HomeMy WebLinkAbout19156-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19922 Date MAY 20, 1991
THIS CERTIFIES that the building
Location of Property 445 MARLENELANE
House No. Street
County Tax Map No. 1000 Section 143 Block 3
Subdivision Filed Map No.
ADDITION
LAUREL, N.Y.
Lot
Lot No.
Hamlet
29
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 20, 1990 ~ursuant to which
Building Permit No. 19156-Z dated JUNE 25r 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 DECK ADDITION & SCREENED IN PORCH ADDITION AS APPLIED FOR.
The certificate is issued to
(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
RICHARD & MARIA ZAHRA
TOWN OF SOUTHOLD
BUILDING DEPART/v~EN'~'
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PER~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No 19156 Z
Permission is hereby g~nted to: v)
....... ....................................
a.~.....~'....~,. ...................................
_~ ,_...~.,-~, .~..~..~. ~;.~;.../z~.?
at premises ,ocat,ed at ........~.....~..~......~.J,~ ....... .,.~...~;..,~.............../-/ .........................................
CounW Tox Map No. 1000 Section .............. Block --~ Lot No..~....~...
/..~.._~ ....................................
pursuant to application dated ............ ~ ........................... , Ic) ........ , and approved by
the
Building Inspector.
Rev, 6/30/80
Form No. 6
TOWN OF SOUTtIOLD
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 archiuect or engineer
r~sponsible for the building.
6. Submi~ 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 - $I00.00
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, Con~ercial $15.00
......... ...................
Date .
~ew Construction .......... ~Old Or Pre-existing Building ..... . ..~'~.' ~
ocatio of Property:. ..... .... .... ....... ....
House No. Street Hamlet
)nwer or Owners of Pro ert '~ ~ ~"~""'
:ounty Tax Map No 1000, Section..~.Y..~ ....... Block ...... ~ ........ Lot ........ ~.,,~. ..........
;ubdivision .................................... Filed Map ............ Lot ..... ~ ................
'ermit No..~/.r.~...~....Date Of Permit .... ~../.~.~Z~.~.Applicant ........ ~ ........ ~ ........
[ealth Dept. Approval .......................... Underwriters Approval .........................
lanning Board Approval ........................
equest for: Temporary Certificate ........... Final Certicate..../. ......
ee Submitted: ~ ,.~'~, Of)
qt ?gt-/ ..... . ........................
Richard Zahra
23 Wood Avenue
Albertson, N.Y.
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN ttALL
SOUTItOLD, N.Y. 11971
MAY I0, 1991
11507
TEL,~,765-1802
TO Whom This May Co,ncern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/--~/ An application for Cer¢ificate of Occupancy
is not on file. .(ENCLOSED)
/_--//No Underwriters Certificate on file.
/~/-~ The check is (o~-~[~7not on file.) $25.00
/~/ No 11ealth Dept. Approval on file.
/_--/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit
Buildinq Dept.
***/-_/
1 9 1 5 6 Z
No Plumber Solder Certificate on file.
( all permits involving plumbing being
.issued after April 1,1984 )
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION SST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING /~ [ F~~INAL
I NSPECTOR~~,/ /~//
?'iELD -~ .....
FOUNDATION (2nd)
ROUGH FRAME &
.FLUMBING
INSULATION ?ER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-~.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ~ ,=o,,.~,.,o...D [ ] ,NSULA.,O.
DATE
INSPEG"'TOR ~<~Z~x.~'
/
.... /oo_ y~ ....
OCCUPANCY 0~
USE IS UNLAWFUL
WITHOUT CERi1FICATE
OF OCCUPANCY
HOWBRD H. STEIN
I ~-L HO .
I-!
~ left, .:
OCCUPANCY OR
USE IS UNLAV,~FUL
WITHOUT CERilFICAI"E
OF OCCUPANCY
I-"1 ~GU~ J ~ BUILDINGDEPART~ENT
~, Z ~~ J, TEL: 765.1802
Dis:ppro~cd afc
~uildi~nspectorf .....
APPLICATION F~H BUILDING PERMIT
BOARD OF HEALTH
3 SETS OF PLA~tS
SURVEY
.............
SEPTIC ' ' '
CALL
HAIL TO:
. ....
