATION FOR BUILDING'PERMIT B~)ARD OF HEALTH 3 SETS OF CIIECK SEPTIC FORH ............ CALL ............. HAIL TO: Date ......... 19~. ,..~· INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink an'd submitted to the Building Inspector, with ~' 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 sti'eet.' 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 tbJs application may not be commence~ before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will igsued 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 Departmen(for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southbld, 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 describbd. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized__ inspectom on premises and in building for necessary~spections.....~..~~~2' ~ - ................. . . (Signatur~ of applicantd6r name, if a corpo~-ation) · (Mailing address o f applicant) State wh~ther applicant is owner, lessee, 'agent, architect, engineer, generai ·contractor, electrician, plumber or builder· ) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done· : ....................... i...' ......... I d,.,y House Number Street Hamlei ..... ~ ' .Z[.~. ,ff2. D ........ Block .. ~. .......... :... Lot/.~.,. ~,~.~ ......... County Tax Map No. 1000 Section Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) 2: State existing use and occupancy of premises and intended Use and occupancy of proposed construction: 0 a. Existing use and occupancy b. Intended use and occupancy ...... '.. ' ............................ ~.'t~/~.~'."~ . ~. i '.'T~.,'O .............. ,...-~1 ,~ l,x~,~.:: :, , ',~.. ,: r, d) ' ' ' 3 N f k(che k hi happli abl ) N B tiding A~dditi ' · . atureo wot c w c c e: ew u ..... : .... on .......... Alter on mb 1 ati ' Repair .............. Re va .. D moliti ......... i ............ e on ..... : ......... Other Work ............... c-~ Esti tedC ''~ iOO(''~''' '"" (Des iption) · ma est . :. . cr · [ . (to be paid on filing this application) 5. If dwelling, number of dwelhng ~mts: .... If garage, number of cars , .......... Nmflber of dwelling units on each floor ..... 6 If business ..... I .................................... . .............. commercial or mixe~ occupancy specify nature and extent of each type of use ................. 7 D ...... if any: Front .................... · ~mens,ons et existing structure~ ' Rear Height Numt~er of Stories .... r .......... . .............. Depth i .............. ............... wiih .................................................. Dimensions of sbme structure alterations or additions: Front Depth ' Height Rear · Nmnber of Stories ' · Dimensions of entire new constrqction: Front. . ' .................... Height Number of Stories ...... ~ ....... Rear . Depth 9 Size of lot: Front I ' ' Rear ' ' ' ........ : ' + ................................. Depth 10 Date of Purchase ' ..................... , · Name of Former Owner 11 Zone or use district in which premises are situated ............................. 12. Does proposed construction violaite any zonlm, law nrd no,,.,, . -. ' 13 ............ s-,*,~e~, ..... ; Will exc~o~ ~-" '- ....... ' ........ fp · ~o~ m~ ou rumored Item premises: Yes No 14. Name of Owner o remises .... ] ....... , ........ Address ..; ...... . Phone No ........ ;.. Name of Architect ........... i ................ Address ................... Phone No ............ : .... Name of Contractor ' · .... Address ................... Phone No ...... L5 19 this property within 300 feet of a tidal wetland? *Yes ........ No ........ ' ......... ' *If yes, Southold Tqwn Trustees Permit may. be required· ' 'i PLOT DIAGRAM Locate clearly and distinctly all uildings, Whether existing or proposed, and. indicate all set-back dimensions from property Hnes. Give street and block n~mber or description according to deed, and show street names and indicate whether interior or corner lot. NOTIFY ~!UILDING DEPART~T 76~~1802 9 AM ~ 4 PM ~OR THE FOLLOWinG ~NSPECTIONS: 1. FOUNDATION '~0 REQUIRED FOR POURED CONCRETE ' Z ROUGH - FRAMING & PLUMBING 3. ~NSULATION 4. FINAL CONSTRUCTION MUST , BE COMPL~E FOR C.O, ALL CONSTRUCTION ,SHALL THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRU~ION ERRORS rATE OF NEW,,-YORK~, ,/~ O NZ¥ OF,... .S.S U~a'~e' ~individ' ~" -~;l's}~i~'4~}~dc}5" ...... being duly sworn, depose.s and says that he is tile applicant )eve named· . '" · t .... " rac r: agent, corporate officer, etc.) ' said owner or owners, ~d is duly authorized to perfo~ or have perfumed the said work and to m~e and file this plication; that all statements contained~ ~ this application are trout to the best of his knowledge and belief; and that the ~rk will be perfumed in the manner set ~orth in the application fil~d therewith· ' ~om to before me this .....