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HomeMy WebLinkAbout21545-zFORM NO. 4 TOW~ OF SOUTBOLD BUILDING DEPARTMENT Office of the Building InspeCtor Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23025 Date JUNE 2, 1994 THIS CERTIFIES that the buildin~ ALTERATION Location of Property 1450 SOUTH HARBOR I~%NE SOUTHOLD House NO. Street Hamlet County Tax Map No. 1000 Section 75 Block 7 Lot 1.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~Y 8, 1993 ~ursuant to which Building Permit No. 21545-Z dated J~LY 20, 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 ALTER AND CONSTRUCT A FOUNDATION TO AN EXISTING OWE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. MICHAEL & PAULA CROTEAU (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. 4141-E JULY 20, 1993 PLUMBERS CERTIFICATION DATED PERFECTION PLUMBING & HEATING ~Bui~ding Inspector Rev. 1/81 FOI~M NO.3 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.~ 21545 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ~,...,z..~...Z.:.. ~'~ ............................. .z~.......~.....~-~. ........ ~., .................. ~.~..¢. ......... ~..¢.... ........................ to.....,~...cz-~z......~. ........... ©~¢~..~.,~........./.......~.~. .................. ...~ ........... ~.......:..~~.'..,z..~. ........... ~......~.,~......;..~ .......... ..../..: ........... ,~...P..,../.:¢ ........ ¢¢G,¢_ ............................................................................................. ............................................................................. ~~~ .................. z /..?..z/.. ..................... CountyTax Map No. 1000 Section ...... ..~....,,O~,,. ........ Block ........ ~ ............. Lot No ..... .,~,.~...~ ........ ,ursuarlf to applloat,oi~ dated ................ .~.~...,~ .......................... 1 9.....~...."'~...... arid approved bythe inspector, Fee $....~...~..% ,..O~..... 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 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 lZ 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 Vpre-existing" land uses: 1. Accurate s~rvey 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 Z.V .............................. New Construction ........... Old Or Pre-existing Building..~ ............ Location of Property...~.~.?....-~.~?.~..~.~?6..~?~9 .................. ~K.~.~A9 ........... House No. Street Hamlet Onwer or Owners of Property...~...~.....~..~.~p....~?.~.~J~.~ .............................. County Tax Map No 1000, Section...~Tf ...... 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 Submitted: $...~..~-;.0~. ..................... i $ ..... . . ', ............. ............. INSPECTORS Thomas Fisher Building Inspector Gary Fish Building Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD 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 CERTIFICATION DATE: Building Permit No. o~ /~'-5 (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of Ig lead. Sworn to before me this ~ ~- day of Notary Public, -~ County MAIN RD MATTITUCK, N~ 11952 $75 6'ro~d Itolle,d [Toad, ~eTv111e, R.Y. 11747 (516) 694-3040 FAX: (516)694-4122 TYPE ...... ORIGIN .... POTABLE WATER ROUTINE DISTRIBUTION LAB NO: 9415644 DATE COLLECTED. 05/12/94 TIME COLLECTED. 1141 HRS. DATE RECEIVED.. 05/13/94 COLLECTED BY... D99 PROJECT NO ..... 