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Home My WebLink About21507-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22740 Date NOVEMBER 22r 1993 THIS CERTIFIES that the building Location of Property 405 LONGVIEW LANE House No. County Tax Map No. 1000 Section 88 Subdivision ADDITION SOUTHOLD~ NEW YORK Street Hamlet Block 5 Lot 5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 19, 1993 pursuant to which Building Permit No. 21507-Z dated JIrNE 30, 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 DECK ADDITION TO EXISTING ONE FAMILY D~k~,ING 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 HOWARD & ESTHER DORFMAN N-291901 - OCTOBER 7~ 1993 N/A Rev. 1/81 Building Inspector FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 21507 Z Permission Is hereby granted to; .... .¢¢.. ........ ~.... ........... Coun~y Tax Map No. 1000 Seotion....~..~., .............. Blook.,,.~...,'~.. ............. LotNo. ~ .................. pursuont to oppllcotion doted .,...~ ......... /,.¢ ............ ,9.'~.,.. ,~, ...... end opprovod bytho Building Inspector, roe ,....~...~..,.~..,¢. Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF 80UTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 requirement.~. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ?pre-existing" land uses: , i. 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 $i~ned 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 dwe!limg $25.G0, 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 Occupaeoy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...~ ~.~ .O.~.T.. ~.~ .,.~[~. ~ ........... New Constructiem ....... . ... Old Or Pre-existing Building ................. Location of Property.... ... ............................................... .. .. ... .. House No. Street Hamlet Onwer or Owners of Prone~tv f-{~P-~ ~'O ~_~-~.. ~t~.~fl~J County Tax Map No 1000, Section...... .... . .. .Block ................ LOt .................. . .. . Subdivision .............................. Filed Map Lot Permit No ................ Date Of Permit ............ Applicant Health Dept. Approval ..................... ... .. Underwriters Approval.......... ........ .... . .. Planning Board Approval ............. ~ ...... Request for: Temporary Certificate ........... Final Certicate.....~. ..... Fee S~bmit ted: $ ............................. ~ ,~ 0 I ? APPLICANT INSPECTORS Victor Lessard Pri,xcipal Building inspector Curtis Horton Sen/or Building [vapector Thomas Fisher Building Impector Gary Fish Building inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L, HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD JULY 27, 1993 HOWARD D. DORFMAN 405 LOHGVIEW $OUTItOLD, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate/~f Occupancy is not on file. (Enclosed) / No Underwriters Certificate on file./ The check is ~not on file.)$25.00/ No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 21507-Z -Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FIELD I~SPECTiON FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & .FLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-~802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ].~NSULATION [ ] FRAMING ~] FINAL REMARKS: ~ 7G5-~802 BUILDING DEPT. INSPECTION ] FO/~JB~TION ~,$T [ ]ROUGH PLBG. //FOUNDATION 2ND ~ ]INSULATION [/~ FRAMING [ ]FINAL THE NEW YORK BOARD 'OF FIRE UNDERWRITERS ~ 1 ~ ~ 0 ~ ~. u REAU O~ E~ECT.ICITY ~" 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT o~y the e~tr~al ~uipme~t ~ ~scri~ be~w a~ int~uced by t~ appl~ant ~m~d on the a~e ap~i~tion number in t~ p~m~es of OR, DOR~M~N, 405 LON~VIg~ in the following location; ~ B~sement ~ Ist Fl. ~ 2nd ~3. O U~' / D~CK Section Bilk Lo~ ~s examlned on 0~0~ 04~99~ and found to be in compl~nce with the N~onal Elect~cal Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS DRYERS SYSTEMS NO. OF FEET E R V I C NO. OFpE~CC~.COND. OF CC, CONO, NO OF HI-LEG OTHER APPARATUS: NO OF NEUTRALS OF NEUTRAL B. O.BOX 1768 GENERAL MANAGER This certificate must not be altered in any manner; return to the o[fice of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUS~NOT BE ALTERED N ANY MANNER TOWN OF $OUTHOL~ Examined .................19 ... ^pprove ,-,,Z.. .... Permit No - Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 gOA~D OF HEA~H /3 SETS O~ ~LAN$ ......... SURVEY .................. ~,ClIECK ................... SEPTIC FOR~I ............. NOT i FY ~ '. 3 '2.