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Home My WebLink About19853-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall southold, N.Y. CERTIFICATE OF O~UPANCY No Z-24218 Date March 18, 1996 THIS CERTIFIES that the buildin~ Location of Property 700 TEEPEE TRAIL House No. County Tax Map No. 1000 Section 87 Subdivision ALTERATION SO~THOLD · N.Y. Street Hamlet Block 2 Lot 25 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 14, 1991 ~ursuant to which Building Permit No. 19853-Z dated MAY 14, 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 ALTER EXISTING CEILING IN FAMILY ROOM TO A VAULTED CEILING AS APPLIED FOR. The certificate is issued to cf the aforesaid building. ROBERT PUFAHL (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building InspectOr lvO~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA4IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 1985~ Z Permission is hereby granted to: .... .~..~.~......~T~......~ .~.....~ ............ ~...~....~a.. ............................... ...~.~ ................ ~,. .......... ..~...J. ............ ,o ...~.~..~.....~.~i12...~.~..,~.~......~~.~ ~'-'-'"~ ........... ~_.....~~...... ........ ~.....:~ ....... ~ ..... =......~...: ........................... at premises located at-" ~0 '/, ' '..~.~ ........... ~..~........~.~/~, ........................ County Tox Mop No. 1000 Section ..... ..~...~..~. ........ Block ..... .~...~.. ....... Lot No...;~.~'. ............. pursuant to application dated .............. ....~...~.../...~.. .............. , 19.~.l..., and approved by the Building Inspector. Fee $ ....................... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTM~ 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-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 i% lead. 5. Commercial build'lng, 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. B. For existing buildings (prior to April 9, 1957) ~on-conforming uses, or buildings and qpre-existing" land uses: i. 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 Buiidinm - $100.00 3. Copy of Certificate of Occupancy - $20~'OO 4. Updated Certificate of Occupancy - $50.00 5. ~Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building....~'... .... ~ .... Location of Property ............. C,,. ~.- ...... 1 .............. -"' .............................. House No. -- Street ~amlet Onwer or Owners of Property ................................................. .. . County T= .000, Seeti n...O. .7. .... . ...... ........... . . . Subdivision -~- .~..v}..~..07 k? .V~?.. ,~ J ..2...~. ................... .. . · ............ . , . . Filed Map .... Lot . . ~ . · Permit No ................ Date Of Permit ................ Applicant. ~.~..~. · ~ · ...'~--.. Underwriters Approval -- Health Dept Approval ..... Planning Board Approval g ..... Request for: Temporary Certificate ........... Final Certicate...~.. ...... Fee abmi ted: $ ...... .':%. .g':.? ?. .............. ............................................................................... TRANSMISSION RESULT REPORT ....................(MAR 22 '9S i~:~TPM) ................. i!~i? SOUTHOLD TOWN HALL 516 765 1823 ............................................................................................. ~!.~ ........................................................................... (AUTO) ..................... DATE START REMOTE TERMIHAL Tt~ RE- MODE TOT~~ PERSONAL LABEL FILE · IDENTIFICATION " SULTS PA~5 NO. 51G ?2? 3958 ~" OK ES 02 004 TIME MAR 22 12:2GPM E)ECM ))REDUCTION S)STAHDARD M)MEMORY D)DETAIL F)FIHE CONFIDENTIAL TRANSFER POLLI196 ~)BATCH Town Hall, 53095 Main Road P. O, Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD COVER LE~I~ER DATE: March 22, 1996 TO: Alan Smith, Atty Attn: Liz FROM Georgia - Southold Town Building Dept. RE: CO Z-24218-Z Robert Pufahl TOTAL NUMBER OF PAGES INCLUDING THIS ONE - 2 If all are not received, please contact the above at 765-1802. FOUND^TION ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. i i :ORAUMN IDNA~ION 2ND [ ][r ~~INA~ATION [ ] FI REPLACE & ~HIMN~/...~ ~ INSPECTO~~ FORM NO* 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .....,Iq 19~J.PermitNo ............ 7isapsr°ved a/° . . (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORH ................ NOTIFY~ MAIL.' INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or areas, and giving a detailed description of lhyout of property must be drawn on the diagram which is part of this appli- cation· e. 