HomeMy WebLinkAbout21430-zFORM NO. 4
ToWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-23067 Date JUNE 24, 1994
THIS CERTIFIES that the building
Location of Property 11228 SOUNDVIEW AVENUE
House No. Street
County Tax Map No. 1000 Section 54 Block 6
Subdivision Filed Map No.
ADDITION
SOUT~OLD, NY
Hamlet
Lot 2.6
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 18, 1993 ~ursuant to which
Building Permit No. 21430-Z dated MAY 21, 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 A DECK ADDITION TO A SINGLE FAMILY DWELLING AS APPLIED FOR.
The certificate'is issued to
JAMES & IX)RI HUNTER
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO. N315590
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
MAY 31, 1994
N/A
Bu£1dmng I~speotor/
L~ORMr NO. Ii
TOWN OF SOU'FI'tOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°-No. ~1430Z
Permission is hereby granted to:
~...~...~..~'. ...... ~..~
Yv.~.~.x...~.~..~.~...~,
at premises located at ...... ./..L...~...~..~......~'~/~~....: ..........................
................................................ ~....~.~:...~....~ .....................................
......................................................................... /...../...~z..~.. ...... : .........................................................
County Tox Mop No. 1000 Section ...~....~....~'.. ........ Block ....~.. ............. Lot No....~...:...~.. ..........
pursuant ,o applicotion doted ....... .~..~....../.~.. ............. , 19..~..~., and approved by the
Building Inspector.
Fee $....~.,~. ,.~., .~
Building Inspector
Rev. 6/30/80
APPLICATION FOR CERTIFICATE OF OCCUPANCY'
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN ~ALL
765-1802
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.
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, 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 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 £ e existing Bu±ld'ng ...............
Location of Property.//~.~....~.~ ...... ~ ..............
House No. Street Hamlet
Onwer or Owners of Proper y ............... w.~,'. .............................................
County Tax ~ap ~o 1000, Section .............. Block .............. Lot ................
Subdivision .................................... Filed Map ......... .~ ........
Permit No.~./..~..~..~i.Z~....Date Of Permit~//f.~. .... Applicant..........~....[[[[.iiiiiiiii
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate .... ~]'~...
Fee Submitted: $.. ., ....................
q3oq i .......................
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
May 12, 1994
Mr. & Mrs. James Hunter
11228 Soundview Ave.
Southold, NY 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx
xx
xx
An application for Certificate of Occupancy is
not on file. (Enclosed)
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 # 21430z
Please contact our office on this matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
Thank you for
FOUNDA'TION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
7GS-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION.ZND [ ] INS~AJ~ION
FRAMING ~!, ~NAL
~REMARKS
THE NEW YORK BOARD OF FIRE UNDERWRITERS i
~.~)I07~ BUREAU OF ELECTRICITY
~ B5 JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT ~
only t~ electrical ~uipmeng ~ ~scrib~ be~w a~ int~uced by t~ t · nu tuber in the prem~es of
J~S ~ER, 1122'~ SOU~ VIeW AVg~, SOUTHO~ N,Y~ ?D ~
~. the foBowlng h,e.t~on; ~ Basement ~ Ist Ft. ~ 2nd t3. OUT C/4:' ~"~ Bl~k Lot
~s examined on ~Y 23 ~ 1994 and found to be in compliance with the ~
FIXTURE FIXTURES RANGES
OUTLETS SWITCHES FLUORESCENT OTHER
2 2
DIMMERS
S STEMS
DRYERS NoS .Y~F FEET
SERVICE DISCONNECT S E R V
NO. OF CC COND. A.W G,
PER ~' OF CC, COND
OTHER APPARATUS:
G & S CONTRACTOR
BOX 2.15
SOUTHOLD, NY, 11971
LIC.
GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FoR BUILDING DEPARTMI~NT. THIS COpY OF CERTIFICATE MUST~ NOT BE ALTERED IN ANY MANNER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
Exanlined ................ , 19...
Disapproved' a/c ................................ ~ ....
BOARD OF HEALTH ........
3 gETg OF' PLANS
SURVEY .................
CIlECK ..................
SEPTIC I'ORH ............
