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HomeMy WebLinkAbout21747-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-23394 Date DECEMBER 6, 1994 THIS CERTIFIES that the buildin~ ADDITION & ALTERATION Location of Propert~ 1675 CEDARFIELDS DRIVE GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 40 Block 5 Lot 1.9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 15, 1993 ~ursuant to which Building Permit No. 21747-Z dated OCTOBER 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 DORMER ADDITION & FINISH SECOND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to VIRGINIA GILMORE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-043086 - OCTOBER 24, 1994 PLUMBERS CERTIFICATION DATED DEC. 5, 1994 - VANETTEN PLUMBING & HEATING Rev. 1/81 FO~M NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT ';OWN ~ SOUTHOLD, N.Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date....,/. ~.,../..~..?. ......................................... 19...~. 21747 Z County Tax Map No. 1000 Section ....... ..~..0.. ........... Block .......... ~ ............ Lot No ......... ~ ............... pursuant to application dated ........ .~.~.~..~... ............................. 19 .~..~. ....... and approved bythe Building Inspector, Fee $.....~..~..~,,~ 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 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 $25.00f~ddit~ons t~dwelling $ Alterations to dwelling $25.00, Swimming pool $2~J~, Acc~s~0, 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. Temp°rary CeTificate °f Occupancy- ResidentialDate $15.00,~. '/' '/'C°mm~.ercial $15.00 New Construction ........... Old Or Pre-existing Buildin.~g .............. Location of Property.../..~..~..~. ........ .~-~.~.~.~~.~....~%. i. ii .~..~ .~.~.~...~... House No. Street Hamlet Onwer or Owners of Property....~//~ .~/..~..~.~...~./..~g~... ~.~ .............................. . County Tax Map No 1000, Section ......... Block ............. Lot ................ Subdivision Filed Map Lot Pe~it /~/~ Permit No. ~. ~. Z .~.~..J~..Date Of ....... /...~. ........ Applicant ~ .~. ~./~../~-..~.~..~... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~ .... Fee Submitted: $ .... 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 CERTIFICATION ( pleas~e p~int) - (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Plumbers Signature) Sworn to before me this ~C~- day of J~~- , 19 9~ Notary Public, .~ County JOYCE M. WlLKIN$ mrm ~ir~ June 1~ FOUNDATION (1st) . FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COM~ Town Hall, 53095 Main Road P. O, Box 1179 Southo[d, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD December 2, 1994 Ms. Virginia Gilmore 1675 Cedarfields Drive Greenport, NY 11944-2125 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. The check is (outdated/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 # 21747-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 7G5-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FF~AU~IiNA~I ,~ON 2ND i ~NSAILJLLATION REMAR~.~ DATE J INS 2'65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ F/MMING FOUNDATION ZND [ ] INSULATION [ ]' FINAL REMARKS: JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Maih Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1 ~,01 CERTIFIED MAIL RETURN RECEIPT REQUESTED Robert Bracken Carpentry 295 Bennett Road Greenport, New York 11944 Dear Mr. Bracken: November 10. 1993 Your check no.'1066, dated October 15, 1993, in the amount of $75.00 has been returned by the bank unpaid. A copy of this check and the notice from the bank are enclosed. This office is required to collect the money for the check and an additional $15.00 charge for a returned check, Payment must be cash. money order, or certified check. The total amount due for this check is $90,00 and must be received no later than closin.q time at 4:00 P.M.. Friday. November 13, 1993, Please be advised that you will not be allowed to give any further checks to any town department until after such time as this matter is taken care of and all fees relating to this check are paid in cash. money order, or certified check. Failure to pay this amount within the specified time will result in the cancellation of your building permit and referral to the Town Attorney's Office for collection. Thank you for your anticipated cooperation. Very truly yours, Southold Town Clerk Enclosure cc:Town Attorney Buildin~j Department 0 0 FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Disapproved a/c ' APPLICATION FOR BUILDING' PERMIT B'OARD OF HEALTH . ~ SETS oT,..~.~**s .'~....'.~ SURVEY .