Loading...
HomeMy WebLinkAbout17340-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22375 Date JUNE 7, 1993 THIS CERTIFIES that the building ADDITIONS Location of Property 420 LAKEVIEW TERRACE EAST MARION, N.Y. House No• Street Hamlet County Tax Map No. 1000 Section 31 Block 9 Lot 11 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 20 1984 pursuant to which Building Permit No. 17340-Z dated AUGUST 22, 1988 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 BEDROOM & BATHROOM ADDITION & DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MARK & SHARON MIDDLETON (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-808733 - MAY 11 1987 PLUMBERS CERTIFICATION DATED N A uilding Inspector Rev. 1/81 xosu 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) N0 ~1734~ Z Date .......~1...2.~ 19..~d Permission is hereby granted to: ~a o to G'am'-~`.~r.-~..~.............. ct premises located at .....~~....,~t%~G•C1:~...~..1~i./~.Q'~ l`.....~,1. . ..............................................................................//................................p................................................ Caunty Tax Map No. 1000 Section .1....~ock ! L/ot No...... pursuant to application doted ......................~..........................,..19f1fl..L, and approved by the ' Building~~Inspector. Fee $.c./..~ DOS o~ ~ /~j30/ 7 B ing nspect Rev. 6/30/80 r~osai xa 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) Date 19..sd..~ N° 13017 Z ~ ~ Permission is hereby granted to: , to . . at premises located at ....~~..~.......1tidR~a.~...N..:v6:S:~C.e:::......~.'~a'~a~.~~?;^.:~;:~....... .........................................................................................................ee.~~...................................................... County Tax Map No. 1000 Section Block ..........J........... Lot No........~.~ pursuant to application dated .....~.Sc~4rS:.Y:~.....c~:.Q 191T.~., and approved by the Building Inspector. Fee S.~a Building Inspector Rev. 6/30/80 ~ Form No. 6 tf~-~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of ly lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from 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: 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. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.0/0,/F//o~~mmercial $15.00 Date ~l•~(.(.~ New Construction........... Old Or Pre-existing Building........ Location of Property.....:~i~a..~l(~O.CAW..a~'~t~............~(a.5"~....~'YI~~GP)(~........ House No. Street Hamlet Onwer or Owners of Property..) :~.a ~~..a.~.... ~ ~ ~/~....~C-!~ft•.4~. 7`/dn . County Tax Map No 1000, Section......?.~. ....Block..... ~.........Lot.../.~ Subdivision F led Map............Lot............. Permit No..~./.~:Gd......Date Of Permit...~.1~~.~~T•..Applicant.~V~~~.`~..l~.~h.:'!{~4~r7/h Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate...../....~ Fee Submitted: $.......~.5.°..~lS / ~ ~``~Y. •...y ~lv~-'~~~y 2' / .APPLICANT ~o~aa3~s r~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIGITV r ~ d~~ ~~t xC,f~~ 65 JOHN STREET. NEW YORK, NE~t~y~~~t~~O38 J'~Q Da[e Application Nu. on file N ~ ~ ~ ~ 3 s? ~ THIS CERTIFIES THAT n~ only the electri~~.~t~u~r~~~~t~F8 i6~d~gefitie°t~Tr'17~d'beYC~:L~ ogpficpnt~on 4he.~6ove opjtlication number in the premises of I}'i x L 7.Vv fn thefolluuinp hrc~"i}fyw~~+~ement ? Ist F'l. ? 