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Home My WebLink About19562-zFORM MO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19820 Date MARCH 28, 1991 THIS CERTIFIES that the building. ACCESSORY SHED AND FENCE Location of Property 790 CLIPPER DRIVE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 79 Block 04 Lot I7~7 SECTION 4 subdivision HARBORLIGHTS Filed Map No. Lot No. 83 conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 29, 1990 pursuant to which Building Permit No. 19562Z dated DEC. 5~ 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 ACCESSORY SHED~ PERMIT AMENDED TO INCLUDE FENCE. The certificate is issued to JOAN & TOR TORKELSEN (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 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~. 19562 Z .......... ~premises located at ....:Z ,~,,.......~...~/r~..~.-(: ................................................ ii ........... County Tax Map No. 1000 Section ......... .~...~., ...... Block ....... ~ ........ Lot No..../..~...<.,Z.. ...... pursuant to application dated .........~//.../~.. ................................ , 19~..~,., and approved by the x/ Building Inspector. Fee $....,~......~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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. 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 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ Date . .~. l~.~l?/ ....................... ..... New Construction........... Old Or Pre-existing Building ............... '.' Location of Property...~.~ ..............(--~/~..~?~. ~.~'. ...... ~.(~. ............................... O'~6/'P .... House No. Street Hamlet Onwer or Owners of Property...,.v.-..-.~..~ ............................................ . .. . County Tax Map No 1000, Section .... 7,~ ..... Block ..... ~ ........ Lot..M'~q~2 ............ ~ ., .................................. Filed Map ............ Lot .................... Health Dept. Approval .......................... Underwriters Approval ........................ . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted:~ ~'$'...~. ........ ~..~. ,~...~... ~.~ . .~....~/ ¢ l ... ......... 1ELD · ........ ~. OUNDA~ION (1st) OUNDATION (2nd) 0UGH FRAME & .FLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL TOWN OF SOUTIIOLD OFF]CE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 HARCH 8, 1991 TOR & JOA~ TORKELSEN 790 CLIPPER DR. SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. x/x_--/ An application for Certificate of Occupancy is not on file. E~CLLOSE~ /Z/ No Underwriters Certificate on file. /~ The check is(~z~/not on file.) $25.00 /~/ No 11ealth Dept. Approval on file. /_/ No final ins.pection has been made. Please contact our office on this matter. Thank you for your cooperation. Dui]ding Permit t~ I 9 5 6 2 Z accy shed Building Dept. ***/Z No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) TORKFLSEN BUILDERS, INC. P.O. Box 1475, Southold, (516) 765-4008 NY 11971 ,,JO BOARD OF HEALTH ............ 3 sETS OF PLANS ............ FORM NO. 1 SURVEY ..................... TEL.: 705-1802 ~ ./:. :. ......... ~ O~ ~OLD Examined -/.~ ........ 19~. MAIL TO: ....... · ' Disapproved a/c ..................................... APPLICATION FOR BUlL'--DING PERMIT q. ......... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par[ of tbJs applJ- ¢. 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 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 apy purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depm-tment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, Suffolk County, Ne~v York, apd.other applicable La~vs, Ordinances or Reaulations, for the constraction of buildings, additions or alterations, or for remov~l.'or demolition, as herein described. 7hg applicant agrees to comply with all applicable laws, ordinances, building code. housin~ code, and regulations, and to 2dmi~ authorized inspectors on premises and in building for necessaD..~,n5 eC~0n.,~>, ~-, .............. [Signature of applicant, or name, if a corporanon) i. g. . p: fo. ~./. .~ :.¥. . . .~. .~. ~ F/f?.'-~...z!..~.? (. (Mailing address of applicant) applicant i~wne~essee, agent, architect, engineer, general contractor, electrician, plumber or builder. State whether .../.og-..../c. ...... ~. o· ~/.~. :<T.e..>i... 21'o .~3me of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... ~ ~ ......... Plumber's License No ......................... Electrician s License No ....................... Olher Trade's License No ...................... Location of land on which proposed ~vork will be done. ' ' . ........... House Number Street. Hamlet ' ~/ /77, Coun,y Tnx Map No. 1000 Section ~2~ .... Block Lot Subdivision ..................... Filed Map No ............... Lot ............... (Name) Stateexistino ~seandoccupanc% ofp ' . ' ' '~ p. ncyofproposedconstrtction: a. Exixtmg use and occupancy ... ~- · -~ ~' '?~ ......................................... 3. Natur. e ut work (check which applicablek ~r ....... Rep;ur .............. Rch~nval , ,,,:w uUuumg .......... Addition .......... /alteration ..... 4. cst,mated Cost o{[..t'.c2'° (Dcscnpt on) } .......... Fee ........................... $. If dm~ clhng, number of dwcHmg units t o be pa~d on-~hng this application) Ifgarage number of cars L ............... Nnmbcr of dwelling units on each floor ' (5 If business ' '.' ' .............. ' .............. commercial m,x:ed occupancy ....................................... . . 7 D' ' ' ~ ,specily naR,re and extent ofeach ............ · ,mens,oas ut existing st]acLu']cs, if any: Front type of use ........ Hci.2ht ' Rear ............ muer ol 5tones .............. · ,~,u,c }Vim a,reratmns or additions. ' ...................... Depth Front ............. · · ..................... tleight ...................... Number of Stories ..... 8. ,D,i.mension~s,,~{fentire new consimction: Front 10. DateD, Purchase l.cj'~':~ ............ Rear ..... t,~.'.J..? ......... 'D;;rh 't'4q ............. 11. Zone or use district in which r~¢r. mlq,,~ ''': ........ Name of Former Owner ~ ~¢~.~.~ ........ -n ........ aremtuated ' ' ' - .................. 12. Does proposed construction vi~late any zoning law, ordina 13. Will lot be re,'radt-a rOt/3 { ncc or regulation: 14. Nm'ne of Owner of prem Oil be removed from premises- Name of Architect ...... [ . of Contractor . ~ ' W_../ ............. c, ouress ...... r,,. ,, '~ .......... , ................. 'Address ..... Phone No. .. . IS.Is this property l°c~3ted within3OO feet of a tidal wetland? *YES .... NO. · If yes, Southold Town Trustees Permit may be required. ''' PLOT DIAG RAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give s ' tree, and block inumber or description according to deed, and show street names and indicate whether interior or COmer lot. { APP/R,p .ED aS NOTED '765-1802 9 AM TO 4 IPM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION . 'IWo REQUIRED FOR POU, RED CONCRETE 2. ROUGH ~ FRA~ING i& PLUMBING 3, INSU LATJON " & FINAL : CONSTR~CTION MUST BE COMPLETE FOR C.O. 'ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS 0F THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT REsPoNSIBLE FOR r-.. DESIGN O~>..CON, STRUCTION ERRORS TATE OF NEW YORK, _ , OUNTY S OF ........... S.~ · ' ' ' ............ i .................. being duly sworn, deposes and says that he is the applicant (Name ofindMdual signing contract) c is the i ' ' (Contractor agent ............................................ ' , , corporate officer, etc.) said OWner or owners, and is duly uthomzed to pc?formeD] have performed the said work and to make, and file this r~licat/on: that all statements contained in this application are true to the best of Ills knowledge and belief;and that the ,rk will be performed in the manner se{ forth in thc application filed therewith. om to before me this NOT, HELEN lC DE VDE i ;~R¥ PUBLIC, St~t~ of ~v - Fie. 4707878, Suff,,~,k Ceuaty ~/ lerm Expires M&rch 30,19..=~ / (Signature of applicant)