HomeMy WebLinkAbout21781-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25997
Date: 09/29/98
THIS CERTIFIES that the building ADDITION
Location of Property: 285 EAST OILLETTE DR EAST MR%RION
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 38 Block 4 Lot 10
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 3, 1993 pursuant to which
Building Permit No. 21781-Z dated NOVEMBER 17, 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 STORAGE SHED ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to GERALD S & BETTY J WELLS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
Building I nspe~or
FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL *
SOUTHOLD, N.Y.
N_o
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
// /?
Date ...................... ~ ................................. 19....,?,,-~,..
21781 Z
Permission Is hereby granted to:
..~ ~:~.....~..~ ~ ~?. ...... ....~..~.zz~ ..................
.~.~...~..~,..~_~..x~ ........ ~../...,.~= ...........
..................................... ~ .......... '..,./** ............ ~....x... . ,
to ............ ~:..~ ........ ~ ............ ~~ .......... ~..~-~ ....... ~~...
. . .~. . ....... ~ ....... £ .x. . ,. .; ~.~. ........... ~. . . . .~, ....... ~,-,'x~. .,. .z ~ ............ ~. ~ //~ '.x. . . . ~ . . .
.... ~.~ ........ .~.(..~.i.~.~ ........... ~.., .......................................................................................... /
at "'rem ses coated at ~-d3'"' ..___~...~..J"Z-' ~,,~,Z"7'~',,~__ .
......................................................... ~.,...~~ ......................................................
Coun~Tax Map No. 1000 Section .....d~ ............ Block ....... ~ ........ Lot No ...... Z~ ...............
pursuant to application dated ................. ../..././.~.... ........................ 19......~..-~... ....
Building Inspector.
and approved by the
Building Inspector
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, i957) non-conforming uses, or buildings and
Upre-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 Building - $i00.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..~..~.. ~..~..~ ~ZZ~. ·
New Construction .... .~. ..... Old Or Pre-existing Building ...............
Location of Property,..~..~. ...... ~.
House No. Street Hamlet
Onwer or Owners of Property ........................................
County Tax Map No 1000, Section..~.~.g/.~.~..Block ................ Lot ......................
Subdivision................ ................... , Filed Map .......... . . Lot .................. .. ..
~../Tz~.z/~ .~. Appli .~- .~ .~f. ~..~. '..~ ~. -/-~
Permit No ..... Date Of Permit ................ cant .........
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 Yo~k 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 9, 1998
Mr. & Mrs. Gerald Wells
285 East Gillette Drive
East Marion, New York 11939
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)
XX, 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 #21781-Z SHED
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 28, 1996
Mr. & Mrs. Gerald Wells
285 East Gillette Drive
East Marion, NY 11939
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)
xx ~ 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 # 21781-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax {516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 5,
1996
Mr. & Mrs. Gerald Wells
285 East Gillette Drive
East Marion, NY 11939
Re: Building Permit ~21781-Z
Premises: 285 East Gillette Drive, East Marion
Suff. Co. Tax Map #1000-38-4-10
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,
$OUTHOLD TOWN BUILDING DEPT.
~OUGH' FRAME' &
-PLUMBING
STATE ENERGY
. . CODE
FI;~AL
ADDITIONAL
COMMENTS:
765-XS02
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [..~/
FRAMING iv] FINAL
INSPECT~
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 1197]
TEL.: 765-1802
, (Bu~fngg[nsp6ctor)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
CIIgCK .
NOTIFy| ....~.
MAIL TO:
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 sfi'eets
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
sh~ll 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 Dep .artment 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 rep~oval or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building c. dd~, housing code~)and regulations, and to
admit authorized inspectors on premises and in building for necessa~ .~.. '.~
-- (Signature of applicant, or name, if a corporation)
.. (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder.
NJmeofownerofpremises ~,~.~.~.,/~,. ~ ~/Z~'///-~' ~' ~'~ ~ ~/~ '
If applicant isa corporation, signature of duly authorized officer.' OA~ /(~74f~ ~8 ~ ,,~/~fi/~
................................ F~I. ~.~J~ ~ u L ~N~ ORnaMENT AT
' (Name and title of co~orate ~[~'~ ~ 765-1802 9 AM ~ 4 PM FOR THE
Builder's License No
............ UNLAWFUL ..
