HomeMy WebLinkAbout39860-Z I.:.zi-.:r4
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ft Town of Southold 8/27/2015
P.O. Box 1179
53095 Main Rd
'. Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 37743 Date: 8/27/2015
THIS CERTIFIES that the building ACCESSORY
Location of Property: 800 Private Rd#21, Southold
SCTM#: 473889 Sec/Block/Lot: 78.-9-35
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
6/10/2015 pursuant to which Building Permit No. 39860 dated 6/10/2015
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:
ACCESSORY SHED AS APPLIED FOR
The certificate is issued to Norklun,Carolyn
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 11043834 12-22-1994
PLUMBERS CERTIFICATION DATED
t riz Signature
-7; =' `t--- TOWN OF SOUTHOLD
1l} 'i'�FFOI,� �+�r a
�1A BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
:e. a ;' SOUTHOLD, NY
3'-:"Poi , 4
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 39860 Date: 6/10/2015
Permission is hereby granted to:
Norkiun, Carolyn
800 Private Rd #21
Southold, NY 11971
To: build an accessory buildilng in the rear yard. Replaces BP 11642.
At premises located at:
800 Private Rd #21, Southold
SCTM # 473889
Sec/Block/Lot# 78.-9-35
Pursuant to application dated 6/10/2015 and approved by the Building Inspector.
To expire on 12/9/2016.
Fees:
PERMIT RENEWAL $10.00
CO -ACCESSORY BUILDING $50.00
C)-----foi-a-1-:--- $60.00
___ Building Inspector
FORM NO. 2
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° 11642 Z Date6)&04Y , 19
Permission is hereby granted to:
1 eNATkaD Nelletv
1,00 -fav 7 PO b a
SOLP71-10L pr 1197 /
to uu.D /4 Are ES.�Dj 'r �v' tO ,rirc i ?t 7H L=
'�1'kfti YA k e7
at premises located at 2 Pk i Y4 7t
$OV7NOt_0
County Tax Map No. 1000 Section 71 Block 9 Lot No. sia
pursuant to application dated OM* z , 19v 4;-and approved by the
Building Inspector.
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a '
Pee $
7.4 d$31X1P(1“00,00.•
Building Inspector
Rev. 6/30/80
h-F-1
,PID
Form No.6
TOWN OFSOUTHOLD LOS - S005
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 Department with the following:
A. 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 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.
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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate'of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property 'O • hoc FA 2 \ A-v\ol c? t k`-'`"c' ,\et-9-
House No. Street Hamlet
Owner or Owners of Propert}> C qrc\N'71 �1Ci�'K1
Suffolk County Tax Map No 1000, Section / 53 Block 9 Lot 3 5
Subdivision Filed Map. Lot:
Permit No. 3 9 b 1 0 Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ 5 0 C
a
0 I Cy�\.A4 Applic. ,t Signature
-- ----— -- -- —
. . ., .' . . BOARD OF FIRE
THE NEW YORK UNDERWRITERS ,PAGE 1
,
8051662 Y
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-4 E 85 JOHN STREET. NEW YORK, NEW YORK 10038 H 043834 Y
DECEMBER 22,1994. Application No.on file 06754494/94 ,
-.; Date PERMIT NO. 100432
•. THIS CERTIFIES THAT :cation number in tlseprerPsises of
�: only the electrical equipment as described below Bind introduced by the applicant named on the above appy
J. iY
RICHARD NORKLUN, 800 PRIVATE�ROAD#21, SOUTHOLD, GAR/OUT Section Block Got ,
•,, in the following location; ❑ Basement ❑ 1st Fl. ❑ 2nd Fl.
DECEMBER 19,1994 and found to be in compliance with the National Electrical Code.
..' was examined on •-
: FIXTURE FIXTURES RANGES COOKING DECKS] OVENS DISH WASHERS]EXHAUST FANS r
OUTLETS ECEPTACLES SWITCHES 4NCANDESCENT NUORESCENT OTHER AMT. K.W AMT. I K.w AMT. I K.W AMT K.W AMT. H.P ,r
v
9 6 7 3
• .v
{' FURNACE MOTORS FUTURE APRUANCE FEEDERS (SPECIAL REC'PT. TIME CLOCKS S REu UNIT HEATERS MULTI-OUTLET DIMMERS .)