12 POINT NO: LOCATION: MIC~IAEL CROTEAU 14'50 S. HARBOR RD., SOUTHOLD REMARKS: SOURCE (KS) FLOW-2.5GPM PARAMETER (S) RESULTS UNITS LIMIT TOTAL COLIFORM BACT. negative ..... negative E. COLI. absent ..... absent CHLORIDE 15 mg/1 250 SPECIFIC CONDUCTIVITY 349 umhos COPPER 0.42 mg/1 [1.3] IRON <0.02 mg/1 0.30 DETERGENTS (MBAS) <0.04 mg/1 MANGANESE 0.02 mg/1 0.30 AMMONIA (AS N) <0.02 mg/1 NITRATE (AS N) 5.1 mg/1 10.0 LEAD <1.0 ug/1 [15.0] PH 7.6 units ZINC 0.84 mg/1 5.0 - Result(s) Reported meet(s) NEW YORK STATE limits for potable water. - Result(s) Reported meet(s) [USEPA action level] for potable water. COPIES TO: ORIGINAL DA~94 ~BORATOR¥ DIRECTOR ~ P ,4,} .~, Town Hall, 53095 Main Road P, O, Box 1179 Southold, New York 11971 Fax {516) 765-1623 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 26, 1994 Mr. & Mrs. Michael Croteau 1450 South Harbor Lane Southold, 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 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. ~/ xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21545-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 'OUNDATIO:I (2nd) %~OUGH FRAME & -PLUMBING .IISULATIOM PER N. Y. STATE EHERGY CODE FI;;nL ,I ~.DDITION~L COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~FINAL REMARKS: DATE INSPECTOR BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [J FOUNDATION ZND [ ~'~,.ATION []FRAMING ~/qFINAL DATE ~1~~~// INSPE BUILDING DEPT, INSPECTION FOUNDATION 1ST [ } ROUGH PLBG. [J FOUNDATION 2ND [ ~/~'LATION []FRAMING [,/~FINAL · 3. N..~.al. ur~of work (check which applicable): New Building .......... Addition . .' ..... i~ ..... '"~' t~5~tat~P-rv ; .... ~R_.e_p~ .............. Re,oval .............. Demolition .... : ......... Ot er Woi!~. j ............ 4 Estimated Cost (to be paid on filing this application) 5. lfdwelling, numberofdwelling~units ............... Number of dwelling units on each floor ................ If garage, number of cars ~ ' 6. If business, commercial or ~iooc~¢cy specify nature and extent oLeac~type of use 7 D' 'onsof ' 'ngst ~m~ ~"f~hy:Fr 7~' Rea A~ ~ ....... ~'~ ........ . ~menst ex~st~ e, ~ ont ............ r . Depth ' ' ' HeiSt ~ ' N bev fStories :g'~ ' ' ........... ' ............ D~ensions of shine structure wi'th alterations or additions: Front . ff~:~. Rear .~.~,~ ..... 8. w~mensxons of entire new construction: Front ..... ~/~ .... ; Rear ...... De th ~eight ............... Number of Stories ........ ('. ..... ' .... . [ [[[[: ........ ate of Purchase ...... Z//0/ZW .....' ......... Namepf Former Owner qF. ~ 1 I. Zone or use dislrict in which premises are situated .... ~ ~.~ '. .............. ' '.' ' ' .12. Does proposed construction viola{e any zoning law,~rdinance or regulation' ~o" ............. 14. Nme of Owner of premises /{l~qff/~ .g.. g~e~¢. Address . l. StWq ~ .n~ 4o..Phone No..'[¢~ ~qq~g, .~' Nme of Architect ~ ~'" Address Phone No Nme of Contractor ~o~f. Address . Phone No ' 15.' I~ this property within 300 feet of a tidal wetland? ~Yes ........ ~ ........ · If yes,'Southold Town Trustees Permit may be required. ' ~ PLOT DIAGRAM Locate clearly ~d distinctly ~t b~ild~gs, W ' ' ' · · hethor ex~stmg or proposed, ~d, ln&cate ~1 set-back ~ensions prope~y Hnes. Give s~eet and block number or description accord~g to deed, and show street nines and indicate whether ~tefior or corner lot. · . (~ontractor, aBent, cor'porat~ ......................... ' officer, etc.) of said owner or owners, ~d is duly authorized to psrfom or have perfomed the said work and to m~e and file this application; that all statements contained ~ t~is'applic~tion ar~ true tO the b,st of his knowledge and belief; and that the work w~l be p~rfo:~ in t~e ~anner set fortNin the application ~led t~er~ith. Sworn to before me ~.. Nota, Public,~.r'~. ._~.' ..... County ~ Publ~ Stem of N~ Yo~ ..... . ........ No. 48795~ V ' (Signature of applicant). ~ Ousllfled in Suffdk CoU~ )'~ ' mission Expire~ De~ember 8, 1.4_' 2) I P. t !. L !llllllllllllllll111Jllllll !I/