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Home My WebLink About21393-z~o ~-2~55 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date NOVEMBER 17, 1994 THIS CERTIFIES that the building Location of Property. 855 HORTON AVENUE House NO. County Tax Map No. 1000 Section 141 subdivision ACCESSORY Block 1 Filed Map No. MATTITUCK, N.Y. Street Lot 34.1 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated MAy 3, 1993 ~ursuant to which Building Permit No. 21393-Z dated MAY 6, 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 GARAGE WITH NON-HABITABLE 2ND FLOOR AS APPLIED FOR The certificate is issued to STEVE ROSIN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N-312295 -- MAY 3, 1994 N/A Rev. 1/81 FO~M NO. ~ TOWH 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~T.° ;B139~ Z Permission is hereby granted to: · .~/~ ~,.~ · , .............. ,...../...,./.,.~. ........ ~..., ...................... ,~, ~ ,o .... ................................................. ~~~ .......................................................................... co~ ,o~ ~ uo. ~0o0 s~,,o~ ....... ~.~Z. ..... ~ ....... Z ........... to, ~o ..... ~..%Z.. 8ulldln~ Inspector. Rev. 6/30/80 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 or new use: t. 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 "pre-existing" land uses: 1. ~ccurate 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 appiicanl. · If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. :. 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 Buildin~ - $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 ..... Date ew Construction .... Old Or Pre-existing Building .............. °cati°n of Prope;~;I · [ I ] f-~.'] ....... .'Z~.-~.'~-'~ .?. ~.'~-..--~-~... i.i.' .,~. ~..~.~. ' .,,,~..C~.~. House No. Street '~a~i;~ ........ wer or Owners of property ..... ...... ounty Tax Map No 1000, Section...~2 ....... Block ....... ~ ........ Lot ..... .~.~.,A .......... ubdivision ...... .~[~'ii~;~ ............... .-~ ~.TiledMap ............ Lot ..... ~ ............. .' · ?~-~¢ .... pp .......... ~: ......... ~alth Dept. Approval ........................ .. Underwriters Approval ........................ . lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate..f ........ ee Submitted: $ ........................ ¥ ............ ... .................... Town Hall, 53095 Main Road P. O. Box 1179 Sou~,hold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1 ~,02 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD October 4, 1994 Mr. Steve Rosin P.O. Box 518 Laurel, N.Y. 11948 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 XX 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. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21393-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 76~-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG, FOUNDATION 2ND [ ] INSULATION FRAMING ~REMARKS: ~. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~;~;~ ~ t~,'7~ee,~ .u.E^u ow [~ 85 JOHN STREET, NEW YORK, NEW YORK 100"48 Da~e }~AY ~3, '[~A9~ ~pplication ~o, onflZ~ 8~[6~294/9~ ~ 332295 THIS CE~IFIES THAT only t~ electrical equ~ment ~ ~scrib~ below and intr~ue~ by t~ 6pplleo~t ~med on the a~ve application nu~r iR the premises STEVE RO~.,IN, 855 HORTON AVE, N(~E, HATTI'[~K~K, in the follow~ng rotation; ~ Basement a~sexaminedon ~P]~II., 28 ~1994 and found to be in compliance with the Na~onal Elect~cal Code. Lot FIXTURE FIXTURES RANGES .'OOglNO DECKS OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER 10 8 DRYERS TIMECLOCKS E E V I C OTHER APPARATUS: FEEDERS NO. OF COND. 3 A.W.G. 6-1. PANELBOARDS: 1- 5 CIR. G.F,C. I~-~7 Q.C. ELECTRIC INC. P.O.BOX 518 [dkURIgL, NY, 11948 LIC, #3823-,E GEN[ItAL /f. M4AGRR 11 ' (,.....~*/ This certificate must not be altered in any manner; return to the office of the I~oard if incorrect, Inspectors may be identified by their credentials. COPY FOR ~UILDINO DEPARTMEiM'f. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. [] FOUNDATION 2ND [, ~ILATION []FRAMING Ir*"] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ DATE ~UNDATIO:~ (2nd) ~UGH FRAME & -PLUMBING ~SULATIO~! FERN. Y. STATE E~ERGY CODE FI;;AL ADDITIO~AL COMME~;TS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 ~, ,~; TEL.; 765-1802 {x~mined .......... , 197.~. )isapprovcd a/c ..... ~- .............. ......................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tlfis applicati°n must be c°mpletety fill~d in by typewriter or in ink and submitted to the Building inspector, with 3 ts 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 ' areas, and giving a deta~Ied description of layout of property must i)e drawn on the diagram which is part of this appli- c. Tile work covered by th. is application may no~ be Commenced before issuance ~)f Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit aJl be'kc, pt on the premises available for inspection throughout the w6rk. e. NO building shall be occupied or. used in whole or in part for any purpose whatever until a Certificate of Occupancy all have been granted by thc Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the · 'ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or m,t anthonzed respecters on premzses and in building for n¢cessaT, inspectj~sZ~..~,~'?y'` o laUons, and to (Signature of applicant, or name, if a corporation) eTD ' (Mailing address of applicant) '¢~ ' ' ' ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.. (as on the tax roll or latest deed) ~pplicant is a corporation, signature ofduly auth~ori;}d officer. ............................. o Ac;/) (Name and title of corporate ............ Builder's License No ' Plum bet's License No ......................... Electrician's License Nb ....................... Other Trade's License No ...................... Location of land on which pro/posed work will be'done. [louse Number Street ..... Hamlet ;ubdivis/on ' ..................................... Filed Map No ............... Lot ............... (Name) late existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ' l,lntended use and .............................................. z:, .... . ............ ~ occupancy ..... 3. Nature of work (check which applicable): New BuiJding .... Addition .......... AJteration . . ~ ...... Repair .............. RemoVal .............. Demolition .............. Other Work .............. 4. Estimated Cost .~O)~ (Description) ....... ? ........................ Fee .......... · j (to be paid on filing this application) 5. lfdwelling, numberdfdwelling nits ............... Numberofdwc~llingunitsoneachfloor.., , · If garage, number of cars .... ~,~ ........ . ............ 6. If business, commercial or mixed]occupancy, specify nature and extent of each 7. Dimensions of existing structures' ir .... ~ . ~/_, . _ type of use ............... ..... ~/ ,, ---y. ,-font... o~,,,q. . Rea, .U~' ~ , o~; · · ' ~.e,gn, ... ~ ......... Numb. er ofStories . . . .[..~ ..... ' .............. oeptn . . &~, .......... olmensmns of same structure with alterations or additions: Fro~ ....................................... D pth i H Jght , ' ................ Rear ............. 8 ft. tm ' ~t~: ....... NumberofStod · .~..~!: ,D. pth ..... ~" ...... · Dimensions o ntire new cons ction: Front ........... Rear .' ' ........ e e~ I um crc ones ......... 9. ~tze otlot: Front . ~9~' ~ ',. .... I,~o t ............ ' .... ' ........ ' .......... ix. ear ..... pth : '/~"~": ': .... i ..... 10. (.~'r ......... De . Date oCPurchase ......... ",~.'UL~ ').¢- lOqi~. · · ' ......... e~N~ame of Former Owner .. ~.~4~v. ,~..,9.~/~(.~.~. I I. Zone or nsc district in xvhich premis*es are situated...I.O~lD~.O.'~JOJ-,-~. ' ........ 12. Does proposed Construction violate da,, zon:-- ,~--- -. Will ' t ' o - ,,.-~ ^~ .,~ ~-g.:w, orainance or regulation' . ..... 13. ~o ce re~,raned . .~/q-~'~.'..7.&t.r.0.oN.~ ~'Locro~w .......... ' ' ' ' , ..... · ............. -, -^ ~ ,. ~.. _ ,w ~,- ......... wm excess mi oe removed ~rom premises: Yes (No) 14. ~,ameo[',Jwnerotpr~m~ses..~T~... '~O.~/tO .... Address~.<7~4.~+~, ~ 1%~:=- ,.. - · . , ' · ,-~-. ~ t~.,w~-e. ~.~,~... rhone Plo. o¢,-I~. .... r~ame of Archateet ~ e.~aO0~.~/.~t?_O.~.~.. Add tess. ff~qC-~.~.~.q,/.e-~.. .... Phone No..~;~ Name of Contractor .. · .... ' Address ............ Phone No ................ tS. Is this property within 300 feet of a tidal wetland? *Yes ........ N · If yes, Southold Tewn Trustees Permit may be required, o~. ...... PLOT D lAG Locate dearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nflmber or description accord/ny to deed, and show street names and indicate whether interior or comer lot. 'OUNTV OF... Mo.)~..W._ .... ~q , ......... , ..... ~..'7~¢~..~.... '~%~../.~.. ........... being duly sworn, deposes and says that he is the applicant (Name of individ ual signing,'contract) rove named. ] '. I (CoMractor agent corporate officer ....................... ' ' , , etc.) a;d Owner or owners ~d ~s duly a~/honzed to perform or have performed the said work hnd to m~c and file this P cation; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the' ~rk will be pcrfo~ed in the ' · mannerset forth m the application flied therewith. ,'om to before me this /='"'") ~ , ................. ~y oa..,~ ..~, ...... , ;9~5.. // / ' ' ' LL~d~I~ ..........County .. / , ' U ~ .d~" s~ ~ ......... ~~ % ~ . . . ~iaY~BtlC,~a~V. . ~./r.':.:...: .........~ ........... $0' 4Z2~9"S~ ~u~ ' ' (Signature of ' Z C f~rl J-7