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HomeMy WebLinkAbout20396-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hali Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20650 Date APRIL 27, 1992 THIS CERTIFIES that the building NEW DWELLING Location of Property 1815 MILL ROAR PECONIC N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 74 Block 2 Lot 38 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 3ANUARY 17, 1992 pursuant to which Building Permit No. 20396-Z dated JANUARY 21, T992 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 ONE FAMILY DWELLING WITH ATTACHED DECK & GARAGE AS APPLIED FOR The certificate is issued to PETER HATZI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-77-APRIL 16, 1992 UNDERWRITERS CERTIFICATE NO. PENDING - APRIL 23 1992 PLUMBERS CERTIFICATION DATED APRIL 18 1992 - GALE KASKE B ilding Inspector Rev. 1/81 Fa89Y NO. 8 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~ 2 0 3 9 6 Z Date ~.Q~euxl~......c7:1........., 19.2.E Permission is hereby granted to: ..........,~.f.........~............ ...~r.,s....~.~.?..:~..~.D. ro ..~%~~L4~:i4:S.~.....°b:.....~:?:1R....~........ ....°..-~.4~:Q:Y'•L!'n.~.,....~!N:!~1....W!~a.......~ of Premises located ot ....1..~~.s~....1!7.:l:Krf:......15-~~:~..... ~Cr.~:t~G' ......(..C:....I.dt~....1.!..... County Tox Map No. 1000 Section .....Q~.~....... Bloek .....Q.~-........ Lot No....~, g ' pursuant to application dated ......~..7............., 19.9.2-., and approved by the Building Inspeetor. Fee ~ ~ ~:.1.:~.... .....I.S.S wilding Inspector Rev. 6/30/80 Form No. 6 ("r7'j°;.u_.;`-,-.. TOWN OF SOUTHOLD ~ ~(,~J I~UILDING DEPARTMENT ~ TOWN HALL ~ ~ APR 7 !9i);? ~,I~ 765-1802 ~m , f!" t;_f . ~ APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ . A. 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-4 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 17 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. x B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildin s and S "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 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 $15.00 Date ..Apra,1..2'.1.992 New Construction..!`!`.!*.... Old Or Pre-existing Building Location of Property ..'{$aFj. ~31~.• Inds • ~@O©ni4 •N~.~o • . • • • House No. Street Hamlet Onwer or Owners of Property......~.'B'teT. $&t].2 County Tax Map No 1000, Section...'~t~.........Block.....~..........Lot......7j8 Subdivision...~iSb» .pr©pe~ty ................Filed Map............Lot...................... Permit No...2O396.Z....Date Of Permit. .'1+~2:1r.92......Applicant..jnjgp,d.$OIDA~SS........... Health Dept. Approval.,Apx+j,],.~6„~,9~2,,,,,,,,.Underwriters Approva1,~31.2.aj.95~.92..... Planning Board Approval ~ , Request for: Temporary Certificate........... Final Certicate..*.*.'!f!`l... Fee Submitted: $.....~2~ ~ . C'~.~ec o y 3 ~6 (,!J - ~ ~ tea- . •••••,•••••••••APPLICANT ~o~ a06$~j TEL. 765-1802 ~pS~FF~~~pG TOWN OF SOUTSOLD OFFICE OF BUILDING INSPECTOR c rn P.O. BOX 728 ~ TOWN HALL fr'a"~.~...,., _ . ~ ~ ` I ~ `iria,; i- "O ~ `t- SOUTHOLD N.Y. 11971 ~ ~ ~ ~ ~ ` ~ - ' ,y'1y ~p t I r Ol ~ ~(I 7t%, C E R T I F I C A T I O N Date Building Permit No. IZ, Z(~3 9 Owner ~~'_a-E:t2 ~-F C~`~ 2 ~ //''~~(plyyease print) Plumber l~~l~ '\C; ~S 1~ 'f_ _ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1~ lead. (plumber's signature) Sw ~ to before/n~ me his day of ~-k ~ ~ Y ~~~~Sd~/r~lJ ~1 19~. V C--Y, Boni 1 NotaryNd~agh~iliE Stoto o(New York r~, a~ra~la Notary Public, SVFP~~IL County Uuali8ed1n8uibNcCou Comm(asbn E~ires Od. i9, i9~.~ INSPECTORS Y~-~~z,~ Victor Lessard ~'~i~~d(;Y Principal Building Inspector i~F.- =z _ ~d Curtis Horton r0q " t~ ~ SCOTT L. HARRIS, Supervisor Senior Building Inspector c~a ~ : 1 ua ; e`,:.~~a ~ Southold Town Hall r". Thomas Fisher ,a. ~ P.O. Box 1179, 53095 Main Road Building Inspector ~ ' ~ Gary Fish .