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Home My WebLink About20947-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z~22149 Date FEBRUARY 19, 1993 THIS CERTIFIES that the building Location of Property 3210 House No. County Tax Map No. 1000 Section subdivision ALTERATION MOORE'S LANE{ CUTCHOGUE~ NY Street Hamlet 116 Block 1 Lot Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 8, 1992 pursuant to which Building Permit No. 20947-Z dated SEPTEMBER 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 TWO BEDROOMS AND ~ATHROOM ON 2nd FLOOR AS APPLIED FOR. The certificute is issued to ELIZABETH A. DONOVAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. 790974/92 PLUMBERS CERTIFICATION DATED._ FEBRUARY 2, 1993 ~l'ding Inspector ! Rev. 1/81 I~On.M' NO. ,s TOWN OF SOfT'OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NgN? 2094TZ Permission is hereby granted to: ; ~ ...~.~....~...~..~.....~:.~..~, ...... ..%~.~....~.~..~.~.~ ....................... ...~...~.~.....~.:.~.,...~...c..~.~...s.. ~L......~ .... ~. ~ ~. .. . ......... O...~.......;...~ .......... ~......~.~. ............................... at premises located at ...~....~../.,.~. .... ~.~. ~ . ~ ............... "' County Tax Map No. 1000 Section ....... /.!.~ ......... Block ...... .~C~..! .......... Lot No.....~..'...~.-~.. .......... pursuant to application dated ..... ~ ...................... , 19.~....'~.., and approved by the Building Inspector. Fee $..~..'..~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted ko 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 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. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Ppre-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 - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date....Z/. J.~./~ .......................... New Construction ........... Old Or Pre-existing Building ................. Location of Property ..... .3.~./.? ................ ./~.?~....~.. ........ ~'.~..~.J..ff~..~..~.~.'-. .......... House No. Street Hamlet Onwer or Owners of Property .... .~-~..~t-....Z~...~.~../'.~ .... ..~..~.O..v.'..M~. ................................. County Tax Map No 1000, section...L/.k ....... Block .... .~.1. ......... Lot .... .~.:.S.'~. ............ Subdivision . .. Filed Map Lot ........ · Permit No ...... ~.~. 2...-~..Date Of Permit ..... .o. ~Z .Applicant..~./~. ~c~...~..~.~.-~g. Health Dept~. Approval Underwriters Approval Planning Board Approval ............... 'i'i .... Request for: Temporary Certificate. '.. .. Final Certicate ..... Fee Submitted: $ ..... ~ c~ ' ~ ~. ~.~.~ TOV/M OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 1179 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Building Permit (please print) (~lease print) I certify thag the solder used in the contains less than 2/10 of 1%' lead. water supply system S. worn to before me this (plumber ' s- signature) / Notary Public~ ~' -- County .~__~in$uffol~SCounty ..q ! INSPECTORS Victor Lessard Principal Building Inspector Curtis Morton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek 0½'dinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCO'I.'I' 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 JANUARY 25, 1993 19 COLLINOS~OOD O~I~ ,,963 ~: ELI~E~ A. DONOV~ 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. xxx The check is ~x~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 % 20947-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: ELIZABETH A. DONOVAN 765-1802 BUILDING DEPT. INSPECTION 765.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]' ROUGH PLBG.' ]'FouNDATION ;ZND [ ~INsuLATtoN [ ] FRAMING REMARKS: [ ] FINAL DATE INSPECTOR 765-~802 BUILDING DEPT. FOUNDATION 1ST INSPECTION ~RROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION ZND [ ] INSULATION [ ] FINAL DATE 7GS-S802 BUILDING DEPT. INSPECTION ]FOUNDATION SST, [~UGH PLBG.' J FOUNDATION ZND [ ] INSULATION ,[ ,] FRAMING [ ] FINAL~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION ZND [ ] INSULATION ~MING [ ] FINAL OUNDATION (1st) 'OUNDATIO:! (2nd) ,.. ',OUGH FRA,.,E ~/ iNSULATIOn! FEE N. Y. STATE E};ERGY CODE FI;;AL ADDITIO~;A'L COMME~;TS: Examined \pproved~.~...~O~. I 0 19el.~. Permit No ~.-O~l q'] ~ Oisapproved a/c .... . ............................... ................................ .... _ ... (BuiFding Inspector) APPLICATION FOR BUILDING PERMIT FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ', TOWN HALL SOU?HOLD, N.Y. 11971 ~TEL.: 765-1803 INSTRUCTIONS BOARD OF HEAL'tH 3 SETS OF ...... SEPTIC FOR~. ......... a. Tiffs 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, relatinnship to adjoining premises or public streets r areas, andozvmo," ' ,, a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~tian. ¢. The work covered by this application may no~: be commenced before issuance of Building Permit. d. L/pon 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 wsrk. 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 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/'or removal or demolition, as herein described. he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to i/nit authorized inspectors on premises and in building for necessary inspections. -- (Signature of applicant, or name, if a corporation) . ... (.q..c..c~..~.&a~.~.. ~/e .... ..~.~. (Mailing address of applicant) [ / ~g: .~ :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... .5...~,..e..~.~..~z, ~,,~,_,, .c.,:~m-~ .............................................. amc of owner of premises .... '~~..~.O..~.0. y..,~.. ............................................... (as on the tax roll or latest deed) appffca~nt is a corporaJ;ion, signature of duly authorized officer. · .~.. v&;m ;" ./,-~...:..: ';~ ............ , ....... t anOjtitle ot arorporate officer) Builder's License No .... .~j! .o{ 1.0...7..~ ........ Plumber's License No ....... El ' ' 's L' N' ~3~) ectncan ~cense o ....... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................... ............ , . .~. . .-,h /. .o. ..................................................... llousc Number Street Hamlet Ill Subdivisinn ..................................... Filed Map No. (Name) Lot <~' ~ State existJug use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~...L~. ! .D..~'~...~:~~ b. Intended use and occupancy .~.~ t ~ ~-'a~l C~' 3. Nature of work (check which 9pphcable): New Building .......... Addition .......... Alteration .... Repair .............. Removal .............. Demolition .............. Other Work .............. I 4. Estimated Cost ........./I/~.. (to be paid on filing this application) 5. If dwelling, number 6f dwellin units ............... Number of dwc~lling 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. Dimensions of existing stmctu .es, if any: Front .. · : ' Rear " ' ............. Deptfi · · Height...............NunberofStories ......... ' ..................... ; .......... Dimensions of same structure ~ith alterations or additions: Front ................. Rear .................. Depth Height ' ............' ' ''''""' · ..................... Number of Stories ............. ~ ......... ~. 8. Dimensions of entire new consimction: Front .... . ...... Rear,. .............. Depth .............. Height ............... Nurnbe~- of Stories ...'~ .............. . ............. '. '2 ......... 9. Size of lot: Front ......... · . Reef .. ' . ' ' . De-th 10. DateofPurchase . . ' ' - .... i; "'~-Z' ......... ~' ................... .... '. ' · · . .... ; · .. ................ name pi Pormer Owner ........................ 11. ,~one or use olstrlct in which pt*emmes are situated . JeaSfr,,-,,m,q,_ .... Does proposed construction violate any zoning, law o-": ...... ,, ' ~' · "" ' ' ' 13. Will lot be regraded ....... dO .................. Will excess fill lie removed from premise~: Yes No 14. NameofOwneroforemises .I ~.,.~ .... ~ . - , .................. r, umu~ ................... Phone No ................ Name of Architect ............................ Address ................... Phone No ................ Name of Contractor .... .... , ...... ' Address .. Phone No. 15. Is this property within i300 feet of a tidal wetland? *Yes ........ No ........... · If yes, Southold ~own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all" buildin s wh .... "'.-- g, ether exlshng or proposed, and, indicate all set-bacl/dnnensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate wh~ther interior or comer lot. . . _ STATE OF NEW YORK, 'S S COUNTY.~)F ........ ~ ...... · · ~ .... ~./{ · · ..--<'..,t¢-~ (.9 · · ? ·, yf~'. .......... being duly sworn, deposes and says that tie is the applicant ((Name of in~,/idual signing cf~titract) ~bove named· ~/ !. . is the ....................... . (Con fractor, agent, ................................................ corporate officer, etc.) i . ff said owner or owners, and is duly ~uth. orized to perform or have performed the said work 'and to make and file this :pplication; that all statements contain;ed m this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this ................... day of..i ...... ' .......... ,19 .~ !v.!DAJ, COOPER ' ~~a '~of;' [, ,.~ i.ubim, StateofNowYol~k ~ · bio. 482256], Suffolk County.")/ · Term Expires D~cember 31, 19--~-- tu pplicant) II 'I 'i' APPROVED AS NOTED NOTIFY BUILDING DEPARTMENT AT 76B-1802 9 AM TO ~- i~M FOR THE FOLLOWING INSPECTIONS; 1, FOUNDATION - TWO REQU!RED FOR POURED CONCRETE '$EP '~ 1819~2 2, ROUGH - ¢RAMING & PLUM lNG 4, FINAL - CONSTRUCTION MUST THE REQUIREMENTS OF ~HE N Y, DESIGN OR CON~RU~ION ERRORS