HomeMy WebLinkAbout19368-zFOPS4 NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19554
Date DECEMBER 3r I990
THIS CERTIFIES that the buildin~
Location of Property 1800 HARBOR LANE
House No.
County Tax Map No. 1000 Section 103
Subdivision
ADDITION
Street
Block 1
Filed Map No.
CUTCHOGUE, N.Y.
Hamlet
Lot 25
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 27, 1990 pursuant to which
Building Permit No. 19360-Z dated SEPTEMBER 6, i990
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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
The certificate is issued to MANUEL CABRkL
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
~uilding In'spe~ctor
Rev. 1/81
FOR,M NO. 0
TOWN OF SOUTHOLD
SUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERJGIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
.... ~.e.../_...~...'/..~ ...............
. ~/~ __~¢~..~_ ~',
~~.~ ......... ~ ........ ~..~.....~~..~..~~
atp mi, ~atd at .,.~{.~.~,.ff~...~ ......................................................
.................................................. ~~~ .......................................................................
co~.~ ~ m, ~o. ,~o~ Se~t,on Z~. ~,~ ......... /. ........ ~o,.o ..... ~ ...............
~uildlng Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF
A. This application must be filled in by typewriter OR ink and .lding
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.
B. 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 Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0
//'~ Date ..... ~f...~.~.~ .~ ~. ~.~. ............
~:ew Construction....~.. .... Old Or Pre-existing Building ................ [[i
Location of Pronertv...~.~.~.O ~'V ~.- ~ ~ ~ - ~ ]'~ - ~
.............. ~ ........ ~ ..... ~ ~ .... ~. ~$ ~y.!~...
House No, Street Hamlet ~
Onwer or Owners of Property....~.~.~*.~~. ....... ~~._
County Tax Map No 1000, Section.~%~f~.~lock..~Z~ ~_
' ' ...... ~'Z .......~'&'~' '~7 ~ '~ .....
.................... i .............. .
Permit No./..~.~.~.Data Of Permit..~,.~.~.~.Applican[~~.[~[.
Health Dept. Approval ....... ~ ................ Underwriters Approval .........................
Planning Board Approval ....
Request for: Temporary Certificate ........... Final Certicate.~.]. ~&
Fee
Submitted:
TOWN OF SOUTtI0i,D
OFFICI~ OF BUILDING INSPECTOR
P.O. BOX 1179
TOWN IIALL
SOUTIIOLD, N.Y. 11971
November 28, 1990
TEL. 765-180,2
Manuel Cabral
1800 Harbor Lame
Cutehogue, New York
11935
To Whom This May Concern,
Ple are unable to complete your Certificate
of Occupancy because .of the following reasons.
/_--//An application for Certificate of Occupancy
is llot on file. (ENCLOSED)
/_--//blo Underwriters Certificate on file.
/.~/--J "I he check i:;(o~[$~l~not on file.) $25.00
/~/ No Health Dept. Approval on file.
/~/ No final inspection has been made..
Please contact ()ur office on this matter.
Thank you for your cooperation.
lhiildir, q Permit l! 1 9 3 6 0 -Z
Building Dept.
***/-/ Ho Plumber Solder Certificate on file.
all permits involving plumbing being
issued after April 1,1984
APPROVED AS NOTEO
DATE.~ B.R # ~
NBTIFY BL~ILDINe DEP~'RTI~T AT
765,-1802 g AM TOe. PM ~oe THE
;FOLLOWING INSeECTIONSY
1. FOUNDATION - TWO REOUIRED
,¥ a FQR POURED CONCRETE
2. ROUGH: FRAMING & PLUMBING
3. INSULATION
4. FINAL ,- CONSTRUCTION Must
BE COMPLETE FOR C.O;:
ALL CONSTaUCTIOU, SHALL= MEET
OF THE N.Y.
REQUIREMENTS
,STATe CONSTRUCTION & ENER6¥
CODES· NOT, RESPONSIBU: FOR
: DES GN OR CONSTRUCTION ERRORS
FOUNDATION
FOUNDATION
2.
ROUOH FRAME &
.FLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FI~;AL
(2nd
(1st)
ADDITIONA~L COMMENTS
' FORM
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
HALL
,_~,,.T?,~,~.i,,~ OF ,e. ou;i',~Ol l') ~ , ~OUTHOLD, N.Y. 11971
Z TEL.: 765-1802
Exannncd...?/. ..........
