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HomeMy WebLinkAbout19343-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20376 Date NOVEMBER 25, 1991 THIS CERTIFIES that the building ADDITION Location of Property75650 MAIN ROAD (aikja 715 FRONT ST.)GREENPORT,N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 48 Block 1 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 20, 1990 pursuant to which Building Permit No. 19343-Z dated AUGUST 23 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 CELLAR FOUNDATION UNDER AN EXISTING ONE FAMILY DWELLING The certificate is issued to FRED GAGEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NjA UNDERWRITERS CERTIFICATE N0. N/A PLUMBERS CERTIFICATION DATED NfA ` wilding Inspector Rev. 1/81 1 i F'OEffi NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HA4L SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No y34~ Z Date ...~..rc°.:~ 19.01... i 4 Permission is hereby granted t . ^ ~..1 ? I . . . ~~~..........~~..r~hf•%~ at premises located at ...~......1.1.~~'K r I County Tax Map No. 1000 Section ........,C.~..Q........ Block Lot No......... pursuant to application dated 19.~~s., and approved by the f Building Inspector. Fee 5..~~~ < ildl for Rev. 6/30/80 i Form No. 6 -u .g F9 t ~ ~l TOWN OP SOUTIIOLD PY}P.-~~--p~s., IlUILDING DEPARTMI:.NT 19 Ste',;^~, ~ } I TOWN l1ALL ? NQ~ 2 2 ll~ 765-1802 6 ~ r::- osi ~ ~.eF~ APPLICATION FOR CERTIPICATR OP OCCUPANCY Tttis application must be filled in by typewriter OP, ink and submitted to the building , inspector with the following: for new building or new use: 1. Final survey of property faith accurate location of all buildings, property lines, streets, and unusual natural or Copographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-O form). 3. Approval of electrical installation from L'oard of Fire Underwriters. G, Sworn statemenC from plumber certifying that the solder used in system contains less than 2J10 of 17 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. .i. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. .lc curate survey of property showing all property lines, streets, building and unusual natural or topographic features. 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 , L. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling 525.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building 525.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 J. Copy of Certificate of Occupancy - $5.00 over 5 years - 510.00 4, Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $771rr5~~.00, ,Co/mm9er/c/ial 515.00 Date .....vCeL.~~(/...l.,C ltew Construction...........-7Old Or Pre-existing~j Building,,.... /~f... .ocacion of Property......./.I~...........,~/CD~?1 ..............4?'LEEI~/,~D/P~........... House No. 'p St/rye/et Hamlet .;rawer or Owners of Property.......l~Ct.'~~...4?'/~.~-s.EYY .....................QQ.~~................ ~:uun[y Tax Map No 1000, Section.....°.......Block........1.......Lot.....1 ~ubdlvision../.q.7./f....y ........................Piled Map............Lot.........../. permit :;0...1.,(?.7.~F.-::Date Of Permit ................Applicant......f.[~E~. ~.19~a~f'S!....... 'icalch Dept. Approval ..........................Underwriters Approval......................... .'!.inning board Approval .request for: Temporary C,yertificate........... Final Certicate.....,~..