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Home My WebLink About23100-zFORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 23100 Z Permission is hereby granted to: , -- .~..o...~...i~..........~....a..../.. ....................... ..... ../...'~...~..~....../..~..~ ..... ~. ~~..~.~~.~..~.,,,, ,,, ~:~:.~ .......... :...~~- CounlyTox Map No. 1000 Section .......... ,,,~...~......~... Block ...... .~....~... ........... Lot No...2,.~., ................ pursuant to applloatlon dated ..................... .~..,~...~.. .......... 19....~..~'~and approved bythe Building Inspector, Fee $....Z..~'... ......... Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCcumANCY No Z-24169 Date FEBRUARY 20, 1996 THIS CERTIFIES that the building ADDITION Location of Property 6645 GT. P~CONIC BAY RD. House No. Street County Tax Map No. 1000 Section 126 Block 10 Subdivision Filed Map No. MATTITUCK, N~WYORK Hamlet Lot 20 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 19, 1995 pursuant to which Building Permit No. 23100-Z dated NOVEMBER 2, 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 ALTERATION, ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. GREG & DARLENE OLSEN SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-377539 - FEBRUARY 9, 1996 N/A TOWN OF SOOT.OLD <~' ' BUILDING DEPARTMENT . TOW~ HALL t,'FEB I 3 1996 APPLICATION FOR CERTIFICATE OF OCCUPANt.s-=?~-''~-~''~'~* 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 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 solder used in system contains less than 2/i0 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer respousible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, ~957) non-conforming uses, or buildings and "pre-existing" ].and uses: l. 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 ~. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swirea~ing 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.OO 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.O0, Commercial $15.00 Date .... ~11 ~ .~.~ .......................... New Constrsction ........... Old Or Pre-existing Building,...~q ........... Location of Property..~gC.~.~. ~)~.~.~....~.~.~.. ~L~./.~ ............... /~.~.'~. [ .'T.V.C~ ......... }louse No. Street Hamlet Onwer or Owners Property ......................... County 'Fax Map No 1000, Section..~'?~..~. ...... Block ..... ]'0 .......Lot .... a.O ............. Subdivision .................................... Filed Map ............ Lot ...................... :%5.\ Health Dept. Approval .......................... Underwriters Approval...~.ES ................ Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...N ...... Fee Submitted: $ ...... ..~S. ,0.~ ............ APPI,ICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 1~.~)4[P~ BUREAU OF: ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 Oue~ FMBRU~Y ~9,1996 ~p~li~.~io. ~o. o./i1~ 1~846495/95 N 377539 o~y :~ el~tr~ ~uipmen~ ~ ~scrib~ be~ a~ intr~uced by t~ ap~icant ~med on the a~ve application number in t~ prem~es of G~EG ~ DA~IN~ O~, P~CONIC BAY BL~. , POI~-43, ~I~3CK, N.Y. in th~fotlow;ng locatlon; ~ B~sement ~ Ist FI. ~ 2nd ~7, O~ Section Bilk Lot ;IX)U~E m ~ ) FIXTURES m RANGES mC~KING DECKS l OVENS ~DISH WASHERS EXHAUST FANS ~T~TS ~ECEPTA~ES SWITCHES m~CXSOESC~N, FtU~E~E.T OTHER ~T. K ~. ~V ~ W. ~T K.W ~T ~ K W ~T. H.P. DRYERS m ~RNACE ~TORS ~ ~TURE A~LIANCE HE~RS iPECIAL REC PT TIME CL~KS I BELL ~ ' DIMM S $ERVI~ DIKONNKT ~. OF S S R V I C E OTHER APPARATUS: PADDLE FAN-1 MOTORS ~ 1-F H ~. P, SMOKE D~,TBCTOR: -2 BOX 222 AQUEBOGUB L.I,, NY, 11931 Per 110EN'i~/t~AGE' This ce~ificate 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 DEPARTMENT. THIS COPY OF CERTIFICATE, , ~ MU?T NOT BE ALTERED IN ANY MANNER. 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 31, 1996 Mr. Kevin D. Stakey P.O. Box 231 Laurel, NY 11948 Re: Gregory & Darlene Olsen - SC31~I000-126-10-20 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: No Health Department Approval on file. No final inspection has been made. xx An application for Certificat~e of Occupancy is not on file. (Enclosed) ~ xx No Underwriters Certificate on file.~ xx The check is not on file. $25.00 ~ No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT 23100-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~.0 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 31, 1996 Mr. Kevin D. Stakey P.O. Box 231 Laurel, NY 11948 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. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 23100-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [/~"~NAL [ ] FIREPLACE & CHIMNEY DATE /~P~7 INSPECTOR~ BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROU~H/PLBG. FOUNDATION 2ND [(.,~4NSU~TION FRAMING [ ] FINAL DATE /)/I,:~-\~.... INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] F/~UNDATION 2ND FRAMING [ ] ROUGH PLBG. ] INSULATION ] FINAL []FIREPLACE&CHIMNEY REMARKS: /~.~'- INSPECTOR ./,~-'/ ~'/ 765-1802 BUILDING DEPT. INSPECTION [,/~OUNDATION 1ST [ [ ~ FOUNDATION 2ND [ ] ROUGH PLBG. ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE&CHIMNEY . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK SEPTIC FORbl ........ ~)M/~ $OUTHOLD, N.Y. 11971 NOTIFY: ~.~ .. _ ' ~/ TEL.: 765-1802 CALL · .~l.~.~ .~.~ ~... Examined ......... i~ . ~ MAIL TO: · ....... ,~ov~........,~ ~.