HomeMy WebLinkAbout18511-z FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 218770 Date FEBRUARY 6, 1990
THIS CERTIFIES that the building ALTERATION
Location of Property 545 WOODCLIFF DRIVE MATTITUCK
House No. Street Hamlet
County Tax Map No. 1000 Section 167 Block 07 Lot 23
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPT. 11, 1989 pursuant to which
Building Permit No. 185112 dated SEPT. 15, 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 INSTALL TWO SKYLIGHTS IN ROOF OF EXISTING DWELLING.
The certificate is issued to RONALD F. & DOROTHY M. LANKSHEAR
(owner, }
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
B di g I spector
Rev. 1/81
soaas xa s
TOWN OF SOUTNOLD
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 0 .L O J ~.1 Z Dote q
Permission is hereby granted to:
~'`.J`.:::~":~f~... ~0i.:`1~.
~QS......~d..
.....~..~:°~~':?:~.....~.:°~:...0 0.9 3............
at premises located at .....ti`~.~~.....5.r41.47~T~.~.....:.°..~.~.:......
County Tox Map No. 1000 Sec .....`.o...~......... Block ........Q .1...... Lot No....°2~...........
pursuant to application dated .~~.P:::°.....d.1 19..1.., and approved by the
Buildfng Inspector.
Fee S•••~~•_••
Buildfng Inspector
Rev. 6/30/80
_ _ _
_ _ _ _ _ D ~
m.~ F, ~ o ~ 3 RG . I I t 73
UI~f~-~!''~ TOWN OF SOUTUOLD ~ "'2~
BUILDING DEPART2[ENT
BLCG. DEPT.
TOWN HALL TON/N 0'r S0UTt30LD
SOUTIIOLD, NEW YOI1K 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
d 1
HEW CONSTRUCTION ._..._,OLD OR PRE-E%Z1S'T11LNG BUILDZNG.:,:_._PACANT LANO.,..___.
'Location of Property-OUSE NO. y.d W~ STREEII~2~ '.HAML~#1..
.Ouaer or Ovners of Property..~~~?'!u-R:~.~_~'.~.Q~C~.==:y_?~:, ~~.^:-~5;::~-~"
County Taz Map No. 1000 Section ,IQ ~AIJ Block . _t7 .I.17~ Lot . ~ 4~~ .C2G~ U
Subdivision FCi~leld~~M//rap ........Lot._.......,
Perait No. I,~~~~,~.Date of PermiC ,/./~^?1.~9_Applicant ._.(J::`:r_::'_..._...
IIealth Dep[. Approval Underwriters Approval.__._....._._.
Planning IIoard Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: $...~~.•Q Q...........
APPLICANT...... L~~t'17 a.. ! : ! .~.~Y4p~~LP„~Lf--"~
~ 3k96/
a~~~yv
G°U Z (~7~0
rev. 10/14/88
_ -
~ FORM NO. 6
. - ~ TOWN OF SOUTROLD
BIIILDING DEPARTMENT
TOWN HALT
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A. 'This application must be filed in typewriter OR ink and submitted to the Building
Inspector with the following; for new buildings or new use:
1. Fiaai 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 Undervriters_
4_ Sworn statement from plumber certifying [hat solder used in system contains Less
than 2j10 of IZ lead.
5_ Commercial buildings, industrial buildings, multiple residences and similar.
buildings and installations, a certificate of code compliance from the 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:
I. Accurate survey of property shoving all property lines, streets, buildings and
unusual natural or topographic features.
2. A properly completed application, a consent [o inspect signed by the applicant
and a certified abstract of title issued by a title 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 stair, thr
reasons thereYOr in writing to the applic.an[.
