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HomeMy WebLinkAbout18697-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18840 Date FEBRUARY 22, 1990 THIS CERTIFIES that the building ADDITION Location of Property 715 WAMPUM WAY & TEPEE TRAIL SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 87 Block 2 Lot 28 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 14, 1989 pursuant to which Building Permit No. 18697-Z dated DECEMBER 14, 1989 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 CHIMNEY ADDITION ON EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to GEODESIC HOMES, INC. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B ilding Inspector Rev. 1/81 rosaz xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ ~ O ~ ~ ! Z Date ..~f~7~./tj.~ 19.. Permission is hereby granted to: cr premises !acoted of ~..,~?..~c...K~.dl.?.? .........~G1.1!~ ....................................................................GG...--.77....................................................,................................. County Tax Map No. 1000 Section .......Q,.1............ Block Lot No. ~r.:..Q......... pursuant to application doted ..1.~...~1~ 19L,~...., and approved by the Building Inspector. ae Fee ~11 ~Bui ng~~lraspectar Rev. 6/30/80 TOWN OP SOUTDOLD BUILDING DEPART:fENT ~ ~ '°u ~J TOWN HALL 0 SOUTIIDLD, NEW YORK i 197 1 f 765 - 1802 BLDG.pFPT. ~Whf OF S0U7HOL0 APPLICATION FOR CERTIFICATE OF OCCIIPANCY ~_~J C,? DATE.. y~~~~`,a.... NEN CONSTRUCTION .......OLD OR PR~,E-En%ZSTING BUILDING.-..,.,L.VACANTNLAND.._.. Location of Property.~~.,f~~~~!~~J/~llG~r/.T.S~~C~G~YYc~!!~d.~.AMLET~ Owner or Owners of Property....~~FFF~~~~~~G/V'"'"•`•4"~...-G! Couacy Taa Hap No. 100+0 Section A.J.. Block Lot' . ~::'4. Subdivision(~J./v.~^:!UJ~~~~~~4~C~1:'~~Filed Map .Lot..~..._. Pcrnit ao ....Date of Permit ..._......Applicaat (,.~~~~Z's°~~Gy%q-`Y~=~'a~ z [Icalth Dcpt. Approval Underwriters Approval.............. PlanninC IIoard Approval Request for Temporary Certificate Final Certificate Fec Submitted: APPLICANT... d~~'y~~ V% ~+~=~~G/N..~.~.. ~I~C~Y' ~~72c2j~~PC ~~~Cd3- rev. 10/14/88 Q~~,.3`~G~~ C o ~ iggy o i ' / FORM N0. 6 TOWN OF SOUTNOLD BIIILDING DEPARTMENT TOWN HAL. 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must be filed in typewriter OR ink and submitted Co the Building Inspector with the follgwing; fox new buildings 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 of Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. , 4. Sworn statement fromlplumber certifying that solder used in system contains less than 2/IO of lZ IeadJ 5. Commercial buildings; industrial buildings, multiple residences and similar, buildings and installaCions, a certificate of code compliance from the Architect or Engineer responsible for the building. 6. SubmiC 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, buildings and unusual natural or topographic features. 2. A properly completed 'application, a consent to inspect signed by the applicant and a certified abstract of title issued by a Citle company which shall show single and separate ownership of the entire lot prior to April 9, 1957. ~ If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in voting to the applicant. 