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HomeMy WebLinkAbout22959-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No E-24054 Date NOVEMBER 30, 1995 THIS CERTIFIES that the building Location of Property 49925 MAIN ROAD House No. County Tax Map No. 1000 Section 70 Subdivision ADDITION SOUTHOLD, NEW YORK Street Block 5 Lot Filed Map No. Lot No. Hamlet 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 7, 1995 pursuant to which Building Permit No. 22959-Z dated AUGUST 22, 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 DECK EXPANSION ADDITION TO EXISTING DECK OF ONE FAMILY DWELLING ~ APPLIED FOR. The certificate is issued to GERARD W. GAUGH~AN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Inspector FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N.O, BUILDING PERMIT {THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ~"~"- Permission Is hereby granted to: '~,/~ . ~ ~,~ ....... .~..,../~......~.~ ............................. ..... ~~./~..~..~. ..................... County Tax Map No. 1000 Section ........ .?....~.. ........ Brock ......... ~ .......... LotNo ....... ~ ............ pursuant to application dated ................. ~.....~... ............ 19...~......~'~.., and approved bythe Building Inspec~,.~ Fee $.,,.?....~.....~.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 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 i. 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-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.06, Connnercial $15.00 Date.. ~. 1~7./~- -~. · .......................... New Construction .......... . Old Or Pre-existing Building...~ ....... Location of Property ........................................... House No. Street Hamlet Onwer or Owners of Property..~.~.~...~...-~.-.~.~--~ .................................... County Tax Map No 1000, Section .... ~.O. ...... Block...~.~.. ......... Lot..~ ................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No..~.~.~. ~...Date Of Permit.. Applicant .% l~ .......... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ........ ~:-.~ ............ l...~. '~' . · .~. ~ ~ __.~ ............ 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 November 22, 1995 Mr. William Conway P.O. Box 1902 Southold, NY 11971 Re: Gerard W. Gaughran - SCTM#1000-70-5-2 Prem: 49925 Main Road, Southold NY 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 # 22959-Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGHPLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [~/FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~/~/~ G9 DATE INSPECTOR FIELD INSPECTION REPORT DATE COHHENTS FOU~DhTIOR { IST) FOU~ATION (2ND) INSULATION PER N. Y. STAT~ E~gRG~ II CODE ,--~-i~ // / - .~ - ~-~ " FINAL !~[ ...... I[ _ _ ...... A~OOF 3~0' f~.OAD FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT.. TOWN HALL SOUTHOLD, N.Y. 11971 ~ ~.._ TEL.: 765-1802 Approved , . . .2-, ............... Disapprgved' a/c .... . .................. / BO,(RD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CI1ECK CALL .~ . . HAIL TO: (Building'ins~~'' '~ :ATION FOR BUILDING PERMIT ~ INSTRUCTIONS a. Tttis 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 mu~t 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 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 Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South01d, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or de~nolition, 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 J, nspeetions. -'- . (Si=nature~°"~ - ' 'of applicant, or naha4, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder. tf applicant is a corporation, signature of duly authoriged officer. (Name and title of corporate officer) Builder's License No .... ] ~57'..~ff.../7/..~. ....... Plumber's License No ......................... Electrician's License No, Other Trade's License No ...................... 1. Location of land on which proposed work will be'done .................................................. . ......., .........' ............ House Number Street Hamlet Cotmty Tax Map No. 1000 Section .. (~).~.(~. .......... Block ... ~ ' Lot ~ Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and o~cupancy of proposed construction: a, Existing use and occupancy .............. . ........................................................ b. Intended use and occupancy '3. Nature of work (check which applicable): New Building ......... ~ Addition ...... Alteration Repair .............. Removal .............. . Demolition .... . Other Work .... ~ (D ripti ) ' est on 4, Estimated Cost ....... £ ..... . ........... Fee .......... i ......................... (to be pgid on filing this application) 5. If dwelling, number of dwelling units ............... Nufi~ber 6f dwelling unltsl on each floor ................ Ifg b of ' arage, num er cars .............. 6 Ifb si i lot i d ....................... 1 ........................... . u ness. commerca m xe occupancy, specify nature and extent of,each typ~ of use ............... 7 Di nsio fexisti t if Fr ...... · me ns o ng strut ures, any: oat ............... Rear ....... ~ ...... Depth ........... Height Number of Stories ' ' Dimensions of shme structure with alterations or additions: Front ............. i ....Rear .................. ptl ' I igl b f St De ~ .................. -le ~t ,: ......... ,..Num ere eries ....... ~ .......... 8. Dimensions of entire new coustruction: Front .............. : Rear ........ ! ..... Depth ............ Height ............... Number of Stories ........................ t ...... .... ................ 9. Size of lot: Fron . ' Rear , .. · ,- ~0 ~' ' ,' ................... tJeptn ~ ................ · ~ate of Purct . · · . .............. ' ......... ~,umu el ~ormer tJ, wner ..: .......................... _ 1. Zone or use district in wilmh premises are s uate ...... ~o ,~ avl ~ ~ ' 2 i di r~ ~'r'~. 3; [,,','.'~r .,~.~.... ....................... _ , Does proposed construction violate any zen n~,law or na ce - ~. -3' Will 10t be regraded .... .~.O'. .................... Will excess fill be removedlfro~ premises: Yes _ 4. Nmne of Owner of premises . O. AqT-~t~ .tO. ~r~,~,~..t,.,,.,~. Address .q.q.~¢.m.,..b .F4,q4.5l~.l,.. Phone No. ,~7~,.~~. .5}.C..o .... . Name of Architect ......................... Address ...... ........... i. · · Phone No ............ Nmne of Contractor ~.~ [h¢.~ .~>.~ .t~.~.~. ......... Address ."~o. $¢4 Jgtq~. ,io,~t~'. Phone No.~,,~.~.'~..~-~.~.,.. 5. I.s this property within 300 feet of a tidal wetland? *Yes ....... !. No...~. · If yes, Southold Town Trustees Permit may be required. '' PLOT DIAG IL52vl Locate clearly and distinctly all buildings, whetlmr existing or proposed, and, indiCate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show ~treet names and indicate whether nterior or corner lot. FATE OF NEW YORK, OUNTY OF ................. · ...~,~t .[~./. lc~.',"r'~ .... .~CI ~.t?O.r4~/ ....... · ......... being duly sworn, depose~s and says that he is the applicant (Name of individual signing contract) ~ove named. ~ ~ . :isthe ....... ........................................ i ............ . .............. (Contractor, agent, cor'porate officer, etc.) ' said owner or owners, and is duly authorized to perform or have perfommd the said work and to make and file this plication; that all statements contained ~ this application are true to the best of hi5 knowledge and belief; and that the >rk will be performed in the manner set fortt~ in the application filed therewith. vorn to before me this ........... NotaP/Public, Stat~ of N~w¥ork ' (S~ture of applicant) No. 4951364 . Qualified in Suffolk County ~ ' Commission Expires May 22, 19 r.~ . _©