HomeMy WebLinkAbout20268-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20954
Date AUGUST 19~ 1992
THIS CERTIFIES that the buildin~ REPAIR
Location of Property 990 BEEBE DRIVE House No.
County Tax Map No. 1000 Section 97 Block 7
subdivision Filed Map No.
CUTCHOGUE,
Stree.t Hamlet
Lot 9
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 8, 1991 pursuant to which
Building Permit No. 20268-Z dated NOVEMBER 8, 1991
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 REPAIR ~ON-HABITABLE STORAGE BUILDING CAUSED BY FIRE DAMAGE
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
CHARLES S. & ALICE G. LEVIEN
N-221153 - JANUARY 20~ 1992
Rev. 1/81
· 'OR.H [qO. 0
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)
N_O 20268 Z
Permission is hereby granted to:
~.,~ ~~ ,,.,.. ; .~ ..... ~.~.-..
---,-, TF":'"TZt' .,.--. ............ .].
.......................................................................................
o,,remises Io¢ot~ ot ..... ~.~...O......~..~.r.. ........... ~..~__.. .......................
Co,~n~, 'ro,~ M,,p No. ~000 Section ....... m..~.-'l ........ B~ ...... ..~...'1 ........ Lot No.~e~.....~..~...
,u,~,,,nt to op~,,'o,on dot~a .... tO....~.....b~. ...... ..~. ............ , ~.~..I.., on,~ o,,~o,,ea by ,,.
Building Inspector.
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OP 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 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:
i. 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 - $100.0'0
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 ......~.~ ........... .... .... .... ......... ·
Locatioa of prope '
~ House No. Street Hamlet
Onwer or Owners of Property. .~ ' '~ .... C ...........................
000, ..... ..... ............... ii
Subdivision... '~- .Filed Map .... Lot ...............
Permit No ............... oate Of Permit ...... Applicant. k .....
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
(peP
Fee Submitted: $ ..... .~...~..: .................
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Padlding 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
AUGUST 12, 1992
BURGER CONSTRUCTION, liNC.
2515 PINETREE ROAD
CUTCHOGUE, NY 11935
ALICE LEVlEN
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 g~--~a~3~-_~not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued~ after April 1, 1984).
BUILDING PERMIT ~ 20268-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
CC: ALICE LEVIEN
THE NEW YORK BOARD OF FIRE UNDERWRITERS
: )0 ~1 i"t BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, NEW YORK JOO3B
Date ~ ~,~L~ ~ ~ ~ ( ~ , ~ 9' ~ ~ Applicatio~ No. on Jile
THIS C~RTIFIES THAT
only the electrical equipment ~ ~scrlbed be~w and inrroduc~ by t~ applicant ~med on the above application number in the premises
in the follow~ng locatlon; ~ Basement ~ I st FI. ~ 2nd FI, O[jr{~ S~tion Bl~k Lot
wasexamlnedott ,) ~i~}~]~ ~t ~ ~,/t '~ ~79~ attdfoundtobeincomplianceu.iththereqttirementsofthlsBoard,
DRYERS
IULTI-OUTLET
SYSTEMS
NO. OF FEET
COND
PER ~'
NO OF HI-LEG OF HI-LEO
OOFNEUTRA[$ A,W,G.
OF NEUTRAL
h)ITVt~O'.JL. NV,. 1. i971
GENERAL MANAGER
, This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may'be/identified by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
FOUNDATION {lstl
FOUNDATION ( 2nd )
2.
ROUGH FRAME &
-PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST l- ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS:
DATE
INSPECTOR~
3. Nature of work (checlg, which applicable): New Building .......... .~..ddition .......... Alteration ....
Repair Removal .............. Demolition ........... Other Work ...... ...
4. Estimated Cost .}.. i~]O.r.QO.~' .~C90 (Description)
.......................... Fee ...............
(to be paid on filing this application)
5. If dwelling, number of dwelling units ...'..r_p~.. ........ Number of dwelling units on each floor ......
6.' If garage, number of cars .......... . ' ' ' ' ' '~ ' 'i ' '
If business, commercial or mixed occupancy, specify nature and extent of each type of use .................
7. Dimensions o~1[~2~41ng structnres if any' Front
He ght . ' ' . ............ Rear .L( .57 De
........... Number ofStones. ~./..~..~.. (4ff ~.zcc~c~lt ........ pth ..C~ ...........