3. Date of any housing code or safely inspection of buildings or premises, or other
pertinent in Foz-mation required to prepare a certificate_
C_ For Vacant Land Certificate of Occupancy:
i_ An application for vacant land Certificate of Occupancy shall be submitted,
and a certified abstract of title issued by a title company showing single and
separate ownership of the entire lot prior to April 9, ]957 shall also accompany
the application. If a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D, FEES:
i. CERTIFICATE OF OCCUPANCY - New Duelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $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 Certificate of Occupancy - $20.00
S. Updated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $25.00 Residential
$50.00 Commezcial
-cv, 10/14/S8
i i_:LD I:: S:'E...iu:: ~~:i i.iE I~ ikYMENTC
1
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?OUIIDATIO:J , ( 1st )
POUtJDATI0IJ (2nd) _
2 . II - -
1
30UGH FRAPIE & I
•PLUMBINC
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IIJSULATIOPJ PER N. Y. y
STATE EPJERGY
CODE
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ADDITIOPJAL COMME[lTS: ~
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~o z~a~~~rr or sou~ruo~a~
~i~~f-.'N~
~ 0f1'1CJi Ol" FIUILUING IidSPECTOR
~i., ~;~jJ`y.A P.O. UOX 723 ~
"lU' < ? t 'F'OtVN HALL
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S0[JF'FS0LD,N...11971
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~--.~r.:~y' FEBRUARY i, l990
DOROTHY S RONALD LANKSHBAR
BOR 39b '
UPTON, N.Y. 11973
To S~Jhom This Iday Concern,
t'+e me unable to co;nplete your Certificate
- of OccuF~anr_y I.1CCaUSC of• the following reasons.
/,V/ Rn application for Certificate of Occupancy
is not nn File. (ENCLOSED)
ro Under:writers Certificate on file.
/~i'he chec}: is(cgp[~gt~g~~/not on file.) $25.00
/ / iin 'Iezlth Dept. Approval un file.
L:o final inspection has been made.
P1.ear;e contact our office on this matter.
Thank yo:.: for your cooperation.- -
FluilcIinr, Pr_rmit 11 I s s 1 1 Z
Building Dcpt.
( iiq F'lumher Solder Certificate on file.
S all permito involvinc7 plumUinp being
issuccl afL•er April 1,19II9 ) -
R fa 12 II M 12 BOARD OF HEALTH • .
D 15 l~J 15 ll V L5 ~ 3 SETS OF PLANS
•FORMNO.1 SURVEY
SEP I 11989 TOWN OF SOUTHOLD CHECK • • • • • • - - • -
BUILDINGDEPARTMENT SEPTIC FORPi
TOWN HALL
BLDG. DE ~'T. N O T I F Y
TOln.m~OF_a?•'n °.OUTHOLD, N.Y. 11971 CALL -
` TEL.: 765-1802 MAIL T0: $ pG • • • • • • , -
Exam' 19 P b• ~ . 11 ~1 ~
A roved ~ ~ 5., 19~~. Permit No.. ~ .8 ! ~.2ti'.
PP
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ......9~.. ~ 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter 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 stree
or areas, and Giving a detailed description of layout of property must be drawn on the diagram which is part of this app
cation.
c. The work covered by this $p'pli~ation tray
no~be commenced before issuance of Building Permit.
d. Upon approval of this appl~catioii, the Building%Inspector will issued a Building Permit to the applicant. Such perm
shall be kept on the premises ava!)'able for inspection throughout the work.
e. No building shall be ~cF,u~ie~,or used in whole or in part for any purpose whatever until a Certificate of Occupan~
shall have been granted by the Buildirpgfin~ect~ j a~ ' '
APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant to ti
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances .
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant agrees to comply with aL1 apphcable laws, ordinances, building code, housing code, an_d regulations, and
admit authorized inspectors on premises and in building for necessary inspections. ~~J ~ IG~Tty~~ .i y~n~~~~r
(Signature ofant, or name, if a corporation)
.........~i o i'jox 396.
~Yl l :l 9.7 3:.Q3
(Dlaili g address of applicant)
State whether applicant is caner essee, agent, architect, engineer, general contractor, electrician, plumber or buiIde,
.........................nn.....................................................................
