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HomeMy WebLinkAbout22146-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OC~umANCY NO Z-23686 Date JUN~ 6, 1995 THIS CERTIFIES that the buildin~ ALTERATION Location of Property. 2820 10 SHIPYARD LANE EAST MARION NY House No. Street Hamlet County Tax Map No. 1000 Section 38.2 Block i Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~T3NE 3, 1994 pursuant to which Building Permit No. 22146-Z dated JUNE 22, 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 INTERIOR NON-~ABITABLE (STORAGE) LOFT TO AN EXISTING CONDO UNIT AS /%PPLIED FOR. The certificate is issued to of the aforesaid building. JOHN LARSEN (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPRovAL UNDERWRITERS CERTIFICATE NO. N352437 PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A MAY 22, 1995 N/A FORM NO.3 TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HAM. $OUTHOLO, N.Y. 222_46 Z BUILDING PERMIT ITHtB PERMIT MUST BE KEPT ON '[HE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) CountyTax Map No. 1000 Section....~..z:~.~...,~--,..... Block ........ 4~./ ......... LotNo ...... ./¢..c~ ............... pur:oant to application dated .._.~.~..., ......................................... 19.Z~..., and approved bythe BulMI~ Inspector. F~ S:../0~..~.¢~.;. , Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ALL 765-1802 ~PLICATION 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. Sworn statement from plumber certifying that the solder used in system contairs 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. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: 1. Accurate survey of property showing ail 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 dwellin§ $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-existinK Euildina - $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-, ~Comm~rcial $15.00' New Construction ........... OldOr Pre-existing Building...__ .%. Location of Property.~.[~...[~/~ .~.~t~.~, ~ .~5~/ .... 2{: ....... . · House No. Street Hamlet Onwer or Owners t.,f Property ..... .~-(+~...~ ~X~.~. ....... .......... '; ....... ~ .... ,~.Filcd Map..,.,..>...L t ...................... Permit No..~.l.~.~.Date Of Permit.~..~...App~i~nt..~.~..~.f.~~ Health Dept. Approvai.'...~ . .Underwriters Approve .................. Planning Board Approvai.~... --. .~ ........ for: Temporary Certificate% .......... Final Certicata.. ~. .... Request FOUNDATION (1st) FOUNDATIOI~ (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FI:~AL ADDITIONAL COM~IEIJTS: 7GS-XS02 BUILDING DEPT. INSPECTION FOUNDATION ].ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ~ ~UI:;ATION [""] FINAL 7GS-I~0~) BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. ~MINGi FOUNDATION :~ND [ ] INSULATION [ ] FINAL REMARKS: INSPECTOR TOWN OF EOIJTHO I BOX 200 [5'16] 7654249 PE~ONIO, NY 119~8 . J/ SUSAN HAL. LOCK --- ~'JJ C LEAVES PO~HT CONDOIvlINIUM~ PRICE Point Vi!lage~ BE COM?LE't'E FOF: 'lYrE REOU~aEME~¥S 0~: THE CODEs. NOT RESPoNSIf~LE FOR THE NEW YORK BOARD OF FIRE UNDERWRITERS 1185~?? MAY 22,1995 O72~2~95/95 N '~52437 JACK L~S~N, ~HIPYARD LAN~, (%2E CLF~VES POIN'r CONDO.). EAST MARION, N.Y. $ I MOTORS I FUTUIm Am, lANCE Fmm~ .ICOOKING OECKS ) OVENS DISH WASHERS I . TIME CLOCKS .LL U.IT .EA.IIS MULTI-OMTLE? V I C E EXHAUST FANS DIMMERS I~.O.BOX 164 C~'[~0GU~, ~iY, 11935 ~.TC. ~3677-1R m MANAeIR This cer~Kate racet not be ttc~cl~ in any manner; return to the office of th~ B~ord if incorrect. Inspectors may be id~fltlfied by their credentials. COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 7654802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~.SULATION // FRAMING [ ,r,j FINAL INSPECTOR~~ Town Hall, 53095 Main Road P. O. Box 1179 Southo~d, New Yo~k 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 26, 1995 Mr. John Larsen 9 Highland Avenue St. James, NY 11780 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. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22146-Z Please contact our office on this matter. cooperation. SOUTHOLD TOWN BUILDING DEPT. Thank you for Town Hail, 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 May 15, 1995 Mr. John Larsen 9 Highland Avenue St. James, NY 11780 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 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 # 22146-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. I~LDG. OEP% ~ Town OF so. Om Examined .. , ~ .......... ^pproved .......¢/.Z .>. ....... l ?¢Permit No. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. ClI~C~ ................... SEFTIC FORH ............. NOTIFY { CALL .................. MAIL TO: INSTRUCTIONS ~ a. This apphcabon must be completely filled in by typewriter or in ink and submitted to the 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 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. ¢. 