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Home My WebLink About21490-zFORM NO. 4 TOWN OF $OUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24098 Date DECEMBER 28, 1995 THIS CERTIFIES that the building. Location of Property 295 VILLAGE LANE House No. County Tax Map No. 1000 Section 25 Subdivision AL'r~ATION ORIENT NY Street Hamlet Block 2 Lot 4.10 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 11, 1993 pursuant to which Building Permit No. 21490-Z dated JUNE 21, 1995 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is REPLACE WINDOWS IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. CLYDE WACESBE~ER SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN NALL SOUTHOLO, N.Y. N~ 21490 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: _ ,~, /- ., _ ~ _. Z~ ~,' '-' ~, '~ ~,,~ '' ,~,~,....~-.,.../..:....~: ........ ~ ...................... : ....... ~, ,o..,~/.~ ....... ~-.¢'.~...... ~.......~ '../...~: ........ ~../.....~.. , // Coun'h/Tax Map No. 'i OO0 Section ...... .~....,-~..'~ ........ Block ...... ~, ............... Lot No ........ ~ ./..~. ....... pursuant to application dated ........~..~/.,"/~" ...................................... 19..~..-:r~...~'*~' ...... Building Inspector, and approved bythe _ ? · ,,/ ~Bullding Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT 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. a. Sworn statement from plumber certifying that the solder used in system contains less than 2/t0 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-existin~ 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 $i5.00 Date. ~ J~ l .l .~...~. ........................ New Construction ........... Old Or Pre-existing Building...V~.. Location of Property..~.~/.l .... ' ..... [.~.l..~...~..~..~....¢~.'= ....... O..~..l.~..~... .......... House No. Street Hamlet Onwer or Owners of Property....~ .~..~. ~>..~. ~.~.~ ~. ~'..~. · .~..,~...~..~./S-.~..~.~. County Tax Map No 1000, Section. 2~ ......... Block ........ ~ ...... Lot..~.,/..~. ............. Subdivision .................................... Filed Map ............ Lot ...................... NO ~ ~ ~0 .--..~'~. ate Of Permit ApplicantC~ ~C~~ Health Dept. Approval .......................... Underwriters Approval ...................... ---. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee B~bmit tad: $ ....................... ....... i ....... Town Hall, 53095 Main Road P. O. Box 1 ~ 79 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 14, 1995 Mr. Clyde Wachsberger P.O. Box 307 Orient, NY 11957 Re: Building Permit #21490-Z Premises: 295 Village Lane Surf. Co. Tax Map #1000-25-2-4.10 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. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New Yor~ 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 21, 1995 Mr. Clyde Wachsberger P.O. Box 307 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 xx 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 # 21490-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUI; DA TIO.~; (1st) FOUNDATIOn.; 2. f2nd) ROUGH FRAME & FLUMBI~,;G INSULATION PER N. STATE ENERGY CODE FI;~AL YJ ADDITIONA'L ~TS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ~F'I~AL [ ] FIREPlACE&CHIMNEY DATE ~'PECTO~/~Z~-~ BUILDING DEPT. INSPECTION [ ] FRAMING [~ FINAL [ ] FIREPLACE & CHIMNEY FORM NO. 1 , TOWN OF SOUTHOLD' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 L; ';,"(~L,~: TEL.: 765-180:2 Examined .~ ..... , 19 ~ Disapproved a/c ..................................... BO^RD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CllECK .................... SEFTIC FORH .............. CALL ................... MAIL TO: .................................... ;"~ ..... 3o'. //J/2 ~ ;~'/i?,~' d//~ · ' .~ (Buil~g Inspector) -~,}:~,;:~ ~¢:~ .... ~, ,; APPL CATION FOR BUILD NG PER~IT ~%,~F~c~ ~ ~'~': ' Date ......... ?~:,~ ...... 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 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 w6rk. 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 authorized inspectors on premises and in building for necessary inspections. ·.../T.~. %~,~.~.O.'r.~....~.e .%~...~.°/q..'~/..~.¥. (Signature of applicant, or name, if a corporation) ... ~....~.,..'(..~.-5.../..,-/.~...~..,~..,.~. 77... ~.... ~... (Mailing address of applicant) State whether ~p,pl!cafi't 'is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~...~. V..'~.,~ .... ~ ('ff..q ~'..-C .~. ~...-~..~..~.,'~ .............: .................... (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 L]cense3Np~.. ,.~ .;./,. ~ 5 ~ ..~.. g'f. (. Plumber's License No ........................ ~. · Electrician's License No .................. 7'.... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ....... ,~. . ~ .5-f. ................... dr.':..~.. ~ o.~. . . . .~. House Number Street Hmulet County Tax Map No. 1000 Section ................. Block ' Y-- Lot .~..,../..c~. Sitbdivision ..................................... Filed Mhp No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... .,~. ~..a'.< .~;.' .,q?V.~./~ ?. ................. .......... ~ .............. b. Intended use and occupancy . , ,, '/~ , 3. Nature of work (check which alSplieable): New Building .......... Addition .......... Alteration-. :..~..... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ........ .~..c?. ~ .,.o...o.. ................ 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 business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~,, if any: Front ............... Rear .... Depth Height Numlber o f Stories ......................... Dimensions of same structure with alterations or additions: Front ............. Rear Depth ' Height Number of Stories 8. Dimensions of entire new onstruction: Front ............... Rear ............... Depth . Height Number of Stories ............ 9 Size of lot: Front ' Rear ............ .............................................. Depth .................... 10. Date of Purchase ........... ~ ........... Name of Former Owner 12. Does proposed construction violate any zoning law, ordinance or regulation' . ~ .o ...... 13. Will lot be regraded /Y. ~ . · ....................... ..... 5Z.: ................. W_dl excess fill be removed from premises: Yes No 14. NameofOwnerofDremises e..~.e¢,4 ~,,,~c~,l ~',~',~%~¢'~. Name of Architect .......... , ................ Address ................... Phone No ................ Name of Contractor Z~ .~.~.. 1 ................ ~'d Phone No ................ i5. Is this property within 300 feet of a tidal wetland?*Yes' , No ......... · If yes, Southold T~wn 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 nlumber or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAV FUL V¢tTHOUT CERTIFICATE 0F OCCUPANCY ;TATE OF NEW YORK, ~ ;OUNTY OF .......... S. ; (Name of individual signing! contract) bore named. 765-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION . ~O REQUIRED FOR POURED CONCRETE 2. ROUGH . FRAMING & PLUMBING 3 tNSLJL ATrlON 4. FINAL CONSTRUCTION MUST 8~ COMPLETE FOR C.O, .. ALL 'CONSTRUCTION SHALL THE ,REQU R~ENT~ OF THE N.~ STATE CONSTRUCTION & ENERGy COOES. NOT RESPONSIBLE FOR DESIGN O~ CONSTRUCTION EflROR8 being duly sworn, deposes and says that he is the applicant is the ; (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly a}athorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true ~o 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 // !fi.. ........... r"% ......... day of ... ~ ..... ' L/ JOYCE M. WILKINS.; ork Notaw Publi~0 State of New!¥ No. 4952246, Suffolk Term Expires June 12, 1 ..... ,19 2'-~ County .--7 L .... (Signature of applicant)