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HomeMy WebLinkAbout20880-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21141 Date NOVEMBER 9~ 1992 THIS CERTIFIES that the building Location of Property 360 House No. County Tax Map No. 1000 Section ADDITION MIAMI AVENUE PECONICz NY Street Hamlet 67 Block 6 Lot 16 Subdivision Filed Map No. Lot No. conforms substantial'ly to the Application for Building Permit heretofore filed in this office dated AUGUST 10r 1992 pursuant to which Building Permit No. 20880-Z dated AUGUST 10~ 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 ADDITION TO A SINGLE FAMILY DW~3,LINGAS APPLIED FOR. The certificate is issued to MELVIN KURS (owner) of the aforesaid building. SUFFOLK COUNTY DEk~ARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFI~%TION DATED N 255749 NO~TEMBER 4~ 1992 OCTOBER 29~ 1992 Rev. 1/81 /~ Building Inspector TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Y. N°_N? BUILDING PER. MIT (THIS PERMIT MUST DE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 20881]Z m,e ................. ~ ....................... , ~9...~./- Permission is hereby granted to: ..... ..... £.~; ....... ..~.~. .......... .~ ........................ · ........... .~.~.~.~.~ ............ ~...~ ....... z~././..~. .......... .,~...~.. ...................................................... at premises ,ocoted Ot ................ ...~...~....~... ........ ~./~'~--~'~.~. ....... ....~...~.~.., ......................................... .......................................... .,~ .............. ..,~.~.~.,.~ ......... ~.Y...:. .......... . .................................. .......................................... C ~.~:~...~..~ IL..~. ........ ~(J..~ .x..~..J .................................. County Tax Mop No. 1000 Section ...~..~..~........,. Block ..... ~..4 ......... Lot No ..... ./.~. ............. pursuant to application ,dated .................... ...~./__Z .......................19.~, and approved by th, Building Inspector. Rev. 6130/80 TOWN OF SO~THOLD ~/~.~, ~ BUILDINGTowN765_1802DEPARTMENTHALL 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 fro~ 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 i% 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. 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 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 - $I0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date /..~ L~...~./. ~..~'.. .... New Construction ........... Old Or Pre-existing Building. ~7~.~..: Location of Property....~.~ ..... ~.~m~.t..~ ~.,. ........ ~~ ~... ~.~ ........... House No. Street Ha~et Onwer or Owners of Property ........ ~. .~ .... · ................................ County Tax Map No I000, Section...~.~.~. ..... Block..~ .......... Lot./~; ................. Subdi~ision..~. ~k~. ~..~m ~ ............ Filed Map..f~ ~ 2...Lot..T ................. . . Permit No.~.~..Date Of Pe~it..~/~O./.~.~...Applicant.[l~.~.~.~.~... Health Dept. ApprovalP~.~.~C~ ~.~J~ ........ Underwriters Approval.~i~.~.~.T ........... Planning Board Approval..~ .................. Request for: Temporary Certificate ........... Final Certicate..~..' .... Fee Submitted: $...~.~.~ .............. ~~ ~ _ : ....... INSPECTORS Victor Lessard Principal B~ilding I,~spector Curtis Horton Senior Building Inspector Thornis Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (5 l 6 ) 765- I800 NO~aaiBRR 2, 1992 LISO CONSTRUCTION COP, P. P. O. BOX 439 JAMESPORT, NY 11947 R~: ~ & I*40LLIIg K IJRS 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) xax No Underwriters Certificate on file. 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 ~ 20880-Z Please contact our office on this matter. cooperation. CC: Thank you for SOUTHOLD TOWN BUILDING DEPT. MEL &MOLLIEKORS TEL. ?654 ~02 BLDG. DEPT. TOWN OF SOUTROLD ,',, . Sworn to before me this Notary Public, ~(~Z~ County Notary Public 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ ]FINAL 765-1802 BUILDING DEPT. [ ] XST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ]FINAL · 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION ZND [ ] ~SULATION FRAMING [/] FINAL DATE INSPEC'/'OR 765-1.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING / [ ] FINAL FOUNDATION FOUt;DATION 2. (2nd1 ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE ye ' FI;;AL RDDITIOMA'L COHMEHTS: FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N.Y. 11971 TEL.: 765-1802 Examined · .'.. Disapproved a[c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS SURVEY CHECK ...................... SEPTIC FORH CALL · · ~' ........ MAIL TO: APPLICATION FOP, BUILDING PERMIT INSTRUCTIONS · a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets 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 street or.areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appU cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such penni shall 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 ar~y purpose whatever until a Certificate of Occupanc, shall 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, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buQdings, ad. ditions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with ail appLicable laws. ordinances, building code, housin~ code, and regulations, and t, admit authorized inspectors on premises and in building for necessary inspections. (Signature o~ applicant, or name, if a corporazzon) . ?. P.. ~ s ~. B..