HomeMy WebLinkAbout22204-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTF~NT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23304
Date OCTOBER 24, 1994
THIS CERTIFIES that the buildin~
Location of Property. 1345 FOUNDERS PATH
House No.
County Tax Map No. 1000 Section 64
Subdivision
ADDITION TO ACCESSORY
SOUTHOLD, NY
Street
Block 4 Lot
Filed Map No. Lot No.
Hamlet
18
conforms substantially to the Application for Building Permit heretofore
filed in this office dated J~/LY 5, 1994 pursuant to which
Building Permit No. 22204-Z dated JULY 23, 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 FOR AN ADDITION AND REPAIRS TO AN EXISTING ACCESSORY GARAGE
AS APPLIED FOR.
The certificate is issued to
of the aforesaid building.
EUGENE F. MURPHY
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N329544
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
OCTOBER 7, 1994
FORM NO.$
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y.
No
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date...~ ........................... ,. ................ ,9~
22204 Z
Permls'sion Is hereby granted to:
CounlyTaxMap No. 1000 Section ..... ~.,...~,., ....... Block .......... ~ .......... Lot No. .. .~... .~.., ...............
Building Inspector,
and approved by the
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
oWN ! t 81994
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPAN
This application must be filled in by typewriter OR ink and submitted to the building
inspecto~ with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lihes,
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 ~ertifying that the solder used in system contains
less than 2/10 of.l% lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and instaliations,.a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit ?lanning 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 dwellin~00~,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building~$2~.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existinR 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 .......... ~ ....... ; ................
ew Construction ........... Old Or Pre-e~xist.~n~ Building.~..~.4.~..~.¢.(~
mouse ~O. Street
Onwer or O~ers of P~opertv .... ~q.~.4:. ~ ~>/
......... /~'-~ ........ FiAed M~. ~. ~ ~...Lot..9. ~ ...............
Permit N~~}~..~Date Of Pe~it.'~ ~.9.~ ..... Ap
Health Dept. Approval .......................... Unde~riters Approval .........................
Planning Board Approval ........................
Request for: .Temp°rary Certificate. 'i Fi~ticate ...........
Fee Submitted.
.
............
FOUNDATION
(1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
.FLUMBING'
INSULATION ?ER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
Town Hall, 53095 Main Road
P. O, Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 19, 1994
Eugene F. Murphy
1345 Founders Path
Southold, NY 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
xx No Underwriters Certificate on file.
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 # 22204-Z
Please contact our office on this matter. Thank you for
cooperation.
/
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
FRAMING [ ] FINAL
765-1802
BUILDING DEPT.
INSPECTION
[ ] F/O~UNDATION IST [ ] ROUGH PLBG.
-~'J"-FOUNDATION 2ND [ / ~ION-/
[]FRAMING [//]~FINAL
DATE
INSPECT~
TITLE NO. 7ES-0103~ ~ S
9~
~0~
%0~
Unaulhorized alteration or addition to th~s survey
section 7209 of the New York State Educatior~ Law.
Copies oF this survey map ~.ot bearing the l~nd su~eyo~s
seal or embossed seal ~hcH nat be conddercd to be a valid
person for whom the ~u,v%, ~, 'r,-:~r,.4, end .:'n h~ behalf
hereon, and fo lhe assignees o[ lhe lending insl~tulion. Guara
or certifications are n~ lmnsferabl~ Io addilynal
SURVEY FOR
EUGENE F. MURPHY
AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY~ N.Y.
SCALE: I"= E,O~
APRIL I0:~ 1972
REFERENCE '
SUBDIVISION MAP OF FOUNDERS ESTATES
MAP NO. 8~4~ FILED MAY 10,1927
BUARANTEED TOt
CHICAGO TITLE INSURANCE COMPANY
SOUTHOLD SAVINGS BANK
EUSENE ~ MURPHY
LAND SURVEYOR
, I~8 ?El
N.Y.
FORM NO. 1
TOWN OF SOUTHOLD,
BUILDING DEPARTMENT
TOWN HALL
~ SOUTHOLD, N.Y. 11971
,~ TEL,: 765-1802
Disapproved' a/c .....................................
APPLICATION FOR BUILDING'PERMIT
BO,~RD OF HE..~,LTH .~,.,..,-..
SURVEY b~.-~
c.~cK =~..~? ...........
SEPTIC FORH ..............
NOTI PY:
CA~ .%St 7~.~.~.. .......
HAIL TO:
Date ................... 19...
INSTRUCTIONS
' a. Th/s application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
gets 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 sfi'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 ttfis 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
shalI 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
admitauth~rizedinspect~rs~npremisesandinbui~dm.~-~rn~cessaryinspe~cti~ns~r~\~~ - ~ ~ .~
. .....
