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HomeMy WebLinkAbout22126-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23406 Date DECEMBER 14, 1994 THIS CERTIFIES that the building 150 SUNSET WAY & Location of Property 3100 CEDAR BEACH ROAD House No. Street County Tax Map No. 1000 Secti6n 91 Block 1 Subdivision Filed Map No. ADDITION TO ACCESSORY SOUTHOLD NY Lot 5 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 27, 1994 pursuant to which Building Permit No. 22126-Z dated JUNE 15, 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 ADDITION TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to JOHN & GRACE FIORE of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N322738 PLUMBERS CERTIFICATION DATED Rev. 1/81 (owner} N/A AUGUST 5, 1994 N/A Building Inspec~r FORM NO.$ 'rowN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. NO 22126 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ~,? ../..~,....~,,.~~..~ .......................... ~ ........ Co~vTa×MapNo. ~000 S~t~on ....... ~/.,. .......... B~oc~ ......... /.. ............. LotNo ......... ~.....~ .......... to application dated.. ~.~.~.. ....................................... 1 9.,.~....~...., and approved by the pursuant Building Inspector. Fee $,,~ .... ~. ~o~o ~ ~,~ ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOTCN HALL 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 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 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. # B. 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 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~-Add~ions to dwelling $25.00 Alterations to dwelling $25.00, Swimming poo .~25.00~Accessory building $25[00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing 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 .... ?.~ .... - .......................... New Construction ........... Old Or Pre-existing Building ................. Location of Property ..... K.~?. .... .~.~.~ ~ ~.K .... ~ ..................................... House No. Street Hamlet O~wer or Owners of Propert .... County Tax Map No 1000, Section...~ ........ Block ..... ~.~ ....... Lot ..... ~ ...... Subdivision .................................... Filed Map ..... Lot ' z Perm~ Ho .......... Da~e O~ Pe~ ............. appZ~can~ .......... · ......... Health Dept Approval ' ' ..................... Underwriters Approval ........ Planning Board Approval ................... Request fo=: Temporary Certificate ........... Fina~/ticate..~ ........ .................... ....... ..... . .......... ' .......................... .... , Town Hall, 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 December 8, 1994 Mr. John Fiore 29 Valentine Drive Albertson, NY 11507 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 # 22126-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. BLDG, DEP'[ TOWN OF SOUTF~O~D 'CT '¢o U 765-1802 BUILDING DEPT. INSPECTION [ ] FRAMING ~/F'INAL REMARKS: , DATE /FF~;,f:~ INSPECTO,~~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING iNSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: ,? I ',3 ~,,,? j<. 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 ................... CIIECK .................... SEPTIC FOR~I .............. App ................... rove ., ermit No. DisapprovedI a/c ................................ ~ .... 11 ,11 ..... / (Buil ng I pector) ' T . I:~., . INSTRUCTIONS a. T~s application must be completely filled in by ~pewfiter or in ink and submitted to ~e Build~g Inspector, Mth 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~ show~g location of lot and of build~gs on premises, relationship to adjoining premises or pubic streets or areas, and giv~g a det~led deschption of layout of property must be drawn on the diagram which is pa~ of this app,- cation. c. The work covered by t~s application may not be commenced before issuance of Building Pemit. d. Upon approval of this application, the Building Inspector will i~sued a Bufld~g Pe~it to the app~cant. Such pemit sh~l be kept on the premises ava~able for ~spection throughout the work. ,~ e. No building shall be occupied or used in whole or in p~t for any purpose whatever until a CeKificate of Occup~cy ~all have been granted by the Building Inspector. ,. ' APPLICATION IS HEREBY MADE to the Bulldog Dep~ment for the issuance of a B~lding Pemit pumuant to the Building Zone Ordinance of the Town of South01d, Suffolk County, New York, ~d other app~cable ~ws, Ord~ces or Regulations, for the construction of bufld~gs, additions or alterations or for removal or .demolition, as here~ desc~bed. The applicant agrees to comply with all applicable laws, ordinan, B~.e~ admit authorized inspectors on premises and in building for nece~ CALL .......... MAIL TO: Date ~"' '~.7 197.