3. Date of any housing cbde or safety inspection of buildings or premises, or other pertinent informationxequired to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An application for vaFant land Certificate of Occupancy shall be submitted, and,a certified abstr~ct of title issued by a title company showing single and separate ownership of,,the entire lot prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in wriCing to the applicant. D. FEES: I 1. CERTIFYCA'1'L OF OCCUPANCY - New Dwelling $25.00, AddiCions to Dwelling $25.00, Alteration Co Dwe~.ling $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certi>icate of Occupancy - $20.00 5. IIpdated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy - $25.00 Residential $50.0(1 Commercial i i rev= 10/14/S8 • TEL. 765-1802 ~~F~ou~c o ,,,~~~~F~ CG TOWN 0~ SOUTIIOLD &1~:~,% ~ ~ OFFICE OF BUILDING INSPECTOR o xr .-T, P.O. BOX 728 ' y°'~`~ TOWN HALL „0,~~0~ SOUTHOLD, N.Y. 11971 February 7, 1990 GEODESIC HOMES #5 HILLTON COURT ST, JAMES, N.Y. 11780 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because of- the following reasons. /g~( An application for Certificate of Occupancy is not on file. ENCLOSED / No Underwriters Certificate on file. /g~ The check is(omds/not on file.) $25.00 / / No Health Dept. Approval on file. A*o final inspection has beery made. I Please contact our office on this matter. Thank you for your cooperation. Building Permit IR 1 8 6 9 7 Z Building Dept. / No Plumber Solder Certificate on file.. ( all permits involving plumbing being issued after April 1,1984 ) _ • ~I y V `-9~ 'OUt1DATZOa (1st) ° 'OUtJDATIO;J (2nd) _ I o '.OUGH FRAME & .PLUMBING y H m 3. ~ c~~ IIJSULATI0II PER N. Y. I ~ ~ ~ STATE E1IERGY CODE r m y. H FINAL I ' ( o m ADDITIOtJAL COMMEtITS: s . ~ ~ Q~ xy _ b H ~ \ 9 • H m~ . - ! ~ a m .a • T65-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN CATION w [ l FRAMING [ FINA REMARKS: DATE ~ C~ ~ INSPECTOR L~ . ~ ~a~- .J ~I I I . ~ rl ~ , I r;~~,~~*~ ~ ~ ~ . }r ~ C: ~C" .i, p r 9 ~ ® l~ ( ~ ~V~ _ 4 ~E~ ~Ft x)t.~t K+~'~igS ~'wo- \ ~i t 1} a ~ S ~ Q ~ k~ h 4 9 n 'N~~n~ ~A~~~?I~ I t i(~ ~ ~A r c" ~~,.~"p ~I i D ) ~ ? C FixlO ~~xt0,~ ~ r- _ _ 4-. 1' ` -Yr I II I~ O O T II - I ~I I~-T._ I r_ . I _ _ , _~_i~ ~T_~~' _I__-_..-. I~~ .....T_ _ ,r--=-- - - _ _ _ M_~ ARE cF ratty r A- 6 i ~C°.d 4-C/iLJ' ~V~~ic~/~'E/~ ! ~ /`Z L~:~ W`~~- ~Ow ~o, g~M169` ~Cy~ 9~FFESlflNPb .r---- ~ ~ ~ ~ i ~ a- r.ti yr. ~r~-, _ , 7 ' ~ 1- ~w~_ a "4` ~;i ~'F fi i ~0 ~ ~~h_-L. ,,NIpE MASONRY ~N~T ~ i~d,a~---`~ GROUT~b SOLD i=_-~~. ~ ~ E~~ ~c _~'u yb~,; ~ Grp - r-" 4 -f ~ ~1 _ 8R1GK ~ F1R~ USE TYPE .A MGR~A----"'~-""_~~ ? GRGUT' ~ k 11 i, & EN _ c~, CE X11 ~ }AIN• ~ m ASR SppGE -1} ~f ji 3" M1N• 1 FULL H~'~G JG~hj5 u` ~ ~'~-t' `l . x-~z E MASpNRY ' F1R~p~-AC RJa;~ t5 { v ; ^ 4 t:~ Qi'. e ~ f( S A FV Ohl ~~....~1 ~4~~,~f p y- s BOARD OF HEgLTH 3 SETS OF PLANS . . FORM N0.1 SURVEY TOWN OF SOUTHOLD CHECK . BUILDING DEPARTMENT SEPTIC FORM TOWN HALL '(-~~~~'-d $OUTHOLD•N.Y.11971 NOTir•Yb TEL.:7G5.1802 CALL ~ . 190/. MAIL T0 . Exantincd ~ Approved ..~1~,/./. ~ 19~!. Permit No./, / ~ . Disapproved a/c : -a ~a . y~ ~•~06~ + 4 ~ (B ding Inspector} gLAG. DEPT. APPLICATION FOR ElUI+ DIN(; PERM TOWN OFSO,U+THOLD ('~s~ • INSTRUCTIONS {3 a. Tltis application must be completely filled in by typewriter or jn 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. e. 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 Regulations, for the construction of buildings, additions or alterations, or for oval or demolition s herein described. The applicant agrees to comply with all applicable laws, ordinances, build' co , h s' od d regulations, and to admit authorized inspectors on premises and in building for necessary inspe ions. l :R (Signature o ap ca r name, if a cor anon - ~c / > (Mailing address of applicant) r/C i~~ , State whbtltl3itrapplicant is owner; lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. A5L"/. ~ Name of ba~r1"e'r'~t~pre3riises " ~ZsZ1?