2nd F'l, .Section Block Lot u~os examined on and found to be in contplimrve with the requirements q( Uris FJoard. W FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS ECEPTACLES SWITCHES M R u r O TL TS INCAN E ENi FIUORESCENi ypPp AMi K W AMi K W AMi KW. MT °IIW ~l AMi. ~HVP t~ d s 2 .C'_%' w~.. ~L~~ DRYERS FURNACE MOTORS FUTURE APPl1ANCE FEEDERS SPECIAL REC'PT TIME CLOCKS ggLL UNIT HEATERS M SYSTEMS ET DIMMERS iy AMi. K W. Olt H. P GAS M. P PMT NO A W. G. AMt AMP AMi AMPS TRANS, AMT H P NO. OF FEET AMi WAIIe" ~ I SERVICE DISCONNECT NO.OF 5 E R V 1 C E AMT. AMP, P.pE METER 1 tW ~ ~W 3 % ~W 3B dW NO OF CC COND. A. W G NO Of HI-lEG A' W G NO OF NFVTRAlS A W G EQUIP. PER % Of CC COND Of HbLEG OF NEUtRAt OTHER APPARATUS: ~ t'iJ.BG°. YYXY0. 1~@ai~.'.CY$: ~.^~...~~LW 2 G,P,C.T. 1 Stnke Detector Marlor3 : a-1hp ~ _ ~ G~~~~ Mark u. DliclitletL~-i 42Q IrDlcauievr `CY~'r~dC7e: ~ EdJ'~ ~k7.7:1O11t iV,Y. x.1939 v GENERAL MANA6F~R-- rr' ~ / . - . Y~Y This certificate must not be altered in any manner, return_,to the office of The Bdaid~if incorrect. Inspectors may be 'fl'ed by their cred ntials, COPY POR 841~DING ©~PART-MB=d.L~THIS COf Y OF CERTI~fCA.1~~~j;AI~7 NOP B ER~D IN ANY hy1P?NER ° ' y~ 765-180x BUILDING DEPT. INSPECTION ' [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ FINAL ~ REMARKS: -A -~~-P F s k ~ G DATE ~ 0 INSPECTOR ~ ~ i 3 _ _ v. ~a.-- ,~3~~- 765-1802 BUILDING DEPT. MNSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ 7 FRAMING [ FINAL REMARKS: i t r i i 44 I q DATE / INSPECTOR _ . f~ pl7 765-1802 BUILDING DEPT. tNSPECTfON [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [ FINAL REMARKS: ~lx DATE C) INSPECTOR 765-18®2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~ FRAMING [ ]FINAL REMARKS: r' v~ ''r a. t ~.l r , T p JJ' - ~jy' \ ~i~r~ "p~ i~ ~/Ft ~ ~ ~f( F P'. DATE ~ ~ INSPECTOR ~ ~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATfON 1ST [ ] IROUCN PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING FINAL i" REMARKS: o ~ 7 ~ ~ ~ ~ ~ t 7z © ~ i r 4 ~ { I I I` DATE ~ ~ INSPECTOR f ~ _ _ . FIELD I;dSPECTION DATE ~ COMMENTS ~ ~ ~ 1. FOUNDATION (1st) ~ I ~ ~ c U. FOUNDATION (2nd) °'g' L. O g, O ROUGH FRAME & 9~ PLUMBING . x 3 . r~ • 7 ~ 9 INSULATION PER N. Y. .a ~ STATE ENERGY ~ !n CODE s m /s' O~ 4 . p FINAL ~ p ~ ~ ~ s~ - ~ ~ - F. ~ Z CTi ADDITIONAL COMMENTS: ~ ~ rP rn x m A ' r \ S ~ ~ . m -v y cuFFO(/~ TEL.7GS•1802 cod Torvrr or souTUOZ.n ~ `4~ 1 OFFICE OF 13UILllING INSPECTOR '""'off' :'rt, ~ I',O. [3OX 728 w ~ ~ TOWN IiALL 0~~~~ .r~~~- SOUTLIOLI7, N.Y. 1 197! This is to ~i advise you that the job under building pcrrnit no. 130172 issued to Mark Middleton on 4. 11 84 _ for Addition is completed and a final inspection has ( ) has not ( X ) been done. ' An'Underwriters Certificate is Needed 1n order to complete this file, it is necessary that n Certificate of Occupancy be issued. Please fill out the enclosed form, return same to [he above office with a check for $25.OOpaynhlc to [he Town of Southold. Please indicate to Whom tl~e Certificate of Occupancy is to be mailed, and ' arrange with this office for an inspection date . Occupancy or use is unlawful without a Certificate of Occupnncy. Please help us to Clear up Chia matter so that legal action does not have to ba taken. 