~..q...4 ~o ~q e.-~....~.: .'~..:.. (Mailing address of applicant) State wh. ether applicant is oxvner, lessee, agent, architect, engineer, general contractor, electrician, pIumber or builder. ................. ~ ,.%: ............................................... -..-:, · -,_- · -_., ~.~ .~ .A.P. PR. O. ~p.A.S..N~.F4)' .... _ Name .T~ ~.L,. ·'w~,~' m~ ~'~-"~- (as on the Ia× rca or latest ~ 8U~LmN6 OifPART~[~N"r [f app~ cdr Dp ration, signature of duly authorized of acer. ?6~-,e02 ~ AM 104 PM FOR LO ANCY OR ..... .-.,~..'?T..-.": :-.~~-. 1, FOUNDATION - 3WO REQUIRED (Name and title of corporate oftlc~r) ' FOR POURED CONCRETE .a E 1.8. UNIgWFUL Builder's License No...~...~.. ~. 9. .... 3. ~SUL~nO~ ,,'ITHOUT CERTIFICATE' Plumber's License No.. ~ ~ ,q.~.. IBE COMPLI:TE FOR C.O. ..... ALL CONSTRUCTION SHALl. MEET Iectr,c,an's License OCCUPANCYT,E oF T,E '' STATE CONSTRUCTION & ENERGY Other Trade's License No .... "77 ................ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS i. Location of land on which proposcd work wilI be done. '.---..-.-..................................,..o' , r tIouse Number Street Hamlet County Tax Map No. 1000 Sectioo ...0.0.7 ......... Block . .~ ...... Lot Subdivision .'~ .~. ),M~..'7(. P~'P'(~'- Fiend Map No. /0 J 7 Lot (Name) -'. State existing use aqd occupancy of premises and intended use and occupancy of proposed construction: E i fiD up .O.,~,Z.~. .~..,~..,~.~..A..~'....O...o~. ~/../_1( ~ .,. , a. x sting use an cc ancy ........................ ' '~ ' , ......... '~/-r.:~';,~, ........ ............. , .t-~ *k' ~'~-~'~ . b. Intended use and occupancy .............. · ............ ~,~..,~ ..... ,. ~, ....... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .~'( · · ..... Alteration ....... Repair .............. Removal .............. Demolition .............. Other Work ............ (Dcscr/ption 4. Estimate'd Cost .... ~.¢.'.~.~.~ ................... ..... Fee ................................. .. (to be paid on filing this application) $. If dwelling, number of dwelling units .... . ...~. ........ Nnmber of dwelling units on each floor .~..-: ¢!¥ :.~..O. If garage, number of ears . ,/~q,t-/t~. ............................................................ 6. If business, commerc al or mixed occupancy, specify natnrc and extent of each t,,,'e of us° 7. DimenSions of exi~sting structures, If any: Front..,~..O. ......... Rear . ~.O. ......... Depth .3. ~ ........ Height . . ~.,~t, ........ Number of Stories . . ~ ................. '," ................... ', ...... Dimensions of same structure w th alterations or additions- Front ,~ O , Rear ~. ~ .... Depth .... ~'~..O. ......... }Ic ght ,.~. ............... Number of Stories...:~,g.../, 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............. Hm=ht ............... Number of Stories .............. ;. m- ............ ............... 9. Size of lot: Front .. ,' ............ Rear . ~. ............. ,/.~.~.' ~z. ....... I0. Date of Purchase w ............................ Name of Former Owner .-7 ......................... 1 1. Zone or use district in which premises are situated ................................................... 12. Does proposed construction violate any zoning Iaw, ordinance or regulation: ... ,/~. ~. ....................... 13. Will lot be regraded . ./54'..~. ...................... Will excess fill be removed, from premises: Yes 14. Name of Owner of premises~tT[~J~ . (<..~'.~.~q ........ Address~/.,,.~./~.t.t~.,~ t~,,,~,:.~d~.~'~r'i'~ne No '~..~'~..-/.'~ Name of Contraetor ..~.: ...... -":.. · "~. .... Addressg~..g.°.¥ .~. ?...q. ...... Phone No. . 5.% "" i ....... : i(o' 5.Is this property located within~00 feet of a tidal wetland? ~YES ...... · If yes, Southold Town Trustees Permit may be required. PLOT D1AG R2~.M Locate clearly and distinctly ~11 buildings, whether existing or proposed, and, indicate all set-back dimensions fro~ property lines. Give street and block number or description according to deed, a_nd show street names and indicate wheth~ inter/or or corner lot. ;TATE OF NEW YORK, :OUNT¥ OF ....... , .......,. S.S ....................................... - .... being duly sworn, deposes o. nd says that he is the applicar (Name of indMdual signing contract) bore named. is the ....................................................................................... (Contractor, agent, corporate officer, ctc.) said owner or owners, and is duly author/zed to perform or have perfo~ed the said work and to m~e and file tk ~plication; that all state~nenrs contained in this application are true to the best of his knowledge and belief;and that th ork wd[ be perfo~ed in the m~ner set forth in the application filed therewith. yom to before me this .......... ..... ...... . .....· ~ ru~l~ s~ ~ ' ~ ............... ' '.2_~ 'fi' ' '. ...... ~o. ~$~ ~ (Signature of applic~: ~m~~ USE IS WITHOUT OF OF{ UNOER~nl~S CUt'fll:l~TE LISO CONSTRUCTION lterrlcl$ Lane P.O. Box 489 ,~lamellporL N.Y. 11tM7 %[¸~ LISO CONSTRUCTION C CUSTOM HOME BUILDERS MAIN ROAD - BOX 439 JAM 722.4851 ,!