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HomeMy WebLinkAbout22857-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23933 Date OCTOBER 5, 1995 THIS CERTIFIES that the buildin~ ADDITION TO ACCESSORY Location of Propert~ 20 ATLANTIC AVENUE GRMENPORT NY House No. Street Hamlet County Tax Map No. 1000 Section 34 Block 5 Lot 5 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 14, 1995 pursuant to which Building Permit No. 22857-Z dated JUNE 28, 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 AN ADDITION TOANACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N364354 PLUMBERS CERTIFICATION DATED KEITH MCCAMY & ARDEN SCOTT N/A SEPTEMBER 22, 1995 N/A Rev. 1/81 FOBM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ 22857 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ................................ 19 ........... Permission Is hereby granted to: ..... ...................... ...... ~~ ......... ~.~....../../...q.~.. to...~..,~.~,~ ........ ~ .......... ~.J.~.~../... ....... ~ ........ ~......~~.,~ ...~...,~........~ .......... ~......~..~ ........ ~: ........................................................... CounlyTax Map No. 1000 Sectlon....?,....~,., ........... Block,,...~ ........... LotNo ......... ~.,..,~,,. ......... pursuant to application dated ............... ~..~..~...../..~.., ................ 19.....~.,~.~..'~.., and approved by the Building Inspector. Rev. 6/30/80 SEP 2 8 1995 BLDG, DF-PT. Form ~o. 6 TOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN UALL 765-1802 TOWN O,F~§O?~J!~,QLD_A~ PLICAT1ON FOIl CER'FIFICATF, OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the £ollowing: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and onusual 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/]0 of L% lead. 5. ~ommercial building, industrial building, multiple residences and similar buildings and installations, 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: 1. Accurate survey qf 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 tbe applicant. If a Certificate of Occupaucy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 1. Certificate of Occupancy - 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 building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00,, Commercial $15,00 New Construction ........... Old Or Fre-existing Building .... ~ .......... Location of Property...~.~ .................. ,~.~.~-...~r~.~ ........... ~.~..~,. House No. Street Hamlet Onwer or Owners of Propert y.. ~J.' ~r~.. ~. ~.~ ~-~ ..... g~p/ ....................................... County Tax Hal, No 1000, Section....-?.z./ ....... ]Hock .... ~.~. .......... Lot.~ .................. Subdivision .................................... Filed H~lp ............ Lot ...................... Per,,,.t .... . . llealtb Dept. Approval .......................... Underwriters Approval .~. ...................... PI. an,lng Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate~f. ........ Fee Submitted APPLICANT -THE 'NEW YORK'BOARD:OE::iEIRE UNDER WRITERS::: A .i'" "~7:1~1093 BUREAU OF ELECTRICITY ,," r ~ ~ ~: ~ ~ ~T :' 8S JOHN STREET, NEW YORK, NEW%/ORK ~OO3B '" ~a~ S~P~R 22,199~ ~pplication~o, on~le ' 8~4~e294/94 * . N 36~354 -THIS THAT only the electrical equipment ~ ~scribed below a~ int~uced by the applicant ~med o~ the a~ve aPPlication number in the premi~es of ~EN SCOTT/~ITH McCOY, 4~4 AT--TIC A~, PO~- 4A, G~ENPORT,~ N.Y. ~s examJned ort ~EPTE~ER 18,~995 and found to be in compliance with the NaMon~ Elect~cal Code. DRYERS mRNACE MOTORS I FUTORE APPLIANCE .EDERS ,PEOALREC PT TI.ECLOCKS [ BELL IuNIT HEATERS I SERVI~ DI~ONNECT I~.01 S E R V - ~ I ~:~C ~E I lee CB 1 X 1 4 1 4 ffHER APPARATUS: MOTORS, 1-F H.P. PANELBOARDS, 1-3 CIR. 1OO G.F.C.I,-7 425 MONSELL LAN~ . . ._ ~: , . CUTCHOGU~, I~'Y, 11935 This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors ~nay be identified b~ their credentials. 