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Home My WebLink About20282-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCDPANCY No Z-20522 Date FEBRUARY 6, 1992 THIS CERTIFIES that the building. Location of Property 1910 THE LONG WAY House No. County Tax Map No. 1000 Section 30 Subdivision ADDITION Block 2 Filed Map No. ~AST MARION~ N.Y. Street Hamlet Lot 128 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 15~ 1991 pursuant to which Building Permit No. 20282-Z dated NOVE~BER 18~ 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 ENCLOSE PATIO BETWEEN GARAGE & DWELLING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF2tLTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED WILLIAM A. SAUSMER N/~ N-221876 - JANUARY 27, 1992 Rev. 1/81 /~ /Building Inspector FORM NO. It TOWN OF SOUTHOLD BUILDIHG DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 20282 Z Date Permission is hereby ?ranted to: . ............ f~ ~.~..m.~_~.......~..'~.~ ............ at premises located at .../..~../...~.. ......... ~...~.~..~....~.~ ................................................ County Tax Map No. 1000 Section ..... ~.0 ......... Block ...... ~ .......... Lot No..../....~...~... ........ pursuant to oppllcation doted ..../'./..../.?....~.. ..................................... , 19.?~...., and approved by the Building Inspector. Fee $.~.~**~,/~... / Bui~ng Inspector Re~ 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~IALL 765-1802 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. 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. 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 Residential $15. 0, Commercial $15.00 5. Temporary Certificate of Occupancy - ~J/~15'~£/ D~te New Construction ........... Old Or Pre-existing Building ................. Location of Property ..... ................. :~.f. .................................. House No. Street~ Hamlet o~ o~ o~ of ~o~ty ......... ~'g~..~.. ~.~ ............................ 000, ..... ..... ..... Subdivision ................................... Filed Map ............ Lot ...................... Permit No...~O~..,Da~e Of Permit ........ ApplScant ................ l Requosr for: Tomporary CertSficate ........... FSnal CertScate...~....,, ~ee SubmS~ted: ~ ~ .......... ................... .............................. ~0 ~5~& ~PLICANT INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Buikli~g Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCO'IT 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 JANUARY 31, 1992 JOH1q C. BORN 1675 CEDAR BEACH ROAD SOUTHOLD, NY 11971 RE: NILLIAHA. SAUSHER & WF 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. The check is ~k~Tnot on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20282-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. CC: WILLIAM SAUSMER & WF THE NEW YORK BOARD OF FIRE UNDERWRITERS c. O0[(}~)~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT O~J~ t~e electrica~ equipment ~ ~scrlbed belo~ and ~ntrod~ced by t~ applicant ~med on the a~ve application n~mber ~n the prem~es of in thefollowlng loca¢ion~ ~ Base~nent ~ Ist ~3. ~ 2nd ~3. Section Bilk Lot ~sexatninedon '5~ A~,', U A~Y 1~992 andfoundtobelncornpllaticeu'iththereqaire.tents~ffthlsBoard. FIXTURE OUTLETS 2 SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST FAN! SYSTEMS N~. OF FEE1 OTHER APPARATUS: E R V I NO, OF CC COND PER ~' A w O NO OF HI.LEG OF CC COND, NO OF NEUTRALS A, WG O~ NEUTRAL ~ '-~ .( ~I~.,U"., HY, ) 19''r, GENERAL MANAGER Pt'r_ This cerfiflcote must not be a~tered in ony manner; return to the office of the Board if incorrect, inspectors may be identified by their credentials. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [~RAMING [ ] FINAL DATE /~-~ INSPECT / / FOUNDATION (1st) FOU~';D ATIO~ 2. (2nd) ROUGH FRAHE & -PLUMBING INSULATION PER N. STATE E~;ERGY CODE Fi;$AL ADDITIO~;~L COMME}~TS: ,p '~g Approv;d.Exanil]}i:i/'/'~J'/>d'°? ,; o!.,//;*'''"-'......,<h~ 7? o ....... 19~19~ ~'~TEL': 765-1802 · ~ff.~ ...... Permit No ........ Disapproved a/c ..................................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 APPLICATION FOR BUILDING PERMIT BOAKD OF HEALTH ../ ...... 