Name of owner of premises ...1~ Pvia.Q~. • F•• , ~ o.r. v9... 1-..~G-i" .
(as on [he to roll or latest deed). -
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
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 bu done . .
House Number Stree7t Hamlet
County Tax hlap No. 1000 Suction , , . Block 7........... Lot ...a 3
Subdivision Filedilap No. Lot...............
(Name)
State existing use and occupancy of promisees and intended use and occupancy of proposed construction:
a. Existing use and occupancy .........0.'~~.~..-.......! .
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration . , , ,
Repair Removal , Demolition Other 11'ork ~?Ffs-.~ft.?t!'p~,
m 2 5/cy ~•y k`~' } (Descri Iion
4. Estimated Costy~ . 7~ ~ . , Fee .
..........p...)
• ~ (to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
If garage,numbcrofcars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any; Front Rear Depth .
Hcigtrt ...............NunrberofStories......................................................-
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 ...............Nut»berofStories........................................................
9. Size of lot: Front Rear...................... Depth
]0. Date of Purchase .Name of Former Owner .
.
1 1. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation: NP .
13. Iti'i11 lot be regraded 1Vi11 excess fill be removed from premises: Yes N
14. Name of Owner of,premises ....................Address ...................Phone No.............. .
Name of Architect ...........................Address ...................Phone No.............. .
Name of Contractor ..........................Address ....:..............Phone No.............. .
15. Is this property located within 300 feetyyof a tiyidal wetland? *Yes No
*If yes, Southold Town Trustees PermitPLOT DIAGILAM ed.
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fror,
property lines. Give street and block number or description according to deed, and show reet names and indicate whethe
interior or corner lot. QCC~PA~'(~,'Y
USE 1S UNLAWFUL
W{TROUT CERTIFICATE
pF OCCUPAWCY
APPR YED AS NOTED I
~ x ~
! ~ 1 s+ary
DaTE: Y B.P s
FEE:~'i~~'~ BY: G.L• >QhNC't
NOTIFY BUILDING DEPARTMENT AT Rou i~
76fi•18D2 9 AM TO ~ PM FOR
FOLLOWING INSPECTIONS.
1. FOUNDATION TWO REOUI ED
FOR POURED CONCRETE
2. ROUGH • FRAMING Zk PLUMB NG y~'x ye
3. INSULATION
4. F4NAL - CONSTRUCTION M ST
BE COMPLETE FOR C.C
ALL CONSTRUC710N SHALL M T
THE REQUIREMENTS OF THE Ivt'--"
STATE CONSTRUCTION & ENERGY q /f r.l ~ Prg k~j~a or~+'~`
CODES. NOT RESPONSIBLE FOR
DESIGN OR GONtiTRUCTION ERRORS w; I> c ~a.~ ~ le ~ 2 k ~
~ov~r/e I~cadro"S ~ /k/Ss b-
ITATEOf=NEIYYORIC, Gerl:µ fp,'sts rn..'Gl ~,~•sa be dog
'OGNTY OF S.S f(
~ ~or.C/e l.LO.cIe~ •wi'fil, t-rco lrya
being duly sworn, deposes and says that he is the applican
(Name of individual signing contract)
Dove named.
is is the ~ ......~L.}?+~12PwZ ~-~l~l!...1..... .
(Contractor, agent, corporate officer, etc.)
f said otvncr or owners, and is duly authorized to perform or have performed the said work and to make and file thi
~plication; [hat alt statements contained in this application are true to the best of his knowledge and belief; and that th
ork will be performed in the manner set forth in the application filed therewith.
wom to before me this q
..........~~...........day of.......... 19 .8f
'~J n
otary Public, . , _ County
~L /~~9 //n .
LA. i122~i~ . Y .
~Bix~,~ ~ (Si nature of applicant
NOTARY PUOLIC, Shte of Neuw~York~ ~ ~L
Terlm~FxpiresTM:rch
30.19--~