Loading...
HomeMy WebLinkAbout21665-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22667 Date OCTOBER 20~ 1993 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 2125 STILLWATER AVE. CUTCHOGUE~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 103 Block 8 Lot 53 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 18~ 1993 pursuant to which Building Permit No. 21665-Z dated SEPTEMBER 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 ACCESSORY GREENHOUSE AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED GEORGE & STELLAPONTINO N/A Rev. 1/81 FOI~M NO.3 TOWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. N£ ~1665 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ,.~,~./,..~.. ............................................... -/ Permission is hereby granted to: CountcTax Map No, 1000 Section ........ ./,,~...~. ..... Block....Z ................. Lot No. ...,,~..,,/,.,..,~... ........... pursuant to application dated ......~ ........................................... 19..~.~.. ....... and approved bythe Building Inspector, Fee $...~'.~...~... Build g p r Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. Conunercial 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. 3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: i. 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. i. 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 $25.00, 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 yea~s - $10.00 4. Updated Certificate of Occupancy - $50.00 5~ Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 . ~ Date . · C ...... - Construction ........ Old Or Pre-existing Building ................. 'cation of Property....~.~.~...f..~l/?;.~7~~ ~e, House No. ' .................... ' .... ~ ...................... Street Hamlet ~Wer or Owners of Property... . . ................................. .unty Tax Map No 1000, Section. .. /.~.~. ..... Block .... ~ ..... ~ot .... ~ ........ bdi isio . ................ e ....... ............ Fil d Map Lot rmit No.~/~f ~ .Date Of Permit.~.~/~/~;~. ~. .' ........... · g · · · F..4,...appAzcant.L~.... ~.~...~$]M JT. 4~A ..... alth Dept. Approval..[.[.~..'~.,. ............... Underwriters Approvai...~%~..., ............. 3nning B6ard Approval..~..~.~ ............... quest for: Temporary Certificate ........... Final Certicate.. ..... · ................. INSPECTORS ~Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD October 14, 1993 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 Mr. & Mrs. George Pontino Box 2 Cutchogue, N.Y. 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xxx The check is (~utd~tcd/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 ~ BP// 21665Z Pleass contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ; ,I TOWN OF SOUTHOLD - ' il! BUILDING DEPARTMENT SE? 8 1993 ::! ,. TOWN HALL · .CTM SOUTHOLD, N.Y. 11971 [~L!')(). )L, 'T, TOWN OF SOU ,"~o!.r~ ...... ,J_ TEL.: 765-1802 Examined ..., 19 ~ Approved ....... 19~ Permit No .......... Disapproved a/c ' N~I:I~~D~[~ ~ . (B~Iding~spector) 765.1802 9 AM TO 4 PM FOR TH~ppLICATiO~,~ ,, FOR BUILDING PERMIT "OLLOWJNG ~NSPECT~ONS: ~. FOUNDATION 'BNO REQUIRED · F'OE; POURED CONCRETE ;~ ~OUGFI ~ FRAMING & PL/.IMS;NG INSTRUCTIONS BOARD OF }tEALTlt ......... 3 SETS OF PLANS ......... SURVEY .. SEPTIC FORH ............. HAIL ............ a.. Tlt~s~,a~t~catf~fi,~fi~ ~g, e6h~rl~-ely filled in by typewriter or zn Ink and submitted to the Buil ' s ,,~ ~, ,, ~ ~:-~,- ,.. -~ .... . drag Inspector, with 3 ets of pl~ns~u~t~ ~l~h to scale Fee according to schedule . .~-~'o~[~: l~ei~, ~}~{ and of buildings on premises relationship to adjoinin remises or ub o ~.. .. ~ ,-~.,:, ~, . .. ~:.. gP p ~cstreets r ar~¢~L,~Oa ~,~{~j~d~i, ig[¢Op of layout of property must be drawn on the dia mm w ' ' '. '- · ,.The wog ~[~(~ ~{~;~¢~lon may not be commenced before Issuance of Bufldin Peru sh-" [ '~ ? ~val g~BJl'l~lzcation, the Buildzng Inspector will ~ssued a Building Pemzt t~the a~tpQcant. Such pemit ma oe ~epr on rne premises available for inspection throughout the work. e. No: building'shall'be: occupied or used in whole or in p~t for any purpose whatever until a Ceaificate'of Occup~cy shaft have~ been~ granted :By :the -Buildihg~ Iffs~ctor. APPL~C~TI0.N'.I~;HEREB~rM~D~i~o~he Build~g Depmment for the issuance of a B~lding Pemit pumuant to the Building Zong;Or~ina¢ce. ~i~tk~.'T9wn of South01d, Suffolk County, New York, ~d other apphcable Mws, Ord~ces or Regulatiq. gs,~foRlhe ~oB~qg }off ;bu~i~gs, additions or alterations, or for removal or demolition, as here~ descfibbd. The app~a~::;gg~e~ '~[o comply with all applicable laws, ordinances, bufld~g code, housing code, and regulations, and to admit aut~q~g;.~ ~spe~lq~s~a~r~mi~.es,~a~fl't~ bulldog for necessa~ insgections. ~ . " ' ..... (Si~ature ~ applicant, or name, if a corporation) D.ES~GI~ O~ CONSTRUCTION E~tRORS (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generaJ 'contractor, electrician, plumber or builder. !~. , Name of owner of premises . ~o ~ ~ ~ (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 .... /.~..X Plumber's License No ..... ~ .,.~.~ ............. Electrician's License No... .f~. Other Trade's License No. 1. Location of land on which proposed work will be done ................ ' z2 7 · House Number . Street Hamlet ' . Cou'nty Tax Map No. I'000 Section . . ~ ..... ~... Block ~-v ..... ' Lot..~ ........... Subdivision ...fJp...... ~.'~.~ ................... '. Filed Map No. /~ Lot (Name) ............................. 2~ Stat~ existing use and occupB~cy of premises and intended use and occupancy of proposed construction: a. xisfing ufi~ and o~eup~n~ .... b. Intended use and occupancy ~.~!. ~. · 3. Nature of work (check which ~pplicable): New Building . [....1~.... Addition .......... Alteration Repmr ...... . ........ Removal ............. ~ Dem°litio?o). ;~, ....... Other Work ....... 4. Estimated Cost ~; ] ~Oa ~ . .... .~,, c~ 7lc-. ~f-e~o--~ /400,,,5'ie_,fli~scription) (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................ · Ifgarage, number of cars I ' 6 Ifbumness .... ............. ~ 'f.'_'j"~":"/":...-......' · , commercial or mixed occunancv snecif ...... ' .................... 7 Di nensions -"~-.: ..... ' . r ,, v ~ ,,~u,u a,,u extent et.each type of use lng structuriu~ u,~t es, If any: Front ~ Rear ............... ' ..... Height Number of Stories ............. ' ...... Depth Dimensions of shme structure With alterations or additions: Front ~D.epth.....~ ..... . .......... ,....Height ........... '-. -. ...~ ............ Rear .................. /.~i~ '";" umber pf Stories ....... ' ' ~ 8. ~J~mensmns of enttre new construction: Front .......... Rear ........... Depth . ,~...Z ........ Height ....... .~.. ~. ..... Nu ~mber of Stories ........ 9. Sizeoflot: Front'.. ]i~O · ' ................. .),~.