HomeMy WebLinkAbout21210-zFOP~M NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22212
Date MARCH 24~ 1993
THIS CERTIFIES that the building
Location of Property 370 TERRY LANE
House No.
County Tax Map No. 1000 Section 65
Subdivision
ADDITIONS
SOUTHOLD~ N.Y.
Street Hamlet
Block 1 Lot 6
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 1~ 1993 pursuant to which
Building Permit No. 21210-Z dated FEBRUD~RY 4, 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 TWO DECK ADDITIONS TO EXISTING ONE FAMILY DWELLING
AS APPLIED FOR.
The certificate is issued to
WILLIAM & PATRICIA MOORE
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPD_RTMENT OF HEALTH kPPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING D£PARTMENT
TOWN HALt.
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PER/vIIT MUST BE KEPT ON THE PRENtlSES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No-No. 21210Z
~...~.~ ..................................................
.. :.
~~:..~..~....~......~. ~....,~ ............................................................................
ot premises located at ...... .7.4~......,,~/',{~. ~'_'_'_'_'_'_'_'_~,.~ .....................................................................
County Tax Map No. 1000 Section ..... ~,,., ,,~,,.. ...... Block ......... L ........ Lot NO ....... .~.. ...........
19..~.Aand approved by the
pursuant to application dated .,.~,/,~,, .......................................
Building Inspector.
~,, ,.z.~..,~",/~ ....
lng In..~:fector
Rev. 6130180
!: '!; I'."IAR 2 3 1993
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 6r 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 6f 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. C~rtificate 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 - $100.00
3. Copy of Cert%ficate 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..,~,~J~O~'b..d~..~../.~..~..'~..
New Construction... ~ ...... Old Or Pre-existing Building ...........
Location of Property...~.7.Q .............. '.~.~. ~[.~....~..~ ........ i. ii' .~.' .D.~O.(~. ~ .........
House No. Street Hamlet
Onwer or Owners of Property ................................... · · .
Count, ,ap No '000, Seetion... ...... ,loe ..OI. ........... Lot....O..O...O. ............
Subdivision .................................... Filed Map ............ Lot ......................
Permit No.~.J.~.)P..~. ..... Date Of Permit..~.l.~.13~ ...... Xpplicant~i!li-~O-+.'.~."~.~.l.~.~. J.~QO~...
Health Dept Approval . Underwriters Approval .....................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certica~e .........-.
5'.00 '
Fee Submitted: ~ .............................
$3 .............................
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inapector
Gary Fish
Building Inspector
Vincent R. Wieezorek
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
MARCH 15, 1993
TRADITIONAL BUILDING & RESTORATIONS
P. O. BOX 203
GREENPORT, NY 11944
RE: WILLIAM & PATRICIA MOORE
To Whom This May Concern:
We are unable to complete your Certificate of
because of the following reasons:
Occupancy
An application for Certificate of 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.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 21210-Z
Please contact our office on this matter.
cooperation.
CC:
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
WILLIAM & PATRICIA MOORE
/.
~OUNDA~ION (lst)~
FOUNDATIO~'~ (2nd)
~OUGH FRAME
.FLUMBING
iNsUL~ATIDN PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIOn;AL COMMENTS:
FORM NO. 1
' TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y, 11971
TEL.:
765-1802
Approved......~..~. ....... , I ,~., Permit No..~. ,/. ,~'. ,/..(?. /~
Disapproved a/c .....................................
APPLICATION FOR BUILDING PERMIT
Received .......... ,19...
Date ................... 19...
INSTRUCTIONS
a. Tltis application must be completely filled in by Wpewriter 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 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 tile 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 regulation_s, and to
a dm :t au.t h onzed n~ sp eot9 ~ .~. p~e;~.i~'~)Clltt~l~in tiding for necessary ~
.......... ( ' 'c orporation)"
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, en,~neer, gene'ral contractor, electrician, plumber or builder.
C o,NTf./~c r~('2.. .................................................
