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HomeMy WebLinkAbout22014-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~TIFICATE OF OCCUPANCY No Z--23013 DateMAY 24, 1994 THIS CERTIFIES that the buildin~ Location of Property 215 HAY HAVEN LANE House No. County Tax Map No. 1000 Section 88 ADDITION SOu'£uOLD Street Hamlet Block 4 Lot 28 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 8, 1994 ~ursuant to which Building Permit No. 22014-Z dated APRIL 14, 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 TWO DECK ADDITION'S WITH 6' X 3' ROOFLESS ENCLOSURE ADDED TO AN EXISTING ONE FAMILY DW~?Z.ING AS APPLIED FOR. The certificate is issued to JACK AND DIANE SPARR (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A / Euilding ;n, ector / FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N£ 22O14 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: ~,-,~- ..~.~ ............................. ......... ~..,.~.... ~......~.,.......~.: ................. ........... ~~.......~.y.. ........ /.'./.~../....: ...... tO ~'- .... .~. ~. .~,(~. .~ .............. /, . . , ,~. . . .¢ ............... ~. . . . . ~. ./J.,~.z ~ ~ ~ : ......................... ...... ~ ........ ~ .......... ~~ ........ ~..,:.~ ........... ~~ ............................... .... ~...J:.. ........ ~..~,~ ~ ,~i... ~-:.)..-. ......... a,~.~,~s,o~o,.~, ............... ~.'....:.... ......-- ~....~...~.....~ ............................... ..................,'~..,.?.~ ...... Coun~yTax Map No. 1000 Section ........ ..~....~.. ......... Block.: ........ ...~2.~ ..... LotNo ........ ~..~,.. .......... pursuant to application dated .......................................i..., 19 ..... Building Inspector. Fee $,., .~,,~..:~.~..~.. ........ and approved by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN t~LL 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 ±ocation 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. Submit Planning Board Approval of completed site plan requirements. Bo 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. Certificate of occupancy - New dwelling $25.00, to dw Alterations to dwelling $25.00, Swimming pool $2'5%%YO~cces~ry 'build~-~-$25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certific~e of Occupancy on Pre-existing Buildinm - $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, Co~ercial $15.00 New Construction ........... Old Or Pre-existing Building ................. Location of Pr~perty~..~..~;.~....~...~...!~.~.V..~..'~?....~-.~:...~..~.~...~.~...~.~-..~.~..j House No. Street Hamlet Onwcr or Owners of Property J ~Q...~. ~ ~.~..,t? .~...~.~..~. County Tax Map No 1000, Section .............. B.kock ................ Lot ...................... Subdivision ............... Filed Map ............ L~7~ .......... ...o U d A - ' .., Health Dept. Approval ........................ n erwriters, pproval ..................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ..... Fee Submitted: $ .................. 11-20-00 ; B:OSPM ; FATICORVHI~ 0000000000:~ .~ [ ] FOUNDATION 1ST BUILDING DEPT.' '~ I NSPECTI'O~4~~~:/~~ [ ] ROUGH P~B.~ FOUNDATION ZND [ ] I~JLATION FRAMING [//~'INAL REMARKS ~ (~ t) E &, LUMBING PER N.Y. _ ~ :NEROy ?OUNDATI. ON ROUGH FRAMt .PLI 3. INSULATION STATE CODE 4. FINAL NA'L COM~ENTS: 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 May 11, 1994 Mr. Jack Sparr 215 Bay Haven 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) 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 # 22014Z Please contact our office on this matter. Thank you for cooperation. $OUTHOLD TOWN BUILDING DEPT. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK ........... t,o?I~¥: 75- C~ CALL .~f~. ?~-.~!.'.~[~. - MAIL TO: Other Trade's Licenge No ............. ; .......... DESIGN OR CONSTRUCTION ERRORS 1. Location o£1and on which proposed work will bc done ........... 'x ....................................... v House Number Street Hamlet County Tax Map No. 1000 Section ............. Block ............. Lot ........ ;~ ..... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) ( 2. State ex/sting use and occupancy of premises and interlded use and occupancy of proposed constrpction: a. Existing use and occupancy .......................... ~.,. b Intended use and occupancy .................... '. :,~ · ::.. · ~ .", .,,,., t. ................... "der's ........... USE .IS. UNLAWFUL Plumber's License No. WITHOUT CERTIFICATE OF OCCUPANCY Electrician's License No ....................... FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSUI..