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Home My WebLink About19021-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19295 Date AUGUST 15~ 1990 THIS CERTIFIES that the building ADDITION Location of Propert~ 615 DOGWOOD LANE & 95 PVT. RD. #4 EAST MARION House No. Street Hamlet County Tax Map No. 1000 Section 037 Block 01 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 8, 1990 pursuant to which Building Permit No. 19021Z dated MAY 15¢ 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 GROUND LEVEL DECK ADDITION TO EXISTING DWELLING The certificate is issued to DIANE DUNBAR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEPd~T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-~ 19021 Z Permission is hereby granted to: .......... .~.~. ........ 1...~ ..~.... ......................... otpremt--s ..... ~ ........................ .t ..... ;...~-.- '~. ~.~;~ County Tax Mop No. 1000 Section ....... ,,O,...~...'/ ....... Block. ....... ..~,..~ ......... Lot No .....~.~ ................. pursuant to application dated ........... ~.....~ ......................., 19~.~., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPAKTMENT TOWN HALL 765-1802 i ' APPLICATION FOR CERTIFICATE OF · ~. 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 streets, and unusual natural or topographic features. Z. Final Approval from Health Dept.. of water supply and sewerage-disposal(S-9 ferm). 3. Approval of electrical installation from Board of Fire Underwrite~s. 4. Sworn statement from plumber certifying that the solder used in system conta/ns ~ less than 2/10 of lZ lead. 5. Commercial building, industrial building, multiple residences and s/miler bu//dings and installations, a certificate of Code Compliance from'architect or engineer responsible for the building. 6. Submit Planning Board Approva~ of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming use~, 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.Upda6ed Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ,/ Date ...... ?.77.1~ ~ f~ New Construction... ~'... ~ ~ ~ . . ' ............................. ......... .~ur rre-ex~stlng Building ................ ' ~ouse No. ~ ...Z' .... 7 ................ Street Hamlet Onwer or Owners of Property ........ County No '000, Section...C'.. 2 ... · 0 Il. · ..Bloc~ ................ Lot ................... ~ealth Dept Approval ' ' ......................... Underwriters Approval ,, App ' / "'. ~lanning Board reval .................. Request for: . Temporary Certificate ........... Final Certicate ........... g/ / ~h o · · ............. . ..... · ~ ~o~( Li~ ' ..' .............. Diane Dunbar 19 Scott Drive Melville, N.Y. TOWN, OF SOUTEtOLD OFFICE OF BUILDING IN~'PECTOR P.O. BOX 728 TOWN HALL $OUTItOL~, N.Y. 11971 August - 7 1990 11747 TEL. 765-1802 To Whom This'.May Co,ncern, We are unable to complete your Certificate of Occupancy becanse .of the following reasons. /--///An application for Certificate of Occupancy is not on file. (ENCLOSED) /_/,/~o U.n. derwriters Certificate on file. /~// The check is(~Xnot on file.) $25.00 /--/ No Hea..lth Dept. Approval on file. /_--/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation% Building Permit tl I 9 0 2 I Z Building Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FOUNDATION (1st) FOUNDATION 2. f2nd) ROUGH FRAME & .?LUMBING e INSULATION PER N. STATE ENERGY CODE Ye FINAL ! ADDITION' L COMMENTS: 765.180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. DATE INSPECTO , ~ / ~/ ~: Q I /11 APPROVED AS NOTED DATE: ~B,P, # ~ NOTIFY BUILDING ' ' " DEPARTMENT AT 765-1802 9 A~ TO 4 PM FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION ,. ~O REQUIRED FOR POURED CONCRETE 3, INSULATION 4. FINAL CONSTRUCTION ~UST 8F COMPLETE FOR ALL CODS~UC~ION SHALL TN~ RFQUIR~MENTS OF THE ~:;TATE CONSTRU~ION ~ C{)DFS, N~T RESPONSIBLE ~OR ' ~"tt,:]N O[] CONSTRucTIoN ERROF~S 765-1802 9 AM TO 4 PM FO~ THE FOLLOWING INSPECT~oA S. 1. ~OU~DATION ,, ~O FOR POURED CONCRETE 2. ROUGH, FRAMING & PLUM3ING 3. 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGy CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRoRs OCCUPANCY OR USE IS [~NLAWFDL OF OCCUPA~CY TOWN OF SOUTHOLD I3UILDING DEPARTMENT TOWN HALL $OUTItOLD. N.Y. 11971 TEl..; 765.1802 BOARD OF HEALTH ...1~,,~ ....... 3 SETS OF PLANS ............ SURVEY ....... NOTIFY: CALL · ''' ^ppro,,ed .... E -, q L% ..... ............... .... (Building Inspector) '?J,J~ ApPl le~TlON FO~ Date ..: ................ INSTRUCTIONS a. TlQs application must be completely filled in by Wpewfiter or i; ink and submitted to thc ~uildi~l~cctor, wit~ sets of plans, accurate plot plan to sc~e. Fee ~ccording to schedule, f~ ~o ~ b. Plot pt~ showing location of lot and of bulldogs on premiss, re]a~onsh~p to adjoining prcm~ or pubic streets or ~rc~s, and giv~g a det~l~d d~scription of layout of property must b~ drawn on the diagram which~p~ of this appU- c~don. c. Thc work covered by t~s application may not be commenced before issuance of. BuQdlng Peril - ' d. Upon approval of this application, the Buildin~ Inspector wQ1 issued a Uulldlng Pc~it to the app~t. Such peri. it ~hall be kept oa the premises avaQablc for inspection throu~out the work. e. No buJld~g shall be occupied or used in whole or i~ par~ for any purpose whatever until a Ce~i~ of Occup~cy Jhall h~vc been grated by ~e Build~g Inspector. ' APPLICA~oN IS HEREBY MADE to the Build~g Dep~mcnt for the issuance of a B~ldlng Pc~it pu~uant to the ~uildlng Zone Ordinance of the Town o[ Southold, Suffolk County. New York, ~d other applicable ~, Ord~ces or Regulations, for the const~ction of bufld~gs, additions or alterations, or for ~cmoval or demolition. ~ hc~:~ described. T~m ,appb~an? ag[ecs to comply w~th all apptic~e laws. ordinances, buQd~g code, h ' ~ c~dc and r aam~t aulaonzcd mspccto~ on premises and ~ bulldog for access: in~~~l~tz°ns' and to (Mailing address of appliemt) State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. wner of premises .... (as on the tax roll or latest deed) If applicant is a co~nration, signature of duly authorized officer. Builder's License No .......... Plumber's License No - Electrician's License No ...................... Other Trade's License No ...................... I. Location of land on which proposed work will be done: ~ ~ ouse Number feet Hamlet ............. . .. Subdivision . .............................. ~ ...... Eiled Map No ............. Lot ....... (Name) " · State existing nsc and occupancy ~Cp~mise~anSinten~ed t,~e~and oc?,pancy or proposed construcdOm b. Intended use and occupancy / '$ 3, Nature of work (check which appiicable): New Building .......... Addition ...... AJlcratmn Repair R~mov~l Demolition ' ' ' poo£ ~4, l:stimaledTennis CoUrtcost .. .......... .~. ~7 c~.)~ .Q.' .<~.A~cess°ry': ,i/; ~ . .~-. .......... Building i~ ...... .'..i [:cc ...... Fence ..' . ....~....Other,. We r k..~. JT.~ 1.<~: ..... ....--'--~ . ''" ilo be paid on filing this application) $. If dwelling, number of dxvclling u6its .......... ; .... Number of dwelling units on each floor ................ If garage number of cars ' Date of Purchase .............................. Name of Former Owner ........................ Zone or use district in which premises are situated .......................... .. · ..................... Does proposed construction vi~taie any zoning law ordinance or regu orion .... ~'.. ~. .................... Will lot be re~raded .:... P/.C~.i ....... .,-. ......... Wdl excess fill be removed from premises: . Yes .... No. Name of O~vner of premises .... [~. ~ ~. },~..'.. Address ....... Phone No ................. ,Name of Architect ........ ..,.....,~ . ..... A.~d~ ........................ ~ Phone No ................. Name of Contractor ....~,.V~.~'.-C~... i ........ Address ................... Phon~No ..... ~v... ~,t'5' .... .15.Is this property local:ed within lO0 feet of a tidal wetland*. ~YES .... NO.-,.. *If yes, Southold Town Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and b!ock n, umber or description according to deed, and show street names and indicate whether, interior or corner lot. lO. 11. 12. 13. 14. 6. If business, commercial or mixed occupancy, specify nature :md extent o£ each type of u~e ...... 7. Dimensions of existing srructurcs,,if any: Front.., ............ Rear ............... Depth Height ............... Number of Stories ......................................... Dimensions of same structure with alterations or additions: Front ................. Rear ... Depth ..................... :. Height ...................... Number of Stories ....... 8, Dimensions of entire new construction: Front ............... Rear ............... Depth Height ........... .... Number of Stones .... .......... ; ............... S ze ofl t: Front .... STATE OF NEW YORK, ..............· . ...... ,. .... ....-......, being duly sworn, deposes and says that he is the applicant (Name of individual signihg contract) above na~ed. He is the ; . ' (Contractor, agent, corporate officer, etc.) of ~aid owner or owners, and is duly authorized to pc,rform or have performed the said work and to make and file this application; that all state~nents contained in this application are true to the best of his knowledge and belief; and that thc work will be performed in the manner set forth in the application filed therewith. Sworn to before me tiffs ,~,', .. . .... County Notav/Public, . (Signature of applicant)