~ )uilding code, housing code, and regulations, and to (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. .............. ...... .... , ......... NJme of owne; of premises...'.qr~...~.~...-~.:...~.'.{{}x..m~.... 'J~''' ~' ' '~t ;'~'~j~ ................... (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...50. ~:~:. ~C.~ '. Plumber's License No ............... . .......... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ....... ............ .... .......... ...... '.: ............. . ltouse Number Street Hamlet County Tax Map No. 1000 Section ...; .............. Block .............. ~... Lot ................... Subdivision ........ . ' Filed Map No ............... Lot ............... (Name) . State existing use and occupancy of premises and in~,e'hded____ ,--use and occupancy of proposed, construction: a. Existing use and occupancy...' ...O..~..~....q'...t~.. ~..c7. ........ i ............ ....................... b. Intended useand occupancy ...... ~...~g...~..~.. ~X ~'-~/.O.A/ · 3. Nature of work (check which applicable): New Building ....... Addition Alt atio R pad R m al ............. er n .......... e r .............. eov .............. Demolition ..; ....... Other Work .............. .~. ' . . ol~ (Description) 4. Estimated Cost ....... !'; ...................... Fee ~ ~ i (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... Number 0f d · If garage, number of cars .. · ...... welling units on each floor .............. fly h typ f u ' · uslness, commercial or mixed occupancy, spec nature and extent of.eec e o se ........... mens OhS o existing structu s, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ...................... Dimensions of shme structure With alterations or additions: Front .................................. ~.. · ~ . I -o. ...................... ... fqumoer ct' Stories .......... 8. ulmenslons olentlre new construction Front D~. ~. .. ' .......... Height ............... Number of Stories :~? .... 9. Size oflot Front ' n~ 1' '~j~' ~i~2~ ..... 10. Date of Purchase ~ ...... .. Depth ............... ~ ..... ..... '.' ' ' ' i ' '. ................ fqame oI eormer uwner ................... 11. ~one or use alstrlct in which premises are situated ,' t, ' "Y',' ~ ....... 12. oes proposed construction violate any zoning law, ordinance or regulation: ................ =4-' ~ ..... ~ .... 13..W. iI1 lot be..regraded ....... "i ................... Will excess fill be removed from premiiE~i':},', q'~-~;:Y~s No 14. mame of owner of premises ., ~ ............... Address ..... Phone NO Name of Architect .......... ~ ............... Address .... Phone No. Name of Contractor ......... , ................. Address ............. . ...... Phone No ................ 15.' 19 this property within 300 feet of a tidal wetland? *Yes ........ No.; ....... · If yes,~Southold Town Trustees Permit may be required· PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. NOTIFY flU~ O~PART~r ~ . 765-1802'9' AM TO 4 PM FOR THE FOLLOWING ~N~PECTIONS: L FOUNDATION ~0 ~EOUIRED FO~I POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FiNA~ ,; CONSTR~CTION 8E COMPLETE FOR C.O. ALL CONSTHUCTION SHALL ME~ THE. REQUIREMENTS OF THE STATE CONSTRU~iON & ENERGY CODES. NOT RESPONSIBLE FOR DESlO~ OR CONSTRUCTION STATE OF NE..~2~,, .~. S S ' country OF ..... . , ......... '.'. ~ ~.......~..,....~.0.¢..~:. i.'-. ........ being duly sworn, deposes and says that he is the applicant (Name of individual signin¢ contract) above named. . He is the i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly. ~uthorized to perform or have performed the said work and to make and file this application; that all statements contained in this'application are irue to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ' Sworn to before me this ..... No'tary Publi .... ~ .... UL A. CAMINffl i ' (. Notar~ Public, State of New Yor~ ...... ' No 5581910 ; . / .... / / · [~lgnature otappncant) · ' Co=mission ~xpiro$ June 30:~ O~_/(~' ~ ' ' "~ . '