~... 'cc Submitted: 5..~ S ~,i~ N 3 oog x;.• • APPL~.. eo ~ &03`1 ~ 765-1802 '7~b~9 ~t~o?-9,T BUILDING DEPT. ~~7"` ~ g3 ~ ~~~~D~"' ~'~v~l NSPECTION [ ] UND ION 1ST [ RO CH PLBG. [ ] O DATION 2ND [ ] SULATION RAMI [ ]FIN S i o ~ REMARKS: ~ ~ !Ii ~ ~.~t~.~-, ~ 1~..(~.1, i t S .~~z-YI lz r~ '~O 1~.,. C ~G c~ 1~t0~1 ~ i ,(~v„~L`~ 1 ~CC~ ~~~~2. ` ~,0 _~Gu ~t~c.ry ~ A ~-d ~~-Y ~ ao ~ ~ ~,t r~ ~r~~ s Po ~T~ ~ DATE $ ~ ~ INSPECTOR INSPECTORS Principal Building Inspector ~ ~~~~~ffOj,g-~n~O Curtis Horton q'• SCOTT L. HARRIS, Supervisor qp Senior Building Inspector a - ~ ; , x Southold Town Hall Thomas Fisher ;Y ~ P,O. Box 1179, 53095 Main Road Building Inspector ' a~%> '%,rs ar~'y ~@ Southold, New York 11971 Gary Fish 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 NOVEMBER 13, 1991 FRED GAGEN 190 GILLETTE DRIVE EAST MARION, NY 11939 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX.Y An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xxx The check is (a/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 # 19343-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. :1::LD i::.`~,.-- ._i1:+ ~~J:.: j~ CiJ:YME.NT,°. ~ -v W 1.. H rOUtiDATIO:i (1st) ~ d3 q _ - c~ FooNDATION (2na) - a. z. o P.OUGH FRAME & ~'1 .PLUMBING ti H m 3. ~ ~ I17SULATIOPI PER N. Y. y STATE EPiERGY 4 CODE r. L y G. FI;iAL ' I o ADDITIOAIAL COMMENTS: x ~ rn x H H (A9 O ~ . ~ 7 • r tJ\ H 5 b'~ 'b H ~ ~ ~j~ ~ 765-1802 BUILDING DEPT. iNSPECTiOhi [ ] F NDATION 1ST f ] ROUGH PLBG. [ FOUNDATION 2ND [ ]INSULATION [ ]FRAMING f ]FINAL REMARKS: ~ DATE / ~ INSPECTOR ~~3~~ r~-18U2 BUILDING DEPT. INSPECTION [ U DATIO 1ST ( ~ ROUGH PLBG. FOUNDATION D [ ]INSULATION [ ]FRAMING ~J [ )FINAL REMARKS: C~/~-c~~, ~ ('rA-z~,~~ C~.~ DATE ~ INSPECTOR c ~ Fr`U~T OCCUPANCY OR ~ ~ USE IS UNLAWFUL _ _ WITHOUT CERTIFICATE OF OCCUPANCY p n i , _ _ t N ~ C i - _ ; y ~ © i ~ ! ~ f s, -a.. .r - r ~ jt~ _ l.G ,h ~j~oc(~s ~'~l~ OA~s~~=b~F}GCS I~~ ('1, Y ' ~ ~ ~ / L ll~ _ ~oo f-l~r~ S ~F~a~~. 4 ~ R G I\ e ~ I BOARD OF HEALTH FORMN0.1 SURVEY OF PLANS p c~ ova ~ TOWN OF SOUTHOLD CNECK ~ 6UILDING DEPARTMENT SEPTIC PORM AW2OI°~ TOWN HALL $OUTHOLD, N.Y. 11971 NOTIFY ~ ~ BLDG. DEPT. TEL.: 7G5-1802 CALL ...77....:-~~~. • , , , , , TOW OF SO TNgLD Examined • ~•.p~.• 19... MAIL T0: Approved . 19 Permit No.~?~7`~~ .......~,Q~ . Disapproved a//c I %a .XJ~~ ~t~~ z:~- (Btti ng Inspector) APPLI ATIO FOR BUILDING PERMIT Date ..:................15... INSTRUCTIONS a. Tlus 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 layout of property must be drawn on the diagram which is part of this appli- cation. ^ 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 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 Re;ulations, for the construction of buildings, additions 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 inspectprgCprr premisfr~'anS in building for necessary inspections ~ ~J (Signature of applicant name, if a corporation) ^ ~~i~.~r~._. . ~ ~ ~ ~ ~ ~ ~ ~ (Mailing address of applic t) - ~~sT ~~io~1 ~~!i 93 ~ State whether applic~n(~is.owngr, lessee, agent, architect, engineer, gen ral contractor, electricia plumber or builder. Name oC owner of`premises fJ~. C~,f1~~•~~ • . (as on the tax roll or latest deed) IC applicant is a corpo7ati'dn, S"ignature of duly authorized officer. (Name and •ti'tPe'd~I' corporate officer) Builder's License No. ......~~.f.4.