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Home My WebLink About20724-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20887 Date JULY 24, 1992 THIS CERTIFIES that the building. ADDITION Location of Property 570 SCHOOL HOUSE ROAD CHTCHOGUE, N,Y. House No. Street Hamlet County Tax Map No. 1000 Section 102 Block 5 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 12~ 1992 pursuant to which Building Permit No. 20724-Z dated JUNE 17~ 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 MARY A. HANNABURY 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 Build~ng Inspector Rev. 1/81 lrOR~ NO. 0 TOWN OF SO~THOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_.N'.° 2072~ Z Permission is hereby granted to: ~ -- ,,c/ . ................................................ ../......~,_~ ........... :../....... ............................................. ................................................ ............................................. County Tax Map No. 1000 Section ...~'.~.~.. .......... Block ........ ~.~..~.. ..... Lot No ........ /./. ........... pursuant to application dated ................... .~././....z~... ................... , 19....~..~'.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TO~q OF SOUTHOLD BUILDING DEPARTMENT TOWN ~h\LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCDPANCY This application must be filled in by typewrite~ OR ink and submitCed to the building inspector with the following: for new building or new use: I. 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. Submit Plauning 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 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 - $i00.00 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 Haml~ t ' Onwer or Owners of Property ......... E/.~..X?/?~..g~. ........................ County Tax Map No 1000, Section ...... ~ ...... Block ...... ~.. ....... Lot .... /~... Subdivision .................................... Filed Map ............ Lot ...................... Permit llealth. Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval... ...................... Request for: Temporary Certificate ...... ..... Final~Ccrticate. ........ .. Fee Submitted: $ ~.~.~. ? co Rev. 6/30/80 INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building I~pector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD 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 JULY 17, 1992 JOHN STEWART HOMg LlqPROVEHENTS P. O. BOX 521 NAIN ROAD I~T~ITUCK, 1~ 11952 RE: MARY HANNABURY 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. The check is ~/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 $ 20724-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: MARY HAI~ABURY FOUNDA'TION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FI;IAL ADDITIONA'L COMMENTS: ', ~i., JUN I2 199;~ i;=~ L. T..~?~J'!d~!'~,3~ :'!~'?'?'~ ~L ~,///. 2. Examined ............. , 19... ...... ~ ..... 19 ~& eemit No. ~ ~.~. Approved Disapproved a/c ...... ~ ............................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971' TEL.: 765-1802 .- ( ' 'r)d~I spector) APPLICATION FOR BUILDING P~FIMIT 3 SETS OF PLAdS"./ ...... su ay ~Y~....~-~-..~ :'..~%. SEPTIC PORH ~L TO: ........ 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. ¢. 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 w6rk. _ e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shill have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to tlie 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 inspections..~._~L ---,~. (Si~,nMure of applicant, or name, if a corporation) .. ...... (Mailin~ address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 60/.,'F, zXZ" 7'~ ~ APPROVED AS NOTED · , - Name ofownerofpremises ...~/J.~.~... If applicant is a corporation, signature of duly auth. orized officer. · (Name and title of corporate officer) 0CC[~PA~{C~ O~ Builder's License No .... /~..O.~..~..,~..Z.. '..~S~ ~S ,,o ..... .............. 0F Electri~ian s License No .... ~/~ .............. Other Trade's License No .... / ~ / Location of land on which proposed work will be'done .................................................. House Number Street Hamlet M County Tax Map No. 1000 Section .................. Bl~ck .................. Lot 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 .......... ~(' .... ~* ....... .~ , 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION,~UST BE COMPLETE FOR C.O.~ , ALL CONSTRUCTION SHALE MEET THE' REQUIREMENTS OF 'I'HE N.Y. STATE CONSTRUCTION & ENERGy CODES. NOT'RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Remdval .............. Demolition .............. Other Work ............... 4. Estimated Cost .... . ....................... Fee .............................. . . ... ... . I (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars" 6 ' If busine'ss ...... ' .................................................................. commercial or mixedl occupancy specify nature and extent of each type of use 7'. Dimension's of existing structure4 if any: Fr;nt ..................... ................ Rear .............. Depth ............... Height ............... Num. ber of Stories ........................................................ Dimensions of same structure w~h alterations or additions: Front Depth i Height ................. Rear .................. 8 ................................... Number of Stories ............. ~j ..... · Dimensions of entire new construction: Front Rear ............................... Depth ............... Height Number of Stories 9 Size ............... ' ..................................................... of lot: Front i Rear ' · ' .......................................... Depth 10. Date of Purchase ..................... ........... ~ ........ ' ......... Name of Former Owner ........... 11. Zone or use district in which pre~nises are situated .................. 12. D°es pr°p°sed construction vml~te any zoning law, ordinance or regulation: 13. Will lot be regraded ......... q .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .... '~. · Address ................................. Phone No ................ Name of Architect ........... 1 ................ Address ................... Phone No ................ Name of Contractor ' i Address ......... Phone No .......... 15. Is this property Within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold T?wn Trustees Permit may be required. PLOT DIAG RAM Locate clearly and distinctly all ~uildlngs, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block npmber or description according to deed, and show street names and indicate whether, interior or corner lot. ~TATE OF NEg~--yDEr'~%: ~/' . ...... ' ~( .NCr~':fi'.f.ihdividual signing contract)" .bore named.. ...... being duly sworn, deposes and says that he is the applicant leis the I gent, corporate officer, etc.) ............... .f said owner or owners, and ' ' m duly autbor]'Z~t.o_.pgr.~rm or have performed the said work and to make and file this pplication; that all statements containqd hn this application are true to the best of his knowledge and belief; and that the /ork will be performed in the manner salt forth in the application filed therewith. worn to before me this Public,~.~.~.~ . .~' C~ ~ ~'/~.~ff~.~. · '. County Iotary ,,,n~, Stat~ .o!~ (Signature of applicant) WINDOWS · GLI~NG ~)ORS REEB Mlllwork Corp. 600 BRIGHTON STREET * RO. BOX 5332 · BETHLEHEM, PA 18015 215--867-6111 WHOLESALE DISTRIBUTORS OF BUILDING MATERIALS GEORGE PETROFSKI OOMMERCIAL & ARCHITEOTURAL REPRESENTATIVE