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Home My WebLink About21786-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office o~ the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22862 Date FEBRUARY 3, 1994 THIS CERTIFIES that the buildin~ Location of Property 37070 MAIN ROAD House No. County Tax Map No. 1000 Section 85 Subdivision REPAIR CUTCHOGUE{ N.Y. Street Hamlet Block 3 Lot 2.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 1993 pursuant to which Building Permit No. 21786-Z dated NOVEMBER 18~ 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 REPAIR EXISTING OPEN PORCH DECK AS APPLIED FOR. The certificate is issued to PHYLLIS RAYNE BYER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLO, N.Y. No BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ,.. ,/./~. ~. ~.. ........................................... 19,,~'~..,, 2~786 Z Permission Is hereby granted to: ,,~,,~,,,,,,~,,,~......~ ........... ~ .......... ~' '~~ .,-,~,-.-':,,.-,/~,~.~-~' ~Z¥""~ ....... r,;'-'"~' ............................. Courtly Tax Map No. 1000 Section .......... ~.~,~'.. ...... Block ..... ~ ............... Lot No....~...~.Z ............ pursuant to application dated ......../..~ ................................... :., 19..~..~. ....... and approved by l he Building Inspector. Fee $,,/,,~,~,. Rev, 6/30/80 Form No. 6 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 i% 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 '7pre-existing" land uses: 1. ~ccurate 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 ~ 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 $25.0'0, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy 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, Con~ercial $15.OO Date ........................... New Construction ........... Old Or Pre-existing Building .... ..~..i ........ Location of Property..~.Y~7?.~ ................ House No. Street~ Hamlet Onwer or Owners ofProperty ............. /~.~.~Z/~ ~.~..~./~.~. .... /~.~.~..~..~. ............................... . County Tax Map No 1000, Section...~ .~. ....... Block.~ ............. Lot..~-~ ................. Subdivision .................................... Filed Map ...... ~ ...... Lot .................... .. Permit No..~Z~..~.~,~..Date Of Permit.~..~ .~ Ali a MZ/~ Z~ ~ ~--] .... ........ pp c mt .... t ..... ~z..~f~ ..... ~.. Health Dept. Approval .......................... Underwriters Approval .................... ... .. Planning Board Approval ........................ Request for: Temporary Certificate ........... 'Final Certicate.. ....~...... Fee Submitted: $...~.~'..~. ................... " .................... APPLICANT INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspecror Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 21, 1994 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 Mrs. Phyllis R. Byer 37070 Main Rd. Cu£chogue, NY 11935 To Whom This Ma~ Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: x~x An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XXX 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 $ BP# 21786Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDATION ( ls t) · FOUNDATION 2. (2nd) ROUGH FRAME & ·PLUMBING 3. INSULATION PER N. STATE ENERG~ CO'DE FINAL ADDITIONA'L COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ' ............. . · . . . (Bffildin~n~pector) ~.: APPLICATION FOR BUILDING'PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS SURVEY ................... CllECK ..................... SEFTIC FORM .............. 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 streets 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 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 Buiiding 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ( 'g of app 'c , rna e, 'f a co p ration) (Mailing address of applicant) State whether applicant is owner, Iessee, 'agent, architect, engineer, generai 'contractor, electrician, plumber or builder. c.~Td_~, c~ .. .' .............. . .................... .... Name of owner of premises .~..~..~/.X,Z. (.-~.. ~..~. ~...~....~..,~/~.,~ .................... ~ ..................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ///..q?.~..~.~.. ' Plumber's License No ......................... Electrician's License No ....................... 1. Location of land on which proposed work will be done. ~ .~t~ ?.' ....... ,:: ~.~..~..q~g~. ~,z~/~,. ~ uT~'~ ..................................... ~ . .. House Number Street Hamlet 000 ............. ........... :... ............ Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of p~emises and intended use and occupancy of proposed constmctiom Existing use and occupancy b Intended use and occupancy ~e~/~J~ - k ( h appli ' .3. Nature ofwor check whic ' cable): New Building Addition .... Alteration .......... Re r ......... Removal .... Demolition Other Work 4. Estimated Cost ...... t .................... Fee .......................... ,.. (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits .... Number of d Iii it each If garage umb of cars ........... · we ngun son floor ................ · , n er ..... [ ............................. 6. If business, co.mmercial or mixe~ occupancy, specify n~ature and extent of.eac~h/type of use ~sj?~./~. ............... 7. Dimensions ot existing structhre , if an 'Front ,347 Rear ~t/ ..... De ,2.j~..c' ~ Y ............ pth ight 1? ~ .............. He .......... Num er of Stories ................................................. Dimensions of shine structure with alterations or additions: Front pf~'~. Rear 4'~ .~'.~-. Depth ¢'&g~. ~-. ! ight .,.f.~.~. z~ ..................... ............... He -; ........ ' ........ ;,. Number of Stories .~'.,~..r~..~_.~. ~ ...... ' ' cf pp 5. ............ 8. Dimensions of entire new construChon: Front .......... ; Rear .......... Depth ............... Height ~fl~r,~ ~,.. I~'. .... Number of Stories ......... · ........ 9. Size of lot Front ~..,~.~ .Zff..~-. . ' .................. · ..... ................. Rear ...'7..Qt ~ ........... Depth ./.~'~.' ................. 10. DateofPurchase ~ ./.~...~..'~.?.~. .' ...... . Name of Former Owner tt~,~.,~.~...4Y¢~'4-f,,~p~/~. ....... 1 t. Zone or use district in which prem~ises are situated ~P'~'/d(.,~. ' ' 12 Does proposed construction violate any zoning law ...................................... · ' ordinance or regulation: 13. Will 16t be regradcxt ~'.¢ ' ' ~ d.~.' · .~.~.'JF~/~/~ ~.' i i ~ Address . .Fl ~..~.q~..g, .t_.~..~..~.. Phone No Z~, ,¢., .~.~..~. ~., ,.. 14. Name of Owner~;~e~" .I ....... Will excess~fill.be removed from premises: Yes No Name of Architect . t ' .......... l~ ............. Address ................... Phone No.. Name ofContractor ~./..~Z/A/~ .~f, /..P~.~..~,~'. .... Address gq~. ~.~'.~'~..~4V~... Phone No. ~.~. r~..~'~.~.' .' 15.' I.s this property within 300Ii feet of a tidal wetland? *Yes ........ No.,..~-FTF..... ~If yes, $outhold Towo Trustees Permit may be required. PLOT DIAGRAM Locate 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 names and indicate whether interior or corner lot. , STATE OF NEWj,YOR[,~, · a/- $ S COUNTy OF .,¢q-ecvc¢~.......~A¢~ · (Name of individual signing contrac0 above named. 't6a-i802' 9 AM TO 4 PM BE COMPLETE: FO~ STATE CONSTRUCTION & ENERGY DESIGN OR CONSTRUCTION ERRORS being duly sworn, depose~ and says that he is the applicant He is the.....~.O,~.F~.. ,2",~../T-,.. (Co~tractor,. agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized, to' perfom or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ thislapplication are true to the best of his knowledge and belief and that the work will be perfomed in the m~ner set forth inlithe application filed therewith. Sworn to before me_~his ........... ' ........... day of.~~~ .... , 19 .~ Nota~Publio, State of New Yofk , . ' (S~gnature of apphcat) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ _] INSU~.AZIGN~ FRAMING [,/~FINAL DATE INSPE .... ~~ CHIC.~"7, ~rLE INSURANCE GOI~PANI