INSTRUCTIONS
a. This application must be completely filled in by typewriter Orin ink and submitted to thc Buildingl~Pector' 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
or areas, and giving a detailed description of lhyout of property must be drawn on the diagram which i~lmr[ of this applJ-
cation.
c. The work covered by this application may not bc commenced before issuance o£ 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 throuo_hout the Work.
e. No building shall bc occupied or used in whole or ~n part for a.ny purpose Whatever until a Ce~tifical~ of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBy MADE to thc Building Department for the issuance of a Building Permit Im-~Uant to the
Building Zone Ordinance of the Town of Southold, Suffolk County. New York, and other applicable Lax~. Ordinancea or
Regulations. for the construction of buildings, additions or alterations, or for ~:cmoval or demolition, ns h~ein described.
Thc applicant agrees to co,.~.'¢'t~¢w/[th~fi[l~.h:lb'l~'lieab]e laws. ordinances, building code, housing code. and rc~ut/tions, and to
admit authorized inspectors on premises and in building for necessary inspections.
State whe'thcr applica ' i ' i'
~l;,is owner,' e~see agen.t, architect, engineer, general contractor, electrician, plumber or build;-r.
................ e.4.
/. ............................
Name o£ owner ofnrcm/.e. / & PC r'
v~l ?, ,~;' , (as on the .......... · .......... ..
, tax roll or latest deed) ....
IFapplic.~nt is a eo~6~[tb}i~, s~gmi,fii're,o£idhly aut~0rized officer.
(Name and title of corporate officer)
Builder's License No .... (~ .......
Plumber's License No ........
Electrician's l. jCen~e
Other Trnde'~ License No '
House Number Street. . ~ ........... ; · ~.
Countyr=,\~apNo'.1000S~c,io.. / Z/.¢'. m,,,ct ....
·
Subdivision Lot
· BlOck
........................ ~ ...... F,,ilcd Map No ,.'
S (Name) .............. Lot .. '
· ( ~n~ure~~or na'n~e, if~ Corpora,mn)
(Mailing address of applicant)
3. Nature of work (check which applicable): New Building ........ d~i~cn ......... 7rattan .... ~, ....
Rep:fir .............. R~mbval .............. Demolition lil~. ~ ~mi~~ hoot .... ~ .....
·~... [Accessory Building ........
s. Ir dwelling, number of dwclhng umtS ............... Number o ~illii:g units on each floor ...............
Irgarng:. number of cars ..... ~ ..........
7. Dimensions of existing st~etur{s, if any: Front ...............
H igl N{b fsi ~ .... pth. .
Depth ' tlci~t ................. Rear ...........
8 .................... ~ ........................ Number of Stories ...............
. Dimensions of entire new conxt~ction: Front .....
............... Rear .............. Depth ........
11. Zone or use district in w~ich prqmiscs arc situated .... ~ ..........................................
12. Docs proposed Construc~mn viol'a~c a ..... : ........ ~ ' '
~vm tot oe regndcd .; .... 1~? ......
N~c'of Architect .... ~ .. Address . . Phon~ No ............
N~c of Contractor ....... ~ ·
15.Is thzs property located within IOO feet
~ ~es, Southold ~o~fi Tru=tees Permit may be required.
PLOT DIAG~M
Locate cle~ly ~d di*tNctly ~l'bufldNgs, whether existing or proposed, ~d. indicate ~I set-back d~endon~ from
prope~y ~nex. Give ztreet ~d block gumber or desc~ption accord~g to deed, ~d zhow street nme, and Ndicate whether
inte~or or comer lot. '
AP, AS NOTED
OATE:~B.P. # ~
FEE ~_~.~.~ BY: ~
NOTIFY,"~B. UI/i/OiNG OEP~M~J'Y AT
76~1862/S. AM TO 4 PM FOR THE
FOLt. OWlNG'INSPfcT. IONS:
1. FOUNDATION - ~/0 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 THE N,Y.
STATE CONSTRUCTION & ENERGY
CODES, NOt* RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
oo
~T~ATE OF NE~V YORK,
· . (Ns'me.f individual signiug contract)
~bo¥c named.
being duly sworn, deposes and says that Itc is the applicant
lOtary Public .......... '..~. .... i. - . County
i (Contractor, agent, corporate officer, etc.)
f sald owner or owners, and is dul~ authorized to pe,rform or have performed tile said work and to make and file this
application; that all statements contailned in this applic0, tion are true to the best of his knowledge and belief; and that the
york will be per 'omled in tile manner[set forth in tile application filed therewith.
,XVom to before mc this ..,
......... .~. .day of.