~.f~ Plumber's License No . . Electrician's License No . . Outer Trade's License No . . 1. Location of land on which proposed work will be done; ~~ry cc~-„L " rl.,C S . house Numbcr Street. Hamlet County Tax klap No. 1000 Section Black ....m. Lot ©.9....... . . Subdivision fiilcd Afap No. Lot . (Name) State existing use and occupancy of premises and intended use and occupancy o f proposed construction: , A. Yxisting use and occupancy...... . f . ~+n; ion!--.....~,,°.,~,, s a~,as;._ • • • • B. Intended use and occupancy... • • Q!y!F •Y~f rrt ~AT.O:':`~-•-4.., s i-~'".~: • .~'?2id9~Y~,.9?t 0~lfi4.Pi~ ¢~?irP~315y$favkF I 3. Nature of work (check which appl}cable): New Building Addition ,Alteratipn .;.f. Re air RRmov~l Demolition ..............Swimming pool.... p Tennis Court Accessory Building..........Fetlce ~ ...Other {yo~k~ Q. Estimated Cost ~.Z.~' . Fce ...,~?1,~~ .........ll.)l........;,jlj . . / (to be paid on IIling this.applicatidn), 5. If dtveiling, number of dwelling units ,l!, Number of dwelling units on each floor . , , , , , , , . . Ifgaragc,numberofcars ' 6. If business, commercial or mixed occupancy, specify ,nanuc and extent of each type of use , , , , , , , , , , , , 7. Dimensions of existing structures,',iCamy: Front 'Rear Depth . . Height Number of Stories . . Dimensions of same structure with alterations or additions: Front .....alarm Rear . Depth .Height ......Number of Stories . 8. Dimensions of entire new constntlgtion: Front .....~.~.^r?:-- Rear Depth . Height ...............Numb~erofStorigs: 9. Size of lot: Front . 5 ~ ' Rear . ...`.54.~........... Depth ..d z.7.. i0. Date of Purchase .f ..............Name of Former Owner ..,ROSE.. 4~a~:~ • • • • • • • - • . . 1 1. Zotte or use district in which premises are situated . . l2. Does proposed construction viol to any zoning ]aw, ordinance or regulation : . 13. 1Vi11 lot be regraded ~-Qrs........ Will excess fill be removed from premises: Yes , No X, 14. Name of Owner of premises ,,~v~,E,l~, , , ,f,>?G~6.~1.. Address ...................Phone No. `f.7,~.'•~~-~7• • • • . Name of Architect ' ...............Address ...................Phone No................ , Name of Contractor . ' .......Address ..Phone No..... , . IS.Is this property locaCed within 300 feet of a tidal wetland? *YLrS....NO )1,.. *If yes, Southold Town!Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all (buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether ' interior or corner lot. AP RQ ED AS NOT/EDT ,,L DATE: ~ ~p B.P. M.~L`~~7" oe NOTIFY B IL 116G DEPART TAT 765-1802' 9 AM TO 4 PM FOR THE FOLLt)WING INSPECTIONS; 1. FOUNnATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH -FRAMING & PLUMBING 3. INSULATION b. FINAL - CONSTRUCTION MU5T BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CC9C9ES. NOT RESPONSIBLE FOR OESICN OR CONSTRUCTION ERRORS STAT)rOFNE YOF~.~-••~S.S COUNTY"~OF~7'~' ,~y; ~~r!I`• being duly sworn, deposes and says that he is the applicant ' (Name of individual signing contract) about named. Eicisthe ~~K-Q/1~............... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application arc [rue to the best of his knowledge and belief; and that the work will be performed in the mannr set forth in the application filed therewith. Sworn to bctorc me this .d~.d~yof.. s~..19. L." Notary Public, • ~ • .County QusQ(lerd Suffa°k Signature of applicant, gpnNMlwlol? E>tpke~ Dxoom~', B, 19