HomeMy WebLinkAbout19993-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22094 Date JANUARY 11, 19.93
THIS CERTIFIES that the building GARAGE
Location of Property 242 SUMMIT RD. SOUTHOLD N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 78 Block 9 Lot 31.3
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 25, 1991 pursuant to which
Building Permit No. 19993-Z dated JULY 1, 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 TWO CAR GARAGE AS APPLIED FOR
The certificate is issued to EDWARD & PAMELA MICHAELS
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE'N0. PENDING - JANUARY 7 1993
PLUMBERS CERTIFICATION DATED N/A
i..dinq Inspector
Rev. 1/81
rows xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLETION OF THE WORK AUTHORIZED)
N ~ 19 9 9 ~ Z Date ~ 19.9.C..
Permission is hereby granted to: ,
i~~~....~.........
ro .........4s.......~..Q:.~t.,.~~.1.YQ4.~.~R,......~...~~5~....
at premises located at .~~..~.~....~~ru'...K:!'n'~......(~..~.~
County Tox Map No. 1000 Section...~~~..]]]..~~..g........ Block .....0.~........ Lot No...s~:t.:.~..........
pursuant to application dated ~{..~Y!11C..... Z 199...., and approved by the
Building Inspector. I
Fee $.~~.g.:.~....
.......~.5~
Inspector
Rev. 6/30/80
~ Form No. 6
• TOWN OF SOUTHOLD
BUILDING DEPARTMENT
, TOWN HALL
765-1802
APPLICATION 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-4 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.
3. 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
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 Euilding - $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 $15Q~.0~0~jCommercial $15.00
Date Y~, , Z
: .
~w Construction....~..-.7, ppOld Or Pre-existing //B~~uQQilding... (p • • ,
cation of Property:....7.0.~~ LV.'1, 1!/,e-c;1, /~C~~"~ • • . • • . '
House No.~_~ ~S~tr~e~et` .Hamlet
ewer or Owners of Property...~""„"„~•~`~~~';!"?~;~•,~,CL.q.... ~ ~~/~;L~~ _
aunty Tax Map No 1000, Section....~~......Block......(. .......,Lot...~`,~,,;~;',~•~.,
bdivision/.C/.qe/ .Filed Map..........~Lo~,t~,~ ~ ~ .
rmlt No. A. (,/,~,,,,,,,Date•Of Permit.,(/,/,!~,,,,,,,,Applicant..`;;;"„~~..D~
alth Dept, Approval.....~./L :T ................Underwriters Approval.........................
anning Board Approval..!K.~ /
quest for: Temporary Certificate........... Final Certicate.........., '
,
:Submitted: $,,,,~;,i~;,, ,
t~ ~ ( /9 •
1.~37`I APPLhCANT~..........
eo ~aao9y. •
INSPECTORS
Victor Lessard ' ~VFFO(~-
Principal Building Inspector p~~ ~p
Curtis Horton ;,=;µr SCOTT L. HARRIS, Supervisor
Senior Building Inspector o . •
va Southold Town Hall
Thomas Fisher c T
~fy P.O. Box 1179, 53095 Main Road
Building Inspector O " ~ ~ ~;N
Gary Fish ~9~ ;~'J~ Southold, New York 11971
1 '?i r' Fax (516) 765-1823
Building Inspector Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
OCTOBER 7, 1992
EDWARD 6 PAMELA MICBAELIS
7815 BAYVIEW ROAD
SOUTHOLD, NY 11971
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
An application for Certificate of Occupancy is
not on file. (Enclosed)
xR% No Underwriters Certificate on file.
The check is (outdated/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 # 19993-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
r1cLD I):S:'EC:iU:J ~~U6.c I i;Oh1MGNT°
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P,000H FRAME &
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IIJSULATIOAI PER N. Y. ~ y
STATE ENERGY '
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ADDITIOPIAL COMMENTS: ~
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PLANNING BOARD MEMBERS ~ Y' ~ „~:u~' ~ ~ SCOTT L. HARRIS
Bennett Orlowski, Jr., Chairman t ~D'~ t ~ I a"'-^ ~ r-~ j1 _ _ Supervisor
George Ritchie Latham, Jr. X99 ~"ut Town Halt, 53095 Main Road
Richard G. Ward a ~:a~ t
Mark S. McDonald P.O. Box 1179
Kenneth L. Edwards Southold, New York 11971
PLANNING BOARD OFFICE
Telephone (516) 765-1938 TOWN OF SOUTHOLD Fax (5 lb) 765-1823
June 19, 1991
Gilbert Michaelis
Summit Road
Southold, NY 11971
RE: Property owned by
Gilbert Michaelis
SCTM# 1000-78-31.2
Dear Mr. Michaelis:
The Planning Board has reviewed your inquiry as to whether
Planning Board action is required for you to transfer Lot 29A of
the map of "Bayside Terrace" to the owner of the adjacent parcel
to the south.
The Bayside Terrace subdivision is excepted from the lot
area and width requirements of the Town's Zoning Code.
Lots 29A and 29 were inadvertently merged by the Town on
April 16, 1984, and should have remained single and separate.
No Planning Board action is required. However, you should
have two new deeds and surveys filed in the County Clerk's
office to reflect the new property boundaries. The Building
Department will not issue any building permits or revised
Certificate of Occupancies until it receives copies of the filed
deeds.
If you have any questions, or require further assistance,
please contact this office.
Very truly yours,
Bennett Orlowski, Jr.
Chairman
cc: Victor Lessard, Principal Building Inspector ?
Robert Scott, Tax Assessors Office
~~~j
765-1802
BUILDING DEPT.