'T'hank you fnr your prompt attention. Very truly y. ' ~ C~ fiJ~ a~srGt._ Victor Lessard fixecutive Administrator vr,:r;ar encl. s ~ _ ~ , _ r~ ~3~a 1 a ,ram„ _s~ .YY~1 t r. n'¢, f.. Y ~ ~ ~ y~ ~ ~ ~ 'k' ~ -rte I% g' ~J'~ Y+ ~ y ; y Y P a' } - d ~k 6. tr r ~ ~ ~ Y ~ t .u ~ w aF' ~ s t ~ y s fi ~ ~ f C`' i ~ ~~P ~ ~ , ~ ~ F ~ ~Nt ~rY'~"~est.t~eYtF,y ~L.i~~+ty;,~ {s~ -y i i ~ s' S` .t s ~ ~ Q ~Q e ~ Z p Getc~es t. jk ~ LfoY.~etiu +[~#:.4xare'~~ ! ~ i 1. ~ Rich h^t c+i w~K ~ ~ Scats = ~C?'- t' i_. . i~.~~`a~„~,_~~_Q.a _ e rrwr ak Nuwnar r ~ ~ ~ ~ ~ ~ ~ - ~ xrcrroN rzm oFS'niR ~w roRR SFAi! { - 1 ~,K ~ ' - ~ . - - RDUCArfQN tAUI. ! - i _ - S COW.fS OF h SNtv9 EAR n67 BEAYRlG ~R TNF :AND 5 Y Y"RS t~'. L A OR { ENROSSlD 5~ HA 1 1 ak C W NRRED ~ ~ TO k A Vn. L V} [ xfs ~ V;>t s`'~~~yF~" ~ BVARAMF4S tML~tark4 gfN<Gv. sHC4 R4lI. 7 ~~~I~?:.~~Gl ~K~~~KS : #i x r ° ~ - ~ ~ ~V ~ r _ ~MEIARRD A~ ~ 7DR vFi.>N -41[ S4RYlY 1 -~kR~ - .ic...~1+ LO TNj ~ w~4~Rl - :yw}.~ .•f~y .,a,t - x.~. , A!{[COLVANY. :rQYxR .~w.1R. ApW~.Y~+tl~ ~,y~ {BORK NS7kf11T,~n LS![D hcReON, iJq 4,; t ~ ~Ib`. ro ~ ~ss~~ces ~r Na uhwra uan. t a~~ ~ x rRrtkoN. cu yRy it $ j _ f~RWOT 34y~~'~1 ~ ~i . i~C1. Y.Si : E''#y~€' ~ _ 3 'q i6HN~4f6 qt ~IgROMRe s.p TEL. 765-1802 o5~Ff0(k~oG TOWN OF SOUTHOLD yet OFFICE OF BUILDING SNSPECTOR c rn P.O. BOX 728 v' ~ TOWN HALL 0~~~ ~ SOUTHOLD, N.Y. 11971 1 a~,~9S(k To Whom This May Co~cern, We are unable ~o complete your Certificate 7~aa~~~ of Occupancy because ,of the following reasons. ~ f An application for Certificate of Occupancy ~-~r is not on file. No Underwriters Certificate on file. ~ The check is(/not on file.}~5~W / / No Health Dept. Approval on file. /r/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # ~ O L ~ 2 Building Dept. / No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 } v \ 'F- ~'_ ~ ~~ -- 9 - _ d~_ __._ -- 6~ ~~ ~ (` L~~' ~ ~ ~~ ~. ~ -~ ~. ~ '"~~ ~' ~ ~~` ln' 7p `~ cr r". `7' °-.~o N~ ~ ~ g` ~, ~ ~ ~~ ~ ~. . =E...:, ~. s . e G ~ .m-~` yap y an6 O I, -. ~ ~- - I ?'n .Lb 1a. W N -~~~Zm v ~i Cl b i-n r- co -n ~~ ~ m ~-n ~..~ 'r ,~ .. ~ 7 yr : ri ~ -a [l ~ ~~ ! ji , 7 ' 7 (y ~~~} : ~ n °~ m 4~ i 1„ .. I ii ~~ > ' -' 'i ? :; _.~ is `~I ~k ¢n --__,->-nwZ~ _ - -~ -- ---~~- .~ G7 ~ Im vGi Z m ~ . - ~---~-~ ~ I ~_ s~~~~ ii I '~;~ ~~!~1 y ©G ~' ' n 9„ r k n ~~ 1 r " ~ ,~ ~-. ~ ~~ 'FORM N0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765.1$02 ixantined U .i.~.. 19~.,f!. Received........... , 19.. . U tt 19~7.PermitNo.I ~~7.~ lpproved ~isapproveda/c ..v. ~.:a-:....... . (Building Inspector) APPLICATION FOR Bl11LDING PERMIT ~Q Date . °T0........., 19~! INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildutgs on premises, relationship to adjoining premises or public streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagrarrt which is part of this appli- ation. 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 hall 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 tttttil a Certificate of Occupancy hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment for the issuance of a Building Permit pursuant to the 3ttilding Zone Ordinance o)";the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or tegulations, for the construction of buildings, additions or alterations, or for removal or demob • n, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, buildi code, ho smg c ,and regulations, and to dmit authorized inspectors on premises and in building for necessary inspe~ion • p Q ( gnature o applicant, r name, if a corporation) r (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. iVameofownerofpremises ,/•'fi'~~!<l.~'2W~•'•//%/W`•'~~N•••••••••••••••••.••••'.•.••••.•••••• (as on the tax roll or latest deed) (f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate o~ff^ice~r ,,'S (ja Builder's License No. . j~i/ . ~l~f'~~!!~`V • • t 7~~"~- re N Plumber's License No . . Electrician's License No. . ¢ K Other Trade's License No . . 1. Location of land,on which proposed work will be done. . .~~~r'"~. ~~~'~!~~""z!.~•" House Numbet• Street Hamlet pp p County Tax Map No. 1000 Scctiott .~v~.~ ..9.:".i~ • • . Block Lot . p Subdivision Filed Ma No. ..~9pcr ~ Lot . (Name) 2. State existing use and occupancy of premises and i tended tse a d occu anc of proposed construction: a. Existing use and occupancy .~l1/ !~.r..~ ! . • ~~d~ . b. Intended use and occupancy f 1.~~E~~~J'•"~-,~ 3. Nature of work (check which applicable): New Building Addition Alteratipn ~(J • Repair Removal , Demolition ;...Other Work . .1f~, . , • ~ (Descnpftron) 4. Estimated Cost . Fee . (to be paid otr filing this application) S. If dwelling, number of dwelling units ~ Number of dwelling units on each floor . If garage, number of cars . 6. If business, commercial or mixed occupancy, specify nat re and extent of each t ~e of use ~ 7. Dimensions of ex stin structures, if any: Front d ~ Rear Depth . . Height . Number of Stories . Dimensions of sa structure with alterations or additions: Front oZSY:.....~ hear eels".......... . Depth .....R~~~ ............Height Numbe ~f, Stories . 8. Dimensions of/enti-raj new construction: Front Rear ..3~ .......Depth . ~.7....... . Height . ~ ~f!~.! ..Number of Stories • • 9. Size of lot: Front r hear ~tesG ~ D t ~ d a a me of F nrrer Owner 2 . 0. Date of Purchase ,~ol~ya . f _9 1. 'Lame or use district in which premises are situated ....~~1,~,•. . 2. Does proposed construction vio to any zoning law, ordinance or regulation: ~ .!?.10 . 3. Will lot be regraded Will exc ss fil be removed from premises: Yes 4. Name of Owner of premises ,/f~/G!.'/.~1Rs: /l//LPX. Address ~Q ~64C1W .'~e.~(~Q~CrPhone No.. ~~:'v~~0... . Name of Architect / . ...............Address . b'V .Ni'. Phone No.... . Name of Contractor ~ ..W/~~• • ..........Address . :ru?~~ ..~;•y ..Phone No..7~>~ c~~O... . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether rrterior or corner lot. y o~ ~ tQ~'er/: btvC ~enr,{~ eti~yc..-- ~ ~~~1z.? a ~'-iw~ ~~"i~ ~ tT ~ Al S" CATS OF NEW~OR~K~~ 5 :OUNTY F , ' . • ,),S`l, ~ ,!!!~c~J'(Jfv~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) j ibove named. ,~,,,,pp ' fcisthe...,..VG.~t~tJlV.rw•\ ....................:.8...'...P..,.......'..::............................ (Contractor a ent cor orate officer eto ) r1' said owner or owners, and is duly authorized to perform or have performed the', said work and to make and file this grplication; that all statements contained in this application are true to the best of 1)is knowledge and belief; and that the ,vork will be performed in the manner set forth in the application filed therewith. Sworn `too b_e~fo~rep me this o`./, r`-v!L~..........day of . ~~L- , 19 Votary Public, ,~,S, •z~~L Ic..... County i , ' ~ R ~ % ~ . t4o1 ry Public State 1 Ne ork (Slgnatnre Of appllCant) ~No. 2-4625897 y Qu in Suffo~k County p,/' ' Commission Expires March '`1 Q'Y