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HomeMy WebLinkAbout20741-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20859 Date JULY 14, 1992 THIS CERTIFIES that the building STAIRS & DECKING Location of Property 55 WEST ROAD CUTCHOGUE NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 110 Block 7 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 18, 1992 pursuant to which Building Permit No. 20741-Z dated JUNE 19, 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 DECKING & STAIRS FOR PARK DISTRICT AS APPLIED FOR. The certificate is issued to CUTCHOGUE-NEW SUFFOLK PARK DISTRICT (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A c l ding Inspector Rev. 1/81 "amNO.f TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N2N° 20741Z Date -r( ........1...9 19.q Permission is hereby granted to: . N :s:..... c+~ lc........... . to ........~1 .d-.............. : at premises located at .;5Z LJ ° : f t.R...... County Tax Map No. 1000 Section .......1.1.0......... Block ;~t..]........ Lot No.....~.,, pursuant to application dated .A.A.-...J 19.1.1 -n-and approved by the Building Inspector. I Fee OLA- ....r4 ....Oing Inspector Rev. 6/30/80 i BUILDING DEPARTMENT 10PLICATION corm Nn. 6 TORN OP SOUTIIOLD TOWN HALL 765-1802 FOR CERTIFICATE OF OCCUPANCY A. 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 17 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. B. 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 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 Date Z/9192 New Construction..deCki.rig. Old Or Pre-existing Building. JD,istrict Location of Property,..55..WP'at.ft oad CutchogRe NY . House No. Street Hamlet Onwer or Owners of PropertyCutchogue-Clew Suffolk Park District Count Tax Ma No 1000, Section......,,: 110 7 13 Y P , .Block ................Lot...................... Subdivision......... Filed Mip............ Lot.. 207412 6/19/92 Lois Roslak " " " Permit NO ................Date Of Permit..........., Commissioner ....Applicant....... Health.Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval X Request for: Temporary Certificate........... Final'Certicate........... Fee Submitted: fee exempt d~? p . © APPLICANT Cd ~.a~'S ~ . INSPECTORS Victor Lessard Principal Building Inspector ©L d Curtis Horton SCOTT L. HARRIS, Supervisor Senior Building Inspector o e Thomas Fisher C' - : a Southold Town Hall P.O. Box 1179, 53095 Main Road Building Inspector Gar Fish Southold, New York 11971 Building Inspector TelepFax hone 516) 6657652 800 Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD alas 6, 1992 CUTCHOGUE-NEWSUFFOLK PARK DISTRICT C/O LOIS ROSLAK TRACK AVENUE CUTCHOGUE, NY 11935 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. XXX 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 # 20741-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 0 FOUNDATION (1st) c • I S TOUNDATION (2nd) I z ;OUCH FRAME & yo .PLUMBING 9 W 3. i -3 y m INSULATION PER N. Y. C-1 STATE ENERGY I CODE rill T y FINAL co ADDITIONAL COMMENTS: x M • x 1--1 • A O m i- y ^o H BOARD OF Ill Ii FORM NO.1 3 SETS OF PLANS j, z~9t~- b S 1~ TOWN OF SOUTHOLD SURVEY JuN'~( H BUILDING DEPARTMENT CIIE,CK i TOWN HALL SEPTIC PORN F1 f La~_ _ - s....r~ SOUTHOLD, N.Y. 11971 G t C =V' _ TEL.: 765-1802 t: OT I FY { T()VJ, I r F,,, A,., CALL Examined , , . 19 L NA I L TO: Approved . ~.9...., 197..-Permit No. ~ Q7 .7..~ . Disapprove a/c . . . i'/J......... . (Buildino ~spector) APPLICATION FOR BUILDING PERMIT Date .........CoI.C~ 19 f Y 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 :)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 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 :hall 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 hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessaryins ections. (Signa ure of applicant, e, if a corporation) `-'ma y . ex.... 3t l rig (MViling address o applicant) )late whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. L°.'s..