3 SETS OF PLANS SURVEY CIIECK SEPTIC FORH .............. CALL ................... HAIL TO: Di]te .................. , , . . INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in 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 applio :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 Permi't 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 ~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. rim applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit author/zed inspectors on premises and in building for necessary inspectio]n~, _. . .... ..... ............... (Si,,nature~df applicant, or name, if a corporation) .. t.t (Mailing address of applicant) State whether applicant is owner, Iessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... b.~.,....Itl. ! .L;L.. ~ .6~.. '~.~ ~'.vltl.k~Ir~ ..................................... (a~ on the tc(x roll or latest deed) It' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... t. 19...'~.'~.q... Plumber's License No ........ ~ ................ Elcctncmn s L~cense No ....................... Other Trade's License No ...................... Location of land on which propoyed work will be don~-_,. ............ k~ ......................... ' ......... llouse Number .... fii/~; L' '7 .... h;~7/~/',;?'''~'; ................ , o · Connty Tax Map No. 1000 Section ' ? ~ ' Lot .... ~ ............ Block ................................ Subdivision ...... ~k~ ..... ~ ............. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed cohstruction: a. Existing use and occupancy ........ ~ ~J~ .......... z, , b. ~ntended use and occupancy ..... ~....~1~...T. ~/~&~S~ -~'; ~~ 3. Nature of work (check which ~pplicable): New Building .......... Addition .......... Alteration ......... Repair .............. Removal . .... Demolition .............. Other Work ... 4 Estimated Cost ~. (Description) 5 If dwelling number of dwellin~ units (to be paid on filing this application) ' ' .............. 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 7 Dimensionsofexistingstructures if any: FrOnt typeofuse Height Nuinb'er of Stories ............... Rear .............. Depth ............... Dimensions of same structure ~ith alterations or additions: Front Depth Rear ................. Height 8 Dimensions of entire new construction: Front .............. Number of Stor/es Height Number of Stories ............... Rear Depth 9. Size of lot: Front .......... i ............ Rear.. 10. Date of Purchase ! .............. Depth .................. .......................... Name of Former Owner ..... I I. Zone or use district in which pr'cruises are situated ..... ' ' · · · · 13. ,D,,.o,es, proposed construction vioilate any zoning law, ordinance or regulation: ........................... 1~% ~°; fb; ~ng;; doefdp ' ' k2dl excess fill be rem°veal from premises: Yes No · '', ....... tess .I.~ I ¢.&...~(,;. ~,t~.t,.~t~... p oneNo ...... Name of Architect ........... . ~ .e h ...... Address ..... p Name of Contractor o~d R- ,, · ....... hone No .... ............. 15. · . ~ ................ Address I.~.}..Y.T.. Is thzs property within ~00 feet of a tidal wetland? v~?~-,.~.~.~,,~hone No ......... . ....... · If yes, Southold ~own Trustees Permit may be required. "'. i PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate all set-back dimensions from property Hnes. Give street and block humber or description according to deed, and show street names and indicate whether interior or coruer lot. 765-i802 9 AM TO 4 PM FOR THE FOLLOWING ~SPECTIONS: 1. FOUNDATION . ~0 REQUIRED FOR POURED CONCRETE 2, ROUGH . FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. At.L CONSTRUCTION SHALL THE REQUIREMENTS OF THE N.E STATE CONSTRUL~ION & ENERGY CGDES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS TATE OF NE~-YOI~K,~ fl," (Name of individual s' ' ! ......... being duly sworn, deposes and says that he is the applicant Igmng contract) )ore named. 2 is the .................. * . . ' I ontractor, agent, corporate officer, etc ) said owner or owners, and is duly a~tborized to perform or have performed the said work ~nd to make and file this plication; that all statements containe.d 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 ' .......... 'day or tary Public, . .... County Notary Publlo. State of New Yo~ .............. ...~.~... No. 4879508 - QualifledlnSuffolg~ounty c~..7 ~.~.~ (Signature of applicant) ~omml~mlon E~lres December 8, 19.L.~