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HomeMy WebLinkAbout22163-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24017 Date NOVEMBER 6, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 960 GREENFIELDS LANE SOu'£~OLD NY House No. Street Hamlet County Tax Map No. 1000 Section 63 Block 5 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 20, 1994 .pursuant to which Building Permit No. 22163-Z dated JULY 5, 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 AN ACCESSORY ABOVE GROUND SWIm, MING POOL IN '1'~ REAR YARD AS APPLIED FOR. The certificate is issued to JOSEPH RADICH of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N367905 PLUMBERS CERTIFICATION DATED (owner) OCTOBER 25, 1995 N/A Rev. 1/81 lding Inspector FORM NO.3 TOWN OF $OUTHOLD BUILt)lNG DEPARTMENT TOWN HAU. $OUTHOLD, N.Y. BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FUEL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted ....... ~ ~......~.,.~.~.~....5~ ............... to....~.,~, ........ ~ .......... ...~....~ ........... ~~. ............... ~.........~ ....... ..... ~ ........ ~.&.....~ ............ ~...~ ......... ~~ ............. ~... ..................... ......................................................................................... otpre~,,e,,ooat~a, ................. .........."'..7..~.~ ........~' ~--~.--/~~.....~'.?,,~....~.,..: ...... ................................................................................ ~~.~ ..................................... '~.. ............ CounC/Tax Map No. lO00 Seotion.....~..~..~... ............Block ......... ...~.....~.... ..... LotNo ......~..../.. ............... pursuant to application dated ..................... ~.~'~.,.. ....................... 19.....,~. '.~.,.., and approved bythe Building inspector, : Fee $ ' ' Building Inspector Rev. 6/30/80 NOV - 2 19 q5 TOWN OF SOUT~IOLD BUILDING DgPARTMEDiT TOWN HALL This application must be filled in by type~r±ter O~ ink and submitted to the building inspector with the following: for new building or new use: Final surYey of property with accurate location of all buildings, property lines, streets, and unusual satural or topographic features. 2. Final Approval from Health Dept. of wntar supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. A. 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 inatalla'tions, a certificate-of Code Compliance from architect or engineer. responsible fgr the building. 6. Submi~ Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or building~and "pre-existing" land uses: a 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. tf a Certificate of Occupancy is denied, the Buildi~g Inspector shell state the reasons therefor in writing to the applicant. i. Certificate of Occupancy - Neu d~elling $25.00, Additions to duelling $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 Prs-existin~ Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20~00 ~. Updated Certificate of Occupancy - $50.00 5. Iemporary Certificate of Occupancy - Residential $15.00-, Commercial $15.00 Construction ........... Old Or P~e-existing Building ................. ~ouse No. Street Hamle~ 'lanning Board Approv;ll ........................ 2equesr for: Temporary Certif±:ate ........... Final Cer~±c~e ....... ............ · ........... 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 25 1995 Mr. Joseph Radich 960 Greenfield Lane Southold, NY 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) xx 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 # 22163-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. OUNDA'TION OUNDATION (1st) (2nd) ~OUGH FRAME & .PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] RO~/H~PLBG. [ ] FOUNDATION 2ND [ /~iSULATION [ ] FRAMING [ ~'] FINAL [ ] FIREPLACE & CHIMNEY DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] .