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Home My WebLink About20569-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22239 Date APRIL 5, 1993 THIS CERTIFIES that the building. ACCESSORY Location of Property 350 BLUE MARLIN DRIVE House No. Street County Tax Map No. 1000 Section 57 Block 1 Subdivision Filed Map No. GREENPORT, N.Y. Hamlet Lot 25 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 1992 pursuant to which Building Permit No. 20570-Z dated APRIL 2i~ 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 ACCESSORY TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED GERTRUDE DAVIS N-255155 - OCTOBER 29, 1892 Rev. 1/81 //ildi/ng Inspector FO~,M 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°-N?, 2055~Z Permission is hereby granted to: /Q .......... ..~.~....~...~..~.~.....~.~.~..... ........ ...~~....~...:~..,. ...... ~.;...~...~..t ........... Co,,n. Tox Map No. ~000 Sec.~....m;~.7 ..... B~k ...... ..O...~ ......... Lot No....~.~ ............. pursuant to application dated ..~......~:). .................. , 19.~...~:~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 · 0~ NO. B TOWN OF SOUTHOLD BUILDING DI*'PARTMEN? TOWN HALL $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N N? 0570Z Dote i 9.9....~¢. County Tax Map No. 1000 Section .... .~...~..'~ ......... Block ......~.,.J. ............ Lot No.....~....~...~. ............ pu~uant to application dat~ ..... .~ ....... ~ ................. , 19~.~ and approv~ by me Building Inspector. · ..~..: · ul ding In.~ector Rev. 6/30/80 Form No. 6 TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPAN This application must be filled in by fypewriter 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 buiidings, 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 6f 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '¥re-existing" land uses: i. Accurate survey of property showing all property lines, streets, buiiding 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. Ce Fees 1o Cgrtificate 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 - $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 Date · New Construction ........... Old Or Pre-existing Building .... Location of Property.., .~,~.O ...... ~j ~....~. ~?.!i?)...~. ,~.. i [ i ......... .... ~5~ i~.~.t l~.. Ni y '~ ....... ~ House No, Street Hamlet / Onwer or Owners of Property .... ~.'~.~..~.~'..~4.~..~.i~ ....................................... · / .4. County Tax Map No 1000, Section ........... Block ............... Lot ................. Subdi¥isio~ ................................ ~±led Map ............ Lot .................... Permit No Date Of Permit . . Applicant .................. .... . Health Dept. Approval .......................... Underwriters Approval ..................... .... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate..~/. ........ -- ~PLICANT ' 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 F/re Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisgr Southold Town Hall P.O. Box 1179, 53095 Main R~ad Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 MARC~ 23, 1993 GERTRUDE HcLEA~ 350 BLUE MtJ~LI~ DRXVE SOWrltOLD, NY 11971 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) No Underwriters Certificate on file. The check is ~3~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Pluraber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20570-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. THE NEW YORK BOARD OF FIRE UNDERWRITERS [000t. 2 J. BUREAU OF ELECTRICITY ~- ElS JOHN STREET, NEW YORK, NEW YORK 1OO,38 THIS CEETIFIES THAT only the olectrJcaJ equipment ~ &scribed below and introduced by t~ applicant ~med on the a~ve application number in the premises of in the/ollowing b,catlon; ~ Basement ~ Ist FI. ~ 2nd ~7. ~aR / O~ Section "l~k Lot ~sexaminedon OC~OBRR 26~992 andfoundtobeincompllancewlththerequivementaqfth~sBoard. FIXTURE OUTLETS SWITCf~ES DRYERS FIXTURES RANGES OVENS EXHAUST FANS SYSTEMS NO. OF FEET OF CC, COND NO OF HI.LEG OF NEUTRAL ITHER APPARATUS: P/~t~F, hBOARD8 ~ [-' 3 CIR. 275 TOWN HgRBOR LaNE $OU~HOLD, NY, 11.97i GENERAL MANAGER Per this certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. :~,LN2NNO2 qVNOZ~Z~Q~ ~-' qVI:I~ 'X 2GOD '[ DNISM~q~' ~ 3~IVE.4 HD~OI 'E 765-~802 BUILDING DEPT. INSPECTION INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND Il INSULATION [ ~F~MING [-~NAL DATE INSPECTOR FORM NO, 1 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . &' ~ 19 ~1 ~- .\pproved . ;~l ., 19 ~.~. Permit No..~. ~..~-.7..0..~ Disapproved a/c ..................................... ................. - ............... (Building Inspector) APPLICATION FOR .BUILDING PERMIT BOARD OF HEALTII ......... 