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HomeMy WebLinkAbout22504-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23583 Date N3%RCH 31, 1995 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 2870 GREAT PECONIC BAY BOULEVARD LAUREL NY House No. Street Hamlet County Tax Map No. 1000 Section 128 Block 6 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NO%~EMBER 17, 1994 .pursuant to which Building Permit No. 22504-Z dated DE~ER 1, 1994 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 A WINDOW ALTERATION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to RENEE GATEHOUSE of the aforesaid building. SUFFOLK COUNTY' DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N344215 PLUMBERS CERTIFICATION DATED (owner) ~C~ 2, 1995 N/A Rev. 1/81 //Building inspector FO~M NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OU1~OLO, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 22504 Z Permission is hereby granted to: ~...~~.~.........~ ../.~....~~ ........... ~.~~....,, ........ ~... ................ . ,o ........ ~ ~ ~ .~..... ~......~ ~ ~..... ~ Z~.. ~ ~ ...... ........ ~ ...... :~,....:~:.:::.~:: ........ ~::.:~...:~.:~ ....... ~~~, ~ ::~ ..... ~.~ ................. .............. Oo,~,,ToxMa~o. ,000 ~eo~,on ....... Z.~...a'...... ~,oo~ ......... ~. ............ Lo,~o..z../. .................... pursuant ,o application dated ............... ZY{~...~'....~?. .............. 19 .~....~... and approved by the Building Inspector. Fee $....~..~.....~... Rev. 6/30/80 Form No. 6 ~ TOWN OF SOUTHOLD ~ , (i~ ~ ~1 ~ ~ ;,' BUILDING DEPARTMENT . [5 t':~ TOWN HALL ~: ~ · 765-1802 FEB APPLICATION FOR CERTIFICATE OF OCCUPANCY i ..... ' ~LDG. DHP%2 This application must be filled in by'typewriter OR lnk and submitted to the building inspector with the following: for new buildtng or new use: 1. Final survey of p~operty with accurate locatlon of all buildings, property lines, streets, and unusual natural or togographic features. ' 2. Final Approval froa-Eealth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation ~rom Board of Fire Underwriters. ~. Sworn statement from plumber certifying that the solder used in system contains less than 2./10 bf 1~ lead. 5. Commercial bufldtng, industrial building, multiple residences and simllar buiidinga and installationsj 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'a~d Upre-existing" land uses: I. 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 Buiiding Inspector shall stat~ the reasons therefor in writing to the'applicant. '' faiteratlions to~dwellmhg $25.00~ Swimmzn~pool $25.00, Accessory Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of .Occupancy - $50.00 5.' Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...~./Y/f~. ............................. ,ew Construction ..... i ..... Old Or re-existing Building..; ......... Location of Property...~.~.~.O, ........... ~.l,.~...~.~./..L).~ .... House Ho. Street Hamlet Onwer Owners of Property County Tax Map No 1000, Section. ~. .Block ............ Lot ............... Subdivision .................................... Filed Map ............ Lot ...................... Permit No...~.. ~5~09Z~--- - · .~.~[.~...~ ........... ~ace Of Pevmit.-/g~///~;'/ .Applican~.~/~..~. Health Dept. Approval ..................... Underwriters Approval...~../~. ................ Planning Board a rov~l...~.l Request for: Temporary Certificate...~..~ Fina~/~ate......~.... i . ............... ~i~1~5 ~'~ ~"'~"'~-~ '~"~PL I CANT ' 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 February 21, 1995 Environment East Inc. P.O. Box 190 Peconic, NY 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. The check is (outdated/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 # 22504-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. :', THE NEW YORK BOARD OF FIRE'. UNDERWRITERS 10>~:}.093 BURE U OF ' ........ ~ B~ JOHN ~TREET, NEW YORK, NEW YORK IOO3B ....... THIS CERTIFIES THAT , ' ~>: , , <-:' ~ o~y the elec*rlcal qulpment ~ ~scrl~ below and in~uc~ by tl~ applicant ~med on the a~ve application n~ tuber ~n .the prem~es o '~ GATEHOUSE, 2870 PECONIC BAY BL~. , POLE$76/2, ~EL, N.Y. ' ~: ' ~. ~,,~./o{to,~.st,,..ao.~ ~ .~,..,~.~ ~ t.~Ft. ~ ~,,a ~'t. OUT .$~,,. : ~t~ , ~o~:: ~:: t~ examined on FEBRU~Y 27,1995 ' and found to be in complianve with the NaHonal Elect~cal Code, ',. CODE F'r;~L Environment East, Inc. 3075 Indian Neck Lane P.O. Box 190 Peconic, New York 11958-0190 516-734 -7474 765-~802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~JI,.ATION FRAMING [~'j' FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND ,~SULATION [ ] FRAMING [ ] FINAL REMARKS: DATE/,~ ~'/~/~/,INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1803 Disapproved a/c .................................... // (... i,,g nspector) / A~,,L~OATION FOR BUILDIN6 PERMIT 80A~D OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK 7Oq'-- CALL HAIL TO ' f 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 schedulp. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas,'apd, 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 this 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 w6rk. 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 Southold, 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, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. --' (Signature of applicant, or name, ifa corporation) .... .ov. . .o. : . ?.'7 ...... ! ............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engin~-'~, general contract~ electrician, plumber or builder. Nfime of owner ofpreraises (as on the tax roll or latest deed) lof duly auth orized officer. Builder's License No ...... ~..?..b".4..~..-~. ........ Plumber's License No. Electric. ian's License No "'-" Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number Street ~. Hamlet I . . County Tax Map No. 1000 Secti(~n . . .' ............. Block ... ,Q ............ Lot .............. ~. Subdivision ...................................... Filed Map No ............... Lot ............... (Name)t 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ........ i? ...... .~ ............................ ~ .... b. Intended use and occupancy .(~...*~.. .~. . . .L~..< I ,¢'AJ 3. Nature of work (check which appilicable): New Building. ......... Addition .......... Alteration .... Repair .............. Remo?l ............. Demolition ............ Other Work ............. (Description) 4. Estimated Cost ./~.fi .~.(~ ~ Fee ............. ' !~ (to be paid on filing this application) 5. If dwelling, number of dwelling uJiits ,, .]. ........... Number of dwelling units oil each floor ................ If garage, number of cars [, 6. I°' ' ialormi d~c ............................ '~ ............................ I ousJness, commerc xe cupancy, specify nature and e~ype of use " Dim ' sol 'sting tructur "fa F ..x,.~Rear ..... JJ D pth ............. t, enslon exl s es Ii ny: rent.. . ..... e ....... ' He'ght~ ............... Num bar o f Sternest, Ig.j(~ .................. i ......... tl}~'o~s..Front ..12.111111 Rear ..... Dimens'ons of s st ' ' ' ...................... anle ructure wi ..... Depth ..................... ;~ .......... Number of Stories ............. 8. Dimensions of entire new constru~q6fi..' Front .............. Rear ........ . Depth ' '" ...... He .... gl ' · ' .............. ~ It ............... ~'{ber of Stories ............................ 9. Size orlot: Front · · · ~.'.' iiii ........ .~.~,;~ ....................... '0 Dte ~"u ' ¢>~ ...... ] .... ~~' '~ [. ',?'_'_'__"_',-k .... u,~v ....................... ~ . a o~r rcnase ............ , ....... . ......... Name of Former Owner ............................. 11. Zone or use district in wliicb prein'ises are situated . . I , '' %.- ............. ~ .......... [ ......................... 12. Does proposed construction vi~lat? any zoning law, ordinance or regulation: ...L~. ¢~ ....................... 13. Will lot be regraded ...... .~..Q .". ....~ .......... Will excess fill be removed from premises: Yes 14. Name of Owner ofpremises(~gf~.~...~,~,~... Address .~..c..~O~W.~3~O.~. Phone Name of Architect ............ i ............... Address .................. Phone No ................ Name of Contractorl~..~ ...... i .............. Address .f~ -' .~../.q.°) .~?.C~.~. ~;..$~hone No. 7~..~..'.~.Y.~.~.., tS. IS this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold To~n Trustees Permit may be required. '. ..../i PLOT DIAGRAM Locate cl0arly and distinctly all bfiildings, whether existing ~r proposed, and, indicate all set-back dimensions from nber or description according to deed, and show street names and indicate whether property lines. Give street and block nu: interior or corner lot. TATE OF NEW YORK, S.S O U~N:r-Y OF ................. i ' .c (Name of individual signing cQntrh~ct) )ore named. , ........ being duly sworn, deposes and says that he is the applicant FOLLOWING iNSPECTIONS: 1~ FOUNDATION . 4. FINAL C() ¢~7"11B Ji~T~ON 8E COMPI,ETE. F()f~ C,O, ~ ' ALL coNs'muc'rto~ SHALL MEET THE REQUIREMENTS OF THE CODE& NOT ~ES~ONSIBCE ~0~ )ESIGN OR CONSTRUCTION ERROR~ ~orn to before me this ........ /.~. ............ day of..~ otary Public, ...... ~.. ' LINDAJ. COOPER Notary Publlo, State of New York - NO,_4822563, Suffolk. County~ ferm expires December 31, 19__ ..... x ...... County/ / e is the ............. ' agon,t, corporate officer, etc.) ho~ to'fo , said owner or owners, and is duly aut rm or have performed the said work and to make and file this , )plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set ~rth in the application filed therewith.