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HomeMy WebLinkAbout20926-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22833 Date J~RqTJARY 11, 1994 THIS CERTIFIES that the building Location of Property 1550 CENTRAL DRIVE House No. County Tax Map No. 1000 Section 106 ADDITION Street Block 2 MATTITUCK~ N.Y. Hamlet Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AHGUBT 28, 1992 pursuant to which Building Permit No. 20926-Z dated AUGUST 31, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ALAN R. CERNY~ JR. Rev. 1/81 / /ilding Inspector rOztM NO. 0 TOWN 01: SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥, BUILDING PERMIT (THIS PEPJ~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N N? 20926Z ~ Building Irksl:mctor J/!!,,1 I O 1'' Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~his 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 ~ith 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 Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 i. 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 $15.00 New Construction ........... Old Or Pre-existing Building.....~. ........... House No. Street Hamlet Onwer Owners of Property AL~.~ ~ ~E~J~. County Tax Map No 1000, Section...~.~. .... Block. ~.7.~ ....... Lot. ............................. Filed Map ............ Lot ...................... Subdivision ./~../.~. . . Permit No .... Date Of Permit.. : ~ .Applicant .......... .~ '.. Health Dept. Approval .... ..... .~../.~. ............... Underwriters Approval ..... A~ .................. Planning Board Approval ..... .~?./.~ .............. Request for: Temporary Certificate...~/.~.~... Final Certicate.[.~., ...... INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wleezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD December 29, 1993 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 Mr. Alan Cerny, Jr. 1550 Central Drive Hattituck, NY 11952 To Whom This May,Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx XXX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is (cut~atcd/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 # BP# 20926Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765.1802 BUILDING DEPT. INSPECTION INSPECTOR ~) ~.-~.,.,~~,~~' '~OUNDA~ION (1st) ~OUNDAT!ON (2n~ ~ ROUGH FRAME & .?LUMBING INSULATION PER N. Y. STATE ENERGY CODE FI~IAL ADDITIONA'L COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 1 1971 ,' T;~V'&~(; ', :;'" SOUTHOLD, ~ ........ ~ ....... - ....~ ', TEL.: 765-18011 Examined ..... 'ppro,'ed 3isapproved a/c ..................................... .. ~,(B~l~lding Inspector) APPLIDATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTII ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK ~ ......... CALL . . .; ..... HAlL TO: a. Tlds application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 ',(s 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 rCareas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~tion. c. The work covered by this applidation may no~ be commenced before issuance ~)f Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit :all be'kept on the premises available for inspection throughout the wbrk. c. No building shall be occupied or, used in whole or in pazt 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 Permit pursuant to the ailding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 2gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described· 'lc applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and ffaegulations, and to imit authorized inspectors on premise~ and in building for necessary~ ~.._~.%&. -- : (Signature of applicant, or name, lq~oration) .k).',j. (Mailing address of applicant) :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ...... : ................................. amc ofownerofnremises ~.k~ ~--~k,~\/ T~- DATE' ~,?~_..-B.P. #~t~j~Y i' ............................. ~Z~,.4, .......... d. ,~: .~. (as on the tax roll or latest delOrES: ~___ 8Y:~. ' NOTIFY BUILDING DEPARTMENT AT applicant is a corporation, signature of duly authorized officer. 765-1802 9 AM TO 4 PM FOR THE title of corpora, re officer) Builders License No...(-,)..iN)g.i'....., Plumber's License No Elcctrisian's Lkcnse N~ ....................... Other Tr~dc's License No ............ FOLLOWING INSPECTIONS. 1. FOUNDAiqON - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3- INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. , ~..~ ~,_~ [ALL CONSTRUCTION SHALL MEET ~*J~ ~'qfNE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Location of land on which proposed work will be'done .................................................. .......... . .: ......................................... Ilouse Nmnber Street Halnlet County Tax blap No. 1000 Section , IO.~. ~..t~. Block O Z., O.Q Lot f2tj./: 0..~>.. .... Subdivision ' Filed Map No Lot ·" (Name) ........................................... State existing use and occupancy of premises and intcuded use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and 6ccupancy ~.~. ~.4..'.'~. 3. Nature of work (check which applicab e)' New Building Addition ..... R ~ ..................... Alteration Repair .............. emoval .............. Demolition ....... Other Work ............... 4 Estimated Cost -- ' Fee · . · ! (to be paid on filing this application) 5. If dwelhng, number of dwelling units ............... Number of dwcSlling units on each floor ........ ~ If garage, number of cars ! ....... 6. If business, commercial or mix!d occupancy specify nature_and extent of each type of use .................. 7. Dimensionsot'existingstructu(es, ifany: Front... .~..'~.~... Rear lll~.-, . Depth '.., ..... Height ............... Number of Stm4o~ '' r ...... ~,~]~. · · Dimensions of same structure with altar-*; ...... 4,m: .... n ' ' ' ' ' 29'~'~; .............. Oe:& .............. Denth I.~.'~.: . ' u~:_,., i~_ ~.is~aer~1. .'1.1r1': ....... Rear,.-i;,'~.~ ............. ~.'- . ' . ' ...... i' · · ,,cx~t .. ~,..'an;., ~,-~l~.--Z. Numh~r,~fStorio~ ~u/'~. 8. Ia~mens~o~:~of~enhrenewconstlmction:Front . .OJ.~ .... ~o,, i~2¢. ~'~T,~."'i~'~a.t ....... ,.~g,~ . .,o..~n- .......... cqumoer of Stories .. · .~q. lT~'.' ..... '. ' .... 9. Szeoflot Front .... I ,, '' .................... ' .......................... · · : ............ t~ear ...................... Depth ..................... 10. Date of Purchase .......... ! .....: ..... ......... Name of Former Owner ............................ I 1. Zone or use district in which pr~mises are situated .............. 12. Does proposed construction violate ~iny zonim, law o-q---~-.f,,; ~-~,.'. ~+~,-' ' ' '~']-~ ....................... 13.. Wdllotbe'regraded . . OI · , . · · ..... . j~O.~ r;.' ~ '~'.:-:.' ~..:,z'"'"~,'__ ..... Will qxg~s fill be removed from nrem~ses' Yes 14. ,~ame ot uwner ot premises r'~ .~154 ..~m~... AddresJ..~...~--~.~.:.. Pblone No.~r..a~.r~ll.. Name of Architect . , ........ · ................. Address ................... Phone No ................ Name of Contractor ....... 4 · · · .... Address ................... Phone Mo ............... 15. I~ this property within' ~00 'f'e'e't' ;'f' ~' tidal wetland? *Yes ........ No..~. ..... · If yes, Southold ~own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, a~d, indicate all set-back dknensions from property lines. Give street and blocklnumber or de ' ' -' interior or comer lot. . scnption accordm~ tu deed, and show street names and indicate wh~ther STATE OF N£.~ORI~ cou rv (.g.. ......... (Name of individual signing co~tract) ~bove named. ' 'lc is the ....................... ....... being duly sworn, deposes and says that he is the applicant said owner or owners, and is duly Pplication; that all statements contair ~'ork will be performed, in the manner ;worn to before me this ............ ,K.Z~..9 ..... day,,of i -,...~. a.,~,~..~/~? ~ ot ~ · , ' ' ( i O -. , / % ~bl~,Sl~eofN~Y~ . ~ ~ ~ ~ ~ ~1 . { ~ NO, 4879505 ~ . ' ~ '~' '~ ......... ~. ~~ lc ~]gn cant) ~mtsslon E~lres O~m~ 8, le~ ~~ · (Confractor, agent, ................................................. corpora.te officer, etc.) mthorlzed to perform or have performed the said work hnd to make and file this ed in this application are true to the best of IHs knowledge and belief; and that the ;t forth in the ~/pplication filed therewith.