The URL can be used to link to this page

Home My WebLink About20660-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20902 Date JULY 31t 1992 THIS CERTIFIES that the buildin~ Location of Property 75 FIRST STREET House No. County Tax Map No. 1000 Section 126 Subdivision ADDITION LAURELr N.Y. Street Block 10 Lot Filed Map No. Lot No. H~let 9.1 conforms substantially to the Application for Building Permit heretofore filed in this office dated ~4AY 22, 1992 pursuant to which Building Permit No. 20660-Z dated MAY 28~ 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 AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A THOMAS J. & JOANNE KRAEBEL Rev. 1/81 FOu~e NO. ~ TOWN OF $OUT~OLD BUILDING DEPARTMENT 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 20660,7 Permission is hereby granted to: ......... ........................ ~o ........ ..~.....~ ........ ~ ...................... at premises located at ..................... .~.~.. ....... '/~~...../........~.~ ........... County Tox Map No. 1000 Section ...... ./...~..~.. ......... Block ...... ./.~.. ......... Lot No....~:./. ............. pursuant to application dated ..... ~..~......~.....~.. ....................... , 19..~.~., and approved by the / Building Inspector. Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTI[OLD BUILDING DEPARTMENT TOWN ~\LL 765-i802 · 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. 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 "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 Certifidate 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 - $i0.00 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 ................. Location of Property....~.~5 ............. .~.]..~.%~..'....~. ].~.~ ........... ..~.~.?..~.. ........ House No. Street Hamlet Onwer or Owners of Property .... .. ~ ............ County Tax Map No 1000, Section. .Block .......... Lot Subdivision .................................... ..~ F~led Map ............ Lot ......... . ............ Permit Xo, Of Permit.h l'. . .... .... · ...... ~ -..app,.zcanc. llealth..Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Finai%Curticatc....~. ..... Fee Submitted: ~ ......... ~.~ ................. APPLIC~NT INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 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 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD 3ULY 15, 1992 TIIOMAS J. KP, AEBEL 75 FIRST STREET LAUREL, NY 11948 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) Ho Underwriters Certificate on file. The check is ~m~W/not on file.)$25.00 No Health Department Approval on file. Ho final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT $ 20660-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. ?OUN DA~TI O__.~ --. (__._1 s..t ) ~OUNDATION (2nd) tOUGH FRAME & -PLUMBING :NSULATION PER N. STATE ENERGY CODE FI~;AL ADDITIO~AL COMMENTS IIIIII urn,,, .-._ fillBUILDING DEPARTMENT ""' TOWNHALL I L -~ I~ SOUTHOLD, N.Y. 11971 J Tnu~ TEL.: 765-1802 /' ' ........... ' ' approved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL ................... ~tAIL TO: Date .................. 19 INSTRUCTIONS 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 ispued 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 shhll 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~ns~..~ '~'~.. h.~. -- (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. .......................................................................... ~0V[~ gS ~01'E~ ........ Name of owner of premises ... X~¢~. ~..... ~ g~ ...... ~}.3~ 2~ ~. . (as on the tax roll or latesl~' ~ BY: ~~ NOTIFY 8U~L,O]NG DEPARTMENT AT If applicant is a corporation, signature of duly authorized officer. 7(~5--18D2 9 AM ~O 4 PM FOR THE FOLLOWING INSPECTIONS: .............................................. 1, FOUNDATION ~O REQUIRED (Name and title of co~orate officer) FOR POURED CONCRETE 2r ROUGH ~ FRAM{NC & PLUMBING 3, INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION · ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 1. Location of land on which proposed work will be'done .................................................. ltouse Number Street' Hamlet Coun**ax 000 S ction . .......... mock .... ........... ........... Builder's License ~o ........................ 0CC U PA NC¥ 0 R Plumber's License No ...................... {JS.[ IS UNLAWFUL ~ITNOUT CERTIFICATE m==tri¢,n'~ Ci=e.~ ~o ..................... OF OCCUPANCY Other Trade's License No ...................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use an~ occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ................. ......... 3. Nature of work (check winch apphcable): New Building .......... Addition .......... Alteration . Repair ............. ' Remdval .............. Demolition .............. Other Work· .~..~-. ;c,:...~<? ........ ...... 4. Estimated Cost . '~--~O . lDO Fee O~ ~ ~5~ (to be paid on filing this application) 5. If dwelling, number of dwelling finits ............... Number of dwelling units on each -f~oor ................ If garage number of cars ' 6. If business, commercial or mixe~ occupancy; specify nature and extent of each type of use 7 Dim nsio sol itingst e~ if ny:F R ..................... · e n ex s ructur , a rent ............... ear .............. Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ............. , ................. Rear ................. Depth .................... I.. Height ...................... Number of Stories ........ 8 D' ' fe tire new onstr~ctio Front R D pth ...... · imenslons o n c n: .......... , .... ear ............... e .............. Height ............... Number of Stories .......................................... 9 Size of lot: Front ' Rear ............. .............................................. Depth ..................... I0. Date of Purchase ........... i ......... ' ......... Name of Former Owner ............... 11 Zo dist' ti wh' hpem' 'tuated ............. · ne or use tlc n lC r lsesare si .................... 12. Does proposed construction violate 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 ................ Name of Contractor ......... g ................ Address ................... Phone No ................ 15. Is this property within 3100 feet of a .tidal wetland? *Yes ........ No ......... *If yes, Southold Tiown 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. STATE OF NEW YORK, S.!S COUNTY OF ................. %. ............. r .............. being duly sworn, deposes and says that he is the applicant (Name of individual signin contract) above named. He is the ...................... ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s:et forth in the application filed therewith. Sworn to before me this .......... · ~..~. ?..~ ...... day of .... ~'~.d~.ff~. ......... , 19. Notary Public, . ........ Coun ,2 , ' ."% .......... '' LINDA J,; COOPER N.otary Public, State of New York (Signature of applicant) ~o. 4822563, Suffolk County ~7 _ T~','m Expires Deeembel?l, 19 TOWN OF SOUTflOLI~ '__ ,i t