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Home My WebLink About21669-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. No Z-23608 CERTIFICATE OF OCCUPANCY Date APRIL 24, 1995 THIS CERTIFIES that the buildin~ ADDITION & ALTERATION Location of Propert~ 415 RACHELS'E ROAD MATTITUCK N~ House No. Street Hamlet County Tax Map No. 1000 Section 108 Block 4 Lot 7.46 Subdivision Piled Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8, 1993 .pursuant to which Building Permit No. 21669-Z dated SEPTEMBER 22, 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 A DECKADDITION & A SLIDING GLASS DOOR ALTERATION TO A ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to KIM & BEVERLY NORKELUN of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A ~uilding Inspe/or FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN 14,e4.t $OUTHOLD, N.Y. 2~669 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to; ~:...?..~.~.......~......~~ ...................... .... ~.: ........... .,r~¢,~..~.. ............ ,~-,-~ ................... ,o..¢~/~~.......~...;.~~.:..~/...~~....~/- ~ ........ ~. .......... ,~/,/~.......~ ........................................................................ CountyTax Mop No. 1000 Section ,,., ..~...O...~... ........ Book ....... ~ ............. Lot No'7.n......~....~... ............. pursuant to application dated......~../.~.. ......................................... 19...~......~. ...... and approved by the Building Inspector. 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. Sworn statement from plumber certifying that the solder used in system contairs less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar bffildings 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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. 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 Buildinz - $100.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00., Commercial $15.00' New Construction...~.%.,.~,_Old Or Pre-existing Buildin= ................. ' ........ Location of. Property..j ..~[~,., ........... .~-~-~-~....~.' ['. ....... .~A .T~.. [I~.~ .~.. · ~ouse ,o. Street Hamlet ....... ......... Co,nty ,ap Ne 1000, Bection...lO.g... O.Zl ." - ........ ~ .... ~ .... ~o t ~.m~r./a..~:.....i. ~..~.L..~ Subdivision ...................... · Filed Map Lot llealth Dept. Approval .................. ........ Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ....... '~' Final Certicate...' ........ Fee Submi_tted: $ .... . .~.. ( .~.~. ................ 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 April 6, 1995 Mr. & Mrs. Kim Norkelun P.O. Box 633 Mattituck, NY 11952 **** SECOND NOTICE **** 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)** 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 # 21669-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED. 7GS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ,~NAL DATE ~INSPECT~//~ Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 5, 1994 Mr. Kim Norkelun 812 Linnet Street Greenport, NY 11944 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is not on file. ($25.00) 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# 21669Z Please contact our office on this matter. your cooperation. Thank you for SOUTHOLD TOWN BUILDING DE~T. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & · ?LUMBING~ INSULATION PER N. STATE ENERGY CODE. ADDITIONAL COMMENTS: u- C, ~-.LF_'W' iI)EC./(, 3B' x7¢' 'x )~:JFY BOIL~ DEPART~AT ~B-~S02 9 AM TO 4 PM FOR THE FOUNDATION ~O REQUIRED FOR POURED CONCRET~ FINAL CONSTRUCTION MUST BE COMPLETE FOR .L CONSTRUCTIOAJ SHALL ~E ~EQU~REMENTS OF THE ATE CONSTRUCTION & )DES. NOT RESPONSIBLE, ~S~GN OR CONSTRUCTION /-J DLL~ ~ ........................... t4gw ^U'DE'P-.sC~¢,~ t,,' _j. 4-- S'l'E lxl k~EW 4. 'i3 E.C, 2..~-I,S~ xo 'PgoPgltrV LIMF < -I /&LI DI/,aG~ FEE: NOTIFY BUILDING FOLLOWING INSPECt, FOR POURED CON( ROUGH ~ FRAMiNi 3, INSDLATION BE COMPLETE FOR ALL COH~TRUCTION STATE CONSTRUCTIOi CODES. NOT I<'- ~t3 I PM FOR THE )NS: NO RECIU~RED F~ETE & PLUMBING ( _ .STEPS xlEw ~EcI< L~O' 3" LIME Examined . .' .ff. ......., 19.~. Approved .......... I¢~,. Pc;mit No..~.4.~. d'a/ ' Disapprove. c ............... ¢ ..................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1197~1 TEL.: 765-1802 BOARD OF HEALTH 3 SETS OF PLANS SURVEY CIIECK .... HAlL TO: State whether applicant is owner, l~ssee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner of premises . K I ~. (as on the tax roll or latest deed) If applicant is a corporation, signatur~ of duly authorized officer.' . ( amc and t~tle of corporate officer) Builder's License No.. ~ ~ ' Plumber's License No .............. . .......... Electncmn s Lmense No ....................... Other Trade's License No... ............. .~. . 1. Location of land on which propos ,d work will ~e done.~¢~ ~-~.'~ .~Q6~........~ ffff....:~¢J ~ .~ ..... ~.~ House Number Street Hamlet Cou'nty Tax Map No. 1000 ' ' Bl~ck · '... Lot. ., SecUo9 ............... Subdivision ......... ..~ ...... (ff~}~d)' ' ' Filed Map No ............... Lot .... : ........ 0' Stat~ existing use and . ~ ' ~. occupancy of premises and intended use and o~cupancy of proposed constructiom a. Existin~ use a~d occupancy ..... . ...................................... .. b Intended use and occupancy ' for necessary~nspe~)o~ i/ . .~'nspe OhS. ' . . . _[atgnature of applicant, or nan,; ifa corporation). L/ ' ' ' .. ...... .¢. (Mailing addresi of applicant)// . J.l~il~= Inspector) . i6PPLICATION FOR BUILDING' PERMIT , i!t' Date .~.e~.- .~.. 19~.'~ INSTRU6TIONS a. TNs apphcat~on must be completely filled in by Wpewfiter or in ink an'd submitted to the Bulldog Inspector, with 3 sets of plans, accurate plot plan to schle. Fee according to schedule, b. Plot pl~ show~g location of lot and of bulldogs on premises, relationship to adjoining premises or pubic streets or areas, and giv~g a defiled description of layout of property muir be drawn on the diagram which is pan of this app,- cation. ' c. The work covered by tNs application may not be commenced before issuance of Building Pemit. ' d. Upon approval of this application the Building Inspector will i~sued a BufldNg Pemit to the app~cant. Such pemit sh:~l be kept on the premises avaflablO for Nspection throughout the work. . e. No building shall be occupie~ or used in whole or in p~t for any purpose whatever until a Ce~ificate of Occup~cy shall have been granted ~y the Building Inspector. APPLICATION IS HEREBY MADE to the Bulldog Dep~ment for the issuance of a B~lding Pemit punuant to the ~uilding Zone Ordinance of the Towh of South01d, Suffolk County, New York, ~d other app~cable Laws, Ord~ces or Regulations, for the const~ction of Ibufldmgs, additions or alterations, or for removal or demolition, as here~ desc~b~d. The app~cant agrees to comply wit~ all applicable laws, ordinances, bufld~g code, housing code, and regulations, and to admit authorized Nspecto~ on premises and N bulldog · 3.Nature of work (check which applicable): New Building .......... Addition .......... Alteration ' Repair .............. Removal .............. Demolition .... : ......... Other Workl, og.C~D. :~).~.q.~... ' ' 6 "[~b~,e~o~ &tb/,~6 ~oOe(Description) 4. EstlmatedCost...~.....~.j ~0.(~.,.Q.O .'i .' ................ Fee 5. (to be paid on filing this application) l[::~}?:~U;breorf°:a7'? '........ Numberof dwelling units on eac elh g umts ...C)..M. h floor ................ 6. If business, commercial or roi.xed occupancy, specify nature and extent of,each type of use ..................... 7. Dimensions of existing structures, if any: Front..d?.¢~.,. 2.:5. .... ~,, ,~2~, - Height ...5.Q ......... Number of Stories ... ~ ....... i ......... :' ' ~' ....... Depth . .o7..&.,. ~. ....... Dimensions of shme structure with alterations or additions: Front ............... .~.o.: ~.. Depth .... ~ ~.~. '. ~ .... Height ~' . ~.~V.~, 3 .. Rear ........ ......................... ... Number of Stories .... 8. Dimensions of entire new construction: Front...~..O....~. ...... ; Rear . .~.O.: ~ ....... Depth .../.O.'.... Height ............. Number ,of Stories ........... .~-.' , 9. Size of lot: Front ......... [.. Rear... :.c?.~. ........... Depth . ' ; ....... 10. Date of Purchase .................... . ......... Name of Former Owner .................... 11. Zone or use district in which premises are situated -.. ......... .12. D°es proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded ,:t4tP . · Will excess fill b ~ ~ .... '- '- ..... 1 ............. e removea ~rom premises: Yes No 14. NameofOwnerofpremises .t~l.~t. .AJo~g[ff.~_ld~ Address--~0, t~3~ ]L/~FrlTtI~' -'- -. . Name of Architect . ~ ......................... Address ................... Phone No ................. Name of Contractor.~ .'0-o./~ ~. ~,~y. I/.,cd.)( Addres~/??,.,,~, .,.-C..~ '5~.~ - ;"F-Phone No ~ 15.' I~ th±s propertyk~±th±n 300 feet of a tidal wetland? ~ye ~27 i.~.-.0v[~; ............ · ~If yes, Southold ~own trustees Perratt may be - .......... -... 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 wheth'er interior or corner lot. LOT STATE OF NEW yORK ,~ · ~' S S COUNTY OF. ~ ' .... .~...~.~.Ll(k .... ~'* '~- · -~' ....... · ......... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. He is the........: .............. . ..................................... . ........ (C ...... ontractor, 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 ~ this application are true to the best of his knowledge and belief and that the work will be perfomed in the manner set forth in the application filed therewith. Sworn to before me this . . I. ' Nota~ Public,~~(~. ~~nt, C Qualified in Suffolk'Cou~ ~ ~ ommissio~ Expire~Mav22, ~ ·