HomeMy WebLinkAbout20580-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-25579
Date: 03/09/98
THIS CERTIFIES that the building ALTERATION
Location of Property: 25 PINE NECK ROAD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map Ne. 473889 Section 70 Block 5 Lot 28
Subdivision Filed Map NO. -- Lot No. --
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 23, 1992 pursuant to which
Building Permit No. 20580-Z dated APRIL 24, i992
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 TO AN EXISTING ONE FAMILY DWELLING AB APPLIED FOR.
The certificate is issued to WILLIAM & MARTINE WARNER
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N245426 08/04/92
PLUMBERS CERTIFICATION DATED N/A
tot
Rev. 1/81
TOWN OS: SO~THOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NgN? 20580Z
cou,w Tox Mop No. ,o0o s.¢,o, ......... .7....0.. ....... .,o~k ......... ~ ...... ,o, No....~.....~ ........
pursuant to application doted ...... .~.../.~...~. .................................. , 19~.....~-., and approved by the
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUT
BUILDING
765-1802
APPLICATION FOR CERTIFIC
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 from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire UndeCwriters.
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 er 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 ~es, 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 spplicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
~reasons therefor in writing to the applicant.
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 Buildin~ - $100.00
3. Copy of Certificate of Occupancy - . .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15,00, Commercial $15.00
Date .........................................
onstruction ........... AOld Or Pre-existing Building .... .~ .........
... .................. ..........
ion of Property~.~. P - ~-~ ~ ~ ~O O~-~ ....................
House No. Street Hamlet
Owners of Property ....
y Tax ap e lOO0, Section.... .O ........ Bloc .... rT.. ........
vision .................................... Filed Map ............ Lot ......................
t No ................ Da me Of Permit ................ Applicant. ~.~.~. ~.~. .............
h Dept. Approval .......................... Underwriters Approval ...... ..~ ................
lng Board Approval ........................
st for: Temporary Certificate ........... Final Certicate..~ ......
ubmitted: $ ~,~.".~.
.......
III.
THE NEW YORK BOARD OF FIRE UNDERWRITERS !
'1~)01@7 1 BUREAU OF ELECTRICITY
~- 85 'JOHN STREET, NEW YORK. NEW YORK 10038
Date ~[[~[~ ~]4~[9~ ~pplicationNo. onfile 773~9~.~/9~ ~ 2~542~
THIS CERTIFIES THAT
only the ol~trlcaJ equipment ~ ~scrlbed be~w and introduc~ by t~ applicant ~med on the a~ve application number in the prem~es of
in thefollowing location; ~ Btsement ~ Ist FL ~ Z,~d FL Section Bilk
~,asexatninedon ~ [~Y 30~1,992 andfoundtobeincompllanceu, lththereqttire.tents~fthisBoard.
Lot
FIXTURE
GUlLeTS EWIICHES
3 ~
DRYERS
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
OTHER APPARATUS:
R I C
E
OF HI-lEG OF N{~UTRAL
G & ~{ CO~qTRhCTOR
GENIAL MANAGER
Per __
This certificate must not be altered in any manner; return to the office of the Board if incorred. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FOUNDATION (1st)
FOUMDATION (2n~)
2.
ROUGH FRAME &
-PLUMBING
I~;SULATION PER N. Y.
STATE ENERGY
CODE
FI~;AL
ADDITIONA'L COMMENTS
"ri:l_ ~o: ~t33 POl
WESTC,~tESTER
GAs oz,~m r~oNs
f~8 TI-IEO~ORE FREIvl~)
AVENUE.
RYE, NEW YOKK 10580
TEL# (914) 933-2943
Coll ~I1 ,, FAX# (914) 921~4030
R~,e District
TO:
Town Hall, 53095 Main Road
P. O, Box 1179
Southord, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 29, 1996
Mr. William Warner
425 Main Bayview Road
$outhold, NY 11971
Re: Building Permit ~20580-Z
Premises: 25 Pine Neck Road, Southold
Suff. Co. Tax Map #1000-70-5-28
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to Occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 10, 1998
To Whom It May Concern:
Re: Premises ~ 25 Pine Neck Rd. & 425 Main Bayview Rd.
Suffo Co. Tax Map #1000-70-5-28
According to the Town of Southold Records, the above premises
are on a corner lot and therefore has two house numbers.
Very truly yours
Southold Town Building Dept.
Forfeiter, ~
Director of Code Enforcement
EF:gar '
P--.o,;'7,o ~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
FIREPLACE & CHIMNEY
[ ] ROUGH PLBG.
