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Home My WebLink About22248-zFORM NO. 4 TOWN OF SOUTROLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z~23455 CEHTIFICATE OF OCCUPANCY Date JANUARY 19, 1995 THIS CERTIFIES that the building ~DDITION Location of Property 860 PVT. RD ~7 (DIEDRICK RD) ORIENT, ~ YORK House No. Street Hamlet County Tax Map NO. 1000 Section 18 Block 3 Lot 29 Subdivision Filed Map No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 22, 1994 ~ursuant to which Building Permit No. 2224S-E dated AUGUST 11, 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 SUNROOM ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 WALTER &M~RJORY SMITH N-337129 - DECEMBER 20, 1994 N/A FORM NO.$ TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED} CountyTax Map No. ]000 Section ........ .~..,~... ........ Block.......?.. ................ LotNo, .,,~,...?.. .................. pu,suonttoopp,,oa,,onda,ed ............ ..J.~i....~.....:.z...~ ........ ~9...¢....y... andap~rovedbythe Building Inspector. Fee $....,/,~.......~.. ..... Rev. &/$0/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION 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. 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. Be 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. Co Fees ........ 1. Certificate of Occupancy - New dwelling $25.00,'~Juid~ns to dwelling $25.0~, 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-existing Buildinz - $I00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00 Date ......... ~.--./.~ ~ ~]~.. .................... New Construction ........... Old Or Pre-existing Building ....... .~.... ..... Location of Property...~.~.~ ........... ~./.~'.P~.~t~.. Y~. ............. ~.~/.~.~. ~ .......... ~ ~.~ ~ Z~'~ House No. Street Hamlet Onwer or Owners of Property....~.~¢..~.~..~....~.g..% /~/~ O~P~ ~ ~[.~'.~.~!f~/7~ County Tax Map No I000, Section. ~.~. .Block. .~ ..... Lot. Subdivision .................................. · . Filed Map ............ Lot ................... . .. Permit No .............. Date Of Permit ....... Applicant. ~/$g~.~/~ ~ gT~ Health Dept. Approval .......................... Underwriters Approval ...................... .. . Planning Board Approval ...................... .. Request for: Temporary Certificate ........... Final Certicate.. ....~. ..... Fee Submitted: $.. ~i . .l~.Q ................... ..... ....................... ..... ~0~ ~. ~ APPLICANT Town Hall, 53095 Main Road P. O. Box 1179 Southotd, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 11, 1995 Mr. Walter Smith Box 754 Orient, NY 11957 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 # 22248-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 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 January 11, 1995 Mr. Walter Smith Box 754 Orient, NY 11957 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. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 22248-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. )UIIDATION {~st) UNDATIOII ' ~2nd) UGH FRAME &. ~......,,... ~,, · 'L)')'"..:.'.;.":PLU BIaO .- -:-, SULATION PER'~. Y. STATE ENERGy CODE FINAL I II 1 I w Z Z W tx) Z · <12 CD .--1 I -~ 212 CO QD X ~ <::IZ Imm."-- 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND FRAMING [ ] IN/S4JLATION [ ~/I NAL INSPECT~ .//-~ 76S*'f 802 INSPECTION [ ~OUNDATION ~$T [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL THE NEW YORK BOARD OF FIRE UNDERWRITERS 10C~773 BUREAU OF ELECTRICITY ~'- 85 JOHN STREET. NEW YORK, NEW YORK 10038 Date DI']C~i~R 2~ ~ 1~9~ 2pplicetion No. on file ~6743394/94 THIS C~IFIES THAT o~y the electrical ~ulpme~t ~ ~scribed be~ and intr~uced by t~ applicant ~med on the a~e application nu tuber in t~ prem~es of W~TER SMITH, DIE~RICH ROAD, POLEt~5, ORIENT~ in the following tocatlo~; ~ Baseme.t ~ Ist Fi. ~ 2nd ~. Sectlo. Bilk Lot u~sexaminedon ~ICE~ER ~2 t 1994 dnd found to be in complianc~ ~ith the Na~'onal Elec~cal Code. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS EWITCHES FLUOKESCENT OTHEfl DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: PORCH-'ol E R OF CC. COND C NO OF HI-LEG ARTHUR A. RUROEDE 23865 HAIN ROA ORIENT, h~, 11957 LIC. #2334-E GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. I.spectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. i ' l[ll 2 2 I BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined ( _ ..// .... ......... Approved ~.[/. .....19~ermit V~F~ BOARD OF HEALTH 73 SETS O.~.PL,x~$ ........ ~SURVEY .T ............... ~' /SEPTIC FORH . .. ~ ......... '. Disapproved a/c ............. ........ -_ / /(Building Inspector) J AP7 'ION FOR BUILDING'PERMIT Date . .