3 SETS OF ?LANS .......... SURVEY ................... CIIECK ................. :.. SEFTIC FORH .............. CALL ................... HAIL TO: Date .................. , 19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 3ts 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 appli- ation. c. The work covered by this 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 permit mil 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 ~all have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building P~.rmit pursuant to the .,uilding Zone Ordinance or, the Town of Southold, Suffolk County, New York, and other applicable'\~.aws, Ordinances or .egulations for the constr~ction of buildings, additions or alterations, or for removal or demolition, ~s herein described. "he applicant agrees to coldly with all applicable laws, ordinances, buildine code, housing code~ and regulations, and to dmit authorized inspectors'on prem;.ses and in building for necessary inspecti~,ns, r---'x (Signat6re of al2plicant, or name, if a corporation) (Marling address of apphcant) )~' ~r ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~'ame o owner rem es ............... ~ .......................................................... (as on the ta[x roll or latest deed) f applicant is a corporation, signature of duly authorized officer. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ......................................... ' ......... It u ........................................................... o se Number Street Hamlet County Tax Map,..No, 1000 Section ...... /7 Block ..../ ....... ......-.... ...... . Lot................... Stbdvson ~,~Ot, t-'7~/~, q-~J0OT"~ FiledMapNo ............... Lot....~. .......... (Name) State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .~ ...... ; ............ 7' ........ LJ '.: ",,; T: b. Intended use and occupancy .... .."~.fO/iffC-~ .C! ~"~C'/ Y" (7) 67 ~-~ "' ~-~'('~&~(,T?,?; ...... ~.- · ,/. · ,t....~ · I ' }"' .... .l'r"C,~; ~.7.~' .;:,'~;:I.;;~.*.~.; ~ .......... 3. Nature of work (check which app icable): New Building .......... Addition .......... Alteration .......... Repair .............. Remoeal .............. Demolition ............... Other Work ............... .~...~..~..0. ~,'0 (Description) 4. Estimated Cost i (to be paid on filing this application) 5. If dwelling, number of dwelling,,uhits ............... Number of dwelling units on each floor ................ If garage, number of cars . . .a~")r~.... 6. If business, commercial or mixed ioccupancy, specify nature and extent of each type of use ..... ~ .... ;. ........... 7. Dimensions of existing structuresl if any: Front ......... '. ~ .,.:. Rear .............. Depth ............... Height ............... Numbler of Stories ...o2 .................................................... Dimensions of same structure wit~ alterations or additions: Front ................. Rear .................. Depth ..................... i. Height ...................... Number of Stories . Dimensions of entire new constmotion: Front Rear .............................. Depth ............... Height ............... Num b~r of StoNes ................. 9 Size of lot Fro .... r'..' ..... ' ...................................... · : nt ............ ~ ....... Rea ............... Depth ................ I0 D fP I ...... · ate e urc rose ............ i ................ Name of Former Owner ............................. 11. 12 Does proposed construction violate any zoning law ................ Zone or use district in which prm~ises are situated ..................................... · ordinance or regulation: 13. Will lot be regraded .......... ! .................. Will excess fill be removed from premises: Yes No 14 Nam of Own ofp emis . e er r es .... ! ................ Address ................... Phone No ................ Name of Architect ' ' Address Phone No Name of Contractor .......... ~ ............... Address ..... ., ............. p [5. Is this property within 3010 feet of a tidal wetland? h~o~e No ................ Yes ........ No.~ ...... *If yes, Southold ToMn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ~ ' ' buddings, whether existing or proposed, an&indicate all set-back dimensions from property lines. Give street and block mimber or descfiptioh according to deed, and show street names and indicate whether interior or coruer lot. ' TATE OF NEW ~0~,f4¢, , .......... ...... bein d l s orn . ........ .... .,. -- (Nam~ of individual signing icontract) ...... ~ .......... so ~.arme is the applicant )ore named· e is the ................... .~..'~...~. ............................................................. ~ (Contractor, agent, corporate officer, etc.) · said owner or owners, and is duly afithorized to perform or ha~,e performed the said work and to make and file this plicafion; 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 [ga~ner se! forth in the application filed therewith. ~oru to before me this / /J i ' .., ,.. ~o. nt'~.~, ~u~018 ~1~7 (Signature of applicant) 're~ ~q~res M~¥ 31,19 ~Y , FORM NO. 1 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ~\pproved . . (.. 19 ,~.~. Permit No ~..~, .~..~..~. Disapproved a/c ..................................... ........................................ (Building Inspoctor) APPLICATION FOR BUILDING PERMIT BO,laD OF HEALTI1 ......... 3 SETS OF PLANS .......... SURVEY ................... CI1ECK ................. SEPTIC FORM .............. TO: Date ................... 