(Building Inspector)
APPLICATION FOR BUILDING' PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3
~ets 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 punic sfi'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.
c. ' 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 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 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 inspec~/~
(Signature of applicant, or name, if a corporation)
State whether applicant is owner, lessee, agent, architect, enoineer, general 'contractbr, electrician, plumber or builder.
(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 .........................
Eiectrician's License No .......................
Other Trade's License No ......................
Locati.on of land on which proposed work will be done ....... .
House Number Street ............... I~i~'1~'; ..................
Couhty Tax }./ap No. 1000 Section .................. Block ......... ' Lot. c:~. ~ .
Subdivision ' Filed Map No ......... Lot
(Name)
State emstmg use and occupancy of premises and intended use and occupancy of ~ro,~d construc'
a. Emstmg use and occupancy ?o~ /25 ~A,,,d ~-
b. Intended use and occupancy . .~....d~....~:~...~
· 3. Nature of ork (check whmh ~Pplicable): New Building .......... Addition .......... ~[[teration .
Re r ..... Removal .............. Demolition .... ; ......... Other Work
pat
c~. ' ' (D ipti )
4. Estimated Cost F_C~OdP, ' ' 7.O~..t...t~...~ff. escr on
· · ' · ............ Fee . .
(to be paid on filing this application)
5. If dwelling number of dwelling units
Number of dwelling units on each floor
If garage number of cars ' ·
6 ' If busine'ss ................................................................... . ....
· , commercial or mixed occupancy specify nature and extent
7 Dimensions o! existing structures if any: Front type of use
,. of each
' Rear ' .... ' .....
.............................. Depth ............
Hight N n~be fSt les ..... i ....
e ...... , ......... u ro or
Dime i f s tmwith rio .....................
D pth '
nsonso ames cture, a ra ns or additions: Front ............... e ................
e ................. ! Hight '
8 Dime si ns of ntir ~ru ti ' N b fSt ri ' ' .
· n o e e new cons c onl Front ....... '. · ......
Height ' NuO%er of Stories .............. ; Rear ............... Depth ...............
9 Size of lot: Fro~t ........................ . .........
I ' Rear ' ' ' .............
10' Date ........................... ~ ......... ; ........ Depth
· of Purchase ......
.......... ;'' Name of Former Owner i ~ ~J'~'i"~ ....
I1 Zone or use district in which ~ " ...............
· pr~mlses are situated ..............
.12. Does proposed construction violate any zoning law, ordinar~ce or regulat
13. Will lot beregraded ;. . .. i .... . . on: ... ' ........... · ..........
14 N fO fP ]n'i}es'.J! J i'Jjj'jj' .,.~W~ ~ fillb dfr i y
· amc o wner o re ..... .-. dl exces eremove om prem scs: es
N f A hit 1 · ,.. · · · ~,uuress ................... Ph No ............ ;'. ~'
amc o rc eot ......... , one .
.................. Address ........... '.. · Phone No .......... ,.
Name of Contractor ........
'akk' ', ........... .. · &ddress ............ :. . ~h,,,,~ ~,,~ .. ·
15.' I.s this property within ~uu Feet of a txdal wetland? *Yes .... ~'~"~ ......... ;
~If yes, Southold . · ....... ~o..-.... ' ....
T. own Trustees Permmt may be required. ' ......
"" i PLOT DIAGRAM
Locate clearly and distinctly all i buildings, ~heth~r 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. I
·
;rATE OF NEW. YORK, :
:oum-v .... ..
........... ' ..... ~ ............ being duly sworn, deposes and says that he is the applicant
(Name of individual signingI contract) .
bore named. ~. .
re is the . .
, (Contractor agent corporate officer etc )
r said owner or owners, and is duly ahflmrizcd to perform oi' have performed the said work and to make and file this
~plication; that all statements containcld in this application are true to the best of his knowledge and belief; and that the
ork wilt be performed in the manner scI forth in the application filed therewith.
.yore to before me this
.....
....... , '/' .
. No. 4951364 I . ' .........
Qualified in Suffo k County'/4~" . (Signature of applicant)
Commission Exp res May 22, ~9