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Home My WebLink About21503-zFORM NO. 4 TOWN OF SOUTHOLD BUILDINO DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. C~RTIFIC~TE OF OCutJ~,ANCY No S-23971 Date OCTOBER 19, 1995 THIS CERTIFIES that the buildin~ ADDITION Location of Property 3005 OLE JULE LANE House No. Street County Tax Map No. 1000 Section 122 Block 5 Subdivision Filed Map No. MATTITUCK~ N.Y. Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated J~NE 17, 1993 pursuant to which Building Permit No. 21503-Z dated J~NE 28~ 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 ADDITION TO EXISTIN~ACCESSORY S~ TO CON~-ERT TO AN ACCESSORY OARAOE AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN i. LAU. SOUTHOLD, N.Y. N~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED] Date ....... ~/..'.'.~. ~.. ........................................ 19.~,,,,-~.,... 21503 Z Permission Is hereby granted to: ~~~..~ ...... ~.,.~ .... ...~.~...c..:.~..~...~.~ ......................... .... ..~...~,,~Z...~....~.:...,....~ ~?. ~.~. CountyTax Map No. 1000 Section ......... ./...-~'~-...'~.,... Block .......... ~ ......... Lot No..~' .~'.. ................... pursuant to application dated., ...~../.~. ......................................... 19..~..,~. ...... and approved by the Building Inspector. Rev. 6/30/80 BLDG. DEPT. TOWN OF SOUT~IOI.D Form No. 6 TOWN OF SOUT}~LD BHILDING DEPARTMENT TOWN HALL 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: ]. 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 Complianoe 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 i. 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 - $I00.00 3. Copy of Certificate of Occupancy - ~20.OO 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date... } .~. I. ~ .~.l .~ .~. ' New Construction .... ~ ..... Old Or Pre-existing Building ................. ~ Location of Property .... ~...C~.~ ......... .~..~.?~.....~.l~.~.~... L~ ....... ~.~ ~k~.~ ...... House No. Street Hamlet Onwer or Owners of Property... ~....., ................... County Tax Map No I000,'Section.%[~'~.~.....Block...~..~.[..~.. ..... Lot...~. ~.~.~.~..~.~ ....... Subdivision .................................... Filed Map ............ Lot ...................... ...... Permit No. D.X,~.~.~.]~..])ate Of Permit... ~. .... Applicant.. ~.~ ~C..~ Health Dept. Approval .......................... Underwriters Approval .......................... Planning Board Approval ......................... Request for: Temporary Certificate ........... Final Certicate..~..~ ....... Fee Submitted: $ .~..~...~O .............. ~~'~ ~~. ~-~, 5~ A~LICANT 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 October 12, 1995 Mr. Keith Radich 3005 Ole Jule Lane Mattituck, NY 11952 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 ~ 21503-Z Please contact our office on this matter. cooperation. Thank you for $OUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: NOTIFY 8UIU~NG OEPA~AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING S. INSULATION 4. FINAL CO~,~TRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE' REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT. RESPONSIBLE FOR DESIGN OR CONSTRUCT, ON ERRORS OJ'F 'y )X f C :z X t..i /d /~ o c 4z' ~'c F~ooR ,4 t. U tV~ I K & ,S/LC O' JUN I ? 1993 JUN I ? 1~93 JUN I 7 1993 JUN I T 1993 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~A~S ~ BUREAU OF ELECTRICITY SS JOHN STREET. NEW YORK, NEW YORK 10038 ~ ~ a:'39~93/93 H e48141 Date DECEM~ ER 13,1995 Applieatlon No. on~le THIS CE~IFIES THAT ~y the e~t~a] ~uipment ~ ~c~ ~ a~ int~u~ by t~ ~t ~ on the a~ ~t~ num~r in t~ ~ of KI~'~ ~ICH, O~ ~LE ~, ~I~CK, N.Y. ~ examin~ o. D;C~ER ~8,1995 and found to ~ in com~ce with the N~o~l ~ec~ C~e. FIXTURE RXTURE$ RANGES OVENS 5 4 2 5 S~RVIC~ D~SCOflNECI' S E R V I C cc. co~o. o~ ~.~ OTkIll AFffARATUS: KIBT~ RADICH eiD JUL~ LAI~ MA~"IRJCK, ~, 11952 This ce~ficete must not be , monner; return to the office of the Board if incorrect. Inspectors may be idmffified by their credentials. CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN HALL SOUTHOLD, N.Y. 11971 "' ;' TEL.: 765-1803 ' Examih~i~; ........ , 19~. . .. ~ Disapproved a/c ~ . /~Builditr~ Inspector) '~ APPLICATION FOR BUILDIN~PERMIT INSTRU~TIONS' t;O?l Fy { ..... ," CALL ' ' '~' ' HAIL TO: Date ' 19 · . This application must be completely filled in by type, writer or in ink an'd submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scgle. Fee accord!nm to g~hedule.. . . . . . . b. Plot pl.an showing !ocation of lot and of bmldings on premises, relationship to adjoining pre. mises or public, streets or .areas, and giving a detmled description of layout of property mu~t be drawn on the diagram wh,ch is part of this appli- cation. ' I ' ¢. ' The work covered by this app_lication may not be' commenced before issuance of Building Permit.. d. Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Sucti permit shall be kept o.n the premises availabl~ for inspection throughout the work. . .o. No building shall be occupied or sed ,n whole or zn 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 Departmerlt fo~' tho issuance of a Building Permit pursuant to tho ~uildjng Zon~. Ord¢~ Pr ~,~e./Tog'z~ of Southbld, Suffolk County, New York, and other applicable Laws, Ordinances or ,teguiations, mr the'~c6nstrucQor/iSf buildings, additions 'or .aJterations, or for removal or demolition, as herein descrlb~d The applica.nt..ag.~eos~to .comply with.all appli~cable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and m building for necessary'in/~~... -2,,:1 :, ~ . {, .: .. (5i~nathr.~ap'p'~c~nnt, orname,/fa corporation) ' . (Mailing address of applicant) State whether applicant is owner, lelssee, 'agent, a~chitect, engineer, generai 'contractor electrician, plumber or builder. Nme of owner of premises ' ' ' ' ' ' : '. ,, (as on the tax roll or latest deed) If. applicant is a corporation, ' ' . ;' mgnature{ o f duly authorized officer.' · amc and title of corpora e officer ' ' Plumber's License No ~ l. Electrician's License No. Other Trade's License No 1. Location of land on which proposeld work will be'done..., ....................... ; ............... Itouse Number Street Hamlet Couhty Tax Map No. 1000 Section{. '1 :~ ., C)l~)...'i Block j.~. 6.,.(2).O. :... Lot..(~. Subdivision { ' Filed Map No Lot · (N~me) " ............................. 2: Stat~ existing use and occup.ancy o) premises and intended use and o~cupancy of proposed constructioni a. Existing use and occupancy * ' ' ...... . ................... . 1.,, .,q, ,)9~f~l ....... .. b. Intended use nd occupancy ' ' · ........ ~,0 -q)Ou ~,,,,¥,~¢~q~.~ {l~,{~ ,,¢¢~,~ ...... · ' . · . ..... ¢.~ .... · 3.Nature of work (check whmh apphcable): New Building ... ~. ..... Addition. : Alte'?~/~ .. ..... . Repair .............. Removal ............. : Demolition ..... : ..... ,~. ..... Other W~..T".~.~ Ti . iptiO 4. Estimated Cost ...... · .......... Fee . :,' (to be paid on filing this applidatipn) : ' 5. If dwelling, number of dwelling units ..... i ......... .. Number df dwelling units 0h%~tSf;ibo~41.?. If garage, number of cars ....... t... CJO~'~ ... ' ..... 6. If busigess, co.mmercial or mi.xed occupancy, specify nat~r~ and extent of.each t3fpe/of use ......... t 7. Dimensions ot~x~isting structures, if any: Front .':....~ ....... Rear <J~ m~.;+~, <~' ' ' ' ..... Height ..... ~.'. ....... Number of Stories ..... ) ............... '' [:' i .":. i i ' ' i i i .'":: ...... Dtmenmons ofs'a,,m~e structure with alterations or additions: Front ...I..~. ...... n-d- "'1' 8. Depth ....... U(~5. ........... Height ..... [~ ........... ,., Number of Stori;s*.'::'. Dimensions of en..tire new construction: Front ..... ) .(o ......~ Rear ....... I.to Depth . .~'. · .Height ... ~ ~ .~"~. Number of Stories .. . I ................. s2 .... . 1.q '" ............ 18- ........... 9. z~ of lot. Front .......:~t .-.~. .... Rear ......., ...... Depth /fi .~.~ 10. zJate of Purchase . . '~ll~'~ . . ~'a ........ ' ^ ' ~2--~" ' ........... 11. Zen u -' . ' . ' ' ' '. ...... . T ' · ~ ..... '. ~ -,u ?~ vormer uwner ..... .,o~s;a~.~,.., ..... : ....... e or se restrict ~n whmh premlses are mtuated .... .~(,-.¢-,-~.x.Cb.~:.',,'~..',:~-~ ........O '..... i ' .I 2. Does proposed construction violate any zoning law, ordinance or regulation: ..... '..~ O ......... ' ......... 13. Will 16t be {egraded ........ .; ............. , .....~.. Will excess fill be removed from premises: Yes No 14. ?time o! ,Ow.n.e,r. o.f premises .~'1~-,\.~ .~ .~,..'c3~.x~xc-.... Address 3.C1~..O.)~-~t.I, h... Phone No. ~).<~z ~O.q.~:'... ' mame o~ Arcm~ect ...................... ..... Address ................... Phone No ........... . .: .... Name of Contractor Address Phone No ' 15.' I~ t:h:[s property w±th±n 300 feet: of a t:idal 'wet:land.9 eyes ........ No, .~. ..... ~If yes,' Southold Town Trustee's Permit may. be required. ~ PLOT DIAGRAM Lqcate clearly and distinctly all buildings, Whether 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 n~nes and indicate whether interior or corner lot. '. APPROVED AS NOTED 'DATE: · FEE. B.Y, ~T' 765-1802 9 AM'TO~4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION * l'WO REQUIRED FOR POURED CONCRETE -'2. ROUGH - FRAMING & PLUMBING 3. IN,qLJLA~ION .4.. FINAL CONSTRUCTION h~US3' BE COMPLETE FOR C.O. ALL CONSTRUCTION SHAI, L MEET TR~' R~QUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ..... O.'.~.~.. J~.'. I. · .~'~. · ............ being duly sworn, deposes and says that he is the applicant (Name df individual signing contract) above named. ' ' · ' (Contract~0rporat~ officer, etc.) ' of said owner or owners, ~d is duly authorized to perfom or have perfomed the said work and to m~e and file thi~ application; that all statements contained ~ this'application are true t~ the best of his ~owledge and belief; and that tho work w~I be perfomedjn the manner set forth in the application filed therewith. Sworn to before ~e this N~ta~ Public, ounty ~ v '