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Home My WebLink About19199-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21135 Date NOVEMBER 6, 1992 THIS CERTIFIES that the building Location of Property 53557 MAIN ROAD House No. County Tax Map No. 1000 Section 61 Subdivision ADDITION SOUTHOLD~ N.Y. Street Block 4 Lot Filed Map No. Lot No. H~let 9.2 conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 10, 1990 pursuant to which Building Permit No. i9199-Z dated JULY 17, 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 TO EXISTING ONE FAMILY DWELLING 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 PLL~MBERS CERTIFICATION DATED N/A STEPHEN & SHERYL-LEE ALBERTSON Rev. 1/81 // Bui/iding 'Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. fi.HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. '~, ~1 ~/ Z Date .'.2'~ ............................................ , ~9....~..~. / at premises located at ..s~....s~...~..~..~.~.~.7~/,,,z' ~(~/~, ....... ~ ...................................................... coun~ To~ Map No. ,000 Section ........ .~../.. ....... B,~k ........... ...~....... ~o, No ...... ~....~ ...... pursuant to application doted ...... .~.././.,.~. ..................................... , 19.~.., and approved by the Building Inspector. Fee $.~~'.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTNoLD BUILDING DEPARTMENT TOWN HALL 765-1802 ': APPLICATION FOR.CERTIFICATE OF OCCOPANCY A. This application must be filled in by typewri~,er OR, ink and submitted to the building inspector with the following: for new building or new use: I. Final survey of property with accurate location of ail buildings, property lines, streets, and unusual natural or top~graphic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation f~om Board of Fire Underwriters. . 4. Sworn statement from plumber certifying that the solder Bsed in system contains less than 2/10 of 1% lead. · 5. Commercial building, industrial b~ilding, multiple residences an~ 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: I. .Accurate surveyof property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed applicatio~ an~'~ 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 dwelli~, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Cer·tificate 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 Ce tzf~cate of Occupancy - Residential $15.00, Commercial $15.00 ti ~L :w Construc on..' ......... Old Or Pre-existing Building .................. .... House No. Street '" ' ............. Hamlet wet or Owners of Property ....... ; .......... .~ .... .~ ....... ooo, Sectioa .... ....... Block .... .......... .... ~dlviaion ' ..................... f% ' Filed Map Lot :mit No... · .... Dar Of Permit ................ Applicant .... . ~lth Dept Approval ' · ' ......................... Underwriters Approval · nning Board Approval ........................ nest for: Temporary Certificate ........... Final Certicate ........... S~bmieted: $ ~..~.. ' INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WIECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD September 15, 1992 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 STEPHEN & SHERYL LEE ALBERTSON P.O. BOX 1268 SOUTHOLD, N.Y. 11971 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) No Underwriters Certificate on file. The check is (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 % 19199-Z (DECK A~D) Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. NOTE: THE ABOVE BUILDING PERMIT IS EXPIRED, PLEASE APPLY FOR CERTIFICATE OF OCCUPANCY. TOWN OF SOUTtlOi, D OFFICE OF BUILDING INSPECTOR P.O. BOX! 179 TOWN IIALL SOUTIIOLD, N.Y. 11971 SEPTEHBER 25, 1990 STEPHEN & SHERYL LEE ALBERTSON 53557 HAIN ROAD SOUTHOLD, NEW YORK 1197! TEL. 765-1802 To Whom 5Ills May Concern, We are unable to complete your Certificate of Occupancy because .of the foiler;lng reasons. / /_--///Tn application for Certificate of Occupancy ,ot on fi .o. (ENCLOSe. O) /_~///,,X',O:__. Underwriters Certificate on file. /--~ Thc~ cheek i:;(gllllI~/not on file.) $25.00. /~/ No tlea],th Dept. Approval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. lhl[l(ling Perm.it {! I 9 I 9 9 Z Build lng Dept. ***/~/ tie Plumber Solder Certificate on file. ( all perm}ts involving plumbing being issued after April 1,1984 ) 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING INSPECTOR FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE (2nd) FINAL ADDITION~L COMMENTS: //%3 SETS ~PL,t,~$ ..... FORM NO. 1 ~SU~VEY .......... : TOWN OF SOUTHOLD ~-~CllECK K.~. ~7~ ........ BUILDING DEPARTMENT SEPTIC FO"M '.... ............ N.Y. Ig a. Pe-.it .o Disapproved ale . ~ PERMIT CALL . HAIL TO: Date INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building f~spector, 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 l~yout of property must be draxvn on the diagram which i.