Dimensions of same structure with alterations or additions:Front ................. Rear .........
Depth ... &2 ~ · tteight ............
................... Number of StoNes .....................
8. Dimensions of entire new constn etlon: Front . . ',7 ........... ~oea~j .......... Depth .......... '
Height ............... Number of Stories ....... ~,.( .....
9. Size of lot: Front .. . I~X~>~.. P' Rear ' · Depth
I0. Dateofeurchase ............................. Nameof~t~onnerO(vner D'~ ~.'-.~.~ ...............
I 1. Zone or use district in ~vhich premises are situated (~/~.-%. / O ...........
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 O~vner of premises . 5..Or'T,/~ .......... Address ................... Phone No '~. Sq. 7.~..c/..~..~...
Name of Architect ............................ Address ...... ; · · · Phone No
Name of Contractor .~...(,~..~. C~9a ..... Address '7,.,~51SOv.' .~.' _~_'~'' ~_)' Phone No'
15. tidal wetland?' '*¢'e'~' '~ .... i; ...........
~I$ this property within 300 feet
· If yes, Southold Town 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 descNption according to deed, and show street names and indicate whether
interior or coruer lot.
05 OCCUPANCY
FATE OF'NEW ~K,
.......... c.
(Name oFindiv~ual signing co~ac0 '~ :~' '
'ore named.
NOTIFY BLHt.OING OEPAg'FMENT
765-1802 9 A~e! TO 4 PM FOR THE
FOLLOWING INSPECTIONS
1. FOUNDATION TWO REQUIilED
FOR POURED CONC[{ETE
2. ROUGH - FRAMING & PLUMBING
3, INSULATION
4., FINAL CONSTRUCTION MUST
BE COMPLETE FOR C,O
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES, N~ RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
being duly sworn, deposes and says that he is the applicant
~'~ ( ntr)c(t~r~int corporate officer, etc.) ...............
sa~d owner or owners, ,md Is dh4.g.g~honz~form or have performed the said work ~nd to m~e 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.
om to before me this
.................... . .....
,
FORM NO, I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .......................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTII
3 SETS OF PLANS
SURVEY
CIIECK
SEPTIC FOg}l
CALL
NAIL TO:
INSTRUCTIONS
letely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
e. Fee according to schcdule.
· , a. Tiffs application must be comt
.ets of plans, accurgte plot plan to sca
,~b.. Plot plan showing location of !lot and of buildings on premises, relationship to adjoining premises or public streets
areas, and giving a detailed descrip!ion of layout of property must be drawn on the diagram which is part of this appli-
:ation.
c. The work covered by th.is appli!cat{on may not be cbmmenced before issuance of Building Permit.
d. Upon approval of this applicat{on, 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 Occupan;y
hall have been granted by the Buildin~ Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
iuilding Zone Ordinance of the Tow~ of Southold, Suffo k County, New York, and other a lJcable Laws, OrdNances or
(egulations, for the construction of uildings, add tions or alterati ns PP
t? o , or for removal or demolition, as herein described.
Fhe applicant agrees to comply with ~li applicable laws, ordinances, building code, housing code, and regulations, and
.dmit authorized inspectors on premis? and in building for necessary inspeckions. ( .to
(Signature of applicant, or name, if a corporation)
State whether appIicant is owner, les[ee,0ge~nt, architect, en~jj;lger, general contractor, electrician, plumber or builder
(as on the t,ax roll or latest deed)
;f applicant Js a corporation, signature of duly authorized officer,
(Name and title of corporatd officer)
Builder's License No. [ IM?.~.
P1 tuber s License No ........ :. ...............
Electrician's License No ......................
Other Trade's License No ....... , ...............
Location of laud on which proposec
Ilouse Number '
work will be done
t .¢.0.. ................... .o..3..u..e_. ..........
Street Hamle, t
County Tax Map No. I000 Section ............... Block ................ Lot ............/-"~ ~
~.,5 . .C-~..'~ .e.
SubdMsion .~O0 ~ .. Filed Map No..~Z~Q. Lot .... '~.~ ......
'" (Nmm) ' :'" '"'
State existing use and occupa~cy of ?remise~and intended use and occupancy of proposed constrfiction:
=. occ. = y .... vee
b Iht d d ndo upancy '