Loading...
HomeMy WebLinkAbout22398-zFORM NO. 4 TOWN OF BOUTHOLD BUILDING DEPA/~T~f~NT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z--24103 Date DECEMBER 31, 1995 THIS CERTIFIES that the building ADDITION & ALTERATION Location of Property 9955 BOUNDVIEW AVE. SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 59 Block 2 Lot 5 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTF/4BER 30, 1994 pursuant to which Building Permit No. 22398-E dated OCTOBER 19, 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 ENCLOSE REAR PORCH, SKYLIGHT & FRONT DECHADDITION TO AN EXISTING SEASONAL DWELLING AS APPLIED FOR "AS BUILT" The certificate is issued to GAIL BUCKLKY (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A H-042962 - OCTOBER 12, 1994 N/A ding I~spector / - FORM NO.3 TOWN OF BO. UTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 22398 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ......... .................. Z .~.~,~:~..~..~:..~....zz...z.,~7, , ,,/...~.~. .......... _Z~-~......~..~..~/~.y.~,~......F~,~..~..,c~.....~ ....... .b...~./.~ ..... ..... ~~. ...... ~.~.~.~< ........ ~....~.~....~...~.~ ....... ~.~<~..~.,..~:~ ...... ~.....~.~ .......... ~.~.~5.~.~.~. ........ ~.~.~.~.L...~.~.~.5.~ ........... ~.~.. ......... ~ .... b.~.~ ........ ~ 0..~ .................. ~ ~ ............................... ~ ~ ................. ~.~.~l.r~ ........................... ;..; .......................... : .......................................................... ~,,~m,,o, ,o=,~ ~, ....... ~~..~~ ~.~.~......~.~ ......... '.~ ............................ ............................................ ~..~..~., .......... ~..~.,. ....................................... oo.,~o. ~000 ~,,o~ ....... ~ ........ ~,oo~ ......... ~ ........ ~o,,o....~.... ......... BulMIng In~peolor. Building Inspecfor~ Rev. 5/30/80 ~ · DEC261995 BLOG. DEPT. TOWN OF $OUTH©~ Form No. 6 i: (: ~ ~,.UG, DEPT. f TOWN OF $,0, UTHOLD, Ai:'PLICATIOB FOR CgA~F~CA~g O~ OCCU~A~C~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 A. 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. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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 Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swi~nihg 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 $15.00, Commercial $15.00 Date../..~.0.~.~..~....... ...................... . ........... o. ..... ....... Location of Property.../~.:d~'~ ~-~ f~ ~gJ~./,~.. ~. '%...""~' ~..~//...- House No. Z~ Street Hamlet ty ............. Onwer or Owners of Proper ................................ County Tax Map No I000, Section..~Z.~..~-~-f-.Block---~.:~-~.~....Lot ...................... Subdivision .-.-- ....... · Filed Map Lot ..................... Permit No~.~.~f~....Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval . Request for: Fee Submitted: Temporary Certificate ........... Final Certicate ........... APPLICANT 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 December 1, 1995 Ms. Gall Buckley 20 Parnell Drive Smithtown, NY 11787 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 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 # 22398-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ** - We are returning your check #5476 for $100.00. It is outdated. In order to process your Pre-Co, we need a new one, as well as a $25.00 check for your CO application for your addition & alteration. iH FRAHE & .. " .... ~ -' '-., ".' -":'~':',~I~,'""-~ STATE ENERGy CODE '. -I ~DDITIONAL ~EIITS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ULATION / [ ] FRAMING [ z/] FINAL [ ] FIREPLACE & CHIMNEY ____~~REMARKS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSU~.ATION FRAMING ~"I=INAL FIREPLACE & CHIMNEY ~_ THE NEW YORK BOARD OF FIRE UNDERWRITERS 8(~5e~19 SUR£AU OF ELECTRICITY I~ Sl~i JOHN STREET, NEW YORK, NEW YORK IOo3B O. te · OC~OB~R ~2,~994 ~pplicationNo. onfil~ 06~894/94 H 042962 THIS C~RTIFI~5 GAIL BUCk, 9955 SOtlNDVIBW ~sexa~ninedon OCTO~E~ 07 ~1994 and fouod W be in compliance with the Na~o~l Elect~ ~de. FIXTURE OUTLETS SWITCHES FIXTURES RANGES OVEN5 DISH WASHERS EXHAUST FANS SERVICE DISCONNECT S E R V I C NO, OF CC. COND, PER ~' AW,(]. OF CC. COND NO. OF HI-LEG OTHER AP~RATUS: *NO VISUAL DEFECTS, "An electrical