[ ] INSU.~ATION
[ ~F~NAL
DATE
INSPECTOR
ii I] FOB~NO. 1
ii <I APR2 TOWN OF SOUTHOLD
BLDg. D~PT. ~ TOWN HALL
TOWN OF SOdTHOLD j
~ ............................ SOUTHOLD, N.Y. 11971
TEL.: 765-1802
ppro ed .. . ~ ....... 19~eermit No. ~.~
Disapproved a/c .....................................
................................
. ( uil ino Inspe~or)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
BOARD OF HEALTII .........
3 SETS OF PLANS ..........
SURVEY ...................
ClI~CK ....................
SEPTIC FOR~I ..............
HAIL TO:
Date . .~. ............ 19 .
a. This'application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
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 publ/c streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
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 permit
shall b,e 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
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 the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
- .......
--' (Signature of applicant, or name, if a corporation)
.....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nameofownerofpremises /q~,t~ d~/~// .~.,.~?..,gg.~.~
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
~/ (Name and title of corporate officer)
Budder s Lmense No ..........................
Plumber's License No...~.'/~. ...................
Electrician's License No. ~'.'.~.~....~...C~.-~l ........
Other Trade's License No .... /~../.kfl .............
1. Location of land on which proposed work will be'done ..................................... ', ............
House Number Street Hamlet
County Tax Map No. 1000 Section .... .'-].0. .......... Block ....~.. ............ Lot..~. .............
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy...0),,~/... ~.t .~...~/....~.~2.~ [,'~' ......... .; .<, '. .................
3. Nature of work (check which appl!cable): New Building .......... Addition .......... Alte, ratiqn ..........
Repair .............. RemovaI ..... Demolition . Other Wo '1~". ' ". :. ....
4. Estimated Cost. ~/.~'.~. ....... ..................... Fee .....................
(to be paid on filing this application)
5. If dwelling, number of dwelling unlits ..·...·...··... 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 ~f a,,,,' Front
,, ..~ ................ Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure with! alterations or additions: Front ................. Rear ..................
Depth ...................... ,! Height. ...................... Number of Stories ......................
8. Dimensions of entire new construc;tlon: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ........................................................
9 Size of lot: Front ' Rear
· ' ............ ' ............................... Depth ......................
10. Date of Purchase ............. i ....... ' ......... Name of Former Owner ...........................
h p i it d "
11. Zone or use district in whic rem scs are s uate ....................................... . ..........
12. Does proposed construction violat~ any zoning law ordinance or regulation:
13-.. Will lot be regraded ........... , ................. Will excess fill be removed from premises: Yes No
14 Name of Owner of premises ] Address
· · ...................................... Phone No ................
Name of Architect .' Address Phone No.
N_ame.o.f Contractor ,,JO .,Y~..~.q'~.~.h ,Ge~Z~,,t'.~ Address d_4q~, tg~.z¢). ~_.~.. Ph,,n~ No 7~a~'" O-¢~d
15. ~S tn~s property within 300 feet of a tidal wetland? *ye~.~...~j~...'. Noff/.~... :.'.' .............
· If yes, Southold Togn Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all bgildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block nmnber or description according to deed, and show street names and indicate whether
interior or corner lot.
ApJ'ROVy:D AS NOTED
N~3~:I~f~-BUILISING Oi~lSARIWIf~NT AT
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1, FOUNDATION '~0 REQUIRED
FOR POURED CONCRETE
Z ROUGH. FRAMING& PLUMBING
3. INSULatION
4, FINAL CONSTRUCTION MUST
~E COMPLETE FOR
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES· N~ RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
JTATE OF NEW. j~ORK,
· . .'...........i.. .............. being duly sworn, deposes and says that he is the applicant
(Name of individual signin~ contract)
,bove named. ,-
lQ is the .................................................................
j (Contractor, agent, corporate office'r, etd.)
f said owner or owners, and is duly ~uthorized to perform or have performed the said work and to m~e and file this
ppi/cation; that all statements contained ~ this application am true to the best of his knowledge and belief; and that the
,ork w~l be perfomed in the m~ner s~t forth in the application filed therewith·
worn to before me this
No. 47~$9, ~.~ ~.W,, , ~ (Signature of ~plicant)
OOCUPA/~Cy OR
USE IS UNLA~/FUL
1~tftTHOUT CERTiFiCATE..
~ OOOUPAI~C¥