-- -- ' {gig~Jture of applicant,jcr name, if a corporati6n)
'
(Mailing address of applicant)
State whether applicant is owner, lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder.
Nmne of owner of premises E00~ ~)1~ t~.~tjtj/~DLkj7
....... (~ ;~'t'~e't'ax roll or
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder s L~cense No ..........................
Plum bet's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ................................. Z ~' ~ .:. ................
·
...,'..~. '.r. ....... ~Z ~'F~ .... ... /. '
House Number Street I Hamlet
Connty Vax Map No. l'000Section-...G.~'. ..... ~.;t:: Block .... ~ ....... ::... Lo:.~. t.~ ........
.,St:bdivision...~.~~e?~T~ ' FiledMapNo~.~~ .:. Lot..~. ........
2: State existing use and occupancy of premises and intended use and occupancy of propbsed construction:
a. Existing use and o~cupancy , .'
· -:~ · .
b. intended use and occupadcy ... , ..... , ...
4. Estimated Cost ~ . '
'~"1 ..... ~ ................ Fee .~-
[ ' (to
5. If dwelling, number of dwellin~ units .,.&~ .... ~ ... Number of dwelling units on each floor .....
. Ifgarage, numberofc~s ........ ~ ~ 1~ ~ ............
If business, commercial or mixed occupancy, specty n~tu? and extent oLeac~ type of use ........... / ......
7. Dimensions of existing st~ct~es, ifany: Front .... ~ ........ Rear /~ ........... De th .t.~ ....
~eight ..... 1.~'~ ~ .... Number of Stories l ' P ...........
i ' ' , · · ............. ~'~ ',' .................... ~ .......
e structure w~th alteratmns or additions Front /~ ~ .....
~ mens~ons of s~ Rear .
Depth ....~.t ~ · ' ...................
8. Dimensions of entire new construction: Front ... ~ ......... ; Rear . .~.~ (~ .... Depth .~.( '"
.Height .. 1 ~..~. ~ ..... Number of Stories .... l~. ' ..............
9, Size of lot Front { I [ ·
11. aone or use &smct in which premises are situated .... ~ ~ ~, ~ r ~.e~r t ~.~..
.12.D°es pr°p°sed construction vidlate any zoning law, ordinadce or regulation: .... ~. .......................
13. Wflllot be regraded~ ..: . . .......
' · · ~_'t ~ ~' '~. ~,~.,.~ ·wm exc. ess fill he remov~ frpm premises: ~ Yes No
14. ~e o[ gw~er of premises ~'~'~J~.~Address[~C~5~4.PhoneNo
~eoIArcnitect :- ~.~, .. ..I. Addre ~ - ' ~ ' ' ;'"
15.' , p p fey wxtn~n puu reec or a tida~ web,and? *Yes ....
. ~If yes,' SouLho~d Town Trustees Permit may be required. ~-. .... o ......... .
:' PLOT DIAG~
Locate clearly ~d distinctly ~1~ bulldogs, whether existing or proposed, ~d. ifidicate ~1 set-back d~ensions from
property Hnes. Give street ~d block humber or description accord~g to deed, and show street n~es and indicate whether
~te~or or corner lot. .
765-1802{9 AM TO 4. PM FOR THE
FOLLOWING iNSPECTIONS:
1. FOUNDATION - 'IiYVO REQUIRED
FOR POURED CONCRETE
2, ROUG~ - FRAMING &'PLUMBING
3. INSULATION
4, FINAL {- CONSTRUCTION MUST
BE CONIPLETE FOR C.O: '
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE' N.Y.
STATE cONSTRUCTION &' ENERGY
CODES., NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
STATE OF NEWC~TEXr~' ,~ fk ,. l, '
COUNT,,, OF..._~.b~ .~3.?.~A. ~'i' ' ~ '
.........
(Name ofindi~dual signing contract~} ., being duly sworn, depo~e~ ~d says that he is the applicant
above named.,.
Heisthe ' j.~~ ~
I (Contractor, agent, corporate officer, 6tc.)
~f said owner or owners, ~d is duly ~ut~orized to perfom or have perfomed the smd work and to'm~e and file this
npplication; that all statements contained ~ thisapplication are true tat ~e best of his knowledge and belief; and that the
~vork will be perfomed in the manner s~t forth in the applicati6n filed therewith.
~w~ to before m~ this { . '
.... ........ ~ '. dayof~
, ,' ' ' .............
, Quallfl¢ in S~ff~k C~U~ 1~" / r ~pature of applicant)
' ~mmlmslon ~ires ue~m~r e, '~ ~ .
-j--