HomeMy WebLinkAbout16957-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z19604 Date DECEMBER 21, 1990
THIS CERTIFIES that the building. ALTERATION
Location of Property 220 BAY LANE (PVT RD. 14)
House No. Street
County Tax Map No. 1000 Section 24 Block 02
Subdivision Filed Map No.
ORIENT
Hamlet
Lot 21
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 19, 1988 ~ursuant to which
Building Permit No. 16957Z dated MAY 11~ 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 CHANGE WINDOWS & MOVE PORCH AS APPLIED FOR.
The certificate is issued to GORDON MEYER
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N038802 OCT. 11, 1988
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
TOWN OF $OUTHOLD
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_ 16957 z
Permission is hereby granted to:
...~..-..~,..~.~.~. .................. ~ ............ '....~.... .....
.C~..~ ........ ~.,..tt,.._.a..~.~.-..7. .............
,o ......
.......~ ~t~r.~. ~) ~
at premises I~ated at ~00 .~ ~ .......
.~....~.~..~.~.~ .............................................................................................................. _, _,
Building Inspector.
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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:
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-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 1% 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.
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.
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 $15.00, Commercial $15.00
New Construction .... Old Or Pre-existing Building ....
HOUS;'~;i ................... ~S~;;~''' Hamlet
rop r y ........ .... ...................................
County Tax Map No 1000, Section .......... Block .............. ~ ......................
Subdivision .................................... Filed Map ............ Lot ..................... .
~ ' ~-~///~... Applicant ~.i~.~(.~.?'.d.~..C.~.~. ~/~
Permit Xo.../.~.?.~T..~.'.~...Date Of ~erml~.~_/. ...... .~..~.. ~.
Health Dept. Approval .......................... Underwriters Approval
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ....... %~..,.~.~.O. ~. ............. x
OUTE~ITS ~RICEPTAC:LISI SWITCHES
This certificote m~st not be oiled in any rf~nner; return to the office of the Boord if incorrect. Inspectors may be
COPY FOR BUIL.DIHG DEP~R?MEHT. THIS COPY OF
FOUNDATION
(lst)
FOUNDATION
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDZTIONA'L COMME
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
] ] FOUNDATION 2ND [ ] INSULATION
FRAMING [ ] FINAL
REMARKS: ~/~/~'~
DATE ~/~-- ~///~f~f INSPECTOR~~ ~/
INSPECTORS
(516) 765A802
VICTOR LESSARD, Principal
CURTIS HORTON, Senior
VINCENT R. WIECZOREK, Ordinance
ROBERT FISHER, Assistant Fire
Building Inspectors
THOMAS FISHER
GARY FISH
SCOTT L. HARRIS, Supervisor
Southold Town Hall
P.O. Box 1179, 53095 lvtain Road
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1800
OFFICE OF BUILDING INSPECTOR
TOWN OF $OUTHOLD
December 7, 1990
Gordon Meyer
220 Bay Lane
Pvt. Rd. %14
Orient, N.Y. 11957
RE: BP16957Z dated May 11, 1988
Dear Mr. Meyer:
I am writing to you regarding the above permit. This permit has
expired.
I am enclosing copies of the notices sent to Sorenson Carpentry
to try to close out this permit.
According to the Code of the Town of Southold, Article XXVIII
100-281 and 100-284 a building permit is needed for any
construction of additions, accessory structures, alteration
new dwellings, and it is unlawful to occupy or use said
structure until the Certificate of Occupancy has been issued.
or
Please contact this office as soon as possible so that we may
clear up this matter. Thank you for your cooperation.
Yours truly,
Enc. Secretary
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
June 21, 1990
Sorenson Carpentry Inc.'.
Box 253
Orient, N.Y. 11957
Re: B.P. #16957Z
Alteratiom Gordon Meyer
_ Dear Bob:
In going through our ready for C.O. files this permit
is ready for C.O.
The underwriters certificate is in the file and it has
had it's final inspection.
Ail that'is needed is the application (enclosed) and a
check for $25.00.
Please contact our office if you have any questions.
Ene.
Yours truly,
Secretary
TOWN OF SOUTtIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
DEC. 15, 1989
SORENSON CARPENTRY INC.
BOX 253
ORIEl, ~.Y. 1195~
TEL. 765-1802
To Who~m This May Concern,
We are unable to complete your Certificate
of Occupancy because .of Lhe following reasons.
~/ An application for Certificate. of Occupancy
is not on file. E~CLOSED -'/~
/5/ -No Underwriters Certificate on file.
The check is(outdated/not on file.) $25.00
/~/ No Health Dept. Approval on file.
/5/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit ti ! ~__9__5 ~?~_, Z GORDON MEYER ALTERATION
Building Dept.
***/5/
No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTIIOLD, N.Y. 11971
~L¥ I~ 19~g~x
TEL. 765-1802
To Whom This' May Concern,
We are unable to complete your Certificate
of Occupancy because .of the following reasons.
/_~/ An application for Certificate of Occupancy
is not on file.
/--_// No Underwriters Certificate on file.
/_/-4 Tile check is(outdated/D~
/_-/. No Health Dept. Approval on file.
