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HomeMy WebLinkAbout21895-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22875 Date FEBRUARY 17e 199.4 THIS CERTIFIES that the building. Location of Property 305 GARDINERS LANE House No. County Tax Map No. 1000 Section 70 Subdivision ADDITION Street Block 8 Filed Map No. SOUTHOLDe NEW YORK Hamlet Lot 28 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 25, 1994 pursuant to which Building Permit No. 21895-Z dated JANUARY 31, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING "AB BUILT" STUART & CAROL RHODES The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED . N/A Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N.0 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ..... ..a..~.~.~.-......~~ ..................................... ......... ~ .~. ......... ~..y..., ............................. ,~.....~ ....... .~ ........ ~.a....c../..< ........ ~..~/).z~.~ .......... ../.~ ........ ~....~ ............. at premises located at a'~a~'~"" ~"¢~a~/'"'"~"~'--'¢ ~-'~"~;~ CountyTaxMapNo. 1000 Section ....... .~..~.. ........... Blook......~...~.. ............... LotNo. a~ pursuant to application dated .............. ,~..J~... .............................. 19.....?..~....., and approved by the Building Inspector. / ~' Build glnsp or Rev. 6/30/80 BUILDING DEPARTMENT TOWN ~IALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 seweragevdisposal(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: 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 ~ Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in.writing to the applicant. C. 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'S25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......................................... New Construction ........... Old Or Pre.-existing Building~ ................ Location of Property .~.O.~. ~?[.~.~../.~.?.~.[ ~ ~~ .......... House No. Street Hamlet Onwer or Owners of Property...~.~ ......................................... County Tax Map No i000, Section .... ~ ...... Block ...... ~ ........ Lot ...................... ................................... ~ ~/~ ~ Filed Map ............ Lot ..................... Subdivision ~--f~ · Permit No. ~/~f' Z Date Of Permit.. /-~ /-~ .Applicant. Health Dept Approval Underwriters Approval . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: ~ .......................... INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fife Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD February 2, 1994 Mr. Stuart Rhodes 305 Gardiners LaneSouthold, N.Y. 11971 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 ~ 21895-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. 7GS-~802 BUILDING DEPT. INSPECTION 10. 11. 12. 13. Height .... /..,-?'.../ ...... Number of Stories . .~./4~.~-. .............................................. Dimensions .of same structure with alterati,ons .or additions: Front .././.'-.~7.: ..... Rear ...~-~-% ......... Depth ...,-~..~../. ....... Height ..../..~.../ ....... Number of Sf~ories ...~..../~...~. .......... Dimensions .of entire new construction: Fpant ................. Rear ............... l~.th ............ Height ~ ........... Number ,~f S~ories ............................................................. Size of }or: Front ../...~..~,. ..... Rear Depth ./.,~?,.¢ ........ Date of Purckase ............................... Name <~ Former Owner ............................. Zone or use district in ~vhich premises are situated .................................................... Does proposed construction vi,olate any z~3ning law, ,ordinance or regulati,3n? ........................... Name of 0wner,of premises .~-7.~..'~..~.....,'~. ?~.,~.,~.... 2kddress .~.~.2--,v~.,~./. ~ .... th.mae No./~..~-,fl~. =..?~.,fffi Name of Architect .................. ~ ........ A, ddress ...................... Ph, qne No ............ Name .of Contractor ./f~.~.~..z'./F~...-?7. ff.. Address . .~.~.~./7z~.~..z'~.... Ph.rme No.,~. ~.~77~./c3 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or .proposed, and indicate all set-back dimensions from property lines. Give street and block number .m' description according to deed, and show street names and indicate whe'cher interior ~or corner 1.ct. STAT~ OF n~ ¥9r~ )s.s, oO NT ......... .~./~...~ ....... being duly sworn, deposes and says that he is the applb /d cant above named. He is the .... [..~.~5}--~'e~. .... ~_,"~-. ~ ............................................ (Contractor, agent, corporate officer, etc.) of said owner ,or,owners, and is duly authorized to perf,?rm or have per~m'med the said mm-k and to make and file this application; that all statements contained in th is applieati,on are true to the best of his knowledge and belief; and that the w,~rk will be performed in the mann er set forth: in the application filed therewith. Sworn to before me this ......... (Signtum of ap,~cant) FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 119TI ........................... TEL.: 765-1802 E.a ,i,',ed- .'