~q X*. 0. . Fame of owner of premises t_ ?Y q . ? f lGt 4f^!e ..T• G~ Y~ . (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . Plumber's License No . Electrician's License No . . - Other Trade's License No . Location, of land on which proposed work will be done. , `c House Number Street Hamlet County Tax Map No. 1000 Section ....110........... Block 7........... Lot 1.,3.......... Subdivision Filed Nlap No. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: ar a. Existing use and occupancy k b. Intended use and occupancy t'7~ t 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition • • • • • • • • • • ~ .Other Work. 4. Estimated Cost Fee \,J, , (Description) ! (to be paid on filing this application) 5. If dwelling, number of dwellingiunits Number of dwelling units on each floor If garage, number of cars , , * * . 6. If business commercial or mixed occupancy, specify nature and extent of each type of use , 7. Dimensions of existing structures, if any: Front . • ' • ' ' ' ' ' ' ' ' • • ' Height • Rear Depth . Number of Stories . Dimensions of same structure with alterations or additions: Front Rear . Depth . Height . Munber of Stories . 8. Dimensions of entire new construction: Front . • ` ' ' ' • ' ' ' ' ' ' ' • • • ' ' ' Rear............... Depth Height • • Number of Stories . 9. Size of lot: Front Rear .......................Depth . 10. Date of Purchase Name of Former Owner • • • . • . • • • • 11. Zone or use district in which premises are situated . . ` • • • ` . • • • • ' • ' ' ' ' ' ' • • • • • ' 12' Does propose g 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 Name of Architect Phone No . Address . . Phone No. Name of Contractor . . Address . . Phone No. . 15. Is this property within 300 feet of a tidal wetland? *yes. *If yes, Southold Town Trustees Permit may be required. No........, 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. i i II LATE OF NE AUNTY OF .f / S/S (S- ..1...C.D.S / 11 being duly swornd (Name of individual signing'; contract) , eposes and says that he is the applicant ove named. is the : . (Contractor, agen corporate office etc.) said owner or owners, and is duly authorized to perform or have per ormed the said work and to make and file this - lication; 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. om to before me thi ~..dayof.. 191 tary Public, ee , County CLAIRE L CLEW o?-~~ . Notary Publle, State of NeMrNotk No.4879506 (Signature of applicant) Commin99Ion ExpIree Suffolk be;` 19 jjQT E+r~/~i<5 t STAiPTL'E 9Dy TG B4'~//57£µ /Ev LONfi J ~L!/ GEG~pE<v5 4 ~~~9~/E rf vT >~t ~ESjGP-E~ Te.- : ~r5.~, cG A PRR "CD 4.1 P40TED DATE. c FL. --51.-..- 765 2~rt.r ~.,rranen~~IT qT AM THE FO: r INSPL, 1. FL 1N JIRED FO;'n CONS i. ROL -9P,91NG ; .,i,WG P ~X/_Jr/Nl INSL,. -INAL -lRUCi; "COI. C.O. 'ON' , :9iiAL1 t'hT -CU" OF TPIL al y ')NS 1,L)CTION & ENES, Y • '9T RESPONSIBLE :.ONSTR(1CTION ERROR OCCUPANCY OR USE IS a9NL IWFIP v- - WITHOUT CER), ipa OF OCCUPAi.,.. y o _ Q 4a~ rolw, >V el • ~ N ELEI/ o ~S~ Uu Qb~M~ n III ~i~G.-i "'~-~~/%•r'/lr-_~~///,~~; 01 IVEdy ~ y1P PS H. iy ~q~ d O~k~ Py ~ Z¢ _ 0. 614 FEM~ SCALE: 7C f APPNOVED BY DRAWN BY DATE: Ld~~ DRAWING NUMBER r, l r f '~~Sa E ELEd. * 1.0 All i I i N I L'1 _ _ _T I{ i~ 4 I i lip' ~l ~7 14 -11 ?v v i ~PouvLSr~foc&" +_i I I II ii$ErAf~j r ~ I+r +-1 I - ,a iel, I tt71 W EpF tdElyd°. f:: ir ~~OFo3Sjp ' ri u a ° o s e "ate y ' ~/6" ~ I /6 ° mil/ ~j/i> •'l~G' ,G f - , e ? SCALE: //-S IJC,EL: APPROVED BY DMWN BV Lv DATE: ~ZK DRAWING NUMBED 1'16ID1lERIlf 1tAl~16 _ _ _ ofZ