HomeMy WebLinkAbout20270-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPD-RTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-20649 Date APRIL 15r ]992~
THIS CERTIFIES that the buildin~
Location of Property 46925 MAIN ROAD House No.
County T~xMap No, 1000 Section 63 Block 6
subdivision Filed Map No.
ADDITION TO ACCESSORY
SOUTHOLD, NEW YORK
Street Hamlet
Lot
Lot No.
2
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 6~ 1991 pursuant to which
Building Permit No. 20270-Z dated NOVEMBER 12, 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 EXTERIOR ADDITION OF STAIRS WITH LANDING TO EXISTING
NON-HABITABLE ACCESSORY GARAGE AS APPLIED FOR.
The certificate is issued to MIlL KORT~ & ELLEIq WIENER
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Rev. 1/81
· // Building Inspector
FOR.~ NO. 0
TOWN OF SOU'DIOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Ne 20270 Z
County Tax Map No. 1000 Section ....... .~...~ ........ Block ..... ..~..:..~.. ........ Lot No ...... 4~.....~...
pursuant to application dated ...../,~ ........................................ , 19.c~../.., and approved by the
Building Inspector.
Fee $,,.~....~.... Z .x~.
Rev. 6/30/80
~q /I ', .... No, 6
= V ,-[ Form
APR I1992 ;}!
TOWN OF SOUTIIOLD
BUILDING DEPARTMENT
TOWN ~ALL
765-1802
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 unnsual 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:
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.
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.O0
Date A~ril 14, ~ ..................
New Construction ........... Old Or Pre-existing Building.ggg .............
Location of ~ .... r~, 46925 Main Road Soughold
House No. Street Hamlet
Micheal Kortchmar & Ellen Wien
Onwer or Owners of _~vv~ ~ ...................................... ~.~?~t,, .. ................... ... .
County Tax Map No 1000 Section P~ ' Siock O~QO Lot PqZvP~q
Subdivision .................................... Filed Map ......... ... Lot .................... . .
Permit No.~a279.%~ ..... Date Of Permit.~.q~YPJ. A~licant Dwayne H. E~rl¥
Health Dept Approval .... Underwriters Approval
Planning Board Approval %UiLL . ..
Request for: Temporary Certificate ........... Final Certicate...gN~ ....
Fee Submitted: $ ~,00 ...... /2 ~
q 3
INSPECTORS
Victor Lessard
Principal Building Inspector
Curtis Horton
Senior Building Inspector
Thomas Fisher
Building Inspector
Gary Fish
Building Inspector
Vincent R. Wieezorek
Ordinance inspector
Robert Fisher
Assistant Fire Inspector
Telephone (516) 765-1802
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
MARCH 20, 1992
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
DWAYNE H. EARLY
310 THIRD STREET
GREENPORT, NY 11944
RE: MICHAEL KORTCHMAR
& ELLEN WIENER
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.
(Ai'i permits involving plumbing being
issued after April 1, 1984).
.'20270-Z
BUILDING PERMIT
Please contact ouT office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
CC: MICHAEL KORTCHFL~R & ELLEN WIENER
FOU~;DA TION ( 1 s t )
FOU:~DATIO~'; (2nd)
ROUGH FRAME &
.PLUMBING
I~;SULATION FER N.
STATE ENERGY
CODE
Fi;;AL
ADDITIONA~L COMMENTS:
I H1L _.. ,,
' u, ~ 81991
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.. 11971
TEL.: 765-18'02
Exa fired///~2~ ,
Disapproved a/c f ......................................
. (Bui~ing In~ctor)
APPLICATION FOR~BUiLDiNG PERMIT
BOARD OF HEALTIt .........
3 SETS OF PLANS ..........
SURVEY, ... ~ ...............
CIIECK . . ~ .................
SEPTIC FORH ..............
C^L'.. Y22:Y0.~.7 .........
FLAIL TO:
INsTRu,6TIONS
a. Tj~is application must be completely filled in bp typewriter or in ink and submitted to the Building Inspector, with 3
.ets of plans, accurcte 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 givkng 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
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
ha{l bare been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
iuilding Zone O.rdinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinancei or
<egulations. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
7b¢ applicant agrees to comply with ali applicable laws ordinances, building code, housing code, and regulations, and to
· dmit authorized inspectors on premises and in building for necessary ~sl~itions
' (Signature ~!t_applicant, or n,3.me, if a c~porationj
· ' (Mailino address of applicant7 ~"''
5rate. beth.e; ~pHca~nt is owner, lessee, agent, architect, engineer, generaI contractor, electrician, plumber or builder.
