HomeMy WebLinkAbout20974-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCcumANCY
No Z-24452
Date JUNE 20, 1996
THIS CERTIFIES that the buildin~
Location of Property 445 BENNETT I~a/~E
House No.
County Tax Map No. 1000 Section 70
Subdivision
ACCESSORY
SOUTHOLD, NEW YORK
Street
Block 9 Lot
Filed Map Nc. Lot No.
Hamlet
20
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 18, 1992 pursuant to which
Building Permit No. 20974-z dated SEPTEMBER 23, 1992
was issued, and conforms to all of the requirements of the applicable
previsions of the law. The occupancy for which this certificate is
issued is INGROUND SWII~4ING POOL & FENCE AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
CHARLES & ROSE FARRELL
N/&
N-255905 - NOVEMBER 5, 1992
N/A
Building Inspect/
I~OBM NO. ~
TOWN OF $OUT~OLD
BUILDING D£PARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N-°N.o 20974Z
Permission is hereby granted to:
...~.2~.....~.~.:. ...............
· ..~.~.?~......~.:..~.:.....!.:.~.~..~... ~ ,
,o '"~'~'"'~'~'"~"~'"'~"'"'""~"'"~'~'~'t ..........
..~.....¥~~...~....= ......................... ~ ................ ~~--,...~ ...........
at premises located at .,....~...?,..~.~......!~..~.~ ....... ~ .......
County Tax Mop No. 1000 Section ........ ..0....~....~. ..... Block ........ ..~...~ ...... Lot No......e~:.....O.. ............
pursuant to application dated .... ..~...~..~.~-..J...~. ......... , 19.~..~ and approved by the
Building Inspector.
Fee $/..~,~..~..:...~
g'~ifd'mg Inspector
Re~ 6/30/80
BLDG, DEPT, i1
: TOW ~ OF SOUTHOI ~ '
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 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. Approvai 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)' ~on-conforming uses, or buildings amd
Upre-~xisting" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or uopographic 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 Buildinz - $100.00
3. Copy of Certificate of Occupancy -
4. Updated Certificate of Occupancy - $50.00
5. :Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
, ..................
New Construction . .. ~.~,.~Old 0Pre-~e~ 1
ocation of Prop erty.. ................. .. ..............
House No. Street ' Hamlet
County T~ ~p ~o i000, Section .... ~ ....... Bloc~....~.~. ......... ~ot .... .~..~ ..............
Subdivision ......... Filed Map Lot ......................
Permit No .... ~.?. ..... Date Of Permit ........ ~ .'...Applicant ........... : ..........
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Reques: for: Temporary Certificate ........... Final Certicate ...........
o,.c. ~¥~' / ................................................. AP~L~C~
Co a
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK 10038
[~ NOVEHBI'H{ O5,~992 03759492/92 l~ 255905
Date Application No. on file
THI~ CERTIFIE~ THAT
the el~tricel equipment ~ ~scribed belo~ a~ int~duc~ ~y t~ applicant ~med on the above application number in the premises of
. 0 C ~0 ~ ~ ~ Z 9 ~ 1 9 ~ ~ attdfouud to be in compliance w th t he require~nents of this Board.
fCEPTACLEE
SWITCHES
FIXTURES RANGES OVENS
OTHER
SYSTEMS
E R V I C
NO OF CC COND.
pER ~'
OF CC COND,
NO OF HI4EG
AWG
OF HI-JEG
NO, OF NEUTRALS
OF NEUTRAL
AP~RA?US:
cover~ compliance at; the date of
environment~ It, i~ advJgable to
,~-ave frequent t;est/atld or repaira
made by a qualified perBon~
NORTHEAST ELHiC,CONTR.INC, LIC,[38J. O fi
30 JERICItO TPR'E,~IUITE 2}32 G$NIERAL MANAIJBII
COM~t/H.'K~ ~¥, 11725 /. I'
Per-~ ~'~ ~/
~his certificate must not be altered in any manner; return to the office of the Board if incorrect. }nspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
Town Hall, 53095 Main Road
P. Q. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 27, 1996
Mr. Charles Farrell
445 Bennets Lane
Southold, NY 11971
Re: Building Permit #20972-Z - (pool & fence)
Premises: 445 Bennett Lane, $outhold
Suff. Co. Tax Map #1000-70-9-20
During a review of our
building permit has expired,
never been issued.
files it was noted that the above
and a Certificate of Occupancy has
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.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] I/,~.~ILATION
[ ] FRAMING [~,/] FINAL
[ ] FIREPLACE & CHIMNEY
DATE
I NSPECT~~~//~
765-1802
BUILDING DEPT.
INSPECTION
[ [ ] ROUGH PLBG.
[ [ ,.]~ON
[ [ ~']"'FI NAL
[ ] FIREPLACE & CHIMNEY
RS'MARKS= .AK.. ~"/~ ~'~ -- 7~ --
- . / - ._ ~ -
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING
INSPECTO~
OUNDA'TION ( 1st)
IOU~DATIO~ (2nd)
:OUGH FRAME &
.PLUMBING
-'NSULATION PER N.
STATE ENERGY
CODE
FI;~AL
ADDITIONA'L COMME~;TS:
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y, 11971
TEL.: 765-1802
Examined . .~.~....wry..~..~.~.., 19
Approved ~~.~ ~.~, 19~. Pemit
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING
INSTRUCTIONS
BOARD OF HEALI'll .........
3 SETS OF PLA?IS ..........
SURVEY ............ , .......
CHECK ................ , · · .
SEPTIC FORH .... ~ .........
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 public 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 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
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.
l'he applicant agrees to comply with all applicable laws, ordinances, building code housing code, and regulations, and to
~dmit author/zed inspectors cn pre,raises 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.
Name of owner of premises ...L~/~,~,.,.~:~ .... .~.~.. · .~..~?..~..4..-~'. ........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
... Afl. Ld'~... ~a ~.~/c,~ .................
(Name and title of corporate officer)
Builder's License No ..........................
Plumber's License No ..........................
Electric. Jan's License No .......................
Other Yrad'e's License No...)..~..? .~. !..~..~. ...... ''
. Location of land on which proposed work will be'done.. :?.~.~...~..'.
..................................... ~ .................
llouse Number Street Hamlet
County Tax Map No. 1000 Section .............. Block ................ Lot ..............
s,,~o~i~o,. ~z~/~;... ~ .......... m~.d ~ No ............... ~ot .... ~ ~. ......
(Name) ,, ~
, State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ........ ~ ..............
b Intended use and occupancy
3. Nature of work (check which applicable): New Building .......... Addition . .~. Alteration ..........
Repair .............. RemOval ............... Demolition .............. Other Work ~ .~..~.O~ f:~-....
i ,, (Description)
4. Estimated Cost ....... ,; .'./f'f~5.:
(to be paid on filing this application)
5. If dwelling, number of dwelling Bnits ............... Number of dwelling units on each floor...
If garage number of cars ' .............
6 ' If busine'ss .........................................................................
. , commercial or mixed occupancy specify nature and extent
7 ' ' . . . , of each type of use
D~menmons of emst~ng structure!s if any: Front Rear .....................
Height Numl~er of Stories ............................. Depth ...............
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ~ Height '
I Number of Stories
· Dimensions of entire new construction: Front
~ ............... Rear ............... Depth ...............
Height ............... ~:Ib e r/o f Stories ............ / ..........................
', ...........
9. Size of lot: Front .................. Rear ..... Depth .El
10. Date of Purchase '' ' ' .NameofFormer Owner ..............
11. Zone or use district in which premises are situated .........
12. D°es pr°p°sed construction violate ;/ny zoning law, ordinance or regulation: ................................
13. Will lot be r~graded ......... i .............. .; ....Will excess fill be removed from premises:
14. Name of Owner of premises c'a'/A,~oA.~. 5....~.~.,~.~7-~. Address ...~O.~ 7-A,'r~. ..... Phone No.2'~. ~>.~ ~r'..'.
Name of Architect ............ . ..... Address ................... Phone No ...............
Name of Contractor ./:'./jt~f~. ' ....
15. Is this property within 3'00 feet of a tidal wetland? *Yes ........ No....~-~r~...
*If yes, Southold T!own 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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
~TATE OF NEW YORK, S.i
?OUNTY OF .......... ,t ...... ,
.......... ' ..................... i ................ being duly sworn, deposes and says that lie is the applicant
(Name of individual signing! contract)
bore named.
Ie is the
: (Contractor, agent, corporate officer, etc )
f said owner or owners, and is duly ahthorized to perform or have performed the said work hnd to make and file this
9plication; that all statements containid in this application are true to the best of his knowledge and belief; and that the
'ork will be performed in the manner se~t forth in the application filed therewith.
worn to before me this
........
'Otary eubli~, .'.f~ ...... ..'~...,~1...!. '~..County
No. 4834049 (Signature of applicant)
Qualified in Suffolk Country
Term Expires
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0
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