~~~r_`y~ ~~*9°9 Southold, New York 11971 Fax (516) 765-1823 Building Inspector Telephone (516) 765-1800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD APRIL 27, 1992 INLAND HOMES, INC. 315 WESTPHALIA ROAD MATTITUCK, NY 11952 RE: PETER J. HATZI & WF To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: _ XxX An application for Certificate of Occupancy is not on file. (Enclosed) Xxx No Underwriters Certificate on file. xYx The check is ~Ii~llnot on file.)$25.00 XXx No Health Department Approval on file. No final inspection has been made. XxK No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20396-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. r'lELD i;:S:c:C::U:J ~~'Jn;= ~ ~ ' _ ~OM~KENT.. ~r~ _ .-,..n FOUtJDATION (lstj ~ a[(' c FOUNDATIOtJ (2ndj N,~ - _ mG `o P,OUGH FRAME & PLUMBING 3. ~ ~ m~ IIJSULATIOP! PER N. Y. m "3 1~ STATE ENERGY CODE C 4 . m H FI;JAL I' ADDITIOPJAL COMh1ENTS: m x "v . m x .J ro ~Y _ H „p • H O 2 r `m ~ A • - H 1. x lA ' o a ~ a H 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T [ ] ROUGH PLBG. (]FOUNDATION 2ND INSULATION [ ]FRAMING [ ]FINAL REMARKS: _ I t f f ~ ~ DATE ~ Zi INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ] FO DATION 2ND [ ]INSULATION [ FRAMING [ ]FINAL REMARKS: . C~~ ~r DATE ~ Z-~ INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL ` REMARKS: i DATE INSPECTOR i BOAKD OF HEALTH p?'ut~ ~ rtn:'~';'•4h 7°' ' 3 SETS OF PLANS h~~. B'i, t; _ y`;"~+ FORM N0. 1 SURVEY t1;'~., , " t~ CHECK ...G/... ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT SEPTIC FORM TOWN HALL No IFY y SOUTHOLD, N.Y. 11971 CALL Z~O ~C TEL.: 765.1802 MAIL T0:• ~ • . uniucd . o-wka~ Ll. 19q.z- ~ , ~ ~ ~ ~ ~ . ~~~(V~ ~ ~~riovcd ew,-w.~-~., 19°.I?:PermitNo.o~~F~.~.1R , , , ~ . ,~-.R ~ ~I~h:oved arc 'i ' ~ 1 ~ C ~ ~ ( y't', ' i y . ~ ' ' ' " (Building Inspector) . APPLICATION FOR BUILDING PERMIT ; p > Date fl.: ~ ~ . ~ 19 ,l,/ _ ~ INSTRUCTIONS ~ ~ ~ ~ ~ ' ~ ' ' ' 'I'ltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 oI plans, accurate plot plan to scale. Fee according to schedule. ' ` " " ' ' ' ' " ' ' 1,. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ncas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- •li.nt, ~ - , ~ ~ ~ 'I'lic work covered by this application may not be commenced before issuance of Building Permit. d. Upai approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit III be kept on the premises avallable for inspection throughout the work. r. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy II have been granted by t.".e Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the '~~ilding 7.one Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or " rulatious, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. i,,, applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ' p p din building for necessary insp ctions. n~laulhonredurs ectorson remisesan ~ n 1 (Signature of appliic~an+-t-,-oar name, if a corporation) (Mailing address of applicant) ~t-~ whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ure of owner of premises ~ . (as on the tax roll or latest deed) ihplicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) V.I. CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSBD Builder's License No. . ~ ~ 7 Plumber's License No. ~ . Electrician's License No. 3'~..~....... / J7~~~~~~~ ~~~I; ~~~',oNl ~ ?rl e)thcr "trade's License No . ~ _ - ' I ocation of land on which proposed work will be done. ~~S . P.:`:'~'• • • • • • • • • • ~~O?•/•~/• I louse Number ~ _ ; .Street „i ~ .-i p,. ~ : ~iamlet,-.. ; , . ia~ ~a~s rd. i n .>fil ' ' ~ <<nmty'faxMap o. 10010~S,ec~tion Block Lot., ,ubdivision . • . Filed Map No. Lot . ~ , . (Name) ~~,~~-I~ ;;tote existing use and occupancy of premises and int nded use and occupancy of proposed construction: Existing use and occupancy . h. lntcnded use and occupancy . ~ i~~rn:,ilddc~o m;euslS) ~ i ~6 6AeW,~~~,e~ . 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