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HomeMy WebLinkAbout20644-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24237 Date MARCH 25~ 1996 THIS CERTIFIES that the building Location of Property 1565 JACOBS LANE House No. County Tax Map No. 1000 Section 79 Subdivision ADDITION Street Block 6 Filed Map No. SOu'£~OLD, N.Y. Hamlet Lot 4.3 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 15~ 1992 pursuant to which Building Permit No. 20644-Z dated MAY 21, 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 SC~EEMED ROOM ADDITION ON EXISTING DECK 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 JACK& KARIN THILBERG N/A H--04100 --MARCK 15, 1996 Rev. 1/81 I~OB,M NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. !'. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ........... ~./.. ..................... NgN.° 3054JZ Dot~, ,~ ........, ]9.~..~ Permission is hereby granted to~ . __ . .... ......... .... ........... // ~ /~.~ ~-~ ~ . at prem,ses I~ated at ............~ .... ........ ~~.....~ ............................. co..w ~ ~ ~o. ~000 s.~.o. ...... ~. ........... ~k ......... ~ ......... ~o,.o ..... ~ ......... pu~uant to application dat~ ..... .~....../~ ......................... , 19.~ and approv~ by the / Building Inspector. Fee $ ........................ /,~Sullcllng Insi~ector Rev. 6/30/80 t · BLDG. DEPT. Form No. 6 TOWlq 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: 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 bu±lding, 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 "pre-existing" land uses: i. 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 New Construction.~.P.~fjO Old Or Pre-existing Building ................. Location of P o eft /~ . . rp y ................................ ~ .......................... .. . . . . .. . . House No.~ Street Hamlet Onwer or Owners of Property ......... '.~. /.~..~..~..././~.. .~...~./.'.~.~ ................ County Tax Map No i000, Section. ~.~ ............ Bi .............. Lot .................. Subdivision ........................ Filed Map .... Lot ......... Permit No.. ~.O.~...~..~..~...Date Of Permit..~.~./.% ~..~...Applicant....~...~..~./.~.. ~..Z~../.~ .~.~./~..~.. Health Dept. Approval .................... ----- · Underwriters Approval ......................... Planning Board Approval ...................... .. Request for: Temporary Certificate ........... Final Certicate...% ....... Fee Submitted: $ ............................. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 14, 1996 Mr. Jack Thilberg 1565 Jacobs Lane Southold, NY 11971 Re: Building Permit #20644-Z (porch add.)*** Premises: 1565 Jacobs Lane, Southold Suff. Co. Tax Map #1000-79-6-4.3 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. *** - ALSO BP#22278-Z EXPIRES 2/24/96 AND HAS NEVER HAD ANY INSPECTIONS. PLEASE CONTACT US ASAP TO RECTIFY THIS SITUATION. THIS IS FOR A SWIMMING POOL & FENCE. FOUNDATION Ilst) FOUNDATIO~U (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI;;AL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]/!N~ULATION [ ] FRAMING [~] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE !1 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 February 29, 1996 Mr. & Mrs. J. Thilberg 1565 Jacobs Lane Southold, NY 11971 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) xx 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. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20644-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. .\pproved . · ........ 19 .~.~'. Permit No. . . Disapproved a/c FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 · flii'u'd&'ng Inspector) APP,L, ICATION FOR BUILDING PERMIT CALL THE REQUIREMENTS OF THE N.Y. .," STATE CONSTRUCTION & ENERGY Location of land on which proposed work will be done. t s' .................... coDEs. b~' ' ~0~ ok' ~6~6~ · .......................... · ............ ~ od~, IIouse Number Street ' ' ' Hamlet ConntyTaxblap No. lO00Section ...Z~. ........... Block ....~. ............. Lot ~ SubdNision ..................................... Filed Map No. (Name) .............. Lot ............... tare ex;sting use and occupancy of premises and in tended use and occupancy of proposed constrnction: :. Existing use and ~ ~[< ~. ff~ occupancy · '. Intended use and occupancy ............... ~l,~ ~m~ 0 t~ Builder's License No. ' ' ...... Plumber's License No ........................ Electriciap,:s License No. W~J~O[~J CE~TIF~CATE ...................... Other Trade's License No ...................... 1, FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSUL,~rlON 4. FINAL CONSTRUCTION MUST 8E COMPLETE'FOR C.O. ALL CONSTRUCTION SHALL M~ET INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter 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- atibn. ¢. The work covered by this application may not be Cbmmenced before issuance of Building Permit. d. Upon 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 work. e. No building shall be occupied or used in whole or in part ,%~ any purpose whatever until a Certificate of Occupancy mi! 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 for removal or demolition, as herein described. he applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, an~gulations, and to lmit authorized inspectors on premises and in bmlding for necessary insnections. ....... (~nature of applicant, or name, ifa c)~t~oration) .... (Mailing address ;~ ap~ii~ant') .... ~"i :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~me of owner of premises .'7,9.C/~.....~..~,~/4.Z.M.....~...?./(d~',,P-.-~' t~ee~m) ~$ .. (as on the t= r'o'~f ~; i&it' ~Z,K '2Z:]Te75' ,~,' ;;.;'.: appucant is a corporation, signature of dul,, author ze" ~"'" · M~,~,~I~.R # ........................................ . NOTIFY BUILDING DEPARTMENT (Name and title of corporate officer) 7~5~~802 9 AM TO 4 PM FOR THE FOLLOWING ~NSPECTIONS: 3. b. Jature tSf work (check which aplplicable): New Building .......... Addition ..... klterat on ......... Repair .............. Remqval .............. Demolition .............. Other Work ...... ' ....... 4. Estimated Cost .... . · " ................... Fee If ~ (to be paid on filial: this application) 5. dwelling, numberofdwelling rots . . Ifg ~ ............. Number of dwelling nnits on each floor .... · arage, number of cars ..... i. · ' ........... 6 If business corn herein! m.~;~ ,' ........................................ ' ......................... Di 'ex ti~2's CUpancy, spem nature and extentofcac 'peofuse ............... 7. H mensionsot is s ~,uany: Front ............... Rear ....... Dc D~ight ............... Nmnber of Stori ptb ............ mensions of same structure wii h alterations or additions:-Front Depth ............... · ................ Rear .... . ~eight ..... 8. Dimensions of entire new constn~ etlon: Front .~.~ Rear . .~ ~/~j~',~' ' '~ ~ ~ 7" Height ... ~t/ .......Nmr er of Stories ..... l ............. '-~ ' '~ .... " ....--' '/~ .... 9. Size of lot: Front ........ ~ · Rear ... . - .. 10. Date of Purchase ~'~ ~ ...................... ~eptn ..... . 11. Zone or use distric~ }~ ~l~i~ ~ '~z.'~ .... - ......... Name of Former Owner ..... j ........ ~ ~u p~umlse8 are situated ..... ' .......................... 12. cods proposed Construction vlola[e any zoning law, ordi~c;¥r re~t ati~n ~ .......................... 13. Will lot be regraded , · , ............................. 14. Nme clowner of nremises~--~ ,1['_' '_ ' ~ ri cx~e~s fill be.re~myyc[frqm premises: Yes No Nme of Architect [.. ~' '~'s's~ ..... Address ~.~~ Phone No. ~ .~ .... N~e of Contractor. ~~'~ ~ ..... Address ...,..,,,,,...,,~.. '1" Phone No ................ .... ~ PLOT DIAG~ Locate clearly and distinctly fil fiuildings, whether existing or proposed, and. indicate fil set-back d~ensions from prope~y Hnes. Give street ~d block n~ ~mber or descfiptioh accordNg to deed, and show street nines and Ndicate whether interior or comer lot. ,, , ' ' ' 7ATE OF NEW Y~K~ )U~voF.. ~.q~[ .. s.s (Name of individual signing c ~n tract) ' ' is the ...... ontractor, agent, corporate officer, etc.) said OWner or owners, and is duly aufimrized to perfo~ or have perfonned the said work and to make and file this )lication that all statements contalno~ll' -. ' · rk'-"' ~ , .... ' ........ imm s a>pucatton are true to t ~e best of his knowledge and belief; and that the ' }~m ce peno~ca ~n tnt m~rset forth in the applicatio ~ filed therewit ~m to before me this ~ ~ h. , ........... ....... ... ~[~f}'O~u~ ~/ ...... ~q~ ..............