HomeMy WebLinkAbout21403-zFORM NO. 4
TOWN OF SOU~OLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22492
Date AUGUST 2~ 1993
THIS CERTIFIES that the building
Location of Property 465 TARPON DRIVE
House No.
County Tax Map No. 1000 Section 53
Subdivision
ADDITIONS
G~F~.N1K)RT~ NEW YORK
Street Hamlet
Block 5 Lot 5
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 4~ 1993 pursuant to which
Building Permit No. 21403-Z dated MAY 11, 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 ADDITION & DECK ADDITION TO EXISTING ONE FAMILY D~XJ,ING AS
APPLIED FOR.
The certificate is issued to
of the aforesaid building.
WI~ BARRY
(owner)
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N-284119 - JULY 27~ 1993
//uild~ng Inspector
TOWN OF SO~THOLD
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? 21403Z
Date ....~.~. .......................................... , 19..~.~..
Permission is hereby aranted to: , ,~ / · ,
_ ..... ~. -~,..~..~_~.: ...... z:..~.~ ...... ~ .
,o .......
...... ~ .... ~ ..... :~. ~j~ ....... ~ ............. :...
at premises located at ...:~..~.~.....,~..~......~..~....~....-~..~/-K~. .................................................................
County Tax Map No. 1000 Section ...... .~.....~... ........ Block ......... ~ ...... Lot No ....... ~ ...........
pursuant to application dated ...... ~ ..................................... , 19.~...~, and approved by the
Building Inspector.
Rev. 6130/80
JUL 2 T 1993
TOWN OF
Form No. 6
TOWN OF SOUTtIOLD
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 all 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 simila~ 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. 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 ~hall 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, Conm~ercial $15.00
Date - July 27, 1993
New' Construction ...... X'.... Old Or Pre-existing Building .................
465 Tarpon Drive, Greenport
Location of Property ............................................................... .... . .
House No. Street Hamlet
Willard Barry and Wf.
Onwer or Owners of Property ........................................................ . . ... . . .. .
County Tax Map No 1000, Section...~? ......... Block ....... ~ ........ Lot ........ ~ .............
Southold Shor~s 38~3 48
Subdivision ............................... · ... . Filed Map ........... Lot ................... .. .
Permit No. 21403Z ~J.1
............ Date Of Permit. 5 /93 ~.~John Bertani Builder I
Health Dept. Approval.....~ ...... Underwriters Approval x
Planning Board Approval .......... ~ .......... ..
xx
Request for: Temporary Certificate .... .. ..... Final Certicate ...........
· ~ 25 00
Fee Submitted: $ ...... ' ......
THE NEW YORK BOARD OF FIRE uNDERWRITERS PA~E
[001(~7[ BUREAU OF ELECTRICITY
~ BE JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THA~
WILLARD BARRY, 465 TARPON DRIVE, $OUTHOLD, N,Y.
in the following Iocation~ [] Bese,nent [] Ist FI. ~ 2nd Ft. OUT Section Bl~k
~s examined on JULY 23t19~3 and found to be in compliance w~h the National Elect~cal Code.
FIXTURE I~
OUTLET~S_ CEPTACtES SWITCHES
DRYERS
SERVICE DISCONNECT
:)THER APPARATUS~
EOTOR$: 1-F H.P.
E E V I C E
G & S CONTRA~TOR
BOX 215
$OUTHOLD, NY, 11971
LIC.g578-E
GENERAL MANAGER
11 /,.','~
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by fhe~r crede~t~'~
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
BuiLding b~pector
Gary Fish
Building Inspector
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
SCOIT L. HARRIS~ Supervisor
Southold Town Hall
P.O. Box 1179, 53095 Main Road
Southold, Ne~v York 11971
Fax (516) '/65-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
JULY 21, 1993
JOItN BERTANI BUILDER, INC.
1380 OAI~OOD DRIVE
SOUTUOLD, NY 11971
RE: WILLARD BARRY & WF
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.~L~
The check is I~~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 ~ 21403-Z
Please contact our office on this matter.
cooperation.
CC:
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
WILLARDBARRY &WF
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ~LJGH PLBG.
[ J FOUNDATION 2ND [~j'INSULATION
[ ] FRAMING
REMARKS:
[ ] FINAL
DATE
INSPECTOR
765-~802
BUILDING DEPT.
INSPECTION
~/FOUNDATION 1ST [ ] ROUGH PLBG.
~OUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS= ~-~r~-/~ ,~
· P ,,,
DATE
INSPECTOR?/~~~~
765-1802
BUILDING DEPT.
INSPECTION
[~'~OUNDATION 15T ~ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
[ ] FINAL
DATE
INSPECTOR
765.1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] INSULATION
[ ] FRAMING [ ' F~INAL
REMARKS:
DATE ~/~_~ INSPECTOR/~//~,~/
~'4, 26 0'7 30 E,
'OUNDATIOX (2nd)
(OUCH FRAHE &
-PLUMBING
~SULATIO~! PER N. Y.
STATE ENERGY
CODE
FI;~AL
ADDITIO~IA'L
COMMENTS:
FORUM NO. 1 ' '
TOWN OF SOUTHOLD :
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y, 11971
TEL,: 765-180:3
......... ,1~..PermitNo.
BOARD OF HEALTH
3 SETS OF PLANS ..........
SURVEY ...................
· CIIECK ....................
SEPTIC' FORH ..............
CALL .... ~ ....... ~.~ .......