- ............. c,,Ec .;;j, ............. C^LL ~77: ...... ~AIL TO: .INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and subinitted to the Building inspector, with ~ sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of btiildings on premises, relationship to adjoining premises or public st?eel. 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 bc 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 Occupanc} shall have been granted l?y the Building Inspector· APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections· · ...~.....~.::~.i'. ............... .. -- (Signatur~ of applicant, or name, if a corporation) (Mailing address of applicant) S~ate whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Nanleofownerofpremises . //" ,.~ t~ {as on the tax roll or latest deed) If applicant is a corporationl signature of duly authori:/ed officer.' (Name and title of corporate officer) Builder's License No ...... ~ ~ ~. ~. p .~. ............. Plumber s License No ....... . ........ . ......... : Electrician's License No. Other Trade's License No ...................... l. Location of land on which proposed work will be done ................. · .~7..¢-.. .... .c.;..a.~r..e.,.~.~.~ ..... .o..~?~. ..... .~. r~ m~. ~'~1- ~ ~ ' Itouse Number Street Hamlet County Tax Map No. I000 Section ... ~ '. .......... Block ..... ~. ' Lot.. J ~ ~ ............. Subdivision ~'~c V;~ta% · ........ . .............. . ......... '. Filed Map No ............... Lot ............... (Name) -.~' Stat~ ex~stmg" ' use aud occupancy of premises and intended use and occupancy of proposed construction: a. Existiug use and occupancy ~ G .......... . ..... b. Intended use and occupancyI ~ ,~'~ .~.~. ......... ....~ · ..,~ ....... ., ,~,,,. ..... ,, .,. ,........,, . . . '3. Nature of work (check wh,ch_ applicable): New Building ....... Additio . / · Repn,r .............. Rem ... · n ........ Alteration ; oval .............. . Demohnon . r~,u__ ,, ,,~ ' ' ' · ~' · · 4. Estimated Cost.. ~ 1'~o~,'~,~,~ -o' o, ' ~ , ....................... 5. · o 2 ~. (to be p~id on filing this application) If dwelhn~, number of dwelling units ... ':'. ....... Number ofdwe I n, ~ Ifgarage, number of cars i ' . .... ~ ......on each floor ........ 6. yss, commercial or ed oCcup y, specl y no r ~' '/' '; ...... ; .................. o~isting stmctures, ifany. Front ~ ~ nt re.each tye muse ....... 7. ~unenaons 0o ~ ~ ~ -~ g .I ............. NumberofStories... r~jj jjj ~ .... Height ~ ~. ' Kear · ~ ......... Depth ~. Dimensions of same structural with alterations or additions: Front ................. Rear ................. epth , ~ ,, · 8. ~lmenstons ofen re new cmlstmction: Front ~6 * ' ................ Rear ............... Depth ....... Height .~..~ ........ NamberofStofies ................... , ...... :..'~ ...... ~. Size of lot Front ! · _ I0. Date of Purchase I ......... Rear ...................... Depth . . . 11. ~one or use d~strlct m which premises are situa~;~ a e of Foyer Owner ...................... : ...... 12. ~oes proposed construction vlola~ ....... :_ , ' ' ';. ' .................. ~ ..................... '.. 14. N~e of Owner ofvremise~ ' ..... ..'J"' ~.~au m~ ve removea irom premises: Yes ' ................ auaress .......... . .......... PhoneNo ... ' Name of Arctutect ........ , ............... . ....Addres[. - ' ..... 'Phone No ...... Y , Southold, Town Trustees Permit may be required. ' ......... [ . ...[ PLOT DIAG~ Locate clearly and distinctly ~l build,ss, ~hether ~xisting or proposed, ~d, indicat~ ~I set-back d~ension~ from property ~nes. Give street ~d bloc' < number or description aCcord~g to deed, and show street nines and indicate whgthg~ ~tefior or corner lot.. COU~F, y oF. .. c2. y~--~ it{ (Name of individual signigg contract) above named. NOHFY BLI~t,,D~K~ DEPAR3[i~ AT '~<35 'i~O,~ ~ A~J TO 4 PM~OR I'HE ?OLLOWtNG [NSPECr{ONS: % FOLtNDATiON 'R~O eEOtJlRED · · ~::OH POUf~ED CONCRETE 2, ROUGH - FRAM{NG ~ PLUMS{NG BE COMPLETB FOR ALL 00~STRUGION SHALL ~tEET 'rk~ REOUIREMENTS OF THE STATE CONSTRUCTION · ENERGY C~'~DES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS being duly sworn, deposes and says thai he is the applicant ' Con ................. . . ~ <C(~t'r~a~t~, agent, Corporate officer, etc.) . :;p~ldati%Wn[l:;a~ra~lV~l;/j~eann~sl:Jn~I~tne ~::ft~)jnm or have performed the said work and ,orate and file Bls ~ PI, are true to the best of his knowledge and belief; and that the .york will be perfomed in the manner ~et forth in the application filed therewith. ~wom to before m~ { x ' 'otaw Pu .' ' nty , ~ p[~llo, SiMs of N~ Y~ ~ ' ou.mt~ ~9 Su~ak cp?~.y..7% .' ............. · ..................... . ~ml~lon ~p~es D~m~ o, ,~ ~ ('Signature of appHc~t) .