~JLATION [ ] FRAMING ~/]"'FINAL [ ] FIREPLACE/~ CHIMNEY REMARKS: ~ DATE INSPECTOr* _~ Town Hall, 53095 Main Road P. O. Box 1179 Soulhold, New Yo~, 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 12, 1995 Mr. Joseph Radich 960 Greenfield Lane 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) No Underwriters Certificate on file. The check is (outdated/not on file.)$25.00 No Health Department Approval on file. xx No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22163-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. Approved .~/~' , 19~.~. Permit No ~'~2/6-.~" Disapproved a/c ..................................... ~,lTtt~ in g Inspector) APPLICATION FOB BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. CALL ................... HAIL TO: Date ...... ; ............ 19... INSTRUCTIONS. a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building inspector, with 3 s6ts 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 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 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 bufldings~ additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with al/applicable laws, ordinances, building code, housing code, and regulations, and to admit author/zed Lnspeetors on premises and in build/a~g for necessary inspections· ....................... '... -- ( i~gature of applicant, or name, if a corporation) .q (Mailing address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or~bl~ilder. .............................................':. ....... ...:..-~,, .... ~...~;... is a corporation, signature of duly authorized officer. If applicant (as on the tax roll or latest _ ............................................. ' RE~UIREO FEE: . ~ .... , ,.BY: _"' ~ .v,~ _ (Name and title of corporate officer) NOTIFY BUILOIN{I DEPARTMENT AT .... .OCCI, . Y OR 765-18029 AM TO 4 PM FOR THE -Builder's License No ................ FOLLOWING INSPECTIONS: ~ ~ UNL~ , 1. FOUNDATION- TWO REOUIRED Plum bet's License No ............... FOR POURED CONCRETE ..,.,...,,~"' CERIIR~TE ~' .QUO. - ,~.M,.~ · .LUM.,.~ ' 3. INSULATION Electrician's License No ............. 'OFOCClJPANCY 4. FINAL- CONSTRU[~TION MUST · BE COMPL, ETE F~R~C:o. ' Other Trade's License No ...................... ALL CONSTRUCT~N SHALL MEET THE REQUIREMENTS OF THE N.Y. 1. Location of land on which proposed work will be done ..................... STATE CONS/RUCJ'IO~. ~..E.N. ER.G.Y. . fi.S>. .....Ge, FO. .................... .o~.~m~l~.u.c.,~..~.~.R.O.R?... House Number Street Hamlet County Tax Nlap No. 1000 Section .' ..... G.(..9. Z.. ;':. Block....~.. Subdivision..~..~-i."I~'Ot_..'C'X.C~'~'~6..C~...'~'..S(2).~lMB~iled Map No. (Name) ........... Lot .... &l ........... .G3.~.3 ..... Lot...-'4 ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: · a. Existing use and ~cc~pancy ..... '['" b. Intended use and occupancy ...... · ..... .,,, .;. ~7'~ 'D..~!~ ................. 3. Nature of work (check which!applicable): New Building ....... Additim{~ ', i · . Alter.~tio:r[ Repair .............. Reinoval . . ''' · I .............. Demolmon . , ,., · 4. Estimated Cost ....... ~.&~ ..................... Fee ..... ~. ~,.~. .... : ([q.keq~md on~fihflg :t 5. Ifdwelling, numberofdwellin---:,- ~,\~ . . ~.app i etlon) ,~ ~, l~b2 umts ~,~,~ ........... Number of dwelling units on each floor 7~": 'i ...... · n garage, number of cars .\~.. 1~ · ..................... ' ' · 6. If business, cum nercial or m/ixed occ'u&~;v ~,,,,'t · . ~' ....... * ~' .................. 7. 'i -~ .... ~, ~.~,ay nature aha extent o~each type of usell~'~.- ..... i ......... Dimensions of existing structures, if any: Front ............... Rear .............. epth .............. Height ............... Nu'mber of Stories . ensions of same struct'ura {th -, ..... ' ........................... ~, - .,.,,. mterauons or aaaitions' Front ' · .. wear ......... netgnt ·. · Number ,-_ ' ...... 