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Home My WebLink About19507-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~-RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19649 Date JANUARY 10~ 1991 THIS CERTIFIES that the building Location of Property 760 House No. County Tax Map No. 1000 Section Subdivision WOOD STOVE ORCHARD LANE EAST MARION Street Hamlet 31 Block 06 Lot 22 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 1, 1990 pursuant to which Building Permit No. I9507Z dated NOV. 8, 1990 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 WOOD STOVE IN EXISTING ONE FAMILY DWELLING. The certificate is issued to SHARON & DOUGLAS ROGERS (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 4~uilding Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 19507 Z . , ....... at pr 's s ~at~ at ...... ~ ............. ~~;.~ ...................................................... Coun~ Tax Map No. I000 Section ...... ~ ........ Bilk ..... ;~ ........... Lot No..~...~ ......... pu~uant to application dat~ ...... ~ ..................................... , 19~., and approv~ by ~e Building Insp~tor. Fee $~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTtlOLD BUILDING DEPARTMENT TOWN HALL 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. 2. 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.O0 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 .... .~..C~%..~.~.~.~.~.~.~ .............. :ew Construction ........... Old Or Pre-existing Building .... ~ocation of Property...]. House No. Street Hamlet )nwer or Owners of Froper .......................... k~' ............................. :ounty Tax Map No 1000, Section... ;ubdivision ..................... Filed Map Lot 'ermit No ........ Date Of Permit ................ Applicant. · [ealth Dept. Approval ......................... · Underwriters Approval ......................... lanning Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate ........... co zt¢ yf · ' · .... . ...................... TOWN OF SOUTtlOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 DECEMBER 18, 1990 TEL. 765-1802 RE: BPI950?Z bp17253Z 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 /5/ -No Underwriters Certificate on file. The check is(Q~x~a~d~xnot on file.)$25 for each permi~ /~/ No Health Dept. Approval on file. /5/ No final inspection has'been made. Please contact our office on Thank you for your cooperation. 19507Z Building Permit Jl ~7253~- Z DOgGLAS & Building Dept. ***/5/ No Plumber Solder Certificate on file. ~ ( all permits involving plumbing being issued after April 1,1984 ) this matter. SHARON ROGE~ 'OU~__~DA~ION ( ~ st) OU~4DATIO,'I (2nd) OUGH FRAME & .PLUMBING IlSULATIO}! PER N. Y. STATE ENERGY CODE Fi;;AL ADDITIO~;~L COMME~;TS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS~TION FRAMING [ ,-]"FINAL OCCUPANCY OR USE IS UNLAWFUL W)THOUT CERTIFICATE OF OCCUPANCY E':o..oo_x.~. ~ :,o',-\~,': ',Jo..,:~nmq:l-8½{:, NOTIFy 8UJL'~JJNG DEPAF~ENT AT Y65.-t8027 ~ AM TO ~ PM FOR THE FOLLOWING INSPECTIONS: I, FOUNDATION ~O REQUIRED FO¢~ POU~ED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL CONSTRUCTION MU~T BE COMPLETE FOR C.O, ALL CONSTRUCTION ~HALL ME~ TH~ REQUIREM~NT~ OF THE N.~ ~TATE CON~TRU~ON & ENERGY CODES. N~ RE~PON~IB~ FOR DESIGN OR CffiSTRU¢ION ERROR~ Examined .......... , 19.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ............... BOARD OF HEALTH ... ......... 3 SETS OF PLANS . ..' .~. ...... SURVEY ........ ; ............ CHECK ...................... SEPTIC FORH ................ INSTRUCTIONS a. This applicahon must be completely filled in by typewriter orin ink and submitted to the Building li~spector, with ::: of plans, accurate plot plan tO"scale. Fee according to schedule. b. Plot plan showing location of lot nnd of buildings on premises, relationship to adjoining premises or public streets r 2teas, and giving a detailed description of layout of property must be drawn on the diagram which is par~ of this appl/- c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,/he Building Inspector will issued a Building Permit to the applicant. Such permit -:2 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 :4 ::ave been granted by the Building Inspector. ' \i'PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the · ;.::ag Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or · '..-'boas. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ' ..:'?!icant agrees to comply with all applicable laws, ordinances, building code, housing ::: authorized inspectors on premises and in building for necessary inspections, code, and regulations, and to (S ant, or n (Mailing address of ~pplicant) · :;ether applicant is o~vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. q3 (as on the tax roll or latest d~c:~) :ant is a corporation, signature of duly authorized officer. ~': ;:nber's License No ......................... · :zc,'rician's License No ....................... r :~er Trade's License No ................ i ..... ~ -zation of land on which proposed work will be done; :,>:::c Number Street, Hamlet ....... w r ,000 s ..un ax Map No. ~ction .............. .. ock ........ .,Mlivision .................................. Eiled Map No (Name) .............. Lot ....... £uttc existing use and occupancy of premises and intended use and occupancy of proposed construction: B. Intended use and occupancy .... /~''/~ '~~:,.[[[[[[[[[ .i;;i;[i.... ' Nature'ofwork (check which appllcable). New Building Addition Alteration Repair .............. R~mov~l .............. Demolition ........... Swimming pool .......... Tennis Court ........ Ad .......... ' .... Estimated Cost .. ~..Q.Q ..Q.Q. ~ ,~,a;- ~ · . ................... tee . .,<5~u~¥.~- ........................... ., ~ (to be paid on filing this application} · If, dwelling number of dwelling un:its Number of dwelling units on each floor If garaee number of cars · If business, commercial or mixed o'ccupancy, specify nature and extent of each type of use .................... ................ · Dimensions of existing structures If' any: Front Rear Depth tleiellt Num be'r of Stories Dimensions of same structure withi alterations or additions: Front . Rear ..................... tIeight ...................... Number of Stories ..... Depth . Dhnensions of entire new construction: Front Rear Depth Height Numbelr of Stories ' Size of lot: Front........ . ~ . Rear Depth Date of Purchase ............. ! ................ Name of Former Owner ............................ Zone or use district in which premises are situated ............................................. Does proposed construction violatd any zoning law ordinance or regulation: ' ¥iil Will lot be regraded ............................., I excess fill be removed from premises: Yes .... No. Name of Owner of premises ......... :.... Address ..... Phone No. ' ' ,,a,me of Architect ......................... Address ......... Phone No ......... :game of Contractor i · Address Phone No ' ,.Is this property loc~tt~d within 300 feet of a tidal wetland? *YES .... NO .... ~If yes, Southold Town ,Trustees Permit may be required. PLOT DIAGRAM Lccate cleaxly and distincfly.~ll b~Hdings, whether existing or proposed, and, indicate all set-back dknensions from :..'rty lines. Give street and block number or description according to deed, and show street names and indicate whether .::or or comer lot. : ' - ::~ oF NEW YORK, i FY OF S.S ' being doly sworn deposes and says that he ~s the apphcant (Name of individual signing:contract) ' ' , ' ::amed. (Contractor, agent, corporate officer etc.) .5~ owner or owners, and is duly authorized to pe,rform or ]lave performed the said work and to make an'd file this .:.':t:on: that all statements contained in this application are troe to the best of his knowledge and belief; and that the ',: ',v:ll be perfommd in tile manner se[ forth in tile application filed therewith. ,rn ro before mc this ~ary Public ........... .~. .. County 7}9 ......... NOTARY PUBLIC, ~ ut New York (Signature o f applicant) No. 4707878, Suffolk Counrg~,