HomeMy WebLinkAbout21854-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25532 Date: 02/09/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 7945 MAIN ROAD/ROUTE 25 EAST MARION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 31 Block 2 Lot 28
Subdivision Filed Map No. __ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 13, 1993 pursuant to which
Building Permit No. 21854-Z dated DECEMBER 27, 1993
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 ACCESSORY STORAGE SHED AS APPLIED FOR.
The certificate is issued to RAYMOND L. & JUDITH JACOBS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
~~r
FORM NO.$
TOWN OF $OUTHOLD
BUiLDING, DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
N-° 21854 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
CountyTaxMap No. 1000 Section ........ ~./... ......... Blook...~ ................. Lot No ..... .~.'~,.,~.. ...............
pursuant to application dated .../'. ~.~,~...,-~',, ..................................... ., 19....~...~.. ......
Building Inspector.
Fee
and approved by the
/'~// / BL~Jlding Inspeo or
Rev. 6/30/80
Form No. 6
BUILD ING DEPARTMENTTOWN765-1802 HALL
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the buildin~
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 Nealth 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.
For existing buildings (Prior to April 9, 1957) non-conforming uses, or buildings and
Vpre-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
f reasons therefor in writing to the applicant.
C. Fees
' 1. Certificate of Occupancy - New dwelling $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-existing Buildinm - $100.00
3. Copy of Certificate of Occupancy - ~ .25~.~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $i5.00
Date ............................. .....
New Construction..........~. Old Or Pre-existing Building ........... ..... .
Location of Property ...... ~.~.~...-~.. /~.~.. ~..~..~. ~.~./ ~. ......
House No. Street Hamlet
Onwer or Owners of Property ..... ~ .~.0~..~...¥...~. ................................
County Tax Map No 1000, Section ..... 2~ ...... Block ....... ~ ....... Lot ...... ~...~.. .........
Subdivision ................ Filed Map Lot
Permit No..~;[..~.~. ~ .~...Date Of PeLit ...... ~. ........ Applicant.. ~fYi O.~.~...~L. ~,~ ~'
Health Dept. Approval .................... ...... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate...~..
Fee Submitted: $ ..... ~...~.....~."~.. ......... "'i
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
January 22,
1996
Mr. Raymond Jacobs
P.O. Box 255
7945 Main Road
East Marion, NY
11939
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 # 21854-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 12, 1996
Mr. Raymond Jacobs
P.O. Box 255
7945 Main Road
East Marion, NY 11939
Re: Building Permit #21854-Z
Premises: 7945 Main Road, East Marion
Suff. Co. Tax Map #1000-31-2-28
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you
for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
fiELD
FOUNDATION ( 1 st)
FOUNDATION
2.
ROUGH FRAME
&
.PLUMBING
INSULATION PER N.
STATE ENERGY
CO'DE
(2nd)
FINAL
ADDITIONAL COMMENTS:
HAP. OF
At'
,/
A;ZEA, 0,52 ^C,
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
] ROU.~LBG.
!./~JLATION
FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS~
DATE// / f INSPECTO'
Town Hall, 53095 Main Read
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 12, 1996
Mr. Raymond Jacobs
P.O. Box 255
7945 Main Road
East Marion, NY 11939
Re: Building Permit #21854-Z
Premises: 7945 Main Road, East Marion
Suff. Co. Tax Map #1000-31-2-28
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y, 11971
TEL,: 765-1802
Examined .../~/~:g~ .......... 19 ~...
., 1 Permit No
Disapproved a/c .....................................
~' (Buj~Sng Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .........
SETS or :: .: :,..: :..
SURVEY ............
ClIECK ....................
SEPTIC F 0 R~'I ..............
NOTIFY;
CALL ...................
HAlL TO:
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 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 c~)mmenced 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 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 author/zed inspectors on premises and in building for necessary...i~inspe~~~o~~~a.~ [' ~' - /
__ ' ; n~n.e:ii ~ ~.~,~.~,,;a;;o.n., ....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .... ~..~...~...~~ ................................
(as one, he 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 No ......................
Location of land on which proposed work will be done ......................................... ' .........
........... ..... ..................... ...............
House Number Street Hamlet
County Tax Map No. 1000 Section ~ [ Block c~ Lot.. c~ ~
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... ..~.. ~q'?T2. ~'.~... ~ C.~.. ~.. ' ,~ ?t !,~,,~ '
/ ~./ c~ 'Y':t ........ 7,.~''~ ........
3. Nature of work (check which apPlicable). New Building . · Addition Alteration '
Ri~pair ............. Removal .......... Demolition .............. Other Work .........
(Descriptio)
4 Etimat dC oo~ Fe
(to be paid on filing this application)
5. If dwelling, number of dwelling u'nits ............... Number of dwelling units on each floor ................
· If garage, number of cars ...... ! ..................................................................
6. If business, commercial or mixed .:occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structuresi if any: Front Rear Depth
Height ............... Number of Stories ........................................................
Dimensions of same structure with, alterations or additions: Front ................. Rear ..................
8. tJimensmns ct' entire new constm'ction: Front. .~. i ..... · D .............. ' ' .......
Height Number of Stories
9. Size oflot: Front ............ .......... .R~[ ........ [~ ........ ~.. Depth ......................
10. Date of Purchase ....... i ........ ..... Name o ormer Own r .....
1 1. Zone or use district in which premises are situated .................
12. Does proposed construction violate any zoning law, ordinance or regulation: ................................
13. W/Il lot be regraded ....... ... .:. ................ . Will excess fill be removed from premises: Yes No
14 Name of Owner of premises i Address
· · ....................................... Phone No ................
Name of Architect ~
........... ~ ................ Address Phone No
Name of Contractor .......... . ................ Address ................... Phone. N~< ..............
15. Is this property within 300 feet of a tidal wetland? *Yes ........ No...~' .....
· If yes, Southold Tdwn Trustees Permit may be required.
... 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 descriptioh according to deed, and show street names and indicate whether
interior or coruer lot.
STATE OF NEW~Oltt~, t} ~ ~ ~
.... I.~..L .... ""~' · 'Or~' · .~.? .............. being duly sworn, deposes and says that he is the applicant
~Name of individual signin~ contract)
above named.
He is the ....................
! (Contractor, agent, corporate officer, etc.)
vf said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and file this
~pplication; that all statements contained in this application are true to the best of his knowledg~ and belief; and that the
~vork will be performed in the manner sdt forth in the application flied therewith·
~woru to before/,,_4 'rl.me~ :f,~
........... /..'~...'~......I.day of...~.~ 19
· ~ · NolaryPu' '"-' 't;hc, State -' - -
flu,tiffed in Suf.o Co Y ./~ v'~.f/./¢ rm ~,. p~/~.~..~. .................
Comm~ssmn Exp'res March 6, 1995 ~/ f ./ (Si~natu
' ' ' I (_.,/ (Sign re of applicant)