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HomeMy WebLinkAbout21346-zFOPS4 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildinq Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22417 Date JUNE 25, 1993 THIS CERTIFIES that the building ALTERATION Location of Property 400 ORIOLE DRIVE SDUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 6 Lot 15.11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 13~ 1993 pursuant to which Building Permit No. 21346-Z dated APRIL 16, 19~3 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 DORMER ADDITION & ALTERATIONS TO 2ND FLOOR OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. KATHLEEN McNAMAR~k (owner) SUFFOLK COUNTY DEPARTMENT OF ~TH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A PENDING - JUNE 24~ 1993 JUNE 2, 1993 - K&K PLUMBING & HEATING Rev. 1/81 FORM ~0. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? Permission is hereby granted to: ......... .~ .............. ~.~....~ ..... ~.~ ~.~,. ............ ~ .... ~/,~ ...................................... ............. ~' '~'~"~~2 ....... ~:'""'"~/~'""~': ........................................ at premises located at ......~'..~.~.. ...... ~~-.~....)~..< .............................................................. County Tox Map No. 1000 Section ...... ~ ..... Block .....~ ............ Lot No ....... ./.~../../... pursuant to application dated ....... .~.././~.... ................................ , 19.'~.~..., and approved by the Building Inspector. Fee *....~~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to 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. 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 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 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 oate .May......27~.!??{ ...................... ... ... New Construction ........... Old Or Pre-existing Building....J~. ............ Location of Property 400 0~0~e D~ve S0o~h0ld . House No. Street Hamlet McNam~ Onwer or Owners of Property.............K~ee~ ......................................... .. .. .. ..... . County Tax M~p No 1000, Section ............ Block ............... Lot ...................... Subdivision ..... ~p~.~O~ .............. Filed Map ............ Lot .... ~ ................. Permit No ................ ~$~6Z Date 0f Permit. .... ~!~/?P ....... Applicant...~.~.~.~ ................. Health Dept Approval Underwriters Approval . . Planning Board Approval ............. Request for: Temporary Certificate. ~ 25.00 Fee Submitted: ~ ................... ..... Final Certicate..~ ....... i..iii..,i 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 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southoid, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD MAY 26, 1993 DBH CONPANY P. O. BOX 2130 GRgENPORT, NY 11944 RE: KATBLEEN McNAI4b~RA 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 ~mN~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 PEP24IT $ 21346-Z Please contact our office on this matter, cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: KAT~LEEN McNAMARA TOWN OF SOUTHOLD OFFICE OF BUILDIHG INSPECTOR P.O. BOX 728 · TOWN 11ALL SOUTIiOLD, N.Y. 11971 TEL. 765-1802~ ~ E, RTI F I CAT I ON than 2/10 cf 1% lead. ,:!' Sworn tho. to befor~ mo bhis (plumber's NOTARY PUBLIC, ~tate Of NeW No. 4882799 Qualified in Suffolk Commission Expires Jan. 20,, ;OU~DA'TION (1st) 'OUNDATIO~ ( 2nd ) kPOUGH FRAME & -PLUMBING .~;SULATIO}; PER N. STATE E};ERGY CODE FI;;AL ADDITIO~;A'L COMME~TS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~.ATION FRAMING [~..,~FINAL DATE 7G5-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~H PLBG. , [ ] FOUNDATION ?NO [~.]'INSULATION [ v~'~MING []FINAL REMARKS: 11. 12. 13. 14. lS.~s this property located within 300 feet of a tidal wetland? ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGI~M Locate cle~ly ~d distb~ctly all buildings, whether existing or proposed, and. indicate ~I set-back d~ension~ from prop'~rty Hnes. Give street and block number or description according to deed, ~d show streei n~es and ~dtcate whether interior or comer lot. Nature of work (check which applicable): New Building Addition Alteration Repair. ....... R~moval .............. Demolition .............. Sw~m~ingdp .;, , ..... Tennzs Court ......... Accessory Building, .,~ ....... Fence ....... Other Work; ........ Estimated Cost ...................................... Fee ..................................... (to be paid on filing this application} If dwelling, number of dwelling units ............... Number of dwelling units on each floor ....... If garage, number of cars ..... If bnsmess. Commercial or inixed occupancy, specify nature and extent of reach ~ype of use .... .~ Dimcnsionsofexistingsttuctures if any: Front 36~ . . Rear .;,3fi. ......... Depth tlciebt ............. ................ NumbcrofStories .. 2 ................... ~ ............... ~ Vt ..... ' Dhnenslons same structure with alterations or additions: Front ........... ar ............. Depth ...2.7 ............... tlc g ~t ................. Number of Stories .% . ~., ......... Dimensions of entire new constmctiou: Front Rear Depth lleiebt Number of Stories ............................... · ~ .......... . Size of lot: Front ...................... P, ear ...................... Depth Date of Purchase ............................. Name of Former Owner ........................ Zone or use district in which premises are situated D.o, gl es proposed construction violate any zonin aw, ordinance or regulation: .......... ,,,:., . ~V. dl lot ~be_,regraded ...... :,' ',,'~ .... t,- :, .......... Will ex~c~,~s ~J.l~b~,rem,oved from premises:' Yes .,. ~ame olrOwnerofpremises K.~..~..e,.e,~ lvlcNct~a~c, AAA .... qUO o~,co,~e~ wz. D M,, ' ' Name of Architect ....................... .. .. Address ................... Phone NO ........ ' N,'une ofContractor . ;/)B~ £0 ........ ~... Addre~o443 ~wcn St., Orpz .... 4'77-2'2'2'3 STATE OF NEW YOP, J{. COUNTY OF, .S.~f.~.°.Z.~i... Richard Israel .............................................' · ' · being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is tile e.o ~td~e~O~ (Contractor. agent, corporate officer, etc.), of said owner or owners, and is duly authorized to pe,rform or have performed tlre said work and to make and fil~ this app[ication: that all statcmests contaiscd in this applicatim~ are true to tile best of Ills knowledge and belief; and that the work will be perfomled in tile marmot set forth in tire application filed therewith. Swam to before rile tiffs NOtary Public, ........... ~. ~ ..... County t, lo. ~2799 Commission Expires Jan. 20~ A ~ 197~ ........ day of .... P (Si~atur~ of applicant) LDG. DE~ T. I TOWN OF SOUYHOLD Appro,'ed ..... 1~, Permit Disapproved a/c ............. FORM NO. 1 TOW~V OF SOUTHOLD BUILDING DEPARTMENT ]'OWN IIALL $OUTItOLD, N.Y. 11971 TEL.: 765.1802 BOARD or ItEALTtl 3 SETS OF PLANS , ....... ~.~ SURVEY C.Ec .......... SEPTIC FORH NOTIFY: c^ u , .V ........ HAIL TO~ '. 5,j3,u il d in ~j, fs p e~: t o r) .... APPLICATION FOIl BUILDING PERMIT INSTRUCTIONS Date . AphSLe. 13, 1993 19 a. Flus appllcat,on mast be coimpletely filled in by typewriter or in plans, accurate plot plan to ~cale. Fee according to schedule, t sets of ink and submitted o the Building Inspector, with b. Plot plan sho~ving location for lot aud of buildings on premises, relationship to adjoining premlses or p bbc streer~ n or areas, and giving a det.~led description of layout of property must be drawn on the diagram which iS part of tiffs nppli. cation. ' . e. The work covered by tiffs al?pl carton may not be Commenced eFore ~ssttanee or Braiding PermiL d. Upon approval or this application, the Bt Idmg inspector will issued a Building Permit to the applicant. Such pemfft shall be kept on the premises availal01e for inspection throuNmut the Work. e. No building shall be oecu,,i~d or nsc-' ' ' ' ,., u m whom or in part for n.ny purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS IIEREBY blADE to the Buildin De . , fin,Id,nc Zone Ordinance of the Town of Sot tbold S~f'-,i-P~t.m.-e.n-! r.o,r th.e. ls?Uanc~, of a Braid!nc Permit pursuant to the Reeulations for the construction Of buildir Cs, additions or alt ' , ,-,,,,. '...runty, prow 'forK, ann other apphcable Laws, Ordinances or 7be appbcant agrees to comt~ v w ~h .n .... ,:~ ,. .. eratmns, or for removal or demobtion as herein ' ......... m,,,~ao,e .aws, oramances, bu,ldmg code, hous,n,4 code, and regulationd~S;:dbetdt; admit authorized inspectors on pren~ises and in building for necessary inspections. (S~gnatnre ut apphcant, or name, ,f a corporauon) (Mailing address of State whether applicant i~ owoer, lessee agent, architect, engineer, general contractor, electricifi~, plumber or builder. gen~ eO~or i Name of OWner of premises .... ~.~e~. ~ (as on the tax roll or latest deed) ................... f apphcant ~5 a corporaHon, signaln{e of duly authorized officer. (Name nnd title of torpor'ate officer) Builder's License No ......... Plu n[ r's Li N Electr'cmn's License No Otb rTr de's Li N Location of land on which proposed work will be done: 400 0~ole D~ve I ,,,, ~".' So.hold Ilouse Number ~ ..................................... i Slreet ''''' ..... ,,,, ........ ,.. ' Ilamlet ' ' '" OUn al) · ~C 0 I ................ ~JOOk Subdivision ~Fhpo~ M~do~ ............. Lot. ,({',~,.., ' .............. ~ .................. Eiled Map No (Nan]e) ' ' ............. I ut ...... St~te existing Use and occupancy or premises and in/encled use and occtmpaney of proposed constrtlclloR: A Existing and [ Single fa~y ~g · use occupancy ........... · talc occupancy ...... ' '