survey has been made of tile eXposed electrical equipment in the premises indicated." "No obvious uns~ti~factor¥ condition wes ~ound. 20 PARNELL DRIVM SMITHTOWN, NY, 11787 GENERAL.MANAGER },1 This certificate must not be altered in any manner; return to the office of the Board if incBr~'ect, inspectors may be identified by their credentials, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUS~iNOT BE ALTERED IN ANY MANNER Disapproved a/c ..................................... {~JIPLICATION FOR BUILDING PERMIT FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTM, ENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... .................... r o . ...... CALL ................ 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 Iocation of lot and of buildings on premises, relationship to adjoining premises or public streets 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 th6 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 pumuant 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 gode, and regulations, and to admit authorizes inspectors on-premises and in building for necessary inspection~;,.~/~//, ,~, ,~,~ . , (Mailing address ~'.a~plicant)//J~/~,, State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporation, signature of duly authorized officer. '~ ~6B-1802 9 AM TO 4 ~ FOR TH~ UNDERWRITERS CERTIFICATE FOIJ.DWING INSPECTIONS: .............................................. ~EQUIR£D 1, FOUNDATI©i¥ 'PMTO ~t~QUIRI~D (Name and title of corporate officer) eom P,'~u: ) ' ' USE IS UNLAWFUL Electrician s License No .................. S;~,, ,,~, ,~. & E~ 0F OCCUPANCY -,-,' Other Trade's License No .... ..................t~ t,,,: . .'~ ~?:',:~8~, ~. 1. Location ofland on which proposed work will be done. . .......................................................... ................... House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction'. b. Intended use and occupancy ...... ~ 9~.~ .... /~o.~ ~i %~,~,. .... .~.,' .4:;.~ ,,~3 ............. 3. Nature of work (check which pphcable): New Building .......... Addition ......... Repair ............ Remo~ai .............. Demolition .............. Othe 5. 6. If business, commercial or mixed !occupancy, specify nature and extent of each type of use '~ ....... ' .... · D~menaons of ex~stmg stmctures~ if any: Front Rear Depth Height ............... Number of Sto~es .......................................... ' .. . . D~enslons of same structure with alterations or additions: Front ................. Rear .......... ~ .... Depth HeiSt Number of Stories 8. Dimensions of entire new cOnstmmion: Front ............... Rear ............... Depth ............. Height ................ Number of Stories .......................................... 9 Size of lot: Front ~ Rear Depth I0 Date of Purchase ' ' Name of Foyer Owner 11. Zone or use district in which pre$ises are situated ................................ 12 Does proposed construction violaie'any zoning law ordinance or regulation: 13. W~ lot be regraded . · .f..~. ..... ~ .... ~ ...... Will excess fill be removed from premises: Yes 14. Nme of Owner of premises .~ ~g~e~ . Address ................... Phone No .............. Name of Architect ..... ~... ~ ...........~" ' . Address ................... Phone No .............. Nme of Contractor .......... ~ ................. Address ................... Phone No ................ 15. Is this property withln 300 feet of a tidal wetland? ~Yas ........ No.~ .... ~If yes, Southold T~n Trustees Permit may be required. -.. ~ PLOT DIAG~ Locate clearly and distinctly ~I 5uild~gs, whether existing.or proposed, and, indicate ~1 set-back d~ensions from prope~y ~nes. Give street and block nflmber or description accord~g to deed, and show street nines and indicate whether (Name or maiwaual signinl contrast) above named. He is the ! (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly &uthorized to perform or have perfo~ed the said work and to m~e ~d file this application; that all statements contain]d ~ this application are tru%to the best of his knowledge and belief; and that the work w~l be perfomed in the m~ner s~t forth in the application filed therewith. Sworn to before me this t ,, g ar reo~appncanu SCALE-30, I m, l,,~oh~ul'4 E NIT ~ · ~'ll:'F_. .,!