Name of owner of premises '--"/-r, ~, ,-,
(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.. I.~. !.~..0...~. ~_.. ~ .........
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done.
House Number Street Hamlet
County Tax Map No. 1000 Section ........ ~>.~. ....... Block ..... ! ............ Lot .... ~ ............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing nsc and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .
b. Intended use and occnpancy
10.
11.
12.
13.
14.
Nature of work (check which applicable): New Building .......... Addition .......... Alterat!.9.n ..........
Repair .............. Removhl ............. Demolition ......... Other Work. ~..e...c~
-J~ '~ ~C.~) ~ (Description)
Estimated Cost .............. l ..................... Fee ......
I (to bo paid on filing this application)
1
If dwelling, number of dwelling uhits ............... Number of dwelling units on eaoh floor ................
If garage number of cars ! ] '
If business, commercial or mixed o. ccupancy, specify _natgje_lnd extent of each t},]?e,.of use ...................
Dimensions ofexi.stingstructuresiifany: Front.. (>.'2' q . .e.t' Rear 6
Height ].~ I.~, Numbler of Stories I ....
Dimensions4.6.'°f same structure with} alterationSigl ,5. L,?) L.~or additions' .............. Frnnt . .;~EJ~h... ~ ./4,,,,,,,,,,,,,,,-~...~. Rear ) .5.,~fC..~. ....
Depth ................... He ~t ................ Number of Stories ......................
Dimensions of entire new construction: Front ...... '7.., ..... Rear ............... Depth ...............
Height ~ Numb'er of Stories ~ /4 7 '/~ I q3
...................... ............
t ...........................
Size of lot: Front
Date of Purchase ~ .,,Nam, e pf Fenner Owner
Zone or use district in which premises are situated ~ s ~ de,, ~-,~ ~
Does proposed construchon violate any zoning law, ordinance or regulation: i .'~'. ?. ...........................
Will lot be regraded ...... ~,..., ..), ................. Will excess fill be removed from premises: Yes No
Name ofOwnerofpremises ~b,lle.'t~raooce Address ~..e.q~ L~ ...Phone No. 7.6'.1-~: ?.q.~.~...
Name of Architect ........... ] ................ Address ................... Phone No ................
Name of Contractor'Tg.q~.~."'.~.~-.. .,..........-.....gl'b~ 4 Address IpJ~-.~.~rfll4ttq6~,,,/./:t.V~h,-,,~,M,-,
· a/d~.~'~¢' ..............................
PLOT DIAGRAM
Locate clearly arid distinctly all ~uildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block number or description according ~o deed, and show street names and indicate whethar'
interior or corner lot.
AP.PROVED AS NOTED
765-1802 9 AM ~ 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION . '~O REQUIRED
~OR POU~ED CONCRETE
2. ROUGH -FRAMING ~ PLUMBING
4~ FINAL CONSTRUCTION MUST
8E COMPLETE FOR C.O.
ALL CONSTRUCTION SHA~
THE REQUIREMENTS OF ~E N.~
STA~ ~NS~U~ON
~OE~ N~ ~0~
O~IGN OR ~N
STATE OF NEW Y~I~_ t,
COUNTY OF....~..?.L~¢..x .'.'~. .... $.S,
.... ~ ~-~ ..... ~M~ · i ................... being duly sworn, deposes ~d says that he is the applicant
(Ndme of i~dividu~igni~g contract)
above named. , -- ~
'~ ~ctor
Itc is the '
I , agent, corporate officer, etc.)
of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e and file this
application; that all statements contained ha this application are true to the best of his ~owledge and belief; and that the
work w~l be performed in the m~ set forth in the application filed therewith.
Swam to before me this / /
.................. ~ o*.~.&'....~ ........ 19 X>
/ ..... ...... ' -
~TARY PUBL 0, ~'N~ .... / ....~ t ~., ..
N~ 4725089, Su ~ ' ........... : ....