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Home My WebLink About21336-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22418 Date JUNE 25, 1993 THIS CERTIFIES that the buildin~ Location of Propert~ 530 SUNSET WAY House No. County Tax Map No. 1000 Section 91 Subdivision ADDITION SOUTHOLD, N.Y. Street Hamlet Block 1 Lot 9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 27, !993 pursuant to which Building Permit No. 21336-Z dated APRIL 15, 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 SHED ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPAR'EMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED LAWRENCE & GLORIA SIMON H-03531I - JUNE 8, 1993 Rev. 1/81 FO~' NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N? 313a6Z Dote ............................................ , 19 Permission is hereby granted to: /...~~...~i~......~:~_/....~. ......... ...~.~...:~ ............... ~...:~.. ....................... ,o .~~~...:..~~y.....~~~.....~ ~~......~~ ....... ~ ...... ~~.~.~ ................................... ~, ~re~,,, ,~,,~ ~, ...~...~.....~~j~ ....................................................... ........................... ~ ........................... Jf~~............~ ~ ....................................................... ~o~.~ ~ ~ ~o. ,000 s,~,,o. ......... ~ ....... ~ ........... ~ ...... Lo, ~o ...... .~. ............. pumu~nt to cpplicction d~t~....~ ..................................... , ig.~.~., end cpprov~ by the Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~his 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 ail buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-Risposal(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. 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 Upre-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 i. 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.O0 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, Commercial $15.00 Date ~/~/~.~. ............... . Ne~ Construction ......... Old Or Pre-existing Building ...... House No~ Street Hamlet Onwer or Owners of Property .... ~-' ~ ~ ~.-~x~-~. County Tax Map No 1000, Section ....... ~/.... ock ..... / ....... Lot .... .~. .......... · Bi ......... Subdivision Filed Map 9-7.-~.~? Lot Permit No ...... ¥. ........ Permit ......... Applicant...~%~ ...... ~.- ............. Heslth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval . . Request for: Temporary Certificate ........... Final Certicate. ...~... ..... Fee Submitted: $ ..................................... · ' ........ , PL OS"¥ THE NEW YORK BOARD OF FIRE UNDERWRITERS,, BUREAU OF ELECTRICITY ~'- B5 JOHN STREET. NEW YORK. NEW YORK 10038 Date ~lpplicatlon No. on file THIS CERTI~IE~ THaT ~s exernJned on ~ .... and found to ~e in comp~nc¢ with thc N~n~ Elect~c~l Code, SaRVI~ DI~ONNECT ~ ~. ~ ~ S E R I C ~ OTHER APPARATUS: ~ TNis cedificate must not be altered in any manner; return to the office of ~he Board if incorrect. {nspecto,s may be identified by the r c,edenfiols. ~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER, INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior B~*ilding Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant F/re Inspector Telephone (516) 765-1802 SCOTT L, HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 1197 ! Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD MAY 26, 1993 LAWRENCE SIMON & WF 1~4-43 13£h AVgNL~ WHITESTONE, NY 11357 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 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 ~ 21336-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. )'OUNDATIO:~ (2nd) ~UGH FRAME & .PLUMBING f~SUL~TIO:~ PER N. STATE E~ERGY CODE FI:IAL ADDITIO~A'L COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~FRAMING [~AL REMARKS: INSPECTOR FORM NO. 1 . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 L,.,.,..,!;'L'",! ~, ,! ' TEL,: 765-1802 Examined · · .~./;5 ...... ,19 9.~ Approved...Y/./5 ........ ,19~.~ermit No..~. ~ ~-~ Disapproved a/c ' . ....................... . ~gutl~n~tor) . APPLICATION FOR BUILDING PERMIT 80A'RD OF HEALTH SL/RV~Y .................. CIIECK .......... :' ' '~t~_ .... CALL . . HAIL TO: Date ... '~.~..~..? .......... 19fizz... INSTRUCTIONS a. Tlds application must be completely filled in by typewriter or in ink and submitted to the B~ilding Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ' b. Plot plan showing location of tot 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- c,ation. 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 the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspecti~¢~ --' (Signature oT applicant, or name, if a corporation) (Mailing address of applicant) ) 123_b-7~ ~ State whether applicant is{owner/>lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. ....b,..~.....~... . .... (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 L~cense No ............. Plumber's License No ......................... Electrician's Liccnsc No ....................... Other Trade's License No ....... : ............. ' ..... : ::...7'...7... 1. Location of land on which proposed work will be'done... .. · k(..4 .v ................. ................... House Number ,~'~ 0 ,~-~..~,.~,.,~ ~,,c~ Street Hamlet County Tax Map No. 1000 Section ,..~.~.ll Block ..... .~.,../ ..... Lot. '~ ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) L State existing use and occupancy of premises and intended use and occupancy of proPosed construction: a. Existing use and occupancy ........... ..: .......... b. Intended use and oscupancy .... '~. dt//.~.~-.~....,/7~.~../(2.../~.~.27.....~/~..~ ~.~,.~..,.~7,~ ,,. · 3 Nature of work (check which applic&ble): New Building ~ ddition Alteration Repair Removal i ................. ' ..... Demolition ' Other Work '.., , , 4, Estimated Cost , (Description) · ' ' i ..................... Fee ~ (to be paid on filing this application) 5. It' dwelling, number of dwelling unit~ ................ Number of dwelling units on each floor ................ · If garage, number of cars ......... ' ........ 6 If business commercial or mixed occupancy specify nature and extent of each type of use · ,menmons ot emshng structures if any: Front .............. ................ Rear .............. Depth ............... Height ............... Nnmberiof Stories ....................................................... Dimensions of same structure with ~lterations or additio'ns: Front Rear Depth ..... ' ...... ~ .......... Height ........... . ......... '.. Number of Stories ........... ' 8. Dimensions of entire ew construct on: Front .............. '. Rear ............... Depth ............... Height ........ Num h~,- ,-,c 9. S eof lot Front ... n .... ' ............... 10. Dar ............. Depth e of Purchase . ,. . _ ^ ...................... ~, ..... · ....... : ............... mame o! lmrmer uwner .......... ,. h p i$ ................... 1 I. z. one or use restrict in whic rem es are situated .................................... 12. Does proposed construction violate any zoning law, ordinance regulation: ................................. 13. Will lot be regraded ........... i ................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..... ; .............. Address ................... Phone No ............. .... Name of Architect ............ ~ .............. Address ................... Phone No. . , Name o£ Contractor ' ' .............. . ' ......................... Address .................... Phone 'No... ............ .. 15. Is this property within 300' feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold To~n Trustees Permit may be required. ' ~ PLOT DIAGRAM Locate clearly and distinctly all btdldings, whether- existing or proposed, and. indicate all ~et-back dimensions fron~ property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. ' . 3TATE OF NEWXORK, r . :'OUtqT¥ OF.. tWr~ .~.). sls (Name of individual signin . contract) boee named... being duly sworn, deposes and says that/l~e is the applicant leis the.. ~ .................... i ................ (ContractOr a~ent ............................................ , , ;;rporat; officer, etc.) f said owner or owners, and is duly m~thonzed to perform or have performed the said work and to make and file this pplication; that all statements contaieed in this appl cation are true to the best of his knowledge and belief; and that the 'ork wi/l be performed in ,the manner,set forth in the application flied therewith. worn to before me this New York State' Department of Environmental Conservation Building 40--SUNY, Stony Brook, New York 11790-2356 ~ ~ (516) 751-1389 A review has been made of your proposal Thomas C. Jodlng Commissioner Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the project is listed in Part 661.5 of 6NYCRR (Tidal Wetlands Land Use Regulations) as a use not requiring a permit. Therfore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law). Please note that any.additional work, or modification to the project as described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, ref: NPN disk~6 Deputy Regional Permit Administrator