19... INSTRUCTIONS a: Tl~is application must be completely filled in by typewriter or in 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this 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 permit mil 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 mil 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 alterations, or for removal or demolition, as herein described. he applicant agrees to comply ~;ith all applicable taws, ordinarices, building code, housing code, and regulations, and to imit authorized inspectors on premises and in building for...nece~sary, inspections~ c"-~ -- /~.,~_ ~' x' ~ " ~' -., ..... -- (Signature of applicant, or name, if a?orpp~ation) (Mailing 2~res~ .... ' ' tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. lame of owner of premises .......................................................................... · '~ '.. ' , ', (as on the t~ roll or latest deed) i applicant is a, corporation, sig~aturb of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~1~ c~.:Jl',}.~..":..~l[J.i .~.:.. Plumber's License No ......................... Electrician's License No ........................ Other Trade's License No ...................... Location of land on whic~ proposed work will be done ................................. ' ... House Number Street Hamlet County Tax Ma..p~o. 1000 Section ....... "~" · 7' ...... B,ock / on ............................. Filed Map No ............... Lot ............ (Name) State existing use and occupancy of~remises and intended use and occupancy of pr~osed construction: ' b. Intended use and occupancy 3. ~ ature of work (check wh:ch appt~cable): New Building .......... Additinn Alteration t',epair .............. Remov!al .............. 'olition '9 ~ ..... ' ................... D~m e o.//;~/Y'. Work... o"J~ther ............ .~.~.~.O oo~ i ~4~1., ~, , ~ (Description) 4. Estimated Cost ........... Fee ././d. ........ (to be paid on filing this application) 5 Ifd iii mb fdw lli ~it N be fd · we ng, nu ero e ngu s ............... um rD welling units on each floor.. ..... .... · If ga mb of cars · ,' .... rage, nu er ...... j ............................ , . 6 Ifb si d6 .......... ; ........ "'' s, commerci I i fly d, t of h typ of .............. · u nos a or m xe ccupancy, spec nature an extort eac e use ................ 7 Dim i f itl [if ny F ' ures, Roar D~pth · ensonso exs ngstruct a : rent ................ ' .... Hight Nunb6rofSt ri ...................... e ............... I 0 es Dim sions f ' .................................................... ith It ado additi Fro '' ' en o same structure w a er ns or ons: nt Depth ~H ight ................. Rear ............... .................... e N mb f St ri ''' 8 Dime sions of entire '~tio ...................... u er o o es ................. F R D pth ..... · n new constru n: rent ............... ear ............... e ..... H igt Nu b~ of St fie ...... e ~t ............... m r o s ..... ''" 9. Sizeoflot: Front ............ ~ ......... Rear 10. Date of Purchase ............. .................... Depth ...................... Il. Zone or use ' i ' ' " . . Name of Former Owner ............................. &str ct tn whmh premmes are situated .......... 12. Does proposed construction violat any zoning law, ordinance or regulation: ............. 13. Will lot be regraded .......... 3 ................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .... i ............... Address ................... Phone No ................ Name of Architect ........... 4 ............... Address ................... Phone No ................ Name of Contractor .......... ~ ............... Address ................... Phone No ........ L5. Is this property within 300 feet of a tidal wetland? *Yes ........ No..~. ...... ' ....... · If yes, gouthold 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 nu'mber or descriptioh according to deed, and show street names and indicate whether interior or corner lot. rAr ¥,ogx,. ou ¥ OF... .... ............. L,-o~tO ................... (Name of individual signing ~ontract) 3eve named. , APPROVED AS NOTED DATE; ~ B.P. # ._~.0~" ~, c/~ FEE: 7a, _BY:_ t,', NOTIFY BUILDING DEPARTMENT AT 1. FOUNDATION ~0 REQUIRED FOR POURED CONCRETE -~,ROUGH- FRAMING & PLUMBING 3. INSUt. ATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.Q being duly sworn, del~es ~grJ:J;t3~pll~e i~o~.t THE REQUiREMeNTS . STATE CONSTRUCTION & ENERGY c isthe ................. ~.~ COORS, N~ RESPONSIBLE FOR · , ................................ ~1~ pR CONSTRUCTION ERRORS (C ) ...... , ontractor, agent, corporate officer, etc. ' said owner or owners, ~d is duly authorized to perform or hage performed the said work and to make and file this plicafion; that all statements containe~ in this application are true to the best of his knowledge and belief; and that the )rk will be perfumed in the m~ner ' .... .... m~forth m tim apphcat~on filed therewith. yom to uetore me this ~ ~ . · ..................... .,. ........... a v. · .... /": ..................................... ' ~,~ (Signature of applicant)