HomeMy WebLinkAbout17386-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19743
Date FEBRUARY 21~ 1991
THIS CERTIFIES that the buildin~
Location of Propert~ I90 PVT. RD. #7
House No.
County Tax Map No. 1000 Section 38
Subdivision
ALTERATION
EAST MP~RION
Street Hamlet
Block 01 Lot 25
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 22~ 1988 pursuant to which
Building Permit No. 17386Z dated SEPT. 2, 1985
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 CONSTRUCT ROOF OVER A MOBIL HOME.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH P~PPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
WILLIAM & BARBARA GUNTHER
Building Inspector
Rev. 1/81
TOWN OF SO~THOLD
BUILDING DEPARTMENT
TOWN HALL.
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NO- 017386 Z Date
Permission is hereby granted ~ ~
to ....... ~ ...... ~. .....
County Tox Map No. 1000 Section .....~.....~.. ......... Block ....... L ............ Lot No ........~...~...
to application dated ......... ~..,....~...~ .......... , 19.~.. ,~and approved by the
pursuant
Building Inspector.
e B~ilding ,~ector ~
Rev. 6130/80
BLDG. DEPi~.
TOWN OF SOUTHOL~
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be fillej in by typewriter OR ink and submitted to the building
-inspector ~ith the following: for new building o~ new h~e]
i. Final survey of property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposai(S-9 form).
~. Approval of electrical installation from Board of Fire Underwriters.
: 4. SWorn statement frog"plumber certifying that the solder used in system contains
less than 2/10 of 1% lead. "
5. Commercial building, industrial building, multiple residences and similar buildings
znd 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
f'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.
Fees
i. Certificate of Occupancy - New dwelling $25.00, Additiohs 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 pf Certificate of Occupancy - $5.00 over 5 years - $10.00 ~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Data ......... .
:aw Construction ........... Old Or Pre-existing Building .....
· ocation of Property... 190 PRIVATE RD. #7
House No. Street Hamlet
'uwer or Owners of Property ..... WILLIAM ~ BARBARA GUNTHER
ty 1000 38 I 25
oun Tax Map No , Section .............. Block ................ Lot ......................
ubdivision ................................. Filed Map ............ Lot ...................
Date Of Permit Applicant
zalth Dept. Approval .......................... Underwriters Approval ..... .....................
Approval .......................
fanning Board .
'quest for: Temporary Certificate ........... Final Certicate ...........
e Submitted: $. 25 O0
... ..........
.......
.~2 I ~ ~P'L-Y. CAZ,'T
TO'tN OF SOUTLIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 1179
TOWN IIALL
SOUTIIOLD, N,Y. 11971
January 17, 1991
TEL. 765-I 802
Terry Rice
2080 Shipyard Lane
East Marion, N.Y. 11939
RE: WILLIAM & BARBARA GUNTHER
To Whom This May Concern,
We are unable r.o complete your Certificate
of Oc/upancy.because_/ .of the following reasons.
/_~ An application for Certificate of Occupancy
s ~lot on file. (ENCLOSED) - .
/~_/ 'File check i:;(~/~l~/not on fxle.) $25.00
/~/ blo IleAl. th Dept. Approval on file.
/-~/ No final insDection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
lh~ilding Permit ti I 7 3 8 6 Z
Build tnW Dept.
*~*/--/ rio Plumber solder Ccrt.i£icate on file.
( all perm'~ts involving plumbing being
issued after April 1,1984 )
ylELD iNS?ECTiON ,~ ~I[DATE
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH
FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
Ye
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
BOA'RD OF HEALTH ........
a St, TS o~ eLA..~S .¢K,. ~ '"
SURVEY .... .<r. ...... : ·:
NOTIFY
C^LL .777: pP. ..........
MAIL TO:
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ................... 19 . . .
INSTRUCTIONS
a. Tiffs application must be completely filled in by typewriter orin 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 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 a~3y 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 inspectors on premises and in building for necessary inspections.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nameofownerofpremises. ~ "~"~ x~'t~~ (7'J ~h
"(~; b~,'t'~e ta~' ~o'li ~,~-iateit' ~'d')' ' ' "~' :' ":"d ...... '~ .......
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No.../. E t.. ~..~..~ ...........
Plumber's License No .........................
Electr cmn s L~cense No .......................
Other Trade's License No .... ~ - . .....
~1. Location of land on which proposed work will be done. '
...... .
County Tax Map No. 1000 Section . .J.~ ........... Biock ...... [ ........... Lot...~.~:T .......
Subdivision ..................................... Eiled Map No. Lot ............
(Name) x~, .................
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
..... ...........
. ............. .... ...................
3.Nature or,york (check which !applicable): New Building .......... Addition .......... Alteration
Repair ........ ...... Removal .............. Demolition .............. Othet:'W~kt~ U"
· Estimated st ........ , ........................... Fe ...........
If d f ~ n! (to be paid on filing this application)
N Ill h fl '
5. welling, number o welli g units ............... nmber ofdwe ng units on eec oor ....
If garage, number of cars ... ~ ............... · .....
6 If '
· business. COmmercial or mix!ed occupancy, specify nature and extent of each e of use ...... ,...
7. typ ...
Dimensions ' ' '
of ex~stmg structulres if any: Front
Height Nu!mber of Stories · ·, ............ Rear ............... Depth
Dimensions of same structun With a terations '' ........................ ' '
or additions: Front ......................
Depth Ileight ................. Rear ..................
........................................... Number of Stories ...........
' 8. Dimensions of entire new con traction Front . . .
Height ............... N~ tuber of Stories, .. . . Rear . . . Depth .............
~. S:ze of lot: Fro,t I ,L ..........................................
Date of Purchase -, ............... Depth .........
~40. " ....... , ............ ~(ear ...... · ....
Zone or .... ,~:~, . ~: '~.',' ' 'i' · '. ...... ~ ......... Namq of ~,ormer Owner ................ ' ......
11 ....... ,rxc, m wmcn premmes are situated ....... /5.."~. ,,O¢~. ...... ' ............
12. Does proposed construction vi+late any zoning law, ordina~'c~ or regular on: ....... i ........ ii.. ii .....
13. Willlot be regraded ...... . · · ·
N14'. Nme of Owner of premises .............. Will excess fill be removed from premises: Yes No
; Address Phone No
Name of Architect ...................
Name of Contractor .................... Address ................... Phone No ................ ·
· i ......... Address .. Phone No. ...
15.Is this property loc ted wlthin~o0 feet of a tidal wetland? ~YBS .... NO ....
~If yes, Southold Towh Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly alt buildings, whether existing or proposed, and. indicate all set-back dimensions from
proper~y lines. Give street and block number or deschption according to deed, and show street names and indicate whether
interior or comer lot.
STATE OF NEW YORK. S
(Name of individual signi~ig con't~c'ti .......... being duly sworn, deposes and says that lie is the applicant
above named.
lie is the ......
: ontractor, agent, corporate officer, etc.)
of said owner or owners, and is
duly authorized to pe,rform or bare performed the sakt work and to make and file this
application: that all statements contaified in this application are true to the best of his knowledge and belief; and that the
WOrk will be performed in the manner &et forth~in the application filed therewith.
Sworn to before me this ~
· "'~ .......... : .day of. :A..(].~'.
uhl,c ......... Co ,nty
NOTARY PUBL C, S'Me at;New Yo~ ' ' · . . .
NO. 4707578, Suffolk ?unty ~ q
TermEx~iresM~rch~O, il9 ~_/ , (Signature of applie~t;