$ part of this appli- cation. c. The work covered by this application may not be commenced before issuance . · ' ,. · · ...,.d~._ ,O._p_o.n ap?,roval of this apphcafion, the Building Inspector will issu-,~ a "-:'-~:--°~?ui~d)-n°?' erring, .... ~,,~ ~: ~ept oq, t~ Rr~/~se~S~aya',dal~ e for ins~cctio- th ..... h ....... ;~" ,~..mn~ :-ermxt to tne appauanL ~ucn permit e. No bu:ldih~ ~hafl ~e occupied or used in whole or in part for an ur , , · $hq. llhav¢. ~.e,~erLg~re~b;y. Ur.e~Buildi~g]i~st~ector . Y p Pose whatexer untd a Certificate of Occupancy uimln~ ,~one/Oi'~in~h~e 6f 'tHe;T6w~. ~: ~ ..... ¢- ~trnen[ ~or the ~ssuance oz a Building Permit pursuant to Re-ulat'hh~ 5r,~,~ ,!,~ ~k_2;_..~,.._L z.~:~ ,~?outno~., auuolk ~ounty, New York, and other applicable Law,]OrdinanceS;; .. i_..s, .......,. -,..,.-u,.uu. ut vuuamgs, auctitions or alterations, or for removal or demolition, a= herein described. The apph.c,~nt .agr, ees. to comply ~th all, applicable laws di ' · . admit authO?4ked;ms~'e~tors $~'~-~nii~[s~.,~ ;~ ~....,- ¢, / or nances., bufldz~g code. housm~ code. and re~ationz and to ~ :.-~:', ~',,)rF 'r-,~ ,, .., . ( ~natur.e O.t apphcant, or n.;~[ne, if a corporal;mn) ...... ........... (Mailing address of applic~t) Stat~ who~2~p$i~ is o~er~,les~e~, ~gent, ~chitect, en~neer, general contractor, electrician, plumber or builder. (as on thc tax roll or latest deed) If applicant is a co~orafion, s~nafure of duly authorized officer. officer) Builder's License No .~.~....~,?~. Plumber's License No ....................... Other Trade'~ Hcensc No ...................... Location &land on which proposed work w/Il be done: louse Number Street. ........ Hamlet ............... Map No. 1000 Section ........... ; Block ............... Lot. /~/ Subdivision.. ' ........ , a. · .............. ' l~ilcd Ma o. (Name) .............. Lot ............ fate exist ' S ing use and occupancy of premises and intended t,se and occupancy of proposed constrt,ction: a. Existing use and occupancy .......................... b. Intended use and occupancy "\x................... " ............ :: ' ' ;' ' '" ' "* ' ' ............ · .l .- Um ro£S[ones 10. Date of Purchase ,~ ...... Rear ................. Depth .............. ,- . . ': .... ." ;;"i ............. Name of Former Owner ....................... 11. z, one°rusedmtrictmwhtchprem,,isesaresituated...~d~ ................................. ~] ]~:]]:i]<a~ i2. Cues proposed construction violat~ any zoning taw. ordinance or regulation: /')~. ..................... 13. '~?I1 lot be regraded .; ........ j ................. Will excess fill be removed from prem scs: Yes 14. Name of Owner of oremises ~ ' - ...... ' ame'of Architect .......... i. . .... Address ................ Phone No ............... ~eofCo=aeto~...] ...... ~.]i'']2'].] .... Add=s ..... ].] ..] ....... Pho~eNo ..... ;'....,.:.~ ~. lli.~ thi~ property located within lO0 feet of a ,tidal wetland.* *YES .... ltO.~. *If yes, Southold Town Trustees Permit may be required. PLOT DIAG R JiM Lqcate clearly and distinctly all bhfldings, whether existina or Drot~osed and. indicate all set-back dimensions from prop.erty tines. Give atreet and block nu nber or description according'to ~leed, ~u~d show street names and indicate whethe? interiorr or comer lot. Nature of work (check wh ch app!icable) New Building .......... Additic, n .......... ,kltcrat,on ......... },epair ............. 1 ,R~moval ....... 1~ ...... DemolitiOn ........... ~...Swimming pool. ............ , (to be paid on filing thii application) fd elli f'd Iii nits . N b fd w ng, ngfnber o we ng u. ............... um er o welHog units on each floor. ........... . . . f garage number of cars . . f business, commercial or mixed ~aCU9ancy, specify nature and extent of each type of use . . ~ .... Height ............... Nunl bpr o f Stories ................................... ~.D pth ............. . . ; ' ;""- ' :' ' r' }Ie~,m. ~,.t ............. ......... Nt. mber of Stones ... j... ~mensmns of entire new cofiat~!~t~on: Front ........... ;... Rear ............... Depth . . APPROVED AS NOTED -- ' .N~FV 8U~[O~NO OE~E~T 76~1802 9 AM ~ 4 ~ FOR ~E FOLLOWING INSPE~IONS; ' 1. FOUNDAT~ - ~ REQUIRED FOR ~URED CONCR~E 2, ROUGH - FRAMING & PL~BING 3. INSU~ON 4. F~NAL CONSTRUCTION BE COMPL~E FO~C.O. ALL C~RUCTtON ~ THE REQUIR~E~OF THE STATE CONSTRU~ & ENERGY CODES. N~ RES~NSlB~ FOR DESIGN OR CONSTRU~ON ERRORS Notary STATE~IO F NEW~,YOR k' S COU, T.y OF ........ S. .......... r ..... ' .................................. being dtdy swum, deposes =d says that lm is the applicant [ (Name ofindividual signing ~ ontract) above nh~ed, ' , (Co~tractor , agent , corporate o fficcr, etc. ) owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~c and file this Pp tcat:.on: that all statements contained2 in this application are true to the best of his knowledge and belief; and that the Work wfl'l be pcrlbmled in tile m~ner set }forth in thc application filed therewith. ,/ SWum t~ before me this [ .'~ ......... day of. ..... iI ............ County IRIS R, BEGORA~ Notl~y Publlo, Stste of New Yo~ NO, 4844781 Quallfi~ in Suffolk Courm/ Commission E~ires Jan. SIo 1~.~ (Signature of aFpllc:n,t)