HomeMy WebLinkAbout18139-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18757 Date FEBRUARY 2, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 575 RAMBLER ROAD SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 88 Block 5 Lot 33
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MAY 19, 1989 pursuant to which
Building Permit No. 18139-Z dated MAY 26, 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to GEORGE & SEAN K. Patterson
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
a~oaa[ xa a
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° Z Date ...`~~.~G 19..1Jc1
Permission is hereby granted to:
,L- ~
ro .~L~ef?7.G~~~'~...~ ..Gr.B..Ra.. BxP
.
....r..-~......~~~,....
at premises located at ............~/..~l.F..~Zl~.`.'I~~,..,~C{.i,..T
County Tox Map No. 1000 Section .........C3./~..... Bloek Lot No.........+1~..3......
pursuant to opplication dated ...........:.~,1./.~~ 19."1.., and approved by the
Building Inspector. /
~ O~
Fee $...c.%. ~
B ding I for
Rev. 6/30/80
,
TOS1N OP SOUTIIOLD
BUILDItfC DEPART:IE2fT n
TOUN IIALL D ~.Y I ~
SOUTIIOLD, NEN YORK 11971
~ ~ ~ _ > >~30
7G5 - III02
APPLICATION t
FOR CERTIFICATE OF OCCIIPAtfC T~",,"JJ/'"" """"~L®
HEN CONSTRUCTION ..._.__OLD OR PRE-E%ZSTZtfC BUILDING...
_-7 'j,) •oACAtfT LAND...
Location of Propcrty__..S r f___.. IlQ//~,~
/.e~_ _
NOUSE HO. STP.EET ~ "
HAMLET
Ovner or Ovncrs of Property.. _ _
County Sax Hap No. 1000 Sectio?
Block Lot'
Subdivision.. J
Filed Map ~o-/...Lot._ _
Pcrnit No. __pate of P 3 7 .
crmit 5~~~~
~•APPLicant
Health Dept. Approval "
" Undcrvritcrs Approval._....._.
Planning Board Approval
Request for Temporary Certificate
. Final CcrtificaCC
Pee Submii[ed: $-..~~iL~
APPLZCANT..t~°.~-.~C;` ..~1.?Y~
reye
10/I4?88
384N1
c' o i?. ~ B 7~5" 7 .
FORM N0. 6
TONN OF SOUTNOLD
BIIILDING DEPARTCUiNT
T0I7N ITAL.
7G5 - IB02 '
~ APPLICATLON FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS
- A. This application must be filed in typewriter OR ink and submitted Co [hc Building
Inspector with [hb fol'lowing; for 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 Dealth Dept. of water supply and sewerage-disposal(S-9 form).
' 3. Approval of clectri~cal installation from Board of Fire Underwriters.
4. Sworn statement frojm plumber certifying ChaC solder used in system contains less'
than 2/10 of IZ lca'd.
5. Commercial buildings, industrial buildings, multiple residences and similar,
buildings and insta~llaCions, a certificate of code compliance from the Architect
or Engineer respons,ible for the building. •
6. Submit Planning IIoa~rd Approval of completed site plan requirements.
B. For ezisting buildings', (Prior to April 9, 1957] non-conforming uses, or buildings
and "pre-existing" land uses:
I. 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 abs',tract 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 state the
reasons therefor in writing to the applicant.
3. Date of any housing code or safety inspection of buildings or premises, or other
pertinent information required to prepare a certificate.
C. For Vacant Land Certificate of Occupancy:
1. Ao application for 'vacant land Certificate of Occupancy shall be submitted,
and a certified absjtract of title issued by a title company showing single and
separate ownership of,~the entire lot prior to April 9, 1957 shall also accompany
[he application. Iif a Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D. FEES:
1. CERTIFICATE OF ,OCCUPANCY - New Duelling $25.00, Additions to Bwelling $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 ofOccupancy an pre-ezisting dwelling - $100.00.
3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00
4. Vacant Land Cer,tificatc of Occupancy - $20.00
5. IIpdated Cer[ifi'cate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $15.00 Residential '
Commercial
,p .
~ I .
t~~'~;c-c~r~. are ~c..1~
Ce. to/14/ss
TEL. 765-1802
o~O~~FF~L/(~0~ TOWN OF SOUTIIOLD
:`c OFFICE OF BUILDING INSPECTOR
~ P.O. BOX 728
o ;,y,F,,~. , ,T,
t' ' ~ TOWN HALL
0~~~~ SOUTFIOLD, N.Y. i 1971
JANUARY 10, 1989
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because oL the following reasons.
/g~ An application for Certificate of Occupancy
is not on file. ENCLOSED
No Underwriters Certificate on file.
fig/ The check is (outdated/not on file.} $25.00
No health Dept. Approval on file.
A*o final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit it 1 8 1 3 9 2
Building Dept.
No Plumber Solder Certificate on file..
