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Home My WebLink About22399-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23564 Date MARCH 22, 1995 THIS CERTIFIES that the buildin~ ALTERATION Location of Propert~ 350 MAC DONALD ROAD LAUREL NY House No. Street Hamlet County Tax Map No. 1000 Section 145 Block 4 Lot 14.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 3, 1994 pursuant to which Building Permit No. 22399-Z dated OCTOBER 20, 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 ROOF ALTERATION FOR A "NON F=%BITABLE" STORAGE AREA TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BERTRAM &MARGERY WALKER of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 H/A N/A N/A FOI~M TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N£ 22399 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ......~....,~..~,.,, ,~., .......................... lg,..?.~ Z Permission is hereby granted~ / , / ~ ,, ....:.~.~....r..~.~......~.~../..~..~..i... ~~/../..~.~ ................ .~ ....................... ~ ..... .......... ~~....:...~..:...~......?....:.,..~ .... to ....~...~..~...~.z(~~....~.......~..,~o~.......>..l/..e~z~.~.... ........ ..~...~..~ ........ ...,~..../.-.~.~.n.7..~......~.. ~.~..~ ..:..~.~. /~,~.~ ~.6 L ...Z.~.......,~.~........:...~..~.6~...:~....~...,.~...~:.~/..~..,~....~;.~.......:. ...... .~.~...~z./.,..~.~ ....... ~.......~.~.?.../.,.:.~...'7(:,~..., ................... : ........ at premises located at......~.,~...(~.. ....... ,~.. ,~,~.......~.,J~),~.J~../~,.......~¢ .......................... ................................................. ~.~~ ./.........~,...~..,. ................................................. Coun~yTax Map No. 1000 Section ...Z .~._,~ ..... Block ........ ~ .......... Lot No..,./....~..~....~.. .......... pursuant fo application dated '"i ............ ~'~'~" ................. 19,, .~...~,.,..,, and approved bythe Building Inspector. Fee $.,, .,~"..~,.. ............ Rev. 6/30/80 STATE ENERGy CODE FI;~AL -.if ADDITIONA'L COM~IEIlTS: Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 TO~JN O ..... O ~O ........................................ APPLICATION FOIl CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new buiiding 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. Appro~] of electrical installation from Board of Fire Underwriters. 4.~ Sworn ~tatement 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-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. Fees 1. 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 Buildine - $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 $i5.00 Date ......................................... ~ew Construction.~.~ ...... Old Or Pre-existing Butlding.../~./~.~ ........ ~ ,ocation of Property...~.~-~... ~..~ ~.~.z~~.. ~..~,. ............. .~.~f~... House No. Street Hamlet )nwer or Owners of Property.. ..~/.~..~"' ............... :ounty Tax Map No 1000, Section [~.~.~2~ .... Block .~.. · . Lot bdi isi ~ Fi] d ---~ L ~ {u v on ............................. --.. · e Map ............ Bt. ..................... >ermit No.~..~..~.~.-.~..Date Of Permit pplicant .... ~. iealth Dept. Approval ..... ~ .................. Underwriters Approval ....... ~ ................. Planning Board Approw~l..~.-~-.. .................. (equest for: Temporary Certificate ........... Final Certicate ........... fee Submitted: $... ~.~....~./.~ ............. ...... ............ 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 March 16, 1995 Mr. Bertram Walker Box 1169 Mattituck, NY 11952 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 # 22399-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION, FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION, [/~RAMING [ ] FINAL 76S.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [] FOUNDATION 2ND [ ] FRAMING/,// ['"~ FINAL REMARKS: ./'?//~/~ Examined Approved Disappr°veda/c i FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTM. ENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 i97 4e it BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FOR~I .............. CALL ......... MAIL TO: ?.ATION FOR BUILDING PERMIT INSTRUCTIONS , a. Tins application must be completely filled Jn by typewriter or in ink and submitted to the Building Inspector, with 3 s~ts 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 streets ~r 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 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 co/fie, housing code, and regulations, and to admit authorized inspectors on. premises and in building for necessary ingpegtiogg. ~ - --// .... ...... -- (Signature of applicant, or name, if a corpffration) ' jz q. .............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ./~.~/~. ~:~Wf~. ?..~..~..,~/~dzq:/~ .,~ ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ Plumber's License No. '~ Electrician's License No ~ Other Trade's License No. ~ Location of land 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) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existiug use and occupancy ~.~.x~. b. Intended use and occupancy 3. ture of work (check wh,ch ap cable): New Building ......... Addition ... Alterat n Repair~ ...... ........ Remove .......... Demolition ............. Ot r ,.. ~/f., 5Z .~.~ ~ e~Descripti°n) 4. Estimated Cost..../ ....... i' i .............. Fee ....................... ............. I i (to be paid on filing this application) 5. If dwelling, number of dwelling ugit~ .......... Number of dwelling units on each floor./~..' ........... If garage number of cars /. : . 6 If business commercial or mixedloc~u ant ' ' ' ................................. · p y specify nature and extent of each type of use · Dlmensmns of existing structuresl if any: Front ........... Rear .............. Depth ........ Height Nu ' ' ' ............... tuber of Stones .................................................. Dimensions of same structure wit~ aiterations or additions: Front .............. Rear ...... Depth ..................... i. Height .......... N of St . , . ~ ............ umber ories ................. 8. Dimensions of entire new cOnstruptmn: Front ............ Rear .............. Depth ............ Hight N bl Of St ' e ............... um er orles .......................... .. 9 Size of lot: Front ' Rear Depth I0 Date of Purchase ~ ' Name of Former Owner 11 ............. i..~ .......................................... . Zone or use district in whichprerais~saresituated....... ................................ .......... .... 12. Does proposed construction violMe'alny zoning law, ordinance or regulation .., ......................... 13. Will lot be regraded ........... . ................ Wfli excess hi1 be removed from premises: Yes No i4 Name of Owner of premises ' ~ Address ' Phone No Name of Architect !" Address Phone No Name of Contractor .......... i. · ~ ............. Address ................... Phone No ................. 15. Is this property within 300 ~eet of a tidal wetland? ¢~Yes ........ No ......... · If yes, Southold TownlTrustees Permit may be required. ~ ! PLOT DIAGRAM Locate clearly and distinctly' ail ~uildings, whether ex/sting.or proposed, and. indicate ail set-back dimensions fronl property lines. Give street and block number or description according to deed, and show street names and indicate whethei' interior or corner lot. Notary Publi~.~[.~ ~ PublleoJ~ of N~ NO. Qualified in Surfak Cot Commission Expire~ De~mbe County STATE OF NE~--YOI~, /// S S .... ~' "{ .~.' "~ '_O~4~. · ' . ~)' (.~.( .~.~ ........ being duly sworn, deposes and says that he is the applicant (Name ofindiviaual signin contract) above named· ' He is the .............. (ff~ .CA)..~ . . ............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly, ~uth. orized to perform or have performed the said work and to make and file this application; that all statements contained in this a"'-li~*~ ............ " ............. i~'k' ~.aL:u,* ut* itU%tV tire Ue~[ otnls ~:nowleage ana oelief; and that the work will be performed in the manner s ,~t forth in the application flied therewith. Sworn to before me this ~