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HomeMy WebLinkAbout20746-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20922 Date AUGUST 7, 1992 THIS CERTIFIES that the building ~DDITIO~ Location of Property 5080 NEW SUFFOLK AVENUE NEW SUFFOLK~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section i10 Block 08 Lot 14 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 19, 1992 pursuant to which Building Permit No. 20746-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 DECK ADDITION & NEW DOOR OPENING TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GERALD & LAURA DONOGHUE (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A TOWN OF SOU33'JOI.D BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING pERMIT FI'HIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NgN? 20745Z Permission is hereby granted to: County Tax Mop No. 1000 Section ........ I:.~...O.. ........ Block ........ ..~...~. ...... Lot No...!...~.. ................ pursuant to application dated ....... ....~J~L~....L...~. ................ , 19.~..~, and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN mLL ~ 765-1802 * , ~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: 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. Subm%t 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 applicJtion 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 - $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 Date .. ~.Z/.~ ~ ~ /~x-- New Construction ........... Old ~r Pre-existing Building ...... %<. ......... / ~ · ~ House No. Street Hamlet O.wer or 0w ers of F operty ...... County Tax Map No 1000, Section. ........................ f/~- OO .Block.. ~ ~(P ..Lot .................... ~.~ ~ Subdivision ...................... ~ .............. Filed Map ............ Lot..~ ................... Permit No..'.~..~..~..~..~..~..Date Of Permit.~.nZfT. f~ .........................Applicant ...... 8ealth Dept. Approval ........................ -- Underwriters Approval ..... , ................... Planning Board Approval ........................ Request for: Fee Submitted: $..~..,.~..~.... Temporary Certificate ........... Final Certicate ........... 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 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 TOW/W OF SOUTHOLD AUGUST 3, 1992 GERALD & LAURA HONO~uuE BOX 151 WASHINGTON AVENUE JAMESPORT, NY 11947 PREMISES @ 5080 NE~ SUFFOLK AVE. NEW SUFFOLK, NY To Whom This May Concern: We are unable,to complete your Certificate of Occupancy because of the following reasons: Au 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 $ 20746-Z Please contact our office on this matter, cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. YIELD ?OUNDA~ION Ilst) ~OUNDATION ( 2nd ) ~,OUGH FRAME & .PLUMBING [NSULATIO~ PER N. STATE ENERGY CODE Fi;;AL , I ADDITIONA'L COMMENTS: \ 765-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING '[~AL ~ ~/~ ~r'~ RrMARKS: ~ ~ ~J ........ dlZ = '"-'L ''<'~ ~ FORM NO, 1 % TOWN OF SOUTHOLD BUILDING DEPARTMENT ' TOWN HALL SOUTHOLD, N,Y. 11971 TEL.' 765-1802 Examined. . )3.., 19~/..x- Approved...~.~..../.~. ,, 19 ~.~Permit No ~..0..~..~../~..~ Disapproved a/c ...... . ............................... · (Building Inspector) APPLICATION FOR BUILDING PERMIT · I INSTRUCTIONS BOARD OF HEALTII ......... 3 SETS OF PLA~;$ .......... SURVEY ................... CHECK 'a. This application must be completely filled in by typewriter orin ink and submitted to the Building Inspector, with 3 ;ets 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. ¢. 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 w6rk. 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 '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and reg lations, and to (Signature of applicant, or name, if~ corporation)/ ;rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ame of owner of premises /3r)r~ ~/~ - (as on the tax roll or latest deed) .%pplicant is a corporation, signature of duly auth~orized officer· (Name and title of corporate officer) Bu'lder's License No. .~0 C5>~5--~. '.~.././..~.. " Plumber's License No ......................... Electrician's License No. Other Trade's License No ...................... Location.of land on 71rich proposed work will be·done. ............. . ......... ~ .... ............... · ~ ........ ~.~~ .~ .Z~ .~ ......... ~ .............. House Num her Street Hamlet ~o,,~,~,~ M~,o. ,000 ~,o, ..././.~..: ...... ,,o~ ..Z ............. ~o,,. Z~ ............. Subdivision ............ .......................... Filed Map No ...... L (Name) ......... ot ............... State existing use and occupancy of pre~nises and in te3ded,use an~ occupancy of proposed construction: ......... ................ a., ......... ................................. ;.;.; k ( ppr ) 3. Nature of wot check which a mable: New Bui/ding .......... Addition .......... A/terafion ....... Repair ......... . ..... Rem'ovM ..... Demolition .... Other Work 4. Estimated Cost ........ ,. . . Fee . ............................... '; (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 mixe~t occupancy specify n .... ature and extent of each type of use 7 Dimensions of existing structurgs' if any: FrOnt De;th Height ............ '. ·. 'Rear .............. ............... Number of Stories ............... Dimensions of same structure wkh ........................................................ Depth ~ alterations or additions: Front ................. Rear ............... ........... Height Nmnber of Stories ' ' ' 8 Dimensions of entire new construction: ...................... · .'. · · Front Rear Dep't~l ............ Height . .. ............. Number of Stories 9. Size of lot. Front .......... i ........... e ................. 10. Date of Purchase ~:-~'~"~)/fi~_ -: ' ............. ~' ........................ ......... "" ........ ' ......... Name of Former Owner .... I 1. Zone or use district in which prelmises are.situated .... .' .................................. 12. Does proposed Construction violate any zoning law, ........... 13. Will lot be regraded ..... /f~/'. ~. or&nance or regulation: ........ .~.~.~. ............... .... · · ·. Will excess fill be removed from Ipremises: 14. ' ......... Yes No FATE OF NEW_YORK, . S 3UNTy OF .~.~.q~.. .~.O/ /~ S. . (Name of individual ore named. . Name of Owner of premises ... ~ ................. Address ........... Phone No ..... Name of Architect ..... , ~ ' m · :' ~- · . · · Name of Contractor ?c".~.' i/]~.' ' id~.~ ],.' ~":a;,~;.~/~V 9]~ress'' ~' '%~"~ff~ Phone No ....... · ~ ~-- -- '' .-; ' k,~k'LY'''~'~;/.~aaress ..6../~<~<.~q~..phnna~ 727- ' &z yes, ~outnoAd T?wn Trustees/Permit may be requi~gfi2 ..... no.~.~ .... PLOT DIAG--' ,b ild~gs, whether existing or proposed, and, indicate ~I set-back d~ensions from umber or deschp[ion accord~g to deed, and show street nines and indicate whether being duly sworn, deposes and says that lie is the applicant (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly al thorizcd to perform or have performed the said work and to make and file this ~lication; that all statements containe, 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 this - ....... ...... s .r I, ........ , . ' Locate clearly and distinctly all property lines. Give street and block interior or corner lot.