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. · '~)~PPLICATION 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 admit authorized inspectors on premises and in building for necessary insp.~e~i~ons. ,~ (~ ..... .... -- (Sionat rd_.[~bf applicant, or name, if a corporation) &z.: (Mailing address of applicant) ( 1'7 ~0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... . .~..~..~...t~.... f.:...LT..~..1~. 5' ~..~....<~./'~...~.[!': .~ ....................... (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 >lc ...................... 1. Location of land on which proposed work will be done...C-...L~.~..~..v'.~...~91t..~....~'~. (/?.~.~....~..~..~../"./~jt.o.r~. f.. uf~7.. ~ %. %.,..~ ~. ~ ~.3~... ~ ~.,.. ~,~...~5 ~ v~..,. ~.. ~ ............ . House Num her Street Hamlet County Tax Map No. 1000 Section . .~.~., ~ ..... Block .... ~1 ........... Lot ..... ).~ .......... Subd~ ~s on . .~ ...................................... Map No. Lot (Name) 7 ............................. 2. State existing use and occupancy of premises and intended use and occupancy o[ proposed construction: a. Existing use and occupancy . .~.(~]~e... ~ ~':T... ~.'~h .... ~. ~.~...e.~ ...... · 3. Nature of work (check which applicable): New Building .......... Addition .......... .~lteration . Repair .............. Removal .............. Demolition .............. Other Work .......... ,~,,_ ~ (Description) 4. Estimated Cost ...... .~.1. ~ ....................... Fee (to be paid on filing~his application) 5. If dwelling, number of dwelling units ...... I ......... Number of dwelling units on each floo~. - . If garage, number of cars ........................................................................ 6. If business, commercial or mixed occtmancy, specify nature and ex~,ent of each t'cp,,e of use ..................... 7. Dimensions or' existing structures, ~:~n~: Front... ~"./.~f.Y: Rear 17~/.. ~.' ....... De~t~ ..... t.~- .~ ....... Height .... ~ ........ Number of Stories ....................... · ..................... '/'../, ....... Dimensions of same structure with alterations or additions: Front .... [ .~ ........... Rear .... 1 .~...Q. ........ Depth ..... ~."~, ............. Height ......... ~ .......... Number of Stories ............. , ........ 8. Dimensions of entire new construction' Front . .1 ~ · ..... Rear ....... ~.: ...... Depth ..... q.... Height ........ ~. ..... Number of St~-ies ..... ..-%-:.. ............................................... 9. Size of lot: Front (,.6~...¢.~).~.,~.~.~.~,..~.~.'.f~.).. Rear ...................... Denth ...................... 10. Date of Purchase ........ kYat. dC ............... Name of Former Owner ... ~,J.q,,..%c~H.r~9..t4~,. .......... 11. Zone or us~ district in which ~re~nises are situated...C.,t4~.~.*¢4 ~.q .,~..-....t'~.~/-.'f/~'.~ .~.. p.~..Et.. ................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...P¢.i~ ..................... 13. Will lot be regraded ............. ~¢~JO .......... Will excess fill be removcd~r~q~,~iscs: Yes 14. Name of Owner of premises ,-~.~ .~. ~.,.l~f~ ./~.... Address ~ .~l~ ~-~f00. ~..~,..~T..';¢. ~one No..~7~. ~.'~ .... Name of Architect ...: ....................... Address ................... Phone No ................ Name of Contractor"~cCY.~. .~:..'~,.?(¥..e~.~4~.~. ..... Address .~-~..n.o~.~.l~. ~ :.f~. ....... Phone No..~.~'..~7..~?I.?'.~.... Is th~s propert:y ~±th±n 300 feel: of a t:±dal ~et:land? *¥es..,/~.. No ......... ~[f yes, Southold Town ~rustees Perm±t: may be requ±red. 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 or description according to deed, and show street names and indicate whether interior or corner lot. tS. STATE OF NEW YORK, S.S COUNTY OF ................. ...... ,~..~¥~ I,,)... ~.-. :.. 1~t~--.,~.. ~..~. ............. being duly sworn, deposes and says that he is the applicant fName of i~divldual signing contract) above named. Heis the ....... ~~ ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfo~ or have perfo~ed the said work and to m~c and file'this application~ that ail statements contained ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfo~ed in the m~ner set forth in the applicatio~ filed therewith. Sworn to before me this .......... .... .... ........ Town Hall, 53095 Main Road P. O. Box 1179 Southold, New Yon~ 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 26, 1995 Mr. John Larsen 9 Highland Avenue St. James, NY 11780 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 # 22146-Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT.