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HomeMy WebLinkAbout20418-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-22768 Date DECEMBER 7~ 1993 THIS CERTIFIES that the building ADDITION Location of Property 140 (a/k/a 819) LINNET ST. House No. Street County Tax Map No. 1000 Section 48 Block 3 Subdivision Filed Map No. GEEENPORT, N.Y. Hamlet Lot 3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 3, 1992 pursuant to which Building Permit No. 20418-Z dated FEBRUARY 5~ 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to TODD JENSEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-24t123 - JULY 1, 1992 N/A Rev. 1/81 FORM'_ NO, 2J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PEP-Jv~IT MUST BE KEPT ON THE PREMISES UNTIL FULL CO/viPLETION OF THE WORK AUTHORIZED) NO_ 20418 Z Dote .....f~T..,,~'.~ .......................................... , / Permission is hereby granted to: ~ ..~ -- . ..~.....~...../..~. .~~ ... ....:...~,~:~...:..~...,,..z,..~~ , ',; ,o .~//.~- ....... ~. ........ ~~.. .;..~.~.... .. ~~ ............... ,~. ...... ~. .~-- . o~ ~,.~ ,o~o~o~ o~ ...... z~, ........ ~.~.~~ .......................................... ............................................ ~....~~i .................................................................... Co~n~ ro~ Uop No. ~000 Sec,~on ..... .~...ff.. ......... B~o~ .......... & ...... Lot No. pur~uont to opplicotion dot,Ri .......... .~..~..~.. .................................. , 19..~...~, ond oppro¥od by Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTItOLD BUILDING DEPARTMENT Tow 765_ s02 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. 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 Planning Board Approval of completed site plan requirements. e 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 Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. 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.OO Date .~..~. ?..~.~. ~.~... !.~...~ ~.~..~.~. .......... New Construction ........... Old Or Pre-existing Building ..... ,.. . Location of Property...~, ~..Ok. .................. .~. [ .~..~.5.~..~-...~.; :: :.: ::: :~,__: 1.1~.~. ~)..~?, ,f~.~...' House No. Street Hamlet Oswer or Owners of Property .... I..(_P..~.~.. .......................................... County Tax Map No 1000, Section ........... Block ............. Lot ...................... Subdivision .................................. · · F~led Map ............ Lot ...................... Permit No ~..~..~J ~ Date Of Permit ..................... ... Applicant ......................... .. . . Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval .... . ........ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ~.~..,.~.. " ............. APPLZC~T - - INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD November 22, 1993 SCOTT L. HARRIS, guperviso~ Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 Mr. Todd Jensen 140 Linnet St. greenport, NY 11944 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) XXX No Underwriters Certificate on file. The check is (outdatod/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Pluauber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ BP# 20418Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION ] 'FRAMING [ ],FINAL __~MARKS: ~ INSP£ 7GS-ZS02 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION / [~/~ F/OUNDATION 1ST [ ] ROUGH PLBG. / FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ,, ~ L~ DATE INSPECTOR 765.'1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 1ND ~j~i~SU~TION [ ] FRAMING FINAL :£xamin~d: .~.L/.C~. ......... 19... FORM NO. 1 TOWN OF SOUTHOLD ' ',BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 3i~approved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIlECK ................. ; . . SEPTIC FORH .............. INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :t~s 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- ation. c. 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 tall 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 roll 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 descr/bed. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to lmit authorized inspectors on premises and in building for necessary inspections. ' -- (Signature of applicant, or name, if a corporation) .t.z. O. . E ¢Tx~.v..~.C... U.r..., .~.tC E;.E:~. P.© ~,5. .... (Mailing address of applicant) rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,ame of owner of prem des ~- 11 ....................................... (as on the t.~x roll or latest deed) ~' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... /~...~.. ~ Z .(Z.-. ~..L..~ Plumber's License No ......................... Other Trade's License No ...................... Location of land on which proposed work will be done ' .../.. .............. .... ¢. , ...... ...... 7. ............. tlouse Number ,Street Hamlet County Tax Map No. 1000 Section 75..~..~2.~ ,Block ....... .~.. ........ Lot ..... ~.... ~37 .... Subdivision .... ~c%:'"~' z~· ~P./..~..~... /?,~../..'/z/--.,/..~Y,~ .~.' '~led Map NO .... Lot ~ (Name) .......... State existiug use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .~.. [ .~..~.[. [; ~../.~ .~.'1. I. i..k/... DW~ t.k 0 3. Nature of work (check which applicable): New Building .......... Addition . .~..~ ...... Alteration .......... Repair .............. Remoyal .............. Demolition .... ~,~: ....-..x,. Other Work ............... ~" ~ '00,0,i ~ t~F~' ~ '~{" $ ption) 4. Estimated Cost J / ' Fee ....... , ................ (to be paid on filing this application) 5. If dwelling number of dwelling ffnits .... I. . .. N her of dwell,.o u..,s on eec 'n~ :ii- h fl Ifg 1,,///.~ ....... oor................urn · arage, number of cars ... 6. If business, commercial or mixed!..... '~5~2 ' ~5 . ''; ' ' ' ~ ..... ' ........ ~ ................... ] Dim 'ex ~,~,-~m,m:,;y, ~t,ecuy nature ann extent or each type of use ...~./.]k ............. 7. ensions ot isting structuresI if any: Front ............... Rear .............. Depth .............. Height ............... NumBer of Stories. ' Dim f .' ' ...................................................... ensions o same structure w:th alterations or additions: Front .............. Rear ............... ° ~D.epth.. .... y.:.. ........... i'Height ...................... Number of Stories ...... /..." .. 8..u~mens,ons ot qn$1r;e new construction Front . . / ..-~-. / ;~,~ ;-- / : --' .... - ')'; ' ' Uei.:.~ /z - .. ; ............... ,,- ...... r..-~. ..... ~epm ..... Z..~ . . :, :e-t ....... ~' ........ l'~um ber of Stories ........ ./.. ' ' ' ' 9. Size of lot: Front ..... r~'~').~' · .l ....... i;'. ~ x Rear . . . r_,.~ ............... Depth I (; Z~ o t~'7 / 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violaie any zoning law ordinance or regt lation' MO 13. Will lot be regraded . ~q0 i ..... ' ........................... .... -- .................. wm excess n, de removed from premises: Yes 14. Name of Owner of premises .TO[.4.D. 0~.0~ ~[d~ co --' ' ............. Address ..... .L,l.kJ .L[ ZU;T. ~.~.. Phone No ................ Name of Architect . l.d /,,[~ . Address ................... Phone No ............... Name of Contractor .[J&X~i(~i ! .~}~ ~'i i L~I~ Ad~t'r~essC,¢&~?..~ .~..~ff_.~.~.r.. Phone No ............... L5. I~ th:is properl:y w±l:h~n 30'0 feel: of a l:±dal wetland, v¢Yes ........ No.~. ...... · If yes, Soul:hold To~n Trustees Perra±l: may be requ±red. .. i PLOT DIAGRAM Locate clearly and distinctly all bluildings, whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and block n~4mber or descriptioh according to deed, and show street names and indicate whether interior or coruer IOtl TATE OF NEW. A~-ORK./'q O r/ OUNTY OF.. ,~,~./. ,~S'S l ' .~ ./.'~..l ~ F/..~ .... being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) )dye named. ' ~ htr agent, corporate officer, etc.) said owner or owners, and is duly au,thorized t6 perform or have performed the said Work and to make and file this plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~rk will be performed in the manner set]forth in the application filed therewith. mru to before me this ..........' ..~. ~,~,..day of....~ , ~2~, ., 19,~' ~.. CLAIRE L. GL.EWi No. 4878505 i ~ulllifl~:l in $uffolk C~unty '~]~ ~ ,.('Signature of applicant) Cormglmllon Expire,= DoO~m~)~l~.l 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ,/ , ~.]~L ~OUNDAT!ON (1st) ~OUNDATION (2nd) ~OUGH FRAME & -PLUMBING ~NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: