HomeMy WebLinkAbout23808-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24866 Date JANUARY 29, 1997
THIS CERTIFIES that the building ADDITION
Location of Property 1955-A-1 CALEB'S WAY GREENPORT, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 40.1 Block 1 Lot 1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 4, 1996 pursuant to which
Building Permit No. 23808-Z dated NOVEMBER 15, 1996
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 , 6'x 12' DECK ADDITION & GARAGE ADDITION TO EXISTING CONDO
UNIT #1A ENTERING EXISTING NON-SLEEPING AREA.
The certificate is issued to LYNDA LEE SPANGEL
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. PENDING - JANUARY 27, 1997
PLUMBERS CERTIFICATION DATED N/A
Building inspecto
Rev. 1/81
FORM NO. f
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° 23808 Z Date .. ! 5........................................ 19Z1
Permission is hereby granted to: ,
....��..r.�:.. ..T. , ......... ... ...............
.... .... ..........J.. ...... Z' .
to
�� . . , .C.„ 3. / .... . ....... � ` �!• ......�. ... ..
. ... . `....... .�....... .. P...... . - .....................................................
at premises located at .....61,?fl............ �
........................................................... `1z3"5................. . .... ..................................
......C,. .� .... .................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ......7q<l...... Block .....1.............. Lot No. ......./..............
i
pursuant to application dated .............. ... ..................................... 19.16, and approved by the
Building Inspector.
Fee $.. 'SJd }/..
...... .. �'} O ...... ....................
/ Buil � g Inspector
Rev. 6/30/80
�aa- S g Y6-L TOW,T OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
i 65-1302 1, 1N 2 8
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 1% lead.
5. Commercial building, industrial building, multiple residences and simzlar 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, Sw?Tning pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Bu:ldinsz - $100.00
3. Copy of Certificate of Occupancy - .25r,-. -
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date . .. . . . . . . . !ta?��. . . . . . . . . . . . . . . . . . . . .
New Construction. . . . . . . . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . .
Location of