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Home My WebLink About20879-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22404 Date JUNE 18¢ 1993 THIS CERTIFIES that the building. ALTERATION Location of Property 565 (aka 220) KNAPP PL. House No. Street County Tax Map No. 1000 Section 34 Block 2 Subdivision Filed Map No. GR¢~NPORT¢ N.Y. Hamlet Lot 12 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 7¢ 1992 pursuant to which Building Permit No. 20879-Z dated AUGUST 7¢ 1992 was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ENCLOSE PORCH ON EXIST/NG ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A DOUGLAS & JUNE PETER~ON Rev. 1/81 TOV/N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERJv~IT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NgN? 20875Z ..~ ........ ~../.. ........ .../...~: .................. .... ~.~...~..../.~.~ ....... ....~'..:~ ................ ,o ....~..~.....~..~.. ................... ;~ ........... ~ ....... ~ ............................................. ~ .................. .~....~....~.~..~.....~.. ............. ~.d~... ........ ..~..~.,..~..~. ....... ~..~_L~.~.:~.~ ........... 0, p~mi,e, ,~o,ed o, .................................... ~......~..'~.~./.....~.: ................................. ............................................................................... ........................... County Tox Map No. 1000 Section ..... ..?...~,./,. ........ Bkx:k ..... .,O,....~., ......... Lot No ......... ,~,.,,~.. ........ ..Z./z pursuant to application dated .................................................. , 19. , and approved by the Building Inspector. /~/Buil'ding Inspector Rev. 6130/80 . ~ ~'~I~.~~~. Form No. 6 ~ ! ! TOWN OF SOUTHOLD ~i BUILDING DEPARTMENT '/~ ~ ~ 'i ':' TOWN HALL . 765-1802 ~"'~'~;,~.:~"O~ 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 ail buildings, property lines, streets, and unusual natffral or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installa~iqn from Board of Fire Underwriters. 4. Sworn statement from plumbar 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property shewing all property lines, streets, building and unusual natural or topographic features. 2.~ A properly completed application and a consent to inspect si~ned 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, ~terations to dwelling $25.00, Swi~ing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $I00.00 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 New Construction ........... Old Or Pre-existing Building ................. House N.o. Street ! Hamlet Onwer or Owners of Property..~. ~..~1.~.~/~.~?..~.. ~.~.~ ~,.~.~.~v-~. ~..~.-~4-~..~'/.. .. ............ . .. . . County Tax Map No i000, Section..~.~ ........ Block.....~...~. ....... Lot...f..2f%.. .............. Subdivision .............................. Filed Map ............ Lot ..................... Permit No..~.~.7.?..~. [Dai:e Of P~r~t[...~/...~.fZ-~pplicant~~-~.~-~%'~ ~. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........... Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted:' $ ....................... ....~. / ~,,m ..................... INSPECTORS Victor Lessard Principal Building Inspector Curtis l-lot t on Senior Building Inspector Thomas Fisher Building lnspec£or Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCO't'r 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 16, 1993 DOUGLAS & JUNE PV. TERSON 565 KN,~PP PL. GRZgh'PORT, ~ I 19444 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. The check is ~mzr~m~"x~m~/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 ~ 20879-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FOUUDAT~0N ADD ITIO}[ ~'L COMMENTS ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FI;IAL 765-1802 BUILDING DEPT. INSPECTION DATE INSPECTOR ALB - II992 -' . SOUTHOLD, N.Y. 11971 ~ ',L,,.~ ~: ' ",: :~:~ TEL.: 765.1802 ExanIincd ...... "'~ ....... 19 .~?" . Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTII ........ 3 SETS OF PLANS ........ SURV£Y ................. CtlECK .................. SEPTIC FORH ............ ,.O, Li=f: CALL ............ ~ :~ ~. TO:,~m2 · (B ui/kfin~grnsp ect or) APPLICATION FOR BUILDING PERMIT Date ................... · · INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter or in ink and submitted to th~ R,,ildJr~g lnept~t'*or, wit.h. ets of plans, accuro.~t, plot plan /-O scale. Fee according to schedule. ' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streei Jr areas, and giving a detailed description of layout of property must be drawn on tile diagram which is part of this appl :,ation. c. The work covered by tiffs application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permi .ha21 be kept on the premises available for inspection throughout the work. ¢. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc 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 th. luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o {egulations. for the construction of buildb~gs, additions or alterations, or for removal or demolition, as herein described 7he appticant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t~ :dmit authorized inspectors on premises and Ln building for necessary/~spections.~~, .. .... ..................... /,(Si~nature'' '~ of applicant, or name, if a corporation) (Mailing address of applicant) applicant is~essee, agent, architect, engineer, general contractor, electrician, plumber or £tate whether builder. APPROVED AS NOTED ............................................... .............. Name of owner of premises .~.Ot4~-~/-,~.X'...~. ~, .t,,t'/~..q..~'~..~'-E/gf'~....l=E~...~.~.f.t,.~. 'e '~Y:~' · (as on the taT. roll or latest ~l~ 8UILDING DEPARTMENT ~ applicant is a corporation, signature of duly authorized officer. ...................... · : ....... OCCUPANCY OR tTarne and title olcorporate officer) __ _ ___ B,,,,der s,.icense UNLAWFUL P,umbe 's.eense No ........ ,..WlIHOUT.CERTIFICATE E,eetrici n's License ,o ........ OF' 'OCCUPANCY' Other Trade's License No ...................... 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. fOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET TH[:: REQUIREMENTS OF THE NY, STATE CONSTRUCTION · ENERGY. CODES NOT RESPONSIBLE FOR ~?~!,f,'~N OR CONSTRUCTION EC~RORS Location of land on which proposed work will be done ................................................. County Tax Map No. I000 Section ....~..~. ........... Block . .o'~ .............. Lot... IR-. ........... Subdivision ..................................... Filed Map No ....... · ........ Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing usg and occupancy ..... /~2~ j...i, O,t[8~..~,..g ................ -0. t- .;:: ......................... b. Intended use and occupancy ............................... ,0 ~..~. ........ ,_ , , 3. Nature of work (check~'which applicable): New Building .......... Addition .......... Alteration .... Repair .............. Removal .............. Demolition .............. Other Work ........... 4. Estimated Cost.. ............................ Fee ................................... (to be paid on filing this application) $. If dwelling, number of dwelling units t/ 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 use .................. 7. Dimensions of existing structures, ii' any: Front ............... Rear .............. Depth ............ Heigitt ............... Number of Stories ........ ./ ............................................ Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth ...................... Ile/ght ...................... Number of Stories ................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............ Height ............... Number of Stories ...................................................... 9. Sizeoflot: Front ...................... Rear ...................... Depth .. ................... 10. Date of Purchase ............................. Name of Former Owner ........................... I 1. Zone or use district in which premises are situated ................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes i' 14. Name of Owner of premises .................... Address ................... Phone No .............. Name of Architect ........................... Address ................... Phone No .............. Name of Contractor Address Phone No ' 15. Is this property within 300 feet of a tidal wotland? *Ye~ ........ No ......... · ;if yes, soutnold Town Trustees Permit may bo required. PLOT DIAG RgJ~f Locate clearly and distinctly all buildings, whether existing or propo~, and indicate ail set-back dimensions fro~ property lines. Give street a~.j block number or description according to deed; ar.d. ~.how street names and indicate wheth, interior or corner TATE OF NEW YOFCK, ,. S~. ' (Name of individual signing contract) the ~c;Jr agent] corporate officer ct; ............. sa~d owner or owners, and is duly authorized to perform or have performed the said work and to m~e and file thi~ plication; that all statemcuts contained in tiffs application are true to the best of his knowledge and belief; and that ~rk will be perfo~cd in the manner set forth in the application filed therewith. r°mt°bef°remethis~ (Signature of ~ppI cant'