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HomeMy WebLinkAbout20993-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21183 Date NOVEMBER 27, 1992 THIS CERTIFIES that the building Location of Propert~ 520 House No. County Tax Map No. 1000 Section Subdivision REPAIR/RENOVATE OAK DRIVE SOUTHOLD 80 Block 2 Filed Map No. Street Hamlet Lot 13 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 28, 1992 pursuant to which Building Permit No. 20993-Z dated OCTOBER 1, 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 REPAIR & RENOVATE EXISTING ONE-FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL D. FURST (owner) of the aforesaid building. SUFFOLK C~UNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N 241618 PLUMBERS CERTIFICATION DATED N/A NOVEMBER 2~ 1992 Rev. 1/81 l~O~ NO. 0 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°_N9 2099~ Z Permission is hereby granted to: , ~.~.~..~.....~ ....... .?..'.~.~ ........... ....~.~.L.- ...~.:..V..,...L./...~.~..t ..... · ~P'~"~'"~'""::: ....................... '-' ................. : ........... ~"'::i'~ ........................... at premmes' located et ........................ ,~.~ "~ 0 .Q.......~.....J..~..I~I ..... ~ '~ ......................... County Tax k4op No. I000 Section ....... ..0.._.%.0.. .... Block ........ ..~....3~.. ..... Lot No ...... I..~ ............. pursuant ,o application dated ....... ~...~....~'~..~......, 10.~.~ end approved by the Building Inspector. Fee $.~.~...:...~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 TempoWary Certificate of Occupancy - Residential $15.00, Commercial $15.00 e~d~/~ 77 ~ ~7 x~ Date ....... '.'..]~ Location of Prope ' ''~''~'''~' ...... ..~-.~.~... ., House No. Street ' /' 3/ ...... Hamlet Cou.ty Tax No 1000, Section .... .B ock .... Subdivision , .................................... Filed Map ............ Lot ..................... Permit No ...... Dat~ Of Permit... . ......................... Health Dept Approval ........................... Underwriters Approval ..................... Planning Board- Approval ....................... Request for: Temporary Certificate ........... Fmnal Certica,te.~;..~/.. .... ....................... . NOV 2 7 1992 b~rL . .'APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ 7~OWN OFSOUTHOLD A. This application must be filled in by typewriter OR ink and suhmitte~ 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 ~nd similar buildings and installations, a' certificate of Code Compliance from architect or engineer responsible for the building. 6. Subm%t Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-~onforming uses, or buildings and ~ "pre-existing" land uses: i. 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. THE NEW YORK BOARD OF FiRE UNDERWRITERS 1001071 BUREAU OF ELECTRICITY ~'~ 85 JOHN STREET, NEW YORK, NEW YORK 100318 Dole NOVEMBER O2~1992 Appllc.tle. Mo,..file 03192692/92 N 241618 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application nt~mber iR the pre~ti~eS of HIKE FURST, 520 OAK DR., SOUTHOLD, ;n thefollo,elngh,eaHon: [] B.se,.ent [~ ;.t FI. ~ 2nd FL OUT DRYERS FURNACE MOTORS I FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT 1 1~ CB 1 X .1 Lot RANGES C EXHAUST FANS DIMMERS G & S CONTRACTOR BOX 215 SOUTHOLD, NY, 11971 LIC.#578-E ': INSPECTORS Victor Lessard principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wiec:orek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765o1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD $COTf 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 I~OVEMBRR 13, 1992 MIC1]AEL D. F~RST 520 OAK DRIVE SOuT"OLD, NY 1197 I 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) ~ ~ ~x No Underwriters Certificate on file. ~xx 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. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20993-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. November 15,1992 Gary Fish Building Inspector, Building Inspector's Office Southhold, N.Y.11971 Dear Mr. Fish, Enclosed is the building permit for may house at 520 Oak Drive, $outhold, and a copy of the underwriters' certificate as you requested. Thank you very much, ~~:~~ Michael D. Furst 520 Oak Drive, Southhold N.Y. 11971 phone: 765 6172 575 2214 or 433 7931 days 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~NAL DATE ~/~/.~,~/~-"~-~... INSPECTOR OUNDAT]~ON ~ lst~ OU~ D A TI 0~'.! ( 2nd ) OUGH FRAME & .PLUMBING ~;SULATION PER N. Y. STATE ENERGY CODE Fi;;AL FORM NO. 1 TOWN OF SouTHoLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 · .'xarni/ied . ..., \pprove~... J .... 19c~.~. Permit No..c~ .O.~..9..~..'.~. )isapproved a/¢ ..................................... ............................ · ., (Building Inspector) ~ ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOAR0 OF HEALTI! ......... 3 gETS OF' PLANS .......... SURVEY ................... CI1[CK · ...... :...::... SEPTIC ....... CALL ................... · ' kb' ...... ...... ...... Date ...... ; ........ , 19 .c - a~. Tltis application must be completely filled in by typewriter erin 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 ' a~eas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tipn. c. Tile work cover6d by th-is applidation may no~ be commenced before issuance ~f Building Permit. d. Upon approval of thls application, the Building Inspector will issued a Building Permit to the applicant. Such permit all be'kept 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 the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Build]ns Permit pursuant to the filding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other ~ppilcable Laws, Ordinances or :gulations, for the construction of buildings, additions or alterations, or for removal or demolition · ~e .appli.eant agrees to comply with all applicable laws, ordinances, building cod~ bc,.~; ...... ,,as he,re .m described. mit authorized insnectors on nremis~e -,,d ;- k,,;uu_~ c ......... ° ~, -:*-~,.o~ou¢, anu ref~mattons, and to (Signature of applicant, or name,ir; ~;;t~gia'tion) ' (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electric/an, plumber or builder. me of owner of premises /- (as on the tax roll or latest deed) :pplicant is a corporation, signature of duly auth. ori~d officer. (Name and tide of corporate officer). Bui der's License No ........ : ...... Plumber's Liccnse No Electrician's License Nb. Other Trade's License No .................... Location of land on which proposed work will be done?~; f~i2 ,,~IN(3 DEPARTMENT t'O 4 PM FOR THE ~ W¢O REQJ CONCRETE ............... · ....... [louse Number Street ~I~t~tt~t NOT RESPqLt~$1~LE FOR" ' D S!GN OR COktgr OCTtO t ERROt $ 2ounty Tax Map No. 1000 Section ......... Block ..... ......... '~ ~ bdmsmn . .4%,~ff¢2¢~J ................... Filed Map No ...... Lot (Name) ........................ ;tare existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and ' occupancy . Intended use and occupancy 3. Nature of w~,k (,chec~k which 9pplicable): New Building .......... Addition .......... Alteration Repair ....... .~.).... Removal .............. Demolition .............. Other Work .............. (Description) 4. Estimated Cost ' J'~'Q~'~''.i ................. Fee ..................................... bf ' ~ (to be paid on filing this application) 5. Ifdwelling, number dwellin units .... '"~' ....... Number of dwc~lling units on each floor If garage, number of cars .... i /- · If business, commercial or mixSd occupancy specify nature and extent of each t e ofu D,menmons ot existingstructutes irony Front ~.~. ~ ' ,,- ,/ Height Numb'erofStories . .' ~ r~ Depth ~. Dimensions of same structure with alterations or additions: Front . ~ O.E. ........... Re r ............ 8. Dimensions of entire new const:ruction: Front .=-' ........... ............... Rear .. ;.-7= .......... Depth .: .=w-. ......... Height .... *-r ......... Number of Stories . ~7... - lO. DateofP '~ }~.~&.. mear ..... .'?.q .......... Depth .. I I. one or use dmtrict c es t . ' ' 12. ~oes proposed construction violate in ...... ' -. " ............ '/ ........................... ,,.,., .... y ~onlng law, oromance or regulation: .. ~/~ .............. 13. *,m ~o~ ne regraaed ........ ~ ................... Will excess fill be removed fr 14. Name of Owner of premises ,/~/~&...k~t~c_,C~T'~ .~ om premises: Name of Architect .... ' .............. ~uuress ................... Phone No . ' ....................... Address Phone No. ' ............. Name of Contractor... i .................................. ................ ' · · Address . Phone No ..... 15. Is ~his property within 300 feet of a tidal wetland? ~ ....... ' ..... · If yes, Southold Town Trustees Permit may be required. ~ ........ .... : PLOT DIAGRAM Locate clearly and distinctly all'ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description aCCording to deed, and show street names and indicate whether interior or comer lot. . . LkTE OF NEW YQRK, ~ 'S S .. .2 .......... (Name of individual signing ~ontract) being duly sworn, deposes and says that he is the applicant )ore named. (Co, orfi;& ........................... ' , otc ) said owner or owners~ ~d is duly au2horizcd to perform or have performed tlic said work hnd to m~e and file this pi/cation; that ail statements contained ~ this application are true to thc best of his knowledge and belief; and that the' )rk will be perfo~ed in the manner set,forth in the application filed therewith. 'o~ to before me this~ t . . .... , ........... g ........ . .