The URL can be used to link to this page

Home My WebLink About22511-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-23493 Date -FEBRUARY 15, 1995 THIS CERTIFIES that the building Location of Property 2050 DEPOT LANE House No. County Tax Map No. 1000 Section 102 Subdivision ADDITION CUTCHOGUE, N · Y. Street Hamlet Block 2 Lot 5 Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 22, 1994 pursuant to which Building Permit No. 22511-Z dated DECEMBER 2, 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 INSTALLATION OF HEATING SYSTEM TO EXISTING MEETING ~ALL AS APPLIED FOR. The certificate is issued to MARIAN COLUMBUS CLUB, INC. of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N-340548 - JANUARY 25, 1995 M/A / ~ //din~ Inspector FORM TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. N~o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AU~.~D) (// 225:1.1 Z / CounlyTax Map No. 1000 Section ....,l~.,..~.. Block ........ ~ ......... Lot No ............................. pursuant toappllcaflondated .............. ,~...d~........~...~ ..... 19 .~......~..., and approved bythe Building Inspector. .... Rev. 6/30/80 Building Insp~or ti_ i - BLDG. DEPT. ', TOWN OF SOUTHOL;D_.,. ........ j Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY At* 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 2/10 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. 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-existinK Building - $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 Date ........ ~./.~?/ ........................ ~0'''~ . New Construction ........... Old Or Pre-existing Building ..... ~.. ......... Location of Property ...................................................... House No. Street Hamlet Onwer or Owners of Property.../.~.~.~!~../~. County Tax Map No I000, Section...~.~...~. ..... Block ............. Lot ...... Subdivision ' Filed Map Lot Permit No.~.~.~..f./...~...Date Of Permit ................................ .. . Applicant ... ..... .. Health Dept. Approval ....................... .. . Underwriters Rpproval ....................... . . Planning Board Approval ....................... . q for: Te porary Certific Final'Certicate ~ Re uest m ate .................. ;,','? 3 ¥c/2, 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 January 19, 1994 Mr. Vincent W. Annabel C/O Marian Columbus Club Depot Lane Cutchogue, NY 11935 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 # 22511-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. LATION PER '~. STATE E~:ERGy 7G5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [/,~AL REMARKS'- ~ /~ V THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1185077 BUREAU OF ELECTRICITY V 85 JOHN STREET. NEW YORK, NEW YORK 10038 Dat~ JANUARY 25,1995 Application No. on file 06849795/95 N 3~5~8 THIS CERTIFIES THAT KNIGHT8 OF COLUMBUS, DEPOT LANE, CUTCHOGUE, N.¥. in the fottowlng location; [] Basement [] Ist Ft. [] 2nd FI. Section Block ~s examlned on JAJ~UARY 19,1995 and found to be in compliance with the National Etectrical Code. Lot FIXTURE OUTLETS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT OTHER DRYERS SYSTEMS E E R I C t40. OF CC COND PER ~' A W G NO. OF HI-LEG OF CC. COND. NO. OF NEUTRALS A. WG NEUTRAL APPARATUS: ROSLAK ELECTRIC P.O, BOX 164 CUTCHOGUE, NY, 11935 LIC. #3677-E GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspq~toFs may be identified by their credentials, COPY FOR BUILDING DEPARTMENT, THiS COPY OF CERTiFiCATE MUST NOT B~'!~RED 'NANY MANNER. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 INSTRUCTIONS B~ARD OF HEALTH 3 SE~$ OF PLANS CIIECK -;;,:,/, .............., SEPTIC hO~py: ~ CALL ................. HAIL TO: Date ............. z~.//. ~..~. 19~,~' ... 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 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 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 t 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, buil~ng code, housing code~ and regulations, and to admit authorized inspectors on premises and in building for necessary i, ns~tio,ns. .