· ................................... ,....,. -,
' ' .................. ....................
(as on the t~ roll orlatest deed)
if applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No.. 1 ~/..~.~./..'~.~./ ....
Plumber s L~cense No ........ ~. ................
Electrician's License No.
Olber Trade's License No.
· Location of land on which propos_ejj work will be done ..........................
t2...o'7.. '.,, Fd .X'. ,,dL,/. i!.. ' ..................
Ilouse Number Street · Hamlqt
County Tax Map No. 1000 Section .............. Block ........ Lot.. .'.. ..
S bdi ii Fil dM pNo L
u v '; OI1 ..................................... e a . '" ot ...............
(Name)
· State existing use and occupancy of premises and intended use and occupa?y of proposed construction:
b. Intended use and occupancy '" ' '
property lines. Give street and block
interior or corner lot.
3. Nature of work (chec~which applicable). New Build ng ' Add tie- ~ .
Repair .............. Remo al ~,''' ',]: .... -. .......... Alteration .........
v .............. oemontlon .............. Other Wo'rk..'.:f] .....
4. Estimated Cost'..~..g. .... ..~ ~ (Description)
lit ........................... Fee .....
(to be paid on filing this application)
$. If dwelling, nu'mber of dwelling units ....... ~ Number of dwelling units on each floor ................
· Ifgarage, numberofcars .... '. /. ........... . ..........
6. If business, commercial ormixdd occupancy, spec fy nature nd ex ~-- ' " '
7. D~mensions el existin, s*,,,,-*-,'~ ;r _ . -, ..., rea~ tent ofeach types>fuse . .,. .
height . .~.~,.. x,u ...... ~ ........... ,~ear .',~..-q-". ~.'X... Denth
Lmnenslons of Same structure. ,~ith alterations or additions: Front 1,3~.'~ .~.. i ....... Relr . . ~ .7..,..~..
Dept I .~...~.' .....
~.. '." . .............. height .... ~---..'~.
8. L-mensmns ote~jre new constructlnn ~-~-* ~'-'; .............. cqumuer_.of Stories...~."~'..
He ght '/J.: "'u-- .... ' ......... Rear ~ .... De-th
9. alze of lot: Front .~..~.1~.. .. - ,c ' .... ';~'~ ...........
Date "" · '..~_.a,.. .}.,..~ ..... ..; Kear ~r~. ' ..... -:.,;'-'~,~ .............
10. o~ t'urchase *~'~l~'..~l ~,Je~']' ''~; .............. Depth ~.~.
1 1. Zone or use &strict in wld~;~ -r~.,-'~,-o ., . . · .,~mame,,~of Former Owner .........
12. D°es pr°p°sed construction violate any zoning law, or% ~o'r're*,u ' ·
13. Willlot bare=reded /~/~ : o lation: ..~.IP '''
14. - .......... Wall excess fill be removed from premise's; .... ~'s
Name of Owner of premises ...-'.5'.,
Name of Architect . ,. ............... Address ................... Phone No ................
........ l ............... Address ....... Phone No .........
Name of Contractor .~, ~'r.~/~ ~'+~...,... ...... .. Address .~l'/l~. ~ ~.'~'~'~,'~/i' Phone No~
15. Is this property within ¢00 feet or a tidal wetland? *v~ i~'$r'~' ; e -.a.~.¢.' .....
· If yes, Southold Town Trustees Permit may be required.
... PLOT DIAGRAM
Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from
umber or descr/ption according to deed, and ihow street names and indicate whet~er
OUXVXOF ..... ,. J.&..
......
(Name oe individual signing ~contrac~ ......
~ove ~ain ed.
being duly sworn, deposes and says that he is the applicant
o ffi ) ................. ......
nt, corporate car, etc.
said OWner or owners, and is duly tltl Onzed to perform or have performed tile saki Xvork 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 sotI forth in the application filed therewith.
'om to before me thi,~
CLAIRE L GLEW · { ·
Not~rv Publio, Stere of New Ymk .....
NO. 4879506 ~ ...... · · ·
c, ommlaaion Expire$ De~ember
oc_
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