The URL can be used to link to this page

Home My WebLink About22525-zFORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCuuFANCY No Z-23486 Date FEBRUARY 9, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property. 915 PRIVATE ROAD ~31 SOUTHOLD NY House No. Street Hamlet County Tax Map No. 1000 Section 77 Block 3 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 5, 1994 pursuant to which Building Permit No. 22525-Z dated DECEMBER 8, 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 ONE CAR GARAGE ADDITION TO AR EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ALICE J. HUSSIE of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 (owner) N/A N/A Building FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N£ 22525 Z Cou~TaxMop~o. ,000 ~eo,,o~ ....... ~.7... ........ B,oo~ .......... .~. .......... ,otNo. ../.~ .................. pursuan, to application dated ................. ~....~....~. ............... 19..¢.¢ ..... and approved byfhe Building Inspector. .... 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. S, worn statement from plumber certifying that the solder used in system contains iess than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Cdmpliance 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 ali 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. 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-existin~ 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 FEBRUARY 8, 1995 Date ....................... ti X Old ildi New Construc on ........... Or Pre-existing Bu ng ................. Location of Property 915 PRIVATE ROAD #31 SOUTHOLU, NY House No. Street Hamlet ALICE HUSSIE Onwer or Owners of Property ............................................................... . .. County Tax Map No 1000, Section .... ~? ....... · Block... . ......... 3 Lot ..... {~ Subdivision .................................... Filed Map ............ Lot ...................... Permit No. 22525-Z .Date Of ~o~m~ 12/8/94 GEORGE TERRY ~ r .................... Applicant .......... Health Dept. Approval ......................... · Underwriters Approval ....................... . . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ..... ~ ..... Fee Submitted: $ 25.00 (CASM) CO#Z23486 - REC#49085 ALICE HUSSIE Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYor~ 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 23, 1995 Mr. George Terry Private Road Southold, NY 11971 Re: Alice Hussy Prem: 915 Private Road #31, Southold 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 ~ 22525-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ,, ...~;:: ;~':. ,';.. -.-.;:,..~ ~..~: .: ?ID.~T~OI! ' ' '"' {2nd } JLgTIOII PER '~. STATE E~IERGy CODE {,5 ...l ~ 0 BUILDING DEPT. INSPECTION [ ) FRAMING ~ BUILDING DEPT. REMARKS DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined · ~' ...... , IgF..~' TEL.: 765-1802 Disapproved a/c ..................................... LIUI DEC APPFI TION FOR BUILDING'PERMIT -- ~ ' ~NSTRUCT]ONS BOAAD'OF HEALTH 3 SETS OF ~LA~s SURVEY ClICCK SEPTIC FORH HAIL DESIGN OR CONSTRUCTION ERRORS I. Location of land on which proposed w'~)rk will be ';:ione ............ ...... i .... · i..: ........ ....... '.: ............. House Number Street Hamlet Cotmty Tax Map No. 1000 Section .................. Block .............. :. · · Lot ................... Subdi¥ision..; ..... . ............................. '. Filed Map No ........... Lot (Name) /~ ~ .s / ~/~ o c c ~ State existing use and occupancy of premises .... , -' - ........ occupancy of proposed construction: a. Existing use and occupancy . /~..,,=fv~Y'r ,'~¢ 5 / d~..,,,/.<.e...] ..,~ - ' ~ -e_- ' ' '~"q ~ ~' "~ ......... b. Intended use and occupancy .. ~ P '- ' .................... , ................ j~,..,~-;'.,;.. ~..' , ;;~., ,. ........... FOLLOWING INSPECTIONS: t. FOUNDAT{ON TWO REQUIF~ED. FOR POURED CONCF1ETE 2. ROUGH , FRAMING & PLUMBING 3. INSULATION 4. F~¥AL CO~4STRUCTION MUST 8E COMPLffrE FO~ C.O. ,ALL CONSTRUCTION SHALL THE REQUIREMENTS OF THE STATE CONSTRUCTION' & E~ERGY COO~S. NOT RESPONSIBLE (Name and title of co druid" ............... : rp officer) · , · /3 o Builder s License No ...................... Plumber's License No Electrician's License No ........................ Other Trade's License No ........ A ' ' ' ~ ......... a. Ttfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ~ 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'eet., 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'befvre issuance of Building Permit.. d. Upo'n approval of this application, the Building Inspector wilt 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 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 i~, building for necessary~.spections.. (Signature of applicant, or name, if a ~;;~gr'ati'o'n') .... . (Mailing address of applicant) ' State whether applicant is owner, lessee, age~t, architect, engineer, gene}ai 'contractor, electrician, plumber or builder. If. applicant is a corporation, signature df duly autliori:~ed officer·' N~FY 8UILOING DEPA~ - ' 7~5-1802 9 AM TO 4 PM FOR THE '3. Nature ' ~ ' ' of work (check which applicable). New Buildin,, ' ' ; ..... ' . ' Repair .............. R~moval .. ~,, .... ./. .... ^oomon .......... Alteration . ..~.. ! ........... ~emouuon ..... ; .......... Other Work. 4 Estimated Cost d ,o p.~.i o o (Description) ' ' (to be paid on filing this application) 5. Ifdwelling, nunlberofdwelli!ngunits [ .; ., ~ . If garage, number of cars / .......... . r~umoer oi awelhng units on each floor.. /. If business, commercial or mixed occunancv s,,ecif- -~, ..... ~ '- ' ' '. .............................. . ,',. · .. · . r r ~, v ,~ ,,ummanaextentot.eachtypebfuse~ ..~.. . . 7. ~lmensmns o~ existing stmctBres, if any: Front..~..~. ~ .... Rear . .. ' .... ~Helght . ..~2.~. ........ NumberofStories ~ ~ . "~. · . Depth i.~.'..~... ~mensmns of Same structure w~th alterations or additions Front ~ ............ : ' ' '~A ............ ................ Rear. ~ .~ ........... De th 0 t ~ ~ P .............. '. · . He ~ ' · . ~ g .................. .. · Number'of Stories..~ ..... '.; 8. Dm~ensmns of entire new con'stmctinn. ~,, ~- m .... ; Rear .~. ~ ~.=~-:~g.m~~ · ' ~ ~ '~l'~t":' .~.~ ......... H ~.~ ~ ........... mberofSt~fies .................... ..~,;. ~ .1~ ~! ~ ~ -. 9. Size of lot: Front ....... ~, ............ Rear ............. ; · · De ..... ~ ...... ...... pth .v. ........ -.. 10. Date of Purchase 11. Zone or u~ ~:~,-' ..... ~ · . ~ · .~Name of Fo~er Owner ~...,~r~. ~ ~ ~,~nCt m wn~cn premises are muated..4~ ...... ~'G ~ ~ ........ ~: ....... 12. ~,~s. proposed construction v~olate any zoning law, ordinance or'r;;3;~;;'~'.'}/(/~ ...... % ........... ' ..... '13. wm lot be re~raded ~) r~ ' '~ ......... - ....... 14. N~e ofOwnerofpremises~¢.~ ~'/'~ '' ../~dl ex~e~%~e~ym~~~; . Yes N~6 of Architect . ~- . : '- NmeofContractor~2g~,¢[~ (~ ,~ ~o~ ~'3'b~;o.d.~.PhoneNo ......... 15.' *If yes, Southold] Town Trustees Permtt may be required. ' 19 thts property wzthxn[300 feet of a rt~a· ..... .-,,~.10~q,...Phon~.~. , u & weuxanat *Yes ........ No.~ ...... ' .. ,[ PLOT DIAG~ Locate clearly ~d distinctly ~1 bulldogs, whether existing or proposed, ~d. indicat¢ ~1 set-back d~ensions from prope~y ~nes. Giv~ street and block number or desc~ption accord~g to deed, and show street n~es and indicate whether ~t¢~or or corner lot. STATE OF N~R~ ill SS ' ..... (Name of~dividu~I's~di~ ~t;d~ '~ ........ being duly sworn, d~pose~ =d says that he is th~ applicant above named. te is the . . o. ~ . ' (Contractor agent .......................... ' .............. ~ , , corporate officer, etc.) ~f said owner or owners, ~'d is dul~ authorized to perfom or have perfomed the said work pplication; that all statements contai'ned ~ thisa-Nicatio ............ and to m~e ~d fie this · / , vv , u,u true m tile oesr OI~lS Knowledge and belief, and york will be pe~fomed in the m~ner%et forth ~ the a--lic ........ t mt the ,worn to before~me tkis [ ..: ...... ;ota~ Publi · · · County ~ ~mi~ion E~lres Oeoember ~,19~ / , ~ s arure oI appuc~t}