HAIL TO~
tapproved a/c '
. (B~ldi~sp~ctor)'
APPLICATION FOR BUILDING PERMIT
Date ........... , 19
~te whethei; applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
meofownerofpremises......../U/E ' ~. ['(~;'q~.O.. .... ~....'?.~..~.
(as on the tax roll or latest deed)
pphcant is a corporation, s~gnature of dply auth?nzed officer.
...... . ............
(Name and title of corporate of~cer).
(?
Builder's License No ...... ' .........
Plumber's License No ./~.//..~.
.
Other Trade's hcense No .................
Location of land on which proposed work will be done .......
......... .~ 6:tL/ ............ /. ~/~..~ .....
House Number Street .." Hanll~ ' /
County Tax I~p No. 1000 Section .. ~, .......... Block ". ............. Lot ................
Sl,bdi~ls,on...,~p.O,~ .... $/,qOt~*S ........... ~iled ~ap No .~.~.~5 ....... Lot .... .~..~.
. . . (Name) . ' ......
State existing use'and occupancy of pr !raises and
~ intended use and occupancy of proposed construction:
a. ~istin~ ~se and occupancy .... ~z'...~.,~. ~'.~.....~/_~. ~.~. ....... , ........................
b. Intended use and occupancy
(Signature of applicant, or name, if a corporation)
:>. ?. . . . ~4<~.,,:~ i . . o~t:~. .~.
(Mailing address of applicant)
,~ i INSTRUCTIONS
a. This application must be completely filled in by typewriter erin ink and submitted to tho Building Inspector, with 3
; of plans~ accurate plot plan to scale. Fee according to schedule.
1~. Plot plan showing location of lot ~nd of buildings on premises', relationship to adjoining premises or public streets
areas, and giving a detailed descnptwn ? layout of'property must be drawn on the diagram which is part of this appli-
o. The work covered.by, this application may not bo 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
il be. kept on the premises available for inspection throughout the w6rk.
e. No building shall be occupied or aged in whole or in part for any purpose whatever until a Certificate of Occupancy
I1 have been granted by the Building Inspector·
APPLICATION IS HEREBY MADE t0 the Building Department for the issuance of a Building Permit pursuant to the
Iding Zone Ordinance of t.h.e Town of ~outhold, Suffolk County, New York, and other applicable Laws, Ordinances or
lulati.o, ns, for thc construction of build~ngs, additions or alterations, or for removal or demolition, as herein described.
; applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
nit authorized inspectors on premises and in building for necessary inspections.
3. Nature of work (check which applicable): New Building .......... Addition ....... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
·" (Description)
t. Estimated Cost .../..5,~'f.q.(~. ........................... 'Fee ......................................
(to be paid on filing this application)
L If dwelling, number of dwelling units ............... Number of dwelling units on each floor
If garage number of cars ................
i. If business, commercial or mixed occupancy, specify n_ature and exteht of each type of use .........
L Dimensions of existing structures, ifany. Front .. d~...r ..... R~-. ~-~/ ,- ': "~.'- , .......
A , ~- · , ~a~ ..t-~t~ .... uepth. .~..o. ...
Height .. ~g..~....-; ..... Number of Stories.. /. ?.2-~. .... ' .....
Dunenmons of sqme structure with alterations or addit~0ns: Front . ~
Depth ...... ~.: ............ Height ...... ~ ~ ........ i ~u~be; o;
t. Dimensions of entire new construction: Front .... /f~. ....... · Rear ...... .~'~' .' ..... Depth ...,,~ ~ ." .....
Height ..... .,f~. t. ...... Number of Stories ........ ~ ..........
} Size of lot: Front ./~ ~' Rear ~('..'~.'(-J ./ Depth ./~.. ,_~
). Date of Purchase .................... . ......... Name of Former Owner ~.~'~'F¢,y,f-~. :/.
~ Zone or use district in which premises are situated ,4/
· L Does proposed construction violate any zoning law, ordinance or regulation: ....~ ~ ........ ......
L Will lot be regraded ..... .,.. t,(J..d. ................ Will excess fill be removed from premises: Yes ~ No
' ~ .~q~. Add :7'~,~,~,~. O,-z/.,~
'.. Name of Owner ofpremlses 224~ ./_/2. Z~.-.~.. ress . · hone No..~4~q'- ...........
No/ne,of Architect ........................... Address ................... Phone No ................
Namg of Contractor ~..e~Z Z",~/.~r.../~ggr~tr~ff...n'T'OC~. Addr&ss tg..~.O tg~'..tOg. Phone No. ,7~,~.'-:-..,:'~.~..tr....
Is this property within 300 feet of a tidal wetland? ~Yes ........ No.~.~ .....
· If yes, Sout~hold Town Trustees Permit may be required.
, ... PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
operty lines. Give street and block number or description acco~ling to deed, and show street names and indicate whether
terior or corner lot.
'ATE OF NEW Y0,RK, 20AO ~'' N.6B°52'BO'x~,
)UNT¥ s.s
....... K~'. ~ff4~.. ,'~..6-~F'~/ .................... berg d~ly swe~,~, deposes and says that he is the applicant
(Name of individual signing contract)
~ve.. flamed.
is the... ~Pag~.~ ............................................................ . (COntractor, agent, corporate officer, etc.) .
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
>lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
rk will be perfo ./Tned in the manner set forth in the application filed therewith.
om to before m6tthis '
.............. .f.. ..... d. .......
County
tary Public '
LINDA J. COOPER
Notary Public, State of New York _
No. 4822563, Suffolk County~ L~
Term Expires December 31, 19 ,.--(
(Signature of applicant)