( all permits involving plumbing being
issued after April 1,1989
PATTBRSON
575 RAMBLER RD.
SOIITHOLD, N.Y. 11971
r , s;: I ~ \cVu~7
_ H
OUNDATION , (1st)
OUNDATIOtJ ( 2nd ) ~'~d
- - m~
OUGH FRAME & ~ C V
PLUMBING
ti~
• H
C1
t1SULATION PER N. Y, y
STATE ENERGY
CODE
x
. /y ~ -J y
FZ,lAL
o
E
ADDITIONAL COMMENTS: x
ro
x
ro
H
• 9
H
O
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a
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/ 765-1802
G BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST ( ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING [ FINAL
REMARKS: --~~~1
DATE y % INSPECTOR
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60ARD OF HEALTH
FORM N0.1 3 SETS OF PL.1NS ~•JC•
MAY 19199 SURVEY U;
TOWN OFSOUTHOLD CHECK ........?~,$fP,1U...
~ BUILDING DEPARTMENT SEPTIC FORM ~
__a__.,e.,._._._~.,t .
~ k~SLDO.DEPT
TOWN OF Spt}~h01_L7 TOWN HALL
~.~----a~-°°-'°"" SOUTHOLD, N. Y. 11~J71 NOTIFY
' TEL.: 7G5•1II02 CALL , ,
Examined .:9,/..~........, 19~i MAIL T0: ~i~~,'~~
Approved „ 1:Y1.1(. Permit No.~0.J:3
Disapproved a/c
i -ng Inspector)
f
APPLICATION FOR BUILDING PERMIT
1 Date 15 ~k.
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in 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.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Buildin; Inspector wdl issued a Building Permit to the applicant. Such permit
shall be kept on the premises avai]able for inspection throug}tout 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 removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspector on premises and in building for necessary insp®e~ctions.
(Signatur~;oi applicant, or name, if a corporation)
~ (Mailing address of applicant)
State wheth~/e,AJr applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ~-PD./.'~~.,~'. j s •1 •Ct ~j~'.?~SU~j!~ .
(as on the tax roll or latest deed)
!f applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No. ~ 3 0
Plumber's License No . .
Electrician's License No .
Otfter Trade's License No . ~-r~~-
1. Location of land on which proposed work will be done. ~~"~~z,',/~rAft ° ~ t ~ ~ /r. ,
~ f'G ~ .
House Number ~ Street l Hamlet ~ ~ ~ ~ ~ ~ ~ ~ ~ '
County Tax D1ap No. 1000 $eet10? ..~,4............ Block , , , , , , , , Lot
Subdivision F.ilcd tap No. ~ Lot .
(Name) r^ •`Q
State existing use and occupancy o(-~p7remises and inn/tended use and occupancy of proposed construction:
a. Existing use and occupancy ....J:~wGI~~-, 6T~~1~-~.......... .
b. Intended use and occupancy r,)!~ ~~~5'.
................~~;~;92_............................
3. Nature of work (check which al~pplicable): New E3uilding Addition a Rea '
Repair Rcrr}oval Demolition Othe~~rk .~LC~<....... .
(Description)
4. Estimated Cost `.1'fV ufl:' .UC~ Fee , .
i
" S (to be paid on filing this application)
o units Number of dwelling units on each door...............
If ~ara~c, number of cars .
6. if business. co nmer oaldorcmixG • •
d occupancy, specify nature and extent of each type of use
7. Dimensions of existing structures, if any: Fron[ . Rear Depth .
Hcigftt Number of Stories . . , .
- Dimensions of same structure with alterations or additions: Front Rear .
Depth height . .Number of Stories .
Dimensions of entire new construction: Front Rear . ,Depth ~ ~ ~ ~ ~ ' ' '
Height Number of Stories . • • • .
9. Size of lot: Front Rear,......................Depth.......................
l0. Date of Purchase ....Name of Former Owner ~ ~ ~ ~ ~ ~ t,
1 I. Zone or use district in which premises are situated . • ~ ~ ~ • ~ ~ ' ~ ~ ~ ' ' ' ' ' ' ' ' ' ' ' ' '
12. oes proposed construction vio~atc any zoning law, ordinance ar regulation: ~ ~ •
d lot be regraded ~ • • .
\Vill excess dll be removed from premises: „Yes No
14. Name of Owner of premises . ................Address . . Pltonc No. .
Name of Architect ................Address..~~....~~~••..•••.Phonr,No..••.•...~~~•~~~
Name of Contractor , Address . .Phone No. .
IS.Is this property located within 300 feet of a tidal wetland? *YES.. .NO.~y.
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly aill buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lines. Give street and block ;number or description according to deed, and show street names and indicate whether
interior or comer lot. ~
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STATE OF NE1V YORK,
COUNTY OF S'i S
• ~ ~ ' ~ • ~ ~ ' • ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' • • • I• • • • • • • • • • • . • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named. ~
!!e is the .
(Contractor, agent, corporate officer, etc.) ~ ~ ~ ~ ~ "
~C said otvner or owners, and is duly I,authorizcd to perform or have performed the said work and to make and dle tltis
~Pplication; that all statements contaidcd in this application arc true to the best of his knowledge and belief; and that the
•vork will be performed in dte manner ~ct forth in the application dlcd therewith.
iwarn to before me [his I
..............~.Q.....dayof.....~/"1/'1. 19~y.
votary Public, ....•~e;Qory;J . ~ . ~,Pr.r~~Z, ,
.County
HE4EN ~ DE VOE ^^~s~~~~ . • • . • • .
NOTARY YUBtlfq State of New York (Signatuze of applicant)
No. 4707878, SuNolk County
Term Expires Maroh 30,18...~~
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