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HomeMy WebLinkAbout22448-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23346 Date NOVEMBER 15, 1994 THIS CERTIFIES that the buildin~ Location of Property 12832 MAIN ROAD House No. County Tax Map No. 1000 Section 31 Subdivision ALTERATION & ADDITION EAST MARION, NEW YORK Block 14 Filed Map No. Street Lot 15 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVE~4]~ER 3, 1994 .pursuant to which Building Permit No. 22448-Z dated NO~]~BER 4, 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 S~ENED IN PORCE WITH GLASS & NORTH SIDE DECK ADDITION, WITH 1/2 BAThROOM ON 2ND FLOOR & EEAT INSTaTe.RD "AB BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 KE~/~IT WEATHERLOW & O~S. N/A PENDING - NOVEMBER 11, 1994 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall SouthQld, N.Y. CERTIFICATE OF OCCUPANCY No Z-23347 Date NOVEMBER 15, 1994 THIS CERTIFIES that the building Location of Property 12832 MAIN ROAD House No. County Tax Map No. 1000 Section 31 Subdivision Filed Map No. ACCESSORY EAST MARION, N.Y. Street Hamlet Block 14 Lot 15 Lot No., conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 3, 1994 ~ursuant to which Building Permit No. 22448-Z dated NOVEMBER 4, 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 ACCESSORY STORAGE SHED "AS BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 KERMIT WEAT~ERLOW & ORS. N/A PENDING - NOVEMBER 11, 1994 N/A FORM TOWN OF SOUTHOLD BUILDING DEPARTMENt' TOWN HALL $OUTHOLD, N.Y. N£ 22448 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Building Inspector~2~ Fee $.. Z.'~/.(~,......'~.,,. Rev. 6/30180 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. 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. 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. C. 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-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 Date November 15, 1994 (ALT. 2ND FLOOR) New Constructio~...~ ...... Old Or Pre-existing Building ................. Location of Property 12382 HAIN ROAD EAST MARION, N.Y. House No. Street Hamlet Onwer or Owners of Property....... .KERMIT WEATHERLOW & ORS. County Tax Map No 1000, Section ...... 3.1. ...... Block...,.4. ........... Lot..,.5 ................... Subdivision ................................... · Filed Map ............ Lot ................... . . . No. 22448-Z NOV..4 1994 J. KEVIN McLAUGHLIN Permit .............. Date Of Permit ....... ' · . ....... Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ................. ....... . Planning Board Approval ....................... . Request for: Temporary Certificate ........ --~Final Cerg~ca~e..: ........ 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 ne~/use: I. Final survey of property with accurate location o~ all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply ~nd~ sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of~Fire Underwriters. 4. Sworn statement from plumber certifying that the ~older used in system comtains 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) nonrcOnforming 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 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 Buildinz - $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 November 15, 1994 (ACCY Sm~D) New Construction...~ ...... Old Or Pre-existing Building ................. Location of Property 12382 MAIN ROAD EAST MARION, N.Y. House No. Street Hamlet Onwer or Owners of Property KEILMIT WEATHERLOW & ORS. 14 15 County Tax Map No I000, Section ...... 3.1... .... Block ....... . ........ Lot .............. .... . . .. Subdivision .................................... Filed Map ............ Lot ................. . . Permit No...2.2.4.4.8.:Z..]...Date Of Permit ...... :. .. pplicant ............................. llealth Dept. Approval .......................... Underwriters Approval ....................... . . Planning Board Approval ~ Request for: Temporary Certificate ........... Final Certicage~...~/z~ Fe~ Submitted: $... ~.~. O0 (2nd ;H F~HE &. .. LATIO~! PER N. Y. STATE E}!ERGY CODE FI;!AL ,.if STATE EHERGy CODE FI;;AL · ~DDITIO~IAL C0.~.h~iEIiTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 'LICATION FOR BUILDING PERMIT B~ARD'OF HEALTH 3 SETS OF PLANS SURVEY CIIECK ...... CALL .................. HAIL TO: rk, ant_other appLicabllc't~j{ws, Ordinances or , r ~rr:~v al'~r~e~ ~s~ h e rein describbd. , bui~ing~9~/fe, h~il~de~/a~d ~gglations, and to ~-.~~~,. :~.