(, ....... ['lA I L TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 gets 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 sti'ects or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli- cation. c. The work covered by tkis 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 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 alteration% or for removal or demolition, as herein described. The applicant agrees to comply with all app!icable laws, ordinances, building code, housing code, and regulations, and to admit autbnhzcd h~sp¢ctors on premises and in building for necessary ipspectionsx_~ ~'~ . . . -- (Signature of applicant, or name, if a corporation) (Ma~ing address of applicant) I; c~ ~7 I State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner of premises ~2~O'-)/~O'-'~ ~ "~5~-Ox~'1¢~ ' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.· (Name and title of corporate officer) · t o Plmnber s License No ......................... Electric an s L cense No ................. , ...... Other Trade'~ t.icenso ?,re ..................... Location of land on which proposed work will be done .................................................. ............... ...... ....... ............................................................ House Number Street Hamlet County Tax Map No. 1000 Section ...--i~..~. .......... Block ~ ' Lot. 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 ........ .~..[...%. ~.~..-~..~..?.~...~: ......................................... .. b. Intended use and occupancy ....... ?..~._~..l~'~..t~.*?o I...~..t:=....-'7...~. ?..~..'~...'54...'~?.~../'~...~.e.-7.~..W'~ ......... '3. ~Natu.re of work <check wh,ch aJ3plicable): New Building..:. ' .:. ; Addi,lrm ~z>OOq'-?P~:C-J<'a,,,~.-J~J! "' ' ' , P ......... Removal ...... ........ Demolition ..:.: ..... .... Other Work . 4. Estimated Cost... ~(~ ~. ~ ' ~ ~ ~; ", ~ripj~) 5. i ' ' If dwelling, number of dwelling Units . . ) .... . :~garage, numberofcars .... ~. I ' ' ............... 6 ~businy c~n~ercial ormi ................ n ;ud 7 ' ' ' , of. · ~mensmns o~ ex~sting structures if an~' Front - - '~ ' ..... ~ ................ ' Height ~ ~ ................ sear .............. Depth Number of Stories ~ 1.'. ' ................ Dimensions of shme structure w~th alterations or additions: Front Depth ] i HeiSt ' . ................. Rear ............ .......... ............. ' ..... Number of Stories ' · ...... 8 D' ' · ' '" · lmensmns of entire new construction: Front .............. ~ ...... Height Number of Stories .............. : 'Rear ............... Depth .. 9: Size ofiut: Front I ........ ~ .i ..... Rear . . 10. Date of Purchase . ] .~ .~.:. k~ .? ~ .... . ......... Name of Fomer Owner . ~.~.~.. ~ ~ ~ ...... I 1. Zone or use district :n wmcn premises are situated.. .. ' ' ': ....... 'ate any zo~in, law or~:-~d .... .12. D~es proposed Construction via. ~. o , um~nce or regulation , . . 13. Will lot be regraded ~'~ .... : ............... ' ,, ' · · '.~ '~ ......... ~ ....... wm excess fill be removed from premises' ' ............. 14. Y~eofOwnerofpremises O ~¢~ Add '~W~6~ C~ . Yes , No · ', .... .. · · tess .. ................ Phone No. 2q~.xq~. ~..." Nme of Architect ......... i ................ Address .............. Phone No. . ' Nme of Contractor ...... ~ Address .......... Phone No .............. 3.. 15.' I.s this proper~y ~ehSn ~00 feet: o~ a Ctdal wetZand~ ~Yas ........ No...~ .... ~If yes, Sou~hold ~own Trustees Permit may be required.. .... PLOT DIAG~ Locate clearly ~d distinctly ~1 ibuild~gs, Whether existing or proposed, ~d. indicate fll set-back d~ensions from property. ~nes. Give street ~d block number or description accord~g to deed, and show street nines and indicate whether ~tefior or corner lot. S~TATE OF NEW YORK, oF ............ . . . ........... - ...... ~, ...-~...--,~. ,. .... r.~ ....... . ......... being dul~ sworn, depo~e~ mid ~ay~ ti~ai he is the applicant (Name of individual signin contract) tbove named. ' {e is the ;,. C~ bLt.k) ~Fd.. (Contract'~r ................................ . ............ , agent, corporate officer, etc.) .f 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 contain .'d in this application are true to the b~st of his knowledge and belief; and that the /ark will be performed in the manner s~t forth in the application filed therewith. ' worn to before me this 'r- i c', ' ' ...... ............. '...day of..!.. Notary Public, State of New York ....... ~ .'. · ~ ~ ...... No 495136~ / (Signature of applicant) Qualified in Su[folk County d~z. ' · ' ' Commission Expires ~;le.,/