' ' ¢ THOUT CERTIFICATE
Plumber s License No ............
FOLLOWING INSPECTIONS:
1. FOUNDATION ' - TWO REQUIRED
FOR POURED CONCRETE
2. ·ROUGH. FRAMING & PLUMBING
3. INSULATION
4. FINAl CONSTRUCTION MUST
Electrician's License No ......... OF'0CQ'JPANC¥ BE COMPLETE FOR C.C.
ALL CONSTRUCTION SHALL MEET
· L p used ork w 11Be'd ne... .'-.df4J..~... .
q.F~4-- ' ' ' ' ZOIT~Ki N.tI~ONST[lU ClIO N ER BO fl 8
House Nmnber Street Hamlet
Con ty Tax Map No. 1000 Section ...: .......... Block .......... Lot ................
Subdivision ........ , ............................ '. Filed Map No ............... Lot ...............
(Name)
2: Stat~ existing use and occupancy of premises and intended use and o~cupancy of proposed construction:
Existing and occupancy '
b. Intended usc ~nd occupancy ...........
'3. Nature of work (check whic a cable · New Building .... Addition . '
m ............... Alteration .........
Repair .............. Re oval ..........
I .... Demolition .... : ......... Other Work ........
d C I .~:q . . (Description)
4. Estimate ost ........ ~. · '-
(to be paid on filing this application)
$ Ifdw lling mbt ofdw llin~units ' N mb old
If ga be of [ .......... u er welling units on each floor
· rage, num r cars ........ ' ................
6 If bus' 1o ' ~ d ..........................................................
l.xe up y spt fly n and extent leach typ fuse ' ' ' ' '
· mess, commercla r m occ anc , c ature o e o .......
7 D' 'ons of 'sti g st b if y: F
nTlensl eXl n ructu es, an ront .............. Rear ...............
· Depth
Height ............... Number of Stories ..... ................
of shme structure ,vita al · d(.l' ' ' ............................. i:'!'"
Dimensions teratlons or a lttons: Front .. ~o~ ......
Depth ................... I. · He~gh Number of Stories ..... ...
8. Dimensions of entire new construction: Front .,z/...'~. .~ .... ; Rear ............... Depth . t~. ......
.Height ............... Number of Stories ......
10. Date of Purchase O.¢?' /*~'/ ;.;. ~,. ......... De th ,/ool ...
12. Does proposed construction vi late any zoning law, ordinar{ce or regulation: ....
Will 10t be regraded ...... :i ................... Will excess fill be remo'ved from premises: Yes No
14. Name of Owner of premises .. i ...... , ........ Address ................... Phone No .............. ·
Name of Architect ~ · · '
......... ~ ................. Address .................. Phone No.
Name of Contractor ... ' ........... : ....
I.s this property wi't~'i~' ~bb ............... Address ............. ...... Phone No ......... ' .......
15.' feet of a tidal wetland? mYes ........ No .........
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate. clearl.y and distinctly
aili buildings, whether existing or Proposed, and indicate all set-back dime '
.Pmr?:;~y lines. G,ve street and block ,number or description accordin~ tn a~oa .... 2 ...... nsmns, from
· ' r or corner lot ,. ...... , u.u uuow street names anu indicate whether
STATE OF NEW¥ORK.O~_D //r-/s
county ·
..... ' ....
(Name of individual signin contract)
above named.
being duly sworn,
depose9 and says that he is the applicant
Heisthe . '..(~). '(~' 3Y~-0. t/''' "
, : (Contractor, agent corporate officer, etc.) .
)f said Owner or owners and is duly at~thorized to perfo~ or '
have perfomed the said work and to m~e and file this
~pplication; that all statements contaiMd M this app ication are/rue to the best of his knowledge and belief; and that the
fork will be perfomed in the manner se} forth in the application .filed therewith.
~Wom to before me t~is.
.' ' mo. 4~7~605 ~ ~ ~ :' ~ ................ ~.~ ~ .~ ~ .........