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 perrait shall 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 shall 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances or Regulations, for the construction of buildings, ad~ditions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature o~ hpplicant, or name, if a corporanon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... '~°'~' ' '~TY "' ' ' L nt tax roll or ,a~ de¥~/;~Jf4 j~ , .el ~ ~l~.~ Ifapplican~is a corporation, signature of duly authorized officer. O :, _.-~--~-~B,, ~,~,.2., -- · ........... r ...... ' '....... .--~ -- . - rPv''~'-- NOTIFY B[ILOING DEPARTMENT AT (Name and title of corporate officer) 765-1802 9 AM TO ~ PM FOR THE Plumber's License No Electrician's License No ............... ~ Other Trade's License No ............. I. Location of land on which proposed work will be done; tlouse Number FOLLOWING INSPECTIONS: 1. FOUNDATION ~PTVO REQUIRED. FOR POURED CONCRETE 2. ROUGH * FRAMING & PLUMBING 3. INSULATION 4~ FINAL CONSTRUCTION MUST BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF /HE N.Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR . DESIGN OR CONSTRuCTIoN ERRORS Hmnlet County Tax Map No. 1000Section .............. Block ....... · ...... Lot....'.~.. .... (Name) ........... Lot .......... '~ State existing ~' usc and occupancy of premises and intended usc and occupancy of proposed construction: A E isting nd cupancy Intended use and occupancy ........................ ~r~.)~D'~,5 ,M .................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alter.~tion .~., Repair ........ ~ ..... Rl~movaJ .............. Demohtlon .............. Swzmmxng pool. .............. Tennis Court ......... Aclcessory BuiLding .......... Fence ....... Other Work; ........... ... Fee 4 Estimated Cost ' ' (to be paid on filing this application} ' N mb fd Iii itso hr $. If dwelling, number ofdwalling units ............... u er o we ng un n eac oor ................. If garage number of cars .!. ......... .... '';'''''''' ' 6. If business, commercial or mixed ~ccupancy, specify natnre and extent of each type of use ...................... 7. Dimensions of existing structures, if any: Front.., ............ Rear ............... Depths..' .............. Dimensions, of.~.7...same structure xvitlt alterations, or additions: Front . .-J.~ ......... ~ ~i; 7 ~ :~ i:~:~ '' D~:pth ................. ~ Hmght ...................... Number of to s ..... Dimensions of ' ' ' Front Rear Depth 8. entire new construqtlon: ........ , ..................... · ............ Height .~..~,~ .......... ,Npmber of Stories .............. ; ...................... i~/. "t ........... 9. Size of lot: ~,ont lop. ...... Rear ...... ! ~ .... Depth of Purchase / .c,/~ .'~ ,, Name of Former Owner 10. Date .. .............................................. . .. . district in which premises situated 11. Zone or use are ................................................... 12. Does proposed construction viola[e any zoning law, ordinance or regulatmn: ....... ~ ....... 13. Will lot be regraded ..... /,~..O. .................. Wiil excess fill be remove_&[ fromm premises: . Yes .... 14. Nme of Owner of premises .... ~..~ .'~:-.Z~7. ~'~-~J~qk. Address . ?..°c?..~e~f~.q~..'.~'.°-e'~Phone No ................. Name of Architect ..................... , ...... Address ....... :, ............ Phone No. '-b;-',~-~ ' ~'4 'l ;"---' ' Name of Contractor .{k]~..C~t~..IJ~.?e~. · .~.~Address .q~-% .11,3: .t~...v-rv~.. ..... Phone No.. !?.~. ~.jL': 't''" 15.Is this property locat'ed within 300 feet of a tidal wetland.* *YES .... No... mlf yes, Southold Town iTrustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ~uildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block nhmber or description according to deed, and show stree{ names and indicate whether interior or comer lot. STATE OF NEW ~P, cI~-~ . 'S S COUNTY oF .... "'"~OA'~i~k~'-' ' I" i ' . .......... -e;,:?,,-? :. ,,?,, , .......... ,.,~mg,dul~ sxvom, oeposcs ~d says that he is the applicant (Name of i~divi,dual signling contract) ~ is tlm ~ ........................... . .; , .,,, ,, ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is du~y authorized to pezform or have performed the said work and to m~e and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work w~l be performed in the m~ner set forth in the application filed therewith. Sworn to before me this ........... .... ...... ' ~k~ ' (Signature 0, applic~t)