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HomeMy WebLinkAbout21450-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24097 Date DECEMBER 26, 1995 THIS CERTIFIES that the building ADDITION Location of Property. 3258 SOUTH HARBOR ROAD SOUTHOLD NY House NO. Street Hamlet County Tax Map No. 1000 Section 75 Block 7 Lot 6.1 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25, 1993 pursuant to which Building Permit No. 21450-Z dated JUNE 2, 1993 wee 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 PERGOLA (TRELLIS} O~q~R AN EXISTING ATTAC~]~D DECK AS APPLIED FOR. The certificate is issued to JOHN & NANCY PEARSON 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 Building Inspector / IeOB, M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERNIIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~T°. 21450Z Permission is hereby gra~nted ~j ,~ / / ~....~~.....Y...~,/ ..................... ...~..~......~..~./~..~......~.., . .....~~~~; ...... .~z~. ~, ,o ..~~~.....~~_~.: ~~~r~~ ........................ ~, .~e~,.. ~,e~ ~, ...~E~.....~/~~__~ .......................................... ................................................... ~~~ ......................................................................... County Tax Map No. I000 Section ....... ~'..~. ......... Block ........ ~ .........Lot No....~.. ................. Building Inspector. Fee $...Z~. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by ~ypewriter 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. 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. 1. Certificate of Occupancy - New dwelling $25.00 ns t9 d_j~welling Alterations to dwelling $25.00, Swimming pool $2f. 00~ Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildin~ - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 Temporary ~ Occunancy Date .... ./~./..'.~7-.~ ~.~.....~.... ....... 5. of ~ - Residential $15.00, Co~]rcial $15.00 Location of Property..~ ........... ~~.~~~.z .... ~.~.~.7~.~.. .... House No. ~ Street ~ Ha~et Onwmr or 0~ers of Property~~ ~ ~:z~~ ~ ~/~' ............ County T~ Map No i000, Section .... ~ ....... Block ..... ~ ........ Lot. ~ ............. Subdivision ........... ~:~. .................... Filed Map ............ Lo t ....... ~ ............. Request for: Temporary Cerr~Scare ........... F~nal Cerr~care......~... // ................................................. 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 December 13, 1995 Mr. John Pearson 3258 South Harbor Road Southold, NY 11971 Re: Building Permit #21450-Z Premises: 3258 South Harbor Road, Suff. Co. Tax Map #1000-75-7-6.1 Southold 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 $outhold, 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. FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~ ]~TION [ ] FRAMING [C~j~FINAL [ ] FIREPLACE & CHIMNEY. i~ ~ ~ MAY 2 § 1993 .... ' '- SOUTHOLD, N.Y. 11971 Exalnined . . ., 19f.~ ' ' Disapproved a/c ..................................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL . (B.i~ng h~j ' ...... - / APPLICATION FOR BUILDING PERMIT SURVEY SEPTIC 'FORH NO~I FY ~ HAlL TO: Date ..~ ............... ,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 locati6n of lot and of buildings on premises, relationship to adjoining premises or public st?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. e. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wiIl 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 shalI have been granted py 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 Southbld, Suffolk County, New York, and other applicable Laws, Ordinances or R~gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. T~e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to a~tmit authorized inspectors on premises and in building for necessary./ms~qtions. ,~ . ' (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ow~e,e' Name of owner of premises * (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 ......................... Electric an s Lmense No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .......... ............... / ........................ ~2x-6~' ~. 4¼~Lo~- /"d&- --~ud&d¢! /~/< //57 House Number Street Hamlet 7~. 7 b Cou'nty Tax Map No. 1000 Section ...: .............. Block ....... ' Lot..; ................ Subdivision ........ . ............................ Filed Map No ............... Lot ............... (Name) 2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ,isting use and occupancy ......... ....... :... b. Intended use and occupancy ............................ ~,,~ ,,, , · Nature of k (check which appli ) ' Additi _u__no .... .. · -;. on ..... Alteration .. ;. ...... .............. OV- ' ........ ; m01ition · ......... OtherWo k. . ....... 4. Estimated Cost ...................... .. · ..... Fee .. ........................ ... . . . , ....... it; (to be paid on tiding' this' apphcahon)' ' 5. If dwelling, number of dwelling u~t~ .. ~...... Number of dwelhng* units on each floor If garage number of cars ~ '". ' ............... 6. If business, co,mm, ercial or mi.xed ~ccupancy, specify nature and'extent of.each type of use ..................... 7. Dimensions of emsting stmctures,lifany: Front .......... ..... Rear .............. Depth .............. Height Number of Stories ' ' ' Dim f hm 'th'~ ' dditi F ensions.o s e structure wi alterations ora . ons: rent ................. Rear .................. r~ ,,~h~e~,~.~ i Height Number of Stories 8. Dimensions of entire new construclion: Front R~r ' ...................... Height Numbel- of Stories .............. : · .......... .D, epth ....... Size of lot: Front ~ Rear ' Depth D fP chas ' Nam fForme Qwner ate o ur e ... Zone or use distilct in which premis~es are situated . ~k:~r rolt,~ ]/~,c~ ~/ ............................ . Do s pr posed tion violate .~ny zoni g law '~ ~ .................. ~ ...................... e o construe n , ordinance or regulation: .... , ......................... NameWill IOtofbeownerregradedof ~ ~" ~' ' ' .&..o..; .... ",~ ................ Will excess fill be removed from premises: Yes No vr¢*ms*~ ...... ~ ............. Address', .................. Phone No ........ . Name of Architect ' Address ............. ~ ........... Phone No Name of Contractor .............. , ............. Address ................... Phone No ................ I~ this property within 300 feet of a t:idal wetland? *Yes ...... No.. · If yes, Southold Town iiTrusteeS Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all bmldmgs, Whethbr existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block numb&r or description according to deed, and show street names and indicate whether interior or corner lot. 10. 11. .12. , 14. ... ,'~J..~.~.'... ,{-~, ..... Z~,¢9. .............. 1'. ... uly sworn, deposes and says that he is the applicant (Name of individual signing contract above named. He is the ...... ,O..&~.1'1 (Contf~actor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized tb perform or have performed the said work and to make and file this applicationl that all statements contained in t ns'apphcatton are frae to the best of his knowledge and belief; and that the work will be performed in the manner set ibrth in th~ application filed therewith. ' Sworn to before me this ~" JOYCE M WILKIN$ Notary Publ{o, S~te of Ne~ No. 4952246, Suffolk Term Expirea June 12, .... '..., ]9 ?_3 . (Signature of applicant) .