8. Dimensions of entire new constmctmn: Front ............... Rear ............... Depth .............. Height .............. Nu ~ ' ' ber of Stones .... 12. Does proposed Constructio!!,~i, ,late any zoning law, ordinance or regulation ...~('7'~ ........... 13. Will lot be regraded · · .L..k ~ · ' ........ · ': '.' ~ :' · x' · ~ .,. ,.,Will exg~.s% filJ, be rexqoyed from premises: Yes Name of Architect ........ Address Phone No ' 7r-Name of Contractor ................................................... ' ,' .............. :'. ·. Address ................... Phone~o .......... . 15. Is this property withi~ i300 feet of a tidal wetland? *Yes ........ No.~. ..... ' ...... · If yes, Southol~ [Town Trustees Permit may be required. .... PLOT DIAGRAM Locate clearly and distinctly al buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocl number or description according to deed, and show street names and indicate whether interior or corner lot. ,. J )STATE OF NE~YO~'i~i.,:~ ~ a ..... ' )f sm~ o~ne~ or oWners, ~d m ' I ' . '~ . duly iauthonzed to perfo~ or have perfo~ed the'said work and to m~e ~d file this ~pplication; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the york will be performed in tlie manner ~et forth ~ the applicati6n flied therewith. ;worn to before me this ~ ~ . . ............... ~..aay b~. .' ........... ~ota~ Public ..... - , NO, 4725~9,_~fl~ ~U~, - . ' (Signature of a~licant) ' 3. Nature ofwork (check which applicable): New Buildin~ .......... Addition ....... ' Alteration ....... . ~.'.:. Re[a~r .............. Removal .............. Demolition ............ ~,[her " ........ ........................ ....... .... ' ............. sci If; "' ~ (to be pazd on filing this application) :.~.~ awemng, numoer of dwelling units ~ ........... Number o · - ~d~[} ~, if garage number ofc~ .~2~ fdwelhng umts on each floor ................ ~. [[~s~, c~e[y,al ~r ~ixed occupancy, specify nature and extent ofeach't~ne d/u;~['~' ' i"i ........ ~ ~m~ena~unS O~ ex~snng structures, if any' Front ...... ... ~. ...... ' ....... ~ ;~;<Y'H ........... Rear .. ~e .. " ~:~; yzght ............... Number of Stories .. [ . . pth ............. '7:~:;5 _~y~szons of same structure w~th alterations or additions' Front ~ ~ ' ............ -?.~ ~eptn ................... Moioht - KeRr .................. . ?8. ' Dimensions of ent~ .......... ' ' ' 7'~'~& ....................... Number of Stories ............. ~ ...... ..... ,~,* uuns[mctlon, front .... Rear ~ - " ' ' ' ............ · ............. ~eptn ............. ~e~ght ............... Num bet of Stohes ........ · ~ze.of lot: Fron ~ A ~ ~ ; 7'A ............................. 2 ......... l~)-Zone ~d_~ ..... ' ' ~]~ ~'~ t '~- * · - .' .........~ame o[Fomer Owner r~ ~ ~O~. ~[Ix~ ' , ~ ~:~ ~ ~*¢.~s[ncz m which premises are situated...~,~.~ X C '~ ~'~'~1 ~ z. ~oes proposed construction ~iolate any 7onin~ law ~-~:~--' - ~" ~'[ J'~' ~ ...... ~,~1 ~ ,~m ~o[ oe rcgraaed · · x 1 .~.~ .......... ' ...... '~ ....................... ~ .... ~ ~ "~ ....... ~.'" ~' · m ',.,..writ ex~Iig oe removed from remis ; ~%~Name of Ar8hltect .. . .~ .~;; ', ...., .. · ....................... ~ress ............. ~Nme of Contractor ....... · ..... · ..... Phone No... 15.~; Is,chis nronere~ wtth~ ~nn ~ ............ ' .......... Phone~ ...... ..~.... ,~.?~tt y s, Southold Town Trustees Permit may be roo.~o~ ' ..~, - ... ' ...... PLOTDIAG~ ' Locate clearly and distinctly ~1 bulldogs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions froTM prope~y ~nes. Give street ~d block number or description accord~g to deed, and show street nines and ~dicate whether ~tefior or comer lot. ' ' ?o~L~ worn to before me this Otary Public ..... actor corporate o cer, etc. 'f said owner or ownem, ~d is duly authorized to perfo~ or have perfomed the'said work and to m~e ~d 'file this pplication; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the 'ark w~l be pcrfomed in the manner set forth ~ the application filed therewith.