/-'/ NO final inspection has been made.
Please contact our office on
Thank you for your cooperation.
Building Permit tt .I -~ ~ ~ ~ Z
Building DDpt.
this matter.
No Plumber Solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
'1 SF, TS OF PI,ANS .......
FORM NO. 1 SURVEY .........
TOWN OF SOUTHOLD CIlECK ..........
BUILDING DEPARTMENT SEPTIC FORM ............. :
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
E×a,nin d .... hq :'.., 19
Approved...:.~...%.(/., 19~.~.PermitNo.!.~..c}.g?%
Disapproved a/c .....................................
NOTIFY
CALL ................
MAlL TO: BO, ~
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tkis 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 pubhc 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 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 apphcable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessT~~ p~ ~/
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contract~l~t~ij~,l~aer or builder.
.............................................................. ....
Nme of owner of premises
................................... N~ .8UI~G. DEPARTMENT .AT ......
(as on the tax roll or ~I~ AM ~ 4 PM FOR THE
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) .
ALL CON, TRACTOR'S RUST BE.. SUFFDLK COUNTY LICENSED
Builder s License No .... /.-,~..~. ~..I... ~..]]~ .......
Plumber's License No .........................
Electrician's License No ..............
FOLLOVVING INSPECTIONS.
t. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & Pt. UMBING
~. INSULATI~
4. FINAL CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
Other Trade's License No. ~ ~1~,'
THE REQUIREMENll OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
Location of land on which proposed wo'rk will :. ;~d~ ........................
. ........
.......... ~' ~ ...............~'~ i ' Hamlet
House Nmn ber
County Tax Map No. 1000 Section ....... ~.~.('[ ........ Block ..... ..ZT .......... Lot ..... ~./. ...........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and ir~tende~, use q,nd occupancy of proposed construction:
a. Existing use and occupancy t/~/¢~ ' ~
b. Intended use and occupancy ........ .~..~../~...'~-]. ..................................................
3. Nature of work (check which applicable): New Building ..... ' ..... Addition ......... Alteration ..... ,.
Repair ............ Removal .............. Demolition . .......... L.. Other Work ...............
fi ~' i (Descrip~tioh)
4. Estimated Cost .... (~.C).... .......... i ...... Fee ....
' (to be paid on filing this application)
5. If dwelling, number of dwelling units £
............... Number of dwelling uni!s on each floor ....
If garage number of cars
6,If business, commercial or mixed occupancy, specify nature and extent of each tylie of use .....................
7.Dimensions of existing structures, if any: Front ............... Rear ....... i ....... Depth ...............
Height Number of Stories ~
Dimensions~of same structure with alterations or additions: Front ............ i ..... Rear ..................
Depth ...................... Heig? ... l[][i,.~[~iii ........ Number of!Stories ......................
8. Dimensions of entire new construction: ,Fll~li'~"'_'2,'~II[ll~[~ ,Rear ........ ! ....... Depth ...............
Height ............... Number of Stonl~l~i,~'~,~.~'?..~,~ ............ ~ ~ ,;.~. ~,~-- i''' ~'' '~ ............. :',"5" ....
9. Sizeoflot: Front ..... ;.~.~... ....... ~t~ ~]~ ~ ~ ~ 'ceph .4-'~i~~
10. Date of Purchase .. ~ [t...~ ....... ~-~.{~l~/r'6t"~: '-ff--Z~'~'~
112.1' DoesZ°ne or use district in which premises are sit~a~.~~ 0~ .......... x' ~' '~w('~?It~;.'~$' ~ '~t ' a'~ .....
proposed construction violate any zoning law, ordinanc~ m regulation: ¢~.~. '.i',' '~.'~ u~l~' ~f' '~!~l' · ·
13. Will lot be regraded ............................ Will excess fill be removed fro~.i~:c 0 Yes No
14. Nme of Owner of premises ~Og0o~ ~Address~ 0~'~; Ph~a~OC~O~
Nme of Architect ...~ ....... ,..;. ~. ~ .~ ....... ~d~ress ........... 1 .,~*;~..~ .~ne No...~ ~*.q, ~T~.,.
N~e of Contractor .. ¢~q~.. ~[~ ~ess ~0~, ~~ PI~
15. Is this property located within 300 feet of a tidal wetland?
· If yes, Southold To~ Trustees Permit maybe required, t , ~fl~D~l.~
PLOT DIAG~M ,, ({)tl, l~' ~- q~(" ~ ~. ',
Locate cle~ly ~d d~stinctly ~1 buildings, whether exmtmg or proposed,
property nnes. Give ~reet ~d block number o[descfiptio~g t~eed, m~8~6~rm'n~es~afid ih:d~it~ ~ether
interior or corner lot. ~ .... ~ ./~-" '~.~ ~ .... . ~__ ,
STATE OF NEW YORK,
COUNTY OF ' S.S
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract) ;
above named, l
He is the ............................................................ '. i ............................
(Contractor, agent, corporate officer, etc.)i
of said owner or owners, and is duly authorized to perform or have performed the shid work and to make and file this
application; that all statements contained in this application are true to the best of h~s~ knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
Z
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