~TION ~ 4. F,.^L - c~s~e,~ON ~UST BE COMPL~ ~O~?~.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLEd FOR ~ [~ ~ (J~'il~g InSpector) '" !I; ~ APPLICATiON'FOR BU LD NG PERM T .i , , Date ........ 19... ~BLDG. DEPT. ~,~TOW~ OF SOUTHOL~_, 1 ~STAUC~O~S ~ a. ~s application must bc completely fi~]~ Jn by ~p~w~te~ o~ in in~ ~nd subm~tte~ to th~ ~uH~g~ ~specto~, witA 3 cafiom c. ~ ~o~ co~d by t~s application ma~ not be commenced b~o~e d. Upon ~pprowl o~ tA~s ~p~Hcafion, t~c Building ~specto~ w~ ~ssued sh~] b~ Acp~ on tA~ p~emJse~ av~ab~ Fo~ ~sp~cfio~ tAmug~out tAe wo~. shah Aave b~cn gm,ted by th~ ~ui]d~g ~p~cto~. AP~CA~O~ ~S BgR~Y ~AD~ to tA~ Bu~M~g Dep~me~t ~o~ tA~ ~ssu~c~ o~ a ~M~ng Pc~ff pu~u~nt to the BuHdi~ Zone O~din~c~ o~ tAc ~own o~ SoutAold, Suffo1~ County, New YozA, ~d oth~ a~p~c~b~ ~ws, O~d~ccs o~ · Ac app~c~nt ~g~es to comp]y w~t~ ~U appficabl~ laws, ozd~nces, bufid~ code, Aousing code, ~nd ~cguhfions, ~n~ to State whet~e~ ~pphca~t is owne~,,]~ssee, ~ge~t, a~cAitect, e~g~, .................. ~~. ~...~.~.g. ~ ........ ~PP~m ~.~qT~: .. Nme of owner of premises ............... ~ ~ ........................ ~. ~. ~. --,~ .~., ~.. ~1 (as on the tax roll or late ~ T If applicant is a corporation, signature of duly authorized officer. 3. Nature of work (check which 3PP icable): New Bu'ilding .......... Addition ......... Alteration Repair Removal Demolition .......... .............. [ .............. · ............. Other Work ............... I (Description) 4. Estimated Cost .......... "~..~.~ '- ·. Fee [ (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ............ · It' garage, number of cars ... i .........................· · ·. ....... ' ' ' ' 6. If business, commercial or mixed occupancy specify nature and extent of each t e of use ..................... 7. Dimensions of existing structuies' if any: Front .' ........ ' ...... Rear ... '....YP Depth ...... ight i " ' DH~ ............... Nu nber of Stories ......... . ..................... . ..... ' ........ mensions of same structure with alterations or additions: Front ' · ...... ' ....... Rear .................. R.epth '.' ' ' ' J.' ' ~ .......... i' ' · Height ....... ;.. ~., ........ ... Number of Stories ................. 8. u,menmons olenrire new construction: Front...,P/..'. . Rear . ".. . De-th ./'7 '! .... Height ............... Nu. mber of Stories ..... ' . ' ~ ....... ; '~' ' ' P ' ~ ........... 9. Sizeoflot Front /.Z,~'? ~," "/'~_'.~"t ........... ;, ......... ',:u't ............. r~ .... ' ;,' ....,,-;,'dF '~',; .......................... oepth . l..~..~. ..... 10. ~, .... .~...~.~:. ........... Name of Former Owner ./~Ze..~ ....... ~.ate ox rurcnase ~,'..e~ ~ '- ' ............. 11. ~one or use restrict ~n which premises are mtuated ............................. ~r.. i"i i. i ............... 12. Does proposed construction violate anv zoning, law c~rd;nar~,-~ ....... ~*;~ · a~ t% .. 13. ' . ..o __, ............ ~ .,.~u~,~,~,n ....,.v..-,- ...... ,, ..... ~,.~, ... Will lot be regraded ~. o. ,~ · . . Willexc ........ ~ · ' ~ ....................... ~ss nu oe remo.v, ea ~rom premises: ~ No 14. Name of Owner of premises .. ~-~J~.4~4~.... Address ~. ~'~5 ~b~k6:.~-~- ~-~i~e-Phone No '7..~','-~ w2'~. ~ i~.~. Name of Architect .... ~. · .(d. v~ · · · J ..... Address .. r/ ' Ph "' '~ "" ' W-' ' Name of Contractor ...~--~P-,~-k.4/ Addres° ..j,; · .¥. ~ ........ ,.,on~ ~o. ~..; .; .......... Is ~'--' .,SZ,_~ - rg',,-~ 5: ' '.' ' % ..... .' ' * · · · ~'~ .............. l'none 1~o .... ~./. ....... 15. cnxs property ~/cnin 3U~0 feet of a tzdal wetland? *Yes.. ',, s/ ' " · If e ,, ' ~ · 7 ...... ~,o. . ~,~r. .... y s, Suu'thold ~own Trustees Permmt ,nay be requmred. 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 mmber or description according to deed, and show street names and indicate whether . interior or corner lot. being duty sworn, deposes and says that he i= ihe applicant Heis the ' , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ~uthorized to perform or hax;e performed the said work and to make and file this application: that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s~t forth in the application filed therewith. Sworntobeforemethis /? i ' : .................. f .~..day--of...1....~\ Notary Public ....