HomeMy WebLinkAbout20575-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTI~ENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20804 Date JUNE 18~ 1992.
THIS CERTIFIES that the building. ALTERATION
Location of Property 2820 SHIPYARD LANE (UNIT 1Gl) EAST F~LRION, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 38.2 Block 1 Lot 13
subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 17~ 1992 pursuant to which
Building Permit No. 20575-Z dated APRIL 22~ 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 ALTERATION FOR BATRROOMS IN EXISTING CONDOMINIU~ ~ APPLIED FOR
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
DONALD H. & DOROTHY A. HENRY
H-029287 - JUNE 12~ 1992
APRIL 28, 1992 - DONALD HENRY
uilding Inspector
Rev. 1/81
· OR~r NO. O
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NgN? 2057~Z
Permission is hereby granted to://
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Building Inspector.
Rev. 6/30/80
BLDG. DEI:T.
__J!OWN oF so 'P, om
Form No. 6
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
A~PLICATION 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:
1o Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
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 and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6o Submit P!auning Board Approval of completed sit~ 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.
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 $i5.00
Date ........ ..
New Construction .......... Old Or Pre-existing Building ...........
Location of Property..'.~..~?....~-'..~.<.~.~.~. ~ ~/~
............. ........ ....
House No. * Street Hamlet
Onwer or Owners of Pro er ~~~ ~~ p ty ....................
Counry Tax ~ap No 1000, Section.. ; ..... ... Block ...... . ........~ .LoC ....
SubdSv~s~on ........................ · .. ....... .. FSled Hap ............ Lo~ ..........
N ,
Perm~r ~o ..... ~ .. are Of Perm~. .. cant
Heakh Dept. Approval ............ · .....-... . .. · Underur~rer8 Approval ...................... .. .
Planning Board Approval ...................... ..
Request for:
Fee Submitted:
Temporary Certificate ........... Final Certicate ...........
TOWN OF SOUTHOLD
OFFICE OF BUILDII,IG INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
~ E~T I F I CA T i O N
TEL. 765-1802
TOWN OF SOUTHOLD
Date
Building Permit No. ~J~3 ~"-
~please prl~nt) r . _
(pl ea~'e prlnt) ~-~
I certify that the solder Used in the
contains less' than 2/10 of 1% lead.
water supply system
Sworn to before me this
19 ~_~__~.
~;Otary Public, /L///3~-//~
(plumber" s sigja~
Notary Public-
County
THOMAS M. ME~INA
NOTARY PUBIJO .8'~*__A_1'~_ (X= NEW YORK
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 Fire Inspector
Telephone (516) 765-1802
SCOTT 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
Il/kY 4, 1992
DOlx~LD H. HENRY
19 HOFSTRA I~IVE
PLAII6/IEW, W/ I 1803
HE: PROPERTY @ 2820 SHIPYARD LANE IINI? IGI
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 (outdated/not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 20575-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
INSPECTORS
(516) 765-1802
VICTOR LESSARD, Principal
CURTIS HORTON, Senior
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, Assistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
SCOTT L. HARRIS, Supervigor
Southold Town Hall
P.O. Box 1179, 53095 MainRoad
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
April 27, 1992
Mr. Donald H. Henry
19 Hofstra Drive
Plainview, N.Y. 11803
Re:
Premises at 2820 Shipyard Lane, East Marion Unit 1Gl
Building Permit and CO Application
Suff. Co. Tax Map ~1000-38.2-1-13
Dear Mr. Henry:
Pursuant to our telephone conversation of today, I return
herewith your check #2451 in the amount of $75.00. Please
submit to this office two checks, one in the amount of $50.00 so
that we may issue the building permit, and $25.00 check for the
Certificate of Occupancy fee.
Once we receive the Underwriters Certificate and Plumbers
Certification, along with the application and $25.00 check, we
will be able to issue the CO.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Georgia Rudder,
Secretary
encl.
P~RICE
DOWN PAYMENT
MONTH. COMMON CHARGES
ESTIMATED ANNUAL
REAL~TATETAXES
Point
TWO BEDROOMS
UNDERWRITERS CERTIF/CATE
REQUIRED
APPROVED AS NOTED ~
NOTIFY BOIL.DING DEPARTME~( A~
765-1802, 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION TWO REQUIRED
FOR POIJRED~CONCRETE
2, ROUGH - FRAMING & PLUMBING
3. iNSULATION
4, FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
i, ' ,. -' 'COOES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORB
PLUMBER CERTIFICATION
ON LEAD CONTENT BEFORE
CERT;FICATE OF OCCUPANCY
SOLDER USED IN WATER
SUPPLY SYSTEM CANNOT
EXCEED 2/10 of 1% LEAD.
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
E8 JOHN STREET, NEW YORK, NEW YORK 10038
only the electrical equipment ~ ~scribed below and intr~uced by t~ appl~ant ~med on the a~ve application number in the prem~es of
in the following location; ~ Basement ~ Ist Fl, ~ 2nd FI, Sect on" Bilk' Lot
~s exatnined on ~J~ )~ ~ ]' ~ ~'~)~)'~ attd found to be in co.tplianee u'ith the requirements ~f this Board.