~,./ ..... .... (~aidn~ ~ddress 0~ ap~fcant) a. This application must be completely filled in by Wpewriter or in ink and submitted to th~ 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 l?y 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. Regulations, for the construction of buildings, additions or alterations or for r The applicant agrees to comply with all applicable laws, ordinances admit authorized inspectors on premises and in building for ~ State whether applicant is owner, lessee, agent, arc, hirt~, engineer, generai contractor, electrician, plumber or builder. .. ~.,~...,~.....t.~.....~.~...o?. ~.% ~.~. ~..o~....~...~,. ....... . ................... ,..: .... (as on the tax roll o~: 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 ...................... 1. Location of land on which proposed work will be'done ................................ ; ~ ............... ...~.~ ...... 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'/, "3 0 -c, cc*~,'= :' .4© '= I' loItUUH loo.qS .~oqmnN osnoH " ............................................................................. .'"~°'~'x.9 ~-~ '~?<~'--,-.'% ............. -.¢~.,%-e. I .................................................. ouop oq ii.~n~ >pon~ posodo.~d rio!tint uo pu~ljO uoD~ooq .[ ...................... oN okuooFI s,opuzL ,~mt;tO ....... ' ............. "' 'ON OSLI9OI"~. S,UI~IaLI'190[~.. ......................... ON OSUOO!qs,zoqtunla .......................... oN osuooH s,aopI!n~ .................. qqVD i~08L-q9/- :'-FI.L [Z6L L 'A'N 'Q'IOHJ. flOS N~IO~I 2I£~I38 'lqVHNMO.I. x~^uas O'lOhlnOS .40 NgOI S~X'qa AO S£7(S ~. t'ONC, lU04 H 't "IV'3 H SO. lluu*~6 [ ~pli ) ildi~'g ': A[dditi · 3. Nature of work (check which a cable: New Bu' ......... on ........ Alteration Repair Re~oval ~ . · .............. · ........... , D~mohtlon ...... : .......... Other Work ~ ' ~ i (D ipti ) 4 E ti d C.~-...~'f-'~'~.. .... · s mate Dst. . i , escr on · '~ .................... i""' Fee ...................... ' :l !N (to be paid on filing this ipplication) $. If dwelling, number of dwellin~ units ...... umber df dwelling units on each floor .. i. If garage, number of cars . i. ' .....'" '" ......... 6 If business commercial or mixed occu ' ' ' ,- ,_. o ' .... 7 Dimensions of eXlStlng struct'ures r ~ ~- v_: ..... ,.. a,u ~ ..... ,~ o, each [ype oi use ' ' if any: Front ' Rear .................... ' ........ ! ............... Depth ............. Height Number of Stories ~ ~ ' ' Dimensions of shine structure with alterations or additioni: Front Rear Depth ' ~ Height ......................... .................... : ............ ' ' Number of Stories ' ' 8 Dimensions of entire new constrUction: Front Height Number of Stories ......... i .....; · ............ .,, Depth ...... . Rear Size ofl0t: Front .... ~i.~Z.2 , ' Rear .... i , pth Date of Purchase .q. : ................. De ..................... ...... , .................. Name of Former Owner ................... .... h p ~m' it d i ........ Zone or use district ~n whit r lSeS are suate ............................................. d 1 i g la dinah ti ~ .... Does propose construction vie ate any zen n w, or ce or regula on Will lbt be regraded ..... . ~ ' ' ........................ , · · ~ ................... Will excess fiI1 be removed from premises: Yes No Name of Owner of premises ' Address ..................... Phone No Nam~ of Architect ' ' Address ............................. .......... ............ , .................. Phone No ................. ' Add ' Name of Contractor ......... , ............ ress ............ Phone No. 15. Is this property within 300 feet of a tidal wetland· *Yes ........ No ......... · If yes, Southold %own Trustees Permit may be required. PLOT DIAGRAM Locate dearly and distinctly alll buildings, wheth&r existihg or proposed, and, indicate ail set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate Whether interior or corner lot. ' ' · 10. 11. .12· 13. STATE OF NEW~jYOt~iL--CI~.~ '.S (Name of individual signi~ above named. APPROVED AS IVOTED / mlFY BUILDING 7es.18o2 9 AM 4 P~FOR THE. FOLLOWING INSPECTIONS: 1, FOUNDATION, . '~O REQUIRED ~OR POUR[:D CONCRETE 2. ROUGH ~ FRAMinG & PLUMBING. 4 r.:~AL CO~STRUCTION MUST ~[: COMPLETE FOR (~,O, AI.L CONSTRHc'rlON SHALL MEET THF R[OtBREM~NTS OF TH~ N.~ SLATE CONSTRUCTION & ENERGY COgffS, NOT RE[~PONSIBLE FOR OESIG~ OR CONSTROCTiON ERRORS ~ (Contractor agent ~or'porate officer etc ) ............. i . of s.aid .owner or owners, and is dulylauthori~ed to perform orihave performed the said work and to m,ake and file this apphcat~on; that all statements contained in this'application areI t'rue to the best of his knowledge and belief and that the work will be performed in the manner,~et forth in the applicatio~ filed therewith, Sworn to before me this · .. .......... i. >>) .... .......... , !19..T . Notary Public, ....~_~_....T~ ...... Counti ~:~ ' ,--'" ' ',.....-::mT.... . Notary Pub~'~ State of Now york ' ' ~ ..... ' , . '. (. ...... 'k ........ oemg amy sworn, deposes and says that he is the applicant contract)-,.~ i