Disapproved ale
.........................' ' ' ~~tor)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH ............
3 SETS OF PLANS ............
SURVEY .....................
CHECK .............. .
SEPTIC FORbl .......
NOTIFY~
CALL
INSTRUCTIONS
a. Tiffs application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with
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
cation.°r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
c. The work covered b~ this application may not be commenced before issuance of Building Permit.
d. Upon approval of tiffs 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
~hall 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, additions or alterations, or for iCemoval 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 i~R.%~ctions.
,., ' - ~~tmgnatu o applicanf, or.~am~poranon) '
'" --~~.~ ,~...~ ,/, ?fgrflailing address ~cplicTt) d~ e ~..'"--
State wh~tber applicant is owner, lessee, agent, architect, engineer, general coat,aero ,M~electrician~piumbe/& ~u~flder,
Name of owner ofpremises ...~,,,t ..... -5 ....~ .......................... ., .~..... ..................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
ame';~ci title of corporate officer) _
Builder s License No ......... .~~ ......
Plumber's License No .........................
Electrician's License No .......................
Other Tradc's License No ......................
House Number ' ' ..... ~' ........
Street Hm~let ~' ......
1000 Section/~. ~..-.
County Tax Map No.
........... ' Block ...... / Lot... ~ :,.~.."~...
Subdivision ..................................... Eiled Map No ........... Lot ..............
(Name) .....
2. State existing use and occupancy of premises and intended usea~ occupancy of proposed construction'
A. Existing use and occupancy. .~ :.. . .............
./ · ii
Bo
Intended
use and occupancy ......... ff~.~'-~.~...~-~.~-r~... ........
3. Nature of work (check which, app!l cable): New Building .......... . . Addition · ,t....~<.. '.~,...~_.. mteratmn_ · · · '~"4 f~,~ ....
Repair ...... REmoval ............ Demoht on .....
· ' ..... ~
Tennzs Court . · ._.:... Accessory Building .......... Fehce ....... OtHer Work.~ .~.~'... ·
4. ':stim t dCost ..... ................ Fee .... ... .. ..,.....
(to be paid on filing this application)
5. If dwelling, number of dwelling ugits ............... Number o f dwelling units, on each floor ................
If garage number of cars ~ ' '
t5. If business, commercial or mixed 6ccupancy, specify nat.re and extent of each type of use ...................
7 Dimensions of existing structures iif any: Front Rear . . Depth
Heiaht ............. .. Number of Stories ......................................................
· ' Rear
Dimensions of same structure w~th alterations or additions: Front ,................ · ............ '''
' Height Number of Stories
Depth....... ........... . ..i ...................... . . ...................
' · Depth
8. Dimensions of entire new constmetmn: Front ............... Rear ............... · ............
Height Numb? of Stories ' · · · · ·
9. Size of lot: Front ............ ~ .......... Rear ...................... Depth ....................
10. Date of Purchase ............ ................. Name of Former Owner ............................
11. Zone or use district in which premises are situated.............................-.... ..................
12. Does proposed construction violate any zoning law o~tnance or regulation: ...............................
13. Will lot be regraded .... ~ ..... /]./~-.~.//..~11 excess fill be removed from premises. . Y s .... No
14. Name of Owner of premises ~~./~//~~dress ................... Phone No .................
w~,~ ~c ~r.h~t~, . _~_ f. ..... ~ .[ ..~./.. Address ........... Phone No ................
.............................. ....... : ..... t" ' '.~.'~ ...... Phone No ........... : · ,.
Name of Contractor .......... i ................ Address ...................
15.Is this property located within 300 feet of a tidal wetland? *YES .... NO ....
· If yes, $outhold TownlTrustees Permit may be required.
i PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block fiumber or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW YORK,
COUNTY OF .................
(Name of individual signing contract)
above named.
being duly sworn, deposes and says that he is the applicant
13e is the ....................
(Contractor, agent, corporate officer,, etc.)
of said owner or owners, and is dully authorized to pe,rform or have performed the said work and to make and file this
application: that all statements contained in tiffs application are true to the best of his knowledge and belief; and that the
work will be perforated in the m=n~r set forth in the application filed therewith.
Sworn to before me this
............ ......... .........
~ POgLIC, ~.~.~ (Signature o~applic~t ~