~o ..... .~.~,.~.~.~ Disapproved a/c ........... R BUILDING pERMIT . Date ..: ................ 19.. ]NSTRUCTIONS ~ - a. T]ds ~pplication must be completely QHed in by ~pewdter or in ~nk and submitted to the Building Inspector, with sets of plans, accurate plot plan to sca]e. Fee according to schedule. b. Plot p[~ showing location of lot and of build~gs on premises, relationship to adjoining premises or pubHc streets or areas, a~d g[v~g a det~Jed description of ]~yout of property must be drawn on the diagram which Js pa~ of t~s appH- caQon. c. The work coveted by t~s application may not be commenced before issuance of BuQding Permit. d. Upon approval of this application, the Building Inspector wQ~ issued a ~ufldJng Pe~t to the appHc~t. Such pe~it sh~li be kept on the premises avaQabie for ~spection throu~out the work. e, No build~g shah be occupied or used Jn ~ho]~ or ~n part for any purpose ~vhatever until a Ce~JQcate of Occup~cy shah have been granted by the Bulldog ]nspectot. ' APPLICATION IS HEREBY ~ADE to the Building Dep~ment for the issuance of a B~]ding Pe~it pursuant to the Building Zone Ordinance of the Town of SouthoJd, Suffolk County, Regulations, for the construction of buUd~gs, additions or alterations, or for ~emova] or demolition, as here~ described. The applicant ~grees to comply ~ith ali applicable laws, o:dinances, bulldog code, housing code, and regulations, and to admit authorized ~spectom on p~emises ~n~ ~ bu~]d~g for neces~.i~spectJons -- ...... (~ailing address of appiic~t) State whethers, applicant is owner, ]essee, agent, ~ch[tect, engineer, genera] contractor, electrician, plumber or builder. ..... ~. z~~. ~. ~ .~.~ ~ ................................................. Name of owner of premises ~.%%~G ~ ~%~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (ame and title of corporate officer) Builder's License No....\ .~, .~.%.% .\5.~ ....... Plumber's License No EIectr,cmn s License No ....................... Other Trade's License No Location of land on which proposed work will be done: bcr St ...... ouse m reet, Hamlet County Tax Map No I000 Section Lot Subdivision Eiled Map No (Name) State existing use and gccupancy of premises and intended use and occupancy of proposed construction: and occupancy ............ b. Intended occupancy ...... · - .' , ~,~:;:;,.. ~.,~ ............................. ~ .~ Alteration .I Additio ' ' 3. Nature of work (cheek which apphcable): New Building .......... n ................. S'¢iraming pool..., ...... , . .., Tennis Court ......... A¢iceasory Building .......... Fehee .... Other Work; ....... 4. Estimated Cost ...... .'--' .'~ · "-'. ................. (to be paid on filing this application) 5, If dwelling, nmnber of dwelling units .............. Number of dwelling units on each floor ................ If garaee, number of cars ....... i .......... 6. If business, commercial or mixed qccupancy, specify nature and extent of each type of use ............ 7. Dimens OhS of tx st ng strUctures, if any: Front.., ......... Rear ......~..1' .... Depth ...... Height ............... Number of Stones ...... · .............................................. Rear Dimensions of same structure witl~ alterations or additions: Front ................................... I · . ..... '. Number of Stories ................... ..................... ..... ... 8: Dimensions. of entire new construction:, ,Fr°nt". .. Rear ............... Depth ~.~, .p../.1~.. ~,. ,. Height ............... Number ot7 Stones, :~ ..................... . -~ ? ............ , · · 9. Size of lot: Front ....... ~ .~.'.'~f.. ....... Rear .... ~.~q). .............. Depth .. i~-.~ ............. ,.. of Purchase i .... . Name of, Former Owner 10 Date · 11, Zone or use dxstnct ~n which prermses are situated .... ; ...................................... , · ' ' ' si ' '' ' ' 12. Does proposed construction vmla;e any zomn aw, ordinance or regulation .......................... 13. Will lot be reoraded .......... I .................. Y~ill excess fill be renioved frolla_premises:~ _ 14. Name of Ow[er of premises .~.~¥~fw .*~ .~l.~q.~.~kl~qress ~.~¢gML~. l).h.'7...F~,~'p.¢?PYrone No. ',~ .~ 7'.Uo.l~o. !... Name of Arcintect ........... ] ................. Address .............. Phone No ....... '~' Name of Contractor ~.'(~.~.l.hl. ~.~4.~.¥ ........ Address ..... iiiii.. ........ Phone No. 15.Is this property loeatled within lO0 feet of a tidal wetland? ~¥ES .... 'NO-/:q-- *If yes, $outhold Town ]Tr.ustees Permit may be required. PLOT DIAGRA~ Locate clearly and distinctly all buildings, whether existing.or p, rop. ose, d, a~. fl~lndic.ate MI set-back~ property lines,, Give street and block number or description accoming to aced, ann snow s~reet names an~ interior or corner lot. STATE OF NEW Y.-~.RK)F'/./, ,o o COUNTY · ...... ~r/~.. ~, · ~~.~ .............. being duly sworn, deposes ~d says that he is the applicant · ..' (Name of individual sign?g Montract) above named, i the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul,y authorized to perform or have performed the said work and to m~e and file this application; that all statements conthined in this application are 'true to the best of his knowledge and belief; and that the work wHl be perfommd in the m~ndr set forth in the application filed therewith. ' Sworn to before me this ~ ...... , .......... .... .... ,