~~~~ 10~ • • • • • • • • • • • • • • • • • . ` ~ ' (as on the tax roll or latest deed) IC applica s r i , e;qf d ly authorized officer. • • 4 , •#tte• ;Of corpora e_officer) Builder's License No . . Plumber's License No . . Electrician's License No . ' ~ Otltcr Trade's License No . . 1. Location of land on which proposed work will be done; Elouse Number ©~/[ree~ ~O U Hamlet County Tax Map/No. 1000 Section ....Ga • • • ~ ~ • • • • ~ BI'gck • . ~ Lot , " • • Subdivision t! 4f!U,t~l~~v.I!~+~ •~?.t~1~=~~-~ Filed A1ap No. .~12.{~ Lot . (Name) State existing use and occupancy of premises~and intended use and occupancy of proposed construction: a. Existing use and occupancy . b. Intended use and occupancy • • • • • • • • • • • • • ?v~rr~•. • • ,X13-A/~ . } . 3. Ptlature of w/?rk check which applicable): New Quilling Addittcn Alteration . Repair ~ ~ Removal Demolition ..............Swimming pool........ , . Tennis Caaurt ..1`.. Accessory Building.........,Fence ......,Other Work:. 4. Estimated Cost ~.~C'~sG1 Fee • (to be paid on filing this application] 5, If dwellin„ number of dwelling units Number of dwelling units on each door If garage,numbcrofcars 6. If business, commercial or mixed occupancy, specify nature and extent o(each type of use . 7, Dimensions of existing structures,i, if any: Front . Rear Depth . . Hei;ftt Number of Stories . , Dimensions of same structure with alterations or additions: Front Rear , . Depth Height Number of Stories . . 8. Dimensions of entire new constnrction: Front Rear Depth . . Hei;ht nb~er of Stories . 9. Size of lot: Front ~ Rear Depth 10. Date of Purchase , , . , , .Name of Former Owner . . . . , 1 1. Zone or use district` in which premises are situated . . . P P l 13-. Does ro osed construcLOn violaje any zoning law, ordinance or regulation: ,/tr.l~ . . 13. '1Vill lot be regraded J ...,tL.lA \Vill excess fill be removed from premises: ;'Yes No 14. Name of Owner of premises . .Address ........Phone No............... , . Name of Architect .Address ;,8~,?~ ......Phone No. Name of Contractor Gv /.~'11~.3rJ?!d,~/. , , ...Address ~5e'a'~e?1~~!6~.. ..Phone No. , 15.Is this property located within 100 feet of 'a tidal wetland? *YL~S...~N0..1.. *If yes, Southold TownlTrustees 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 dumber or description according to deed, and show street names and indicate whether interior or corner lot. ~ - .y x APPROVED AS NOTEO DATOw B.P. M • ~ NOriFY BUILDING DEi'ARTMEMT AT 765-1802 9 AM 1T1 4 PM FOR THE FOt.LOWING INSPECTIONS: 1. FOUNDATION TWO REQUIRED FOR PQURED CONCRETE 2. ROUGW - FRAMING ~ PLUMBINQ 3. INSULATION 4. FINAL - OONSTRIJCTION MUST BE COMPLETE FOR C.O. ~ ALL CONSTRUCTION SHALL MEET THE REQUIREMENT8 Of THB N.V, STATE CONSTRUCTION f[ HRCiY CODE5. NOT RE$PON818LE fOR • dESIGN OR CONSTRUCTION ERROR8 STATE OF NE1V YORE, S.S COUNTY~OF • • • • • ~>!Pi`tl ~2`+~~G'r /•!G'."~:. • • being duly sworn, deposes and says that he is the applicant (Name of individual si ding contract) „ about named, i Fie is the ~G'.~i.L~.i~.?~.~.'~',/~f~..~~C'~.~ . (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 true to the best of his knowledge and belief; and that the work will be perforned in the manner set forth in the application filed therewith. ~ Swom to before me this .......day of ....:~~.~~~?.'?~Er\.. „ 19'1`. t Notary Public, . ~ 4,~~D L~~. , County N TA ~ BtIC, State of New York " " " " " " ' • ' No 52.4764836 (Signature of applicant) Qualifjed m Sutfolk County 9~ _ Cammrssia{~ Expires ~,6 ,fig 19~ • `