~:.f~..,, ........... · . . . ......... ~ ................ Rear... 10. Date of Purchase : .... ~.~.~'~ ........ ... ' .................... . ... · · ...... Name of Former Owner . .~!..~: .)5'~,.~ ............... 1 I. Zone or use district in which premises are situated 12. ,D,,:o,,eS,_rP.r~posed c.on. struct~on vi~ojat~e a_ny zoning law, or~a~c~ oT;e~fflat[o';. ~.'t~;" i . ' ......... 13. ~m ~ut oe regraoea ~xt o ,,,,. · ........... i .... .... ' '. ...."2 .......... ,~' ' · '.-e-' ~' writ excess fill be removed from premises: Yes 14. name m owner ofpremases ./2~.~?. ~'..%, .~ ?.. N/./.WAddress ~O. T.c.~b q .~¢.q. .... Phone No..¢.7./-/. ;.~../. ]~.?. Name of Architect .... Name of Contractor h4~.,~ ~ e~.. ~'.<~ ~,.w ~ -.. .,.~..,~..~ ........ Phone No ........... . ...... ' . .,_. '~'-r _ 'r-~- 15. ~s uaxs property withim ~00 fee~ of a tidal wetland?--,ge~ No~. : *If yes, Southold ~own Trustees Permit may be requi;ga~ ..... ' ..... '". i PLOT DIAGRAM Locate clearly and distinctly all lbuildings, whether existing or proposed, and. indicate all set-back dimensions from property Hues. Give street and block number or description according to deed, and show street names and indicate wheti~er interior or corner lot. STATE OF NEW YORK, COUNTY OF ......... . S.$ ........ ' ......... being duly sworn, deposes and says that he is the applicant (Name of individual signin; ', contract) , ~bove named. {e is the : " (Contractor agent corporate officer etc ) ............. ,f said Owner or owners, and is duly 'uthorized to perform or have performed the said work and to make and file this pPlication;.that all statements containbd in this application are t'rue to the best of his knowledge and belief; and that the fork will be performed in the manner s~t forth in the application filed therewith. ' .worn to before me this LKIN · Notary Publio, State of N.ewY¢~t{ ' · .... No. 4952246, Suffolk Cotmtlg ~. ' . (Signature of alpplicant) · Term Expires June 12,, 1~9_-~ ~ .... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ ij. 8§077 BUREAU OF ELECTRICITY ~- lBS JOHN STREET. (flEW YORK. NEW YORK IOO:~S o~ly the e~trical ~ipment ~ ~scrib~ be~w a~ in~uced by t~ applicant ~m~ on the a~e application n~mber ~ the prem~es of ~s examined on J A N U A ~ Y 2 8 , [ 9 9 4 and found to be in compliance with the NaMonal Elect~cal Code. OTHER AP~R~U$: PANELBOA.RDS,I-6 CIR. 100 164 C[~['C}{OC~U~, NY, 11935 GENIERAL~ MANAGER This cert[fkote must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR [~UILDI[~G DEPA[T~7~/IENT, THIS COPY OF C~'~TtF~C~,TE I~UST NOT BE ALT~'IED ~N AP~Y I~AN~Efi. THE NEW YORK BOARD OF FIRE UNDERWRITERS 1_ [ ~ ~ ~.} ? ] BUREAU OF ELECTRICITY ~-~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 Date 00?(}[~J~ ~.99~ ~pplicationNo. onfile ~;J~49[~/~ ~ ~[~? 2~ THIS CERTIVIE~ THAT o~y the e~trlcal ~u~pment ~ ~scrlb~ be~ a~ intr~uced by t~ applicant ~med on the a~ve appli~tion number in t~ prem~es of ~EOR~E 170~71~0, 21''~; "~ ' ' " ' " ~' , i~ thefollo~'ing lacatlon; ~ B~s~ment ~ 1~ FI. ~ 2~d }]. 011'? Sectlo~ Bilk Lot u~sexaminedon OC ~0}~ ~[~ ~7,1993 and found to be in compHance with the Na~onal Elect~cal Code. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET E OTHER APPARATUS: s E R C  A'W G NO, OF HI-LEG A,W-G. NO, OF NEUTRALS 'O~E~C,~CONO OF CC. COND, OF Hi-lEO GENERAL MAHAGER [t Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE Must NOT BE ALTERED IN ANY MANNER.