8 1995 BLDG. DEPT TOWN OF Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD August 25, 1995 Mr. Arden Scott Box 635 Greenport, NY 11944 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 # 22857-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. R£O. UI~ED OCCUPANCY OR USE IS UNLAWFUL WITHOUT C, ERTIFICATE OF OCCUPANCY APPROVED AS NOTED DATE: NOTIFY BUILDING DEPARTMENT,,AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE, 2. ROUGH - FRAMING & pLUMBING $. INSULATION 4. FINAL o CONSTRUCT{ON MUST BE COMPLETE FOR C~O, ALL CONSTRUCTION SHALL MEET REQUIREMENTS OF THE N.Y. CONSTRUCTION' & ENERGY NOT , RESPONSIBLE FOR CONSTRUCTION ERRoRs q , .~ ~ F'OO'FIM~ ~F__'.LI2=~ N.$ PE CT [ ON REPORT DATE COlqHENT$ FOUNUATION (2ND) ~ . !! ====~= .................................... INSULfiTIO~ PER N. ~. _ ......... ADDITIONAL COHHENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ] I~JLATION ~]~'INAL ] FIREPLACE & CHIMNEY REMARKS: DATE iNsPECT~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION lST [ ] ROU~PLBG. [ ] FOUNDATION 2ND [/_~4NSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE-& CHIMNEY RrMARKS~~ ,INSPECT~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]/~N~DATION 2ND [ ]INSULATION [~/]' FRAMING [ ] FINAL [ ] FIREPlACE&CHIMNEY R£MARKS. ~~~,~~~'-- DATE INSPECT~~~ 76S.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION l ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL []FIREPLACE&CHIMNEY DATE , INSPECTO LOT I MA P OF CLAUD/O t~ BUCKLEY. , PROPER TIES ON ATLANTIC A~HNU, E A T GREENPORT TOWN OF S OUTHOL. D SUFFOLK CO, F/LED d,4N. II~ [SOft FILE Ns 481 cLAd010 CENT/F/ED TO .' USL IFE T/T'LE INSURANCE CO. ltEN BEN T H. MARDEL . donack associates ~1~ west main street riverhead, new york 1'1901 (51~)3~9-,1¥17 (21~) 746-30P0 J April 29~1983' John~- B3-241 ! 1000'034-05~05 Scale = I"= ZO" Examined ............... , 19 Disapproved a/c ' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD~ N.Y. 11971 TEL.; 765-1802 , APPLICATION FOR BUILDING PERMIT BOARD OF SETS OF PLANS ~SURVE¥ ~CIlECK .SEPTIC' FOR}I ? ......... HAIL TO: Date. ................... 19... '" INSTRUCTIONS a.~ This 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 public sti'eets or areas, and giving a detailed description of layout of property mugt be drawn on the diagram which is part of this appli- 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 i~sued 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 gr. ant~d by the Building Inspector. ~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a B~ildi~g Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordknances 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, and regulations, and to admit authorized inspectors on premises and in building for necessary in~ ' -- (Signature of applicant, or name, if a corporation) .... ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Name of owner of premises t1~.¢¢.. ~.¢r/7 ¢- ~.¢/~// ~td~t>/ . (as on the tax roll or latest deed If applicant is a corpgration, signature of duly authorized officer. ' (Name and title of corporate officer) Builder's License No .......................... Plumber's Licen~ No .......................... Electrician's License No ......... ' Other Trade's License No ...................... Loc¢tion of and on which proposed work wil be done .~o.~.~.rk/l//.rf.~..,{.~/~. , : ............. ' ..... .......... ' ........ .77 ....................... ltouse Number Street Hamlet County Tax Map No. 1000 Section ... :...