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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 ~ ' ........... : ....