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Home My WebLink About20372-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20474 Date JANUARY 13~ 1992 THIS CERTIFIES that the building Location of Property 1200 PRRITY LANE House No. County Tax Map No. 1000 Section 109 Subdivision ALTERATION CUTCHOGUE, N.Y. Street Hamlet Block Lot Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 3, 1991 pursuant to which Building Permit No. 20372-Z dated JANUARY 9~ 1992 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 CONVERT EXISTIN~ STORAGE SPACE OVER GARAGE INTO A PERSONAL OFFICE ROOM AS APPLIED FOR. The certificate is issued to RICHARD & GLORIA VAN CAESSELE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A H-026087 - DECEMBER 16, 1991 N/A - - ~uildihg I~sp~c~or Rev. l/B1 FORM NO. 0 TOWN OF SOUTHOLD SUILDING DEPARTMENT TOWN HALl. $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 20372 Z Permission is hereby granted to: ..... /..~. .~,...l/~....d.,~~ .... /...~.~..~~ ....... ~.~... at premises Ioca~led ct .,~',,.. ~..~ ~ ~~~ ................ ............................................. ....................................... Cou"b/ Tox Map No, 1000 Section ./..~.....~.. ....... Block ...... ~ ....... Lot No....~...~.. ......... pursuant to application dated ...... ~~ ............. .~. ........... , 19.~.../., and approved by the Building Inspector. Fee $...~..,~. .............. Building Inspector Rev. 6/30/80 TOWN OF SOUTIiOLD BUILDING DEPARTMENT TOWN I/ALL 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: 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· 3. 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, t~e 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 - $100.00 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 $i5.00 Date .. .~ . . Xaw Construction ........... Old Or Pre-existing Build~g....f~.. .......... . Locatlon of Property...~.~ ............. hOuse No. , ~treet ~ Hamlet~ Onwer or Owners of Property..~04~..~...~.~.~...~4~..~~.~.~.' ........ . .... :ounty Tax No 1000, Sectioe..ftP. ....... Block...537.. .......... .......... ;ubdivision ....... !ealth Dept. Approval ........................ · · Underwriters Approval ................... · . n~ng goard Approval eqnest for: Temporary Certificate ........... Final Ccrticate...~ ...... ee Submitted: $''.2~ ....... 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 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 9, 1992 Richard VanCaeseele 1200 Praity Lane Cutchogue, N.Y. 11935 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 (outdated/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 $ 20372-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FiRE UNDERWRITERS BUREAU OF ELECTRICITY FIXTURE I:)XTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT OTHER 7 ~ OEYERS MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: S E R NO, O~ERC~yCOND, I C E A W G NO OF HI.LEG OF CC, COND A W G NO OF NEUTRALS OF HI.LEG AWG, OF NEUTRAL GENERAL MANAGER This certificate must not be altered in any manner; return to the office o( the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT~ THIS COPY O,F CERTIF CATE MUST NOT BE ALTERED IN ANY MANNER. 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 Five Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 9, 1992 SCOTT L. HARRIS, Supervisor SouthoId Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Ri_chard VanCaeseele 1200 Prait¥ Lane Cutchogue, N.Y. 11935 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 (outdated/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 plum~ing being issued after April 1, 1984). BUILDING PERMIT ~ 20372-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. F,.O. U:~ D A T I 0~'! ( 2nd ) ROUGH FRAME & .PLUMBING I~;SULATION FERN. STATE E~ERGY CODE Fi;;AL CC.~fC.ILNTE ADDITIO~;A'L COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Exanfined ................. 19... Disapproved a/c . .~ ' ' . .................................. BOARD OF HEALTIt ......... 3 SETS OF PLANS .......... SURV£Y ................... ClIECK .................... SEPTIC FOR~I .............. CALL ................... }tAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl/- :ation. c. The work covered by this application may not be c~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit .hall 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 ,hall 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 ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New, York, and other applicable Laws, Ordinances or ~egulations, for the construction of buildings, additions or alterati6ns, or for removal or demolition, as herein described. fhe applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the t~lx roll or latest deed) II' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... .~z< ..... 'D' ....... Plumber's License,, No .............. ~.,~,f~../I/ : ...... Electrician s License No ............ V .......... Other Trade's License No ...................... one .......................................... Location of land on which proposed work will b~ ........ .............. ............. llouse Number '~' Street Hamlext ~ ......... County Tax Map No. 1000 Section ./.O..~. ........... Block ~,~5~.. ............ Lot.. ~ ............ Subdivisinn ..................................... Filed Map No ............... Lot ............... (Name) State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use a~d occupancy .... ,.¢ ..... ~1~ '.'~ .... ~,~,~ ~` .~.~ ~ ... b. Intended use and occupancy .... ~ ~ ..... ~t.~ . . .~.~ ~ .~[-- ~''0,.~ t~.,,.;: }P~,;O,~;" "~ '~"~?~.!~?;~ g ~" A ~ _ - 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .,,~ ....... Repair .............. Removal .............. Demolition .............. Other Work ..... . .......... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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 u, se .............. 7.Dimensions of existing structures, if any: Front.. ...... ....... Rear . , Depth .. ........... Height ............... ~umber of Stories i ...................................................... Dimensions of same stmctur~ with alterations or additions: Front Depth Height ................. Rear ................. 8 Dimensions of entire new construction: Front Number of Stories ' Height Number of Stories ............... Rear .. Depth 9 Size of lot: Front ............. i'. · " Rear ; ................. 10 Date of Purchase ........................... : ............ Depth .................. I1' ' ....... "~ ......... ' ......... Name ofFormer Owner 12. Does proposed construct on violate any zoning aw, ordinance or regulation: Zone or use district in which Premises are situated ................................................... 13. Will lot be regraded ................................. ......... ................... Will excess fill be removed from premises: Yes No 14.- Name of Owner of premises ...... . ..... Address ............... Name of Architect .... ' ..... - · ·. Phone No .......... ............. · .... Address ...... Name of Contractor ........ ' .... · .................. Phone No ................ .................. Address Phone No. . · 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No.. · If yes, Southold 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 property lines. Give street and block number or descriptioh according to deed, and show street names and indicate whether interior or comer lot. TATE OF NEW YC~RF'r~. ~ ou, r¥ OF .... , S:S ..... (Name of individual signing contract) )ore named. being duly sworn, deposes and says that he is the applicant is the (Contractor agent corporate officer ) ........................... , etc. said OWner or mvners, and is du y aut ~orizcd to perform or ha~,e pb'rfonned the said ..... '- ~ - - · ~,~,~ anu ~o ]n~e and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in the m~oer set forth in the..app ieation filed therewith. 'om to before me this ' - ........ taw Public,. ~~ >2~:~' "~..' '~OWN OF SOUTHOLrJ~..I~.~ ~ 9/',i 'i 7, 8, 9, 10. 11, 1,2. 13. ~oRYAR:, ,A~T~ N ABOVE GRADE; TYPE GR~, ,DE; ,OTHF~R, TYPES, . AS , REQU RE'bY AP~UCA~ON;L A ,HOR~NT~E REI~QRglNG: ~DE~ TRUS~, ~P~, ~ eAeE WtRE~ITH D~FORMED 8JD~ ~RODB. ,USE IN a RE~J~G~S '~ ~FeRM~,B~S ASTM A 615 D~SGN CONSUL?ANTS OR RECORD ~RCHIIECT-~NGI~ER ARE NOT :RESPONSIBLE' FOR THE INSPeCTiON. SUR~ISIDN. O~, ADMINISTRATION OF ~HI8 CONSTRUCTION PBOJECT. THIS DRA~NG IS AN INSTRUMENT PBEPARED TO FAgJ~ITATE~ CONSmRUCTION A~D SHAL~' NOT' BE CONmRUED AS A CONTBACT BETWeeN BUILD~B AND OWNER. , THIS STRUCTURE HAS BEEN D~SIG~ED IN ACCORDANCE WITH THE NEW YORK STATE ENERGY CONSE~VATION CODE, IT IS SUGGESTED THAT A CONSTRUCTION' BUDGET CONTINGENCY OF FIV~ JBJ PERCENT BE ALLO~ TO ACCOUNT FOR ]N~VITABL~ ERRORS AND OMISSIONS. ~LECTRICAL ANB.~ECHANICAL COMPON~NTS TO BE AND SPECIFIED BY OTHERS. ALL STRUCTURAL' ~L TO BE ASTM A38 WITH ONE COAT E~XY PAINT. AkL FASTENeRS. TO BE ASTM~-325 BOLTS, 3/4" C~NTRACTOR SHA~L OBTAIN AL~ PERMITS AND, INSUBANCE NECESSARY TO PROTECT THE ENGINEER AND OWNER, FLO0t PLAN NEW OFFICE LAYOUT FLOOR t:? L A N OCGU?ANC,¥ OR 'USE IS UNLAWFUL WITHOUT CEMiFICATE OF OCCUPANCY' UNOERWRITERS CERT REQUIRED