-.J'. u.k',f.., g ~ .... 19 .~..~ INSTRUCTIONS ' a. This application 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 pubI/¢ sti'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. ¢. The work covered by thi~ application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. ¢. No building shail be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted l?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 South61d, 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 describbd. 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 inspections. ! .% .... -- (Signature of applicant, or name, if a corporation) .... O.. o. ?. . 7.~. .'-t . .o. .~ ~. ¢-.~.T , . . t~. ~. .,. l ~ .q. C. ?. ... . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder. Q ..~q. o:'60, ' N~e of owner orpremises . .'Vd.x. ! .E .e..~.. A .~.~...~..~.t .~.~.,~ .,,/..~ .V~.~ ................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. CALL ................... HAIL TO: a, ' (Name and title of corporate officer) : Builder's License No .......................... lumber s Lmense No ......................... Electrician's License No. Other Trade's License No ...................... Location of land on which proposed work will be done. · .... ltouse Number Street Hamlet cmmty Tax Map No. 1000 Section ... :..~.'.~ ......... Block ..~. .......... i . Lot.. ~.c/ .............. Subdivision ........ . ............................. Filed Map No ............... Lot ............... (Name) State existing Use and occupancy ofj0remises and intended use and occupancy of proposed construction: a. Existing use and occupancy. .....~,~ , ~......(o,e?} ¢~¢¢ ~ , . ~,, . b. Intended use and occupancy . . ...... k ( h ~Ppli ) . '.~.. ' · 3. Nature of wot check whic cable: New Building .......... Addition ....... Alteration ....... ', Repair .............. Rerfioval ........ Demolition . Other Work ......... 4. Estimated Cost ~ , {9 0 '. j~--. · escr tion) ........ Fee ? ' (to be paid on filing ~ ppplic.ation) ~ 5.. If dwelling, number of dwellin~ units.. Number of dwelling units ou each h . If garage, number of c~s .... ~ .... j.~u~ ~yq. ' ' .................. & .............. ; .... ;dlo ..... jj ............... 6. ss, c ~ ercml or m~,xqd occupancy specify nature d extent oLeach toe o 7. ~unenmons oi exmting structures if any' Front ' q ~ ~ ~ w~- ~ ................. - ................. sear . . ~ ........ Depth Height . ~. ~.'~p~ ..... Nu~ha~ ~e ~,~,;~o I ' t D~ ' f sh ' i ...................................... ~ith lte ti dditi : F ........................ ~. enslons o me structure i a ra ons or a on8 ront .......... Rear .............. Depth · · . H -- . · .............. ,.. ....... ......... .......... 8. Dimensions ofen?~ ~e~,constmction: Front ..... I~ ./."...: Rear ... l.~.~.qX~'J Depth ..... Height . ~.10 t. &~.. Number of Stories [ " " 9. Size of lot: Front .. i . . . - · 10. Date of Purchase ¢ ,) ~ , .[ ~. ~.~ ..... lqear . .~7 .... ;k. ........... Depth ............... Xl~,' .... ,'," . ..... ; ...... ,.,,' ......... ~am~o~*'o~rO~=r .......................... aone or use aistnct ~n wluch pr~mises are situated ................ ; ............................ 2. '.. 12. Does proposed construction violate any zoning law ordinance or re-ulati · 0 ' 13. Will lot be regraded ~ ~ ..... o o~... ~ '" 14. ' ..... 7 ............. t .... win excess fill be removed from premises: Yes No NmeofOwnerofpremises ~W{[qV.~l.'.~m.,SMddress B,V. 2~.~.O¢I~T PhoneNo &~2¢{{0. Nme of Architect .......... l ......... ' ....Address ...... .. , N~eofContractor~A~ ~{~l ...... ~0~ ~,'~ ..... J'U PhoneNo. 3~:~66.q .... . , ~ · ..:.. · ...... ~.v .... aaaress°...q.~.g~3~v PhonaN~ 15. ~.s un~s property w~thin 300 feet of a tidal wetland? ,~11 b[joW'[~-'-'.'~ ............... *If yes,'Southoid Town Trustees Permit may be requirg~['~ ~o..~ ..... ... ~ PLOT DIAG~ ; t ?~t Locate clearly ~d distinctly ~I ~bu[Id~gs, Whether exisling or proposed, ~d. indicate ~1 set-back d~ensions from prope~y Hnes. Give street ~d block ~umber or descHption accord~g to deed, and show street nmes and indicate whether mtedor or corner Io~. % e e S ~ · 7 · ~ STATE OF NFs-~RK ('~,, f~" '. '~OUNTY OF ~-.07~V. ?/.5 s.S{ , ~ .... ..... ........ (Name of individual signing~ contract) tbove named. being duly sworn, deposes and says that he is the applicant ontractor, agent, cor orate officer, etc. said owner or .owners, and is duly a~ithonzed to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are t'rue to the best of his knowledge and belief; and that the :ork will be performed in the manner selt forth in the application filed therewith. worn to before me this