~) ~/oa 7, . /~ ~ . (Signature of applicant, or name, if a corporation) (Mailing adTtress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. .......... (5. ' Name of.owner of premises . . g) ~ /3 0 5' ~ ' (as on the tax roll or latest deed) If applicant is a corporation~ignature of duly author!ied officer. . (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Locaiion of land on which proposed work will be done..~...~. 0...~.~. ..... .~.~../~.,/~...:ff~. f./f..O, fff. 5 ..... ).- House Number ' "'~'~' Street ............................... Hamlet ............. Connty Tax Map No. 1000Section ...:/.d~..~. ........ Block .....~. ....... :... Lot....~.: ............ Subdivision ........ . ............................. Filed Map No ............... Lot ............... (Name) State existing use and oc.:':y'..:-;, ,,f p~,m: i>. ,nd intended use and occupancy of proposed construction: a. Existing use and occupancy . . .'/.~.}.~.-'..~..f.f./.¢?. .... · '~' '/? f' '~'] .......... *:;'.';qL'.:i..<;. i ............ b. Intended '3. Nature of work ( heck whtct~ apphcable): New Building .......... ,~ddition .......... Altera~;[on .... Repair .............. R~movai .............. . Demolition ..... ther Work .~...e~. ' .... ' ] ' ~ ..... ' ~ cription) 4. Estimated Cost , ' .-- ' ' ' (to be paid on filing this application) 5 If dwelling number of dwelling units Number of dwelling ' ' ............... . units each floor If garage number of c~s , on ............... 6. If business, commercial or mi~d ~, panty spec'~y d e tent of h type of use 7 D' ' ' ,-- ..... u , a naturean x .eac .; ....... · imens~ons ol existing stmctOres, if any: Front .... ~ Rea ............ Hight Numbe fSt i ' , . Depth e .......... , .... ro ores ..... ... Dim nsion of shin stmct [ ith alterations o dd ..................... ' ' Front ................ e s e tlre w r a ltlong: D pth ' [ HeiSt .............. Rear " " Nub fStofi '" 8 Dimensions ofenti construction: F nt ' Re Depth ' ' . re new ro .............. : ar, ............... .. .......... ... Height ............... N~mber of Stories ......................................... 9 Size of lot Front .. 'Rear .............. ' : ......... " .......... ~ ........ Depth I0. DateofPurchase I ~ ' '.~'" ' 2 .......................... I 1 Zone ............................. ~ame OlrOmer uwner .... district in whi h ~remi itu ted ......................... . oruse c sesares a .., ......... 12 Do sp oposed co tructio v~olate ny ni gl ordin ~ce lation ' ' . e r ns n a zo n aw~ a or regu : .... , ............... 13. Wflllot be regraded 14 N ~ ~ ' ' ', .... t .................... Will excess fill be ~emoved from premises: Yes No . me o~wner mpremmes . ~ ......... , ........ Address ................... Phone No ............ ;... N~ of ~chitect .... ~ ' Nm f C .... ~ .................. Address .......... Phone No. . e o ontractor .... ~ Add · ' ................... : .... 1300 No ' ' ty ...................... tess ................... Phone ................ 15. I.s this proper within feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold~Town Trustees Permit may be required. ~ ' PLOT DIAG~ Locate clearly ~d distinctly ~1 bulldogs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from prope~y ~nes. Give street and bloc} number or description accord~g to deed, and show street nines and indicate whether ~te~or or corner lot. FOLLOWING ~NSPECTIONS: BE COMFL~T5 ~- :'re C 0 STATE CONSTRUCTION OESIGN OR CO~TRUCTtON ~RO~8 ' STATE OF NEW~RK~ //~ couNv oF., % / (Nam~ of individual signing oontr~) ......... being duly sworn, d~poses ~d says that h~ is the applioant abov~ named. He is the . 5.. i ' (Contracto~;r~g;at~ oiL;g; e~ ~ ............. ' ...... 0 ' . I . . f smd owner or owners, ~d ~s dul~ authorized to perfom or have perfomed the said work and to m~e ~d file this application; that all statements contained m this application are /rue to the best of his ~owledge and belief; and that the work will be perfomed in the m~nerlset forth in the application filed therewith. ' 5worn to before me tgig N.W Publio, State of N-- Y~ . .~~~ ' No 487950E . ~ ' '~ ............ · ................. Quallf~d in S~ffolk ~un~ k~ " ' ' ~ ' (Signature of appl c~t) . ~mission =xp~res ueeem~er u,,?;~ ,