DRYERSSYSTEMS AML. WATTS r
NO.OF FEET : i
�' AMT K.W OIL M.P ` GAS N.► AMT. NO. A.W G. AMT. AMP AMT. AMPS. TRANS.1 AMT.i H.P }
I •
2 i
S E I C
1 SERVICE DiSCONNKT '�• R v A.w G. NO.OF NEUTRALS I "~ G .Y
��=mumENI
► 1 p Te/ 1/3W R 3w 3 A'tw NO.OF CC COND.I A.w G. I NO.OF Nt-LEG OF Nt•LEG i OF tJEUTRAI `
PER B OF CC.GOND I '�
-G OTHER APPARATUS: r
v
1' SHED-1
PANELBOARDS:1-6 CIR. 60,1- CIR. 20 �
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RICHARD NORKLUN --:‘!. ....:C!; , s'
1
-t• 800 PRIVATE ROAD #21 GENERAL MANAGER T
SOUTHOLD, NY, 11971 11
r
Per
., This certificate must not be altered in any manner; return to the office of the Board if�incorrect. Inspectors may be identified by,their /credentials.1 (1 , 11 `:r
,
11 ( i yr vri�[isuirr.«vr yr rr/Mrerst tor Tar�rrvr AVwO-Qrllr W ur lit Arne ler Milli&am'.iir.Mr rl'ilfll inn
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROU PLUMBING
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING / STRAPPING [ FINAL , Sic
e:43
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS: A .40 A tt1u,IuV .
.
DATE Ii 7 (
INSPECTOR 7544
-3(181ac -a' ,,,,,,,,,,,
40f SO#4.
(f \
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPEC;pN
[ ] FOUNDATION 1ST [ LUMBING
[ ] FOUNDATION 2ND [ ION
[ ] FRAMING / STRAPPING [ AL Sp
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
GD
DATE INSPECTOR
FJULD II SPgens*mixer DATE ( coI4?yK ekas I e 1 )11
.�
• FOt ATONN(1ST)
I • . . .. • . s
FOUNDATION(2ND) ' P
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ROUGH FR.AMFNO& ` ' • • .
PLUMBING .
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INSULATION I'Elk N.Y. • y
STATE ENERGY CODE
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4/t1/52- Pc �a” 3 c(Ae j67
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined . . . . . . . ! . r'... . . ., 19 . . . O Application No
Approved I , 1 Permit No �—
Disapproved a/c
lel
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date `A 4yn°C , 19�
. INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necess inspection
(Signature of applicant, or name, if a corporation)
�-00 Pr j. t't D #a} souTa-0 iy. //9,/
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
cApaoe
Name of owner of premises i,c 1 e- ) ,/V oe1'LUN'
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate 6offitccer)��
Builder's License No. -7' " `.1 \ -
Plumber's License No.
Electrician's License No.
Other Trade's License No.
1. Location of land on which proposed work will be done.
8'00 'Iv�TE filo- #a/ cSooTN�c��
House Number Street Hamlet
County Tax Map No. 1000 Section 7e •
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
0/1/.&- •41/4 I 2,/ �G✓ELL//✓r
b. Intended use and occupancy O L S (4 C ::
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
115--M / P (Description)
4. Estimated Cost 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
7. Dimensions of existing structures,if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height 1 Number 9f Stories /
8. Dimensions of entire new construction: Front . ./o Rear h' Depth /U
Height I/ Ntynber of Stories /
9. Size of lot: Front . . . ./74-- Rear . . . /.75 Depth . .c?0 v
1
10. Date of Purchase APe(t.- i`7'7. e of Former Owner dam^/
11. Zone or use district in which premises are situated /j-/eEs:
12. Does proposed construction violate any zoning law, ordinance or regulation: .1,10 ill
13. Will lot be regraded . . . Mon Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ricf-/Aie° gp,Plei-o# Address Boo fL7,eD4`Xso�``1`4a Phone No. 7615--/34/"3
Name of Architect Address Phone No.
Name of Contractor Address Phone No.
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.
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0 STATE OF NE ` Y•RK, S /96 1 )4
COUNTY OF- :�
-'�� -• • 4/'c 16-4i..lri_. being duly sworn, deposes and says that he is the applicant
(1 ame of individual signing c tract)
above named.
He is the 62...4-(1../.-7 ,-r
(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 his knowledge and belief;and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before meetisthis
4 ", day of. . . . a :
- AAPTR)DVZD AS NOTEL
DATE: q(1/a72---13 P. # ( 1 6 vd- 2----
_....,...,..._
FEE: 7-6-1 : BY : ,/"741------
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. —....-P......•••••••••*,11.11V.411.0*
•
NOTIFY BUILPwG r:'EPARTMENT AT
765-1802 9 Ati Tr) 4 PM FOP, THE
occupANcy OR
FOLLOWING CTIONS:
1. FOUNflAT'n" - TI"P) REQUIRED
USE IkS IM FOP PCLIF'-`, C'..)N1r.'2TF
2. ROUGH - LP ^MIN(.7, i?: PLUMBING
,i,.= 7'-'-• ,-.,-a i T:
vtilgo-TIFIrt.oli- fi .( g VLiir , 3. INSULATr" '
Cii gatkt I UL ' I a :1 T
BE COMP! '--r '-"'- P r 0
ALL CONSTR ''.:—' c' r/\I L
OF OCCUPLITY - THE REQUIRE"'''s — THE * ''
STATE COW-
conEs a - '. '----"s`rtBLE __,
, , , , i , DESI:Gthol, C.4‘11-TRYCTION ERP,r2r'S..
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