NSPECTION
[ FOUNDATION i5T [ ] ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[)FRAMING [)FINAL
REMARKS: ~
DATE INSPECTOR ~~i~~
- ~ 60ARU OF HE,\LTII ,
,(~y~ ~(~~\a~,l~,,~;s FORM NO.1 J SETS OFiP
(_.A :IS -
- ~i i~j TOWN OFSOUTHOLD SURVEY
' ~BUILDINGDEPAfiTM[NT Cilr.ch _ _
TOWN HALL SEPTIC I'OR:!
„
%.?d~ ' SOUTHOLD, N. Y. 11~J71 _ _ . ~ • ~ • ~ ~ ~ -
~c i~ - ~ TEL.: 7651£302 OT I F't ; j Q
t X43, 1,.')I,t i CALL 7JF:~-~.~C~~........
`t_ r1ntL ro:
pProved ~ 19 Pcrmrt No. .
m.
isapprovcd a/c D .
(I3ut i~ g Inspector) pp,
APPLICATION FOR BUILDING PERMIT UTMOLD
' 1
Date 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
s of plans, accurate plot plan to scale. Fee according to sc}tedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
i.~n.
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
1" be kept on the premises available for inspection throughout the work.
e. A'o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
Il 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
(ding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
;ulations, for the construction of bindings, additions or alterations, or for removal or demolition, as herein described.
applicant agrees, to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
lit authorized inspectors on premises and in building for necessary i pections.
(Signature of app leant, or name, if a corporation)
7s 6AY... -.sa J1'.~ ~ l,p
(nlai]ing address of applicant)
to whether applicant is owner lessee, agent architect, engineer, general contractor, electrician, plumber or builder.
.........Q. V1/N ~.I~
. f _ t
neofownerofpremises ..~.1. `r.!-:~~~ ~ ~ lC.~~:~t ~ ~k°.~...'".~.! :I~ Q ~4./t*~L° ~~(~.pTi~~~.ds6
(as on the tart roll or latest deed)
rplicant is a corporation, signature of duly authorized officer. '
(Name and title of corporate officer)
f
f
Builder's License No. , tJ~-7(7,
~
Plumber's License No . .
Electrician's License No, , , , , , , , , , , , , , , ,
Otltcr Trade's License No . . .
ocation of land on which proposed work will be done. ~ ~ L/ 1' I I `1 ~ • p,• • • • •
ouse Number
•-~Street Itamlct
ounty Tax b[ap No. 1000 Section Block
_ Lot .
ibdivision ~ I ~ ~~~.h~.?`1 e~ Filad Map No. / O 2, %
(Namc) Lot
ate existing use and occupancy of premises and intended use and occupancy of proposed construction;
Existing use and occupancy
•-i~~.~ f its
ded use and occu . ~ t. Gs [ • ~ u ~ ~~tti°.,,..... .
Pancy
. ;
3. Nature of work (check which appjicablc). New Building ~ > , , , r
Rcpt A Idrtion ,!Iteration .
move
al . Demolition .
.OtherlVork
~0~3.
4. Estimated Cost ~3~3'~ (Descnption)
eu, Fcc. "
5. If dwcllim• I (to be Paid on 81ing this application)
number of dwellin^ nits Number of dwelling units on each floor .
If garage, number of cars .
.
6, If business, commercial or mixed gecupancy, specify nature and extent of each type o6 use .
7, Dimensions of existing structures, if any: Front , , , , , , , Rear ~ ~ • • • • • • • • ' '
Hei;;ltt .Numb Depth .
of Stories ,
Dimensionsof~saht•.$~...
~;.,~1,.~~a; ~f~rahonsoradditions:Front Rear
r
Heinht . , ergltt Number of Stozics .
~ ,i i t tioq:' Front Rear , . .
4.. ......Depth
unensions~ ntire_ ttet ons rc~r off; Stones i , .
9. Size of lot: nt Retir . .
0. Date of Pur f19si~~.;.;.: . . ,n.' :r:~~Y,', , Depth .
l . Zone or use distrtt~tr _ ~s' ~~1t~~,~ • • • • • • • • ' ' ' ' ' ' • • Name of Former Owner .
.I7i i~ ` s arc situated .
Does propose construction violato, any zoning law, ordinance or regulation: ~ ~ • • ~ • • • • • •
3. 1Vill lot be regraded , , , , , , ,Will excess till be removed from premises: Yes No
Address...................Phone No,
Name of Architect
anteo prorert1ewits•••••••••••••~•"'•.Address.......• PftoneNo.
NantcofContractor........
i. Is thisIf es, Southold Tow0' Address . . Phone No........ ,
' ifeeC of a tidal wetland? ~
t, y n 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
roperty lines. Give street and block nugiber or description according to deed, and show street names and indicate whether
uerior or corner lot. i
I
.
r
V
i .
N
i
ATE OF NGN YORK,
JNTY OF S.S
• • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(N:unc of individual signing contract)
named. '
;the
(Con tractor, agent, corporate officer, etc.) ~ • • ~ • • ' • ' • ' ' ' ' ' ' ' ' '
nd owner or owners, and is duly authprizcd to perform or have perforntcd the said work and to make and file this
cation; that all statements contained ir1 this application arc true to the (Zest of his knowledge and belief; and that the
will be performed in the manner set fo~fth in the application filed thcrcwi(h,
n to bcforo me this
...........a?Q . .day of i 19 ~l
Public, 1./:.. ~:~f'~.... County ~
NEtEN K DE YCE
• NCCIIRY PUBLIC, State M NewWik ~~G~~.":::
k°.. l~, , .
Tenn•ExaresMarchro301,1~~ • • (Signature of applicant) ,
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