~...~. ........ Block ..~. .......... :... Lot...Jif. .... .......... Subdivision ........ . ................... ......... '. Filed Map No ............... Lot ............... (Name) 2; State exJstJug use and occupancy of premises and intended use and occupancy of prOposed construction: a. Existing use and occupancy . .'.~ .~. (.~.~'.,X~/..~'7 ................. J~.k,T[QO¢..~.I[.}i.~[~Q~J ..................... b. Intended use and occupancy . . .~.-~..~¢...~..~., .~....'¢~.. ...... .'~.q .m,3.. ~of~¢P, ,ell[);dg~ .et~. . · ' , ~et ,ii~;fi~'~i~'~'.'~f~' ................. .3. Nature of work (check which]applicable): New Building .......... Addition..' · · · Alteration ....... ~.. Repair .............. Removal : ......... Demolition · ... i ........... ' ......... Other Work ............ 4. Estimated Cost ~ .~.~.~. ! · ' ' ' ~0 ~?. (Description) ·' ' ............. Fee i (to be paid on filing this application) 5 If dwelling number of dwelliig units Number · If garage ' · .............. ofdwelling units on each floor ................ · ,number of cars .... . 6. If business, commercial or mi~ed occupancy, specify natu a~nd extent of.each t,y~pe of use ...... 7. Dlmenstons o! existing structulres' if any: Front .... Rear . .t De '~" ' ight it3 6 ..... · pth ....... .......... Number of Stories ~ ' ' ........ with ..................................................... Dimensions of shine structure alterations or additions: Front IL % Depth ~,~'~ .~." · Rear It '~ ............... 4...Height ...... · ........ ,. Number of Stories 1 8 D' 'onsof tire n Itu ti Fro Rear · lmensl en ew cons c on: nt .............. : ............... Depth j.. Hight Number fSt ri ' ' 9 Si flor F t ~.~ I.~'.'..J Re r .~q .......................................... · /~-.~ ' D pth SO~a~. 10. DateofPurchase . /{'.~.~ ] ..... NameofFo ....... '' Zone or use district m whmh premises are situated . .~'.$.1~.~'&'/'~4-~- ' ' ' ' ' 12. ' .~ · ' ' ' .................................. Does proposed constructmn violate any zomng law, ordinance or regulation' ' . ' ..... 13. Will 10t be regraded }/~.~ . ! .......................... Will excess fill be removed from premises: ~es v~o 14. Name of Owner of premises ~..~r.'!. bi .c~--a..~.~ ..... Address 4~4':~rl~rlc. d~K ..... Phone No. Name of Architect ................. Address .......... Phone No ........ ~ ': .... Name of Contractor ........ i .................. Address ................... Phone No .......... , ..... 15.' 19 this property within1300 feet of a tidal wetland? *Yes ........ No .... ; .... · If yes,'Southold iTown Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly ali buildings, Whether existing or Proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or descriI tion according to deed, and show ~treet names i ~djcate whether interior or corner lot. '! , . ~ . · . ,~.rt. mv~e~ j~,~ . 'i FNEW~ , ~i~ ' ~.t~' : cou y ....... · .,. ' ' '~ ...... l ................... being duly sworn, depose5 and says that he is the applicant (Name of individual signin,g contract) above named. . i . ~eis the ~ " "" : (Contractor agent cor'porate officerv etc ) ............. ~f said owner or owners, ~d is duly hutfio~zed to perfom or have perfomed the said work and to'm~e and file this ~pplication; that all statements c~ ~i~ed M this'application are true to the best of his knowled e and belief' ~ork ~fll [oe?erfoa~d m the~ ~e] s~et forth m tile application filed therewith, . g , and that the )worn to oelore me t~is / / ]. .............. .......... ~ .... ~...~cc y . /I .......... ' 4 l oas, . / '. ........ ( ..... ........ . ~,~ ~r,, Ma~ 31, 15~¢ , [~,gnature ?l applic~t) .