--//5/ ' "'.'TV ...... ,i9... Disapproved a/c · · ~rui~ing Inspector) APPLICATION FOR BUILDING'PERMIT · INSTRUCTIONS 8~ARD OF HEALTH ~/~.URV£Y ......... ~,/JZIIECK ........... SEPTIC FORH TO: Date ................... I .~.. a. Tiffs application must be completely filled in by typewriter orin 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 street, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl] 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 shali 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 ·hall have been granted t~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, and other applicable Laws. Ordinancesor 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 codercl~u;si~~ code, and regulations, and to (Signature of applicant, or name, if a corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. · (as on the tax roll or latest'~)~~~'~'~il If applicant is a corporation; signature of dulv authorized africa/ ' FEE;/ ~g'tt/o BY: . . ........... .NOTIPY BUILDING DEPARIMENI 765-1802 9 AM,TO 4.pM FOR THE ............................................ ~' FOLLOWING INSpeCTIONS: ' ' (Name and title of corporate officer) 1. FOUNDATION ' - ~ TWO R~:QUI ~RED . FOR POURED CONCRETE Builder's License No ........... 2. ROUGH - FR,&MING at PLUMBING 3. INSULATION Plumber's License No ....... . ................. : 4. FINAL - CONSTRUCTION MUST 8E (i~)MPLETE FOR C.O. Electrician's License No ....................... ALL, CONSTRUCTION SHALL MEET THE REQUIREMENTS' OF THE N.Y. Other Trade's License No ...................... STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR 1. Location of land on which proposed work wilt be done· DESIGN OR CON, S.T. RUCTION ERRORS ltouse Number Street Hamlet Cotmty Tax Map No. 1000 Sc, etlon ... :..'~..~. ........ Block ...........~.- .'. Lot ~ ' 2; State existing use a!]d occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . · 3.~ Nature of work (check which applicable): New Building . ~ ........ Addition ....... Alteration ...... · Repair .............. R~moval ......... ; .... Demolition ... . .~¢.2/c.~ .. ........... ~.. O!he)- Work .... - ' ' ipti ) 4. Estimated Cost .......... I. · ·: ..... F ' escr on 5 If d llii (to be paid on filing this application) ' N rhb fd · welling, number ofdwe n§ units .......... u er o Iling its on eac fioor ....... ·Ifgarage numberofcars i .... · we un h 6 Ifb ' . "r ........................... ' ...... usmess, commercm 'fY .... 7' Di I or mixed occupancy, spem nature and extent of.ea'c use ............... · mensions of existing struc res, if any: Front ............... Rear .......... De~th ..... igl ND f St ..... He ~t ...... . ......... unber o ories ................ ' .......... Dimensions of same structure with alterations or a ons: Front · Depth .... ~ ........ i ................ Rear .... · H igl .... ..... ~ .... e ~t .................. : · · Number of Stories ........... ~ ......... 8. Dimensions of entire new construction: Front ............. : Rear ............... De .. H,.mght ............... Npmber of Stories ......... j.. pth ........... ~. S~ze of lot: bront ......... i ; ........ ~ R .................... ......... 'i ' . . ear .................. a o mcr wner . 11.. ct in whic r i .................. ' gl on: ..... ' ...... i ............ 12. Does proposed constructmn violate any zonin aw, ordinance or regulati ....... 1J. Will lot be regraded ~ .................. .............................. Will excess fill be removed from premises: Yes ' Nc 14. Name of Owner fprem~ses .; ......... , ........ Address ..; ...... . .......... Phone No ............ ;.. ............... ' . . .'Phone Name of Architect ........ I ' '. ·.. Address ................ No ............. ... ameofContractor ... i ... ' . . ~ ,~ .~._ . ' _ ; ............ ~muress ......... . .... rnone No... ' 15.' ~,o ca&~ property within) 300 feet of a tidat wetland? *Ye~ " ~. ....... ; ...... · *If yes, SoutholdI T. own Trustees Permit may be PLOT DIAGRAM Locate clearly and distinctly ~1 buildings, whether existing or proposed, and. indicate a/l set-back ' ' . .plop.~ay nnes. O,.ve street and block n~mber or description acoording to deed, and show stre~ ..... .a~.cn~,o,~. fi.om STATE OF NEW~O'RK b, ~ ~ COUNTY OF $ S .............................. i .......... ' ......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. -~ lie is the . .,. ....... . ...... . ................. i ontractor, agent, cot:porate officer, etc.) ....... ~f said owner or owners, and m dulylauthor~zed to perform or have performed the said work and to make and file this lpplication; that all statements contaiimd in this application are true to the best of his knowledge and belief; ,york w/Il be performed in the manner ~et forth in the application filed therewith. ' and that the ~wom to before me th~s~ /) i h · CLAIRE L. Not~y Pubil~, State of New YOd~ /*' .............................................. No. 4879505 .(~),d~ ' (Signature of applicant)