DRYERS
RANGES OVENS DISH WASHERS EXHAUST FANS
SYSTEMS
B
ITHER APPARATUS=
E R V I C
NO. OF CC CQND.
PER ,~
OF CC, COND,
NO, OF HI-LEG
OF NEUTRAL
PI,~Y[NVTIt'{,i, NY~ L IJ]03 GENERAL MANAGER
:i, :~ ~,'
Pet_
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.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST I- ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ~Fi~NAL
REMARKS:
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
.~.~.~./ TEL.: 765-1802
Examined .. ~ '-~ 19 .~.-
Approved .. ~../2-:. ~,~.. ..... 19P~Permit No..,~...O. .....
Disapproved a/c .
APPLIGATION FOR BUILDING PERMIT
INSTRUCTIONS
BOARD OF HEALTH .........
3 gETS OF PLANS .......
/.~SURVEY ....
CALL ...................
HAIL TO:
g. 'This application must be completely filled in by Wpewriter 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.
¢. The work covered by this application may'not be ommenced before issuance of Building Permit·
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
hall 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
.hall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Depm'tment for the issuance of a Building Permit pursuant to the
;uilding Zone Ordinance of the Town of $outhold, 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 with all applicable laws, ordinances, building code, housing code, and regulations, and to
:tmit authorized inspectors on premises and in building for necessary inspgc.tions7-'%
(Si=nature° qf applicant, or naT~ if.a'~'~poration)
(Mailing address of applicant)
;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~
lameofownerofpremises ... dc'..~.f-.~. .~.. .... ,' ...~.~. .......... ~ .................. . .....
tas on the t.wA roll or latest deed)
? applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land od which ~roposcd work wi 1 be done ......... · ,
......... ......... '.
IIouse Number Street Hamlet
County Tax Map No. lO00 Section ..... ~ ........ Block ........... ot /
(Name) .........................
,te existing use and occupancy of premises and intended use and occupancy of proposed construction: ~ .
3 Nature of work (check which applicable) N ' '
· Building Addition kite etlon
Repair Rembval . ew .................... , r .
.............. · ............. Demolition Other Work'. ........
4 E timated C ' (D ription)
i (to be paid on filin~ this application)
$ Ifd ell' ~b fd lling hnit / N b f
· w :ng, nu er o we s .............. urn er o dwelling units on each floor.../ ......
· If garage, number of cars ....... -2 ;..~ ...... ·
7' Di u ness, commer a ormxe Cnpancy, specify naturc and extent of each type of use ........
· mensions of exist!,n_g_structure~, if any: Front.. 7;. R ' ' ............
Height :' Nu lb fStoi .......... ear . ...":T. ...... Depth
............... m er o r es ....... '.".,. ..... ' .......... . ....
Dim sin ors i'th alt .........................................
D en ns amestructure w erationsoradditions: Front ................ Rear ...............
pth ...... ' ·
· Hight Nt b fSt ri '
8. Dimensions of entire new constqmtion: Front ..... ':-T' ......'Rear
Height ....... 7~'~'... Num bet of Rt~,q,' ~ ............... Depth ..... '7'7 .........
9. Stze of lot: Front ....... --- ~ · ............................................
12. i. Joes proposed construction rio" ....... - ..............................................
,u~t~ ,my zomng law Orulsance or regulation: ~..c) ...............
13. Will lot be regraded ....
.... ~ ................. Will excess/iii be removed from premises' Yes No
Name of Architect i ~ , .,
p p rny w~tnzn ~00 feet of a tidal wetland? ~zes...~v%..... No .........
· If yes, Southold TSwn Trustees Permit may be required.
.... , PLOT DIAGRAM ,
Locate clearly and distinctly all lcuildings, whether existing or proposed, and. indicate all set-back dimensions from
property tines. Give street and block npmber or descriptioh according to deed, and show street names and indicate whether
interior or comer lot. i
/&i
3UNTy OF ~'~'~'~'~
................ .................. being duly sworn, deposes and says t
(Name of individual signing ~ontract) hat he is the applicant
ore named.
· is the ' - ' ....
i (Contractor, agent, corporate officer, etc.)
said owner or owners, and is duly auihorized to perform or have perfomled the said work and to make and file this
~lication; 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 manner set iforth in the application filed therewith.
om to before me this
.. ' A /
I · t.,.-,'..-.'~ .0':','...,xt..°'P7.:/ ...... County
c,'~.-.---,.~ ' ,,,_.~_:_~, / , ~ , L,. ' ,,-.:,
.. ,'~o 4920784 . . ..
- uue f ed n'Nassau County ' ......
.,.; i . ' ' · . to:gj*a[ure o/appucan[)
~11mis~ion Ex~pire§ F~bruary 16, ~99y. , . ,. .