HomeMy WebLinkAbout17128-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19448 Date OCTOBER 16, 1990
THIS CERTIFIES that the building ADDITION
Location of Property 70 RABBIT LANE EAST MARION N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 31 Block 18 Lot 4
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 10, 1988 pursuant to which
Building Permit No. 17128-Z dated JUNE 20, 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 SHED ADDITION TO EXISTING ONE FAMILY DWELLING WITHOUT
FRONT YARD ENCROACHMENT.
The certificate is issued to JOHN T. LUSCHER
(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
Fos;ss 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 fl 01712 ~ Z Date ~..rL!'nn....a~ 19~. o
Permission is hereby granted to:
..........a4~'~.-..0.3.........B3ed
~a ..C.rJ.~:"...s~.,....~.~J...a.~..,d~-t.~.roya...,~.....ra:,-,....~~.....r1~.~..,.......
~~jj
ct premises located of ............7.5?......J4.. .Q^:~l..y. ~4-Q........... l1,1.e6a{k.M
. . .nn . . . . ,
p.... . . . . . . . . . . . . . . . .
County Tax Map No. 1000 Section Block Lot No......0~"••••••••.•••
pursuant to application dated 19..8, and opproved by the
Building Inspector.
Fee
wilding Inspector
Rev. 6/30/80
. .
V,r .
i `
• ~ TOWN OF SOUTIIOLD
BUILDING DEPARTaIENT Tr
~ ~ ~ ~ ~r~
9 g
TOWN HALL ~•~LL~ ~~~~m`'r..!~a__.,,..•_y~19 y
SOUTIIOLD, NEW YORK I ~~y~ ~~7 ~ ~ •°~~9~
765 - 1802
~.w.m.r,_~..r., _.,~.~...e'r
_ rov~r~wsr~u~ara1D
APPLICATION FOR CERTIFICATE OF OCCIIPANCY GGjj qq g
DATE..l~ ~I,J`~..._..
NEW CONSTRUCTION _...._•-.OLD OR PRE-E%ISTING 'BUILDING. ..VACANT LAND........
Location of Property...l.~..._..: ./`;~!JJ~,tT_~if~/I:g._...._.-.E~~~'„/h,~R/.!1/I.
HOUSE NO. STREET HAMLET
Owner or Owners of Property....:~.dHw...~--. LY•1:G/s/e~l-..-.__..__-'.-__.....•
County Taa Map No, 1000 Section 3/;UUHlock ~y'~~ Qd(~. (J00
- Lot .l~.....
Subdivision........... Filed Map ........Lot.
Permit No. ~!_f~$..L..Date of Permit ..........Applicant 70H/V.T_LUSG{J~.
Health Dept. Approval Underwriters Approval.......__.....
Planning Hoard Approval
Request for Temporary Certificate Final Certificate
Fee Submitted:
APPLICANT.(TOHA..T---.LIrJ`Cf/22________________
~ r
rev. 10/14/88
C~.ee• 406g~f
c a~ l9 x(48"
l ~
FORM NO. 6 •
1.
TOWN OF SOUTl10LD
BUILDING DEPARTMENT
TOWN HALL
765 - 1802
APPLICATION FOR~,CERTIFICATE OF OCCUPANCY INSTRUCTIONS
A• 'This application must b'e filed in typewriter OR ink and submitted to the Building
Inspector with the following; 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 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'iplumber certifying that solder used in system cogtains less
than 2/10 of 1Z lead;
5. Commercial buildings industrial fi,~i,ldings, multiple x~sideuces and similar
buildings and installations, a certificate of code compliance from [he Architect
or Engineer xesponsible 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 alb. property lines, streets, buildings and
unusual natural or topographic features. ,
2. A, properly completed'j`application, a consent to 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 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• M application for vaunt 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
th'e application. If ~ Certificate of Occupancy is denied, the Building Inspector
shall state the reasons therefor in writing to the applicant.
D• FEES: I
1. CERTIFICATE OP OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00,
Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $10.00
Addition to Accessory buildings, $10.00. - Businesses $50.00.
2. Certificate of Occupancy an 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. IIpdated Certificate of Occupancy - $50.00
6. Temporary Certificate of Occupancy - $15.00
II!
I
r~0. 10/14/$8
~~FOr
~,T~, TEL. ?GS-1800
p5,;~~~. ~0~~ ~ TO~Y'N UI~ SOUTFIOLD
l'ya E;;:,rl~ y;4 ..c ~ OI I'ICIi OC: PSUILDING INSPECTOR
~ ''^e A~;tt~; ~ !'.O.I10`C I I79
~ TOtiVN IIALL
'•~C',y~ SOUTIiOLD, N.Y. 1 1971
~~p~. ~s ~ \
.~arr_..~- \
October 18, 1989
Mr. Charles B. Luscher
70 Rabbit Lane -
East Marion, N. Y. 11939
To t9hcm This May Concern,
4.e are unable r.o complete your Certificate
of Occupancy because of the follocoiny reasons.
An application for Certificate of Occupancy
is not on fi].c.
/ / No Underwriters Certificate on file.
'Phc chcc4: .i:: (~tna~x3cxti~xk/nut on file. j $25.00
A:o llaa].th Dept. Approval on file.
D:o final insl~~ect:ion has been made.
Pleaur. contact: our office on this matter.
Thank you for your cooperation.
L'u.ilc]ira] Perm.i.t-. If y -Z ~ _2 8 Z
Duilclinq Dupl.
tk~k/-/ tlo i'lumbcr ;;older Cer t.if icate on file. ~ '
( a7.1 perr,+its involvi.n9 plwnbing being
iasucd after ,1pr5.1 1,1984 j
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• OCT 15 ~
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FOUNDATION (1st)
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FOUNDATION) (2nd) rn
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P,OUGH FRAME & ~
PLUMBING
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IIJSULATIOII PER N. Y.
STATE ENERGY n_
CODE d
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4. C .
FINAL
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ADDITIOIIAL COMMENTS: x`
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p5 CO, TO~Y'N UI' SOUTIIOLD
/~n,~
1~~~~ Y.4 ={c~ OI~1'ICE C1F PSUILDING [NSPF.CTOR
' ~~l sus SOiJTI10LD, N.Y. 1 1971
'vrxrr~..td'
October 18, 1989
Mr. Charles B. Luscher
70 Rabbit Lane
East Marion, N. Y. 11939
'Po Lvhcm This May Concern,
4Je are unable r.o complete your Certificate
of Occupancy because of the follocoing reasons.
~~1( An application for Certificate of Occupancy
is trot an fil.c.
/ / *Jo tJnderwritcrs Certificate on file.
't'he c1~ec:F; .i:;(~m;txkx4~~xkJnot on file.) $25.00
Dto ILal.th Dept. Approval on file.
No final inspection has been made.
Plen:;e contact: our office on this matter. -
Thank you foz your cooperation.
t;u.ilclir;c7 Pcrm.i.t-. 11 1.- _Z. ~ 2 8 Z
Duildiny DupL-.
tto I'lumbcr :;older Certificate on file. '
( n7.1 permit:,' involvi"ng plwnbing being
i~sucd aft.cr April 1,1964 )
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~~JY BOARD OF HEALTH
r
I~~"~ . ~ 3 SETS OF PLANS 1-~...... .
I C'71:5,. m..,. , ~
f~f ,r ~ FORM NO. 1 SURVEY ? , , , , , , , •
Ip ~ TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC FORM
' TOWN HALL
BLDQ.DEi'T. SOUTHOLD,N.Y.11971 NOTIFY `TAFR LuscHt/y
TOWNUF50UTHOLD TEL.: 765-1802 CALL
MAIL T0: ~'a- cL~92!< p
Examined .~.u!''t!+..a10 19 T• '
M 6199YG d M Mry
Approved .~.tk'f1A... °Z:o , 19 p~ Permit No. ~
!/70Sz
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
- jai.*•.r~«~n~~,~. Date Y~..-l.U...., 19~1P'
L • X YtaS, i4' S~
P R.~I.a W,c .
INST}~;UCTI.QN~~ ' j~t~ i"1k
~.re
<<
a. This application must be completely~fillpd in by typedirit~t"of`in'ihtk n$d`~itbmitted to the Building Inspector, with 3
Sets of plans, accuratecplot plat~~f6 §t'aYd;'„~ee_ according to schedule.
b. Plot plan showing IciC~'i~n`~tf~~ol~y~`d-pf buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a d'etail`ed H~sYc;ipti~~n: of layout of property must be drawn on the diagram which is part of this appB-
c. The work coveied 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 avaflable 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 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 inspectio s.
(S• ature of ap ant, or name, if a corporatton)
. 8~... C L,ltf R,K, , s~ !1'< S!`? p.Y. G d!k !t'•?~ .
• (Mailing address of applicant) 3
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. a. fv .
Name of owner of premises L.(/SC`j G ~'1 b/~ G 2S', , , , , ,
e~.........
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
1. Location of land on,which proposed work will be done. .
House Number Street Hamlet
County Tax Map No. 1000 Section 3~......... Block , , , , , , • , Lot
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......f~d !`l ? • • • • • • • • • • • • • • • • • .
b. Intended use and occupancy ST Q/2 F~ G?....'r~~~~
i
New .rFie,~
3. Nature of work (check which applicable): New Building Additions Alteration , , , , , , ,
Repair Removal , Demolition Other Work .
(Description)
4. Estimated Cost . t/.~ ~ ~ Fee , . , .
(to be paid on filing this application)
5. 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 nature and extent of each type of use , , ,
/~y
Dimensions of existing structures, if any: Front , , , , , , , , ,Rear nFi Depth , sr,~f•
Height ...............NumberofStories....,~,,,,,,,,,,•,,,•••~•
Dimensions of sa a structure with alterations or additions: Front ~ Rear , .
epth Hei t Number,,
' 8. Dimensions of enttre new construction: Front , Depth
• ~ nes of Stories .
• • Rear .
S Number of Sto t"~
Hei ht
9. Size of lot. Front ......a~ . Rear . , . a~':........ , Depth /t`rT:............ .
10. Date of Purchase , .Name of Former Owner
p
11. Zone or use district in which remises are situated . . .
2. Does proposed construction violate any zoning law, ordinance or regulation : .
] 3. Will lot be regraded " " " " "
..Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ~?H¢; , T; , G prckl ta. , , ,Address .4 S pRk, , ST,•„ , , , , , S/~ ; b 3UO o
Phone No... , ~7, ,
Name of Architect nr, p ' ' '
...........................Address A ;OY, toh . ....Phone No. .
.
Name of Contractor . .Address ...................Phone No.
IS.Is this property located within 100 feet of a tidal wetland? *YES....NO....
*If yes, Southold Town Trustees Permit may be require';d.
PLOT DIAGRAM
Locate clearly and distinctly all 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 corner lot.
APPROVEp q$ N01'ED
BATE' to -3d P is 8
NOTIFY gt)ILpING pEPARTMENT AT
765. 1802 9 AM TO 4. PM FOR 7HE
FOLLOWING IN~upECTIONS. -
1 • FOUNpgTION TWO REOUIRED '
FOR POURED CONCRETE
2. ROUGH • FRAMING !4 PLUMBING
3. INSULATION
4. FINAL CONSTRUCTION MUST
8E COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REOUIREMENT$ OF THE N.Y,
STATE CONSTRUCTION 8 ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN Oq CONSTRUCTION ERRORS
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE'',
STATE OF NE1 QR S OF OCCUPANCY
COUNTY OF '
„slt,n
.TO flN r , • ..L. U1:C 61,PR, • . • • , , , , , , , , being dyly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the . . . d /~-r? j/
(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 are true to the best of Itis knowledge and belief; and that the
work will be performed in the manner set forth in the application bled therewith.
Sworn to before me this
fin'
Notary Publ'c , , , .County
,q.s ~
CLAIRE L. CiLEW
Notary Pu61b, State of New
Yak • •
No. 4979606 • ~ '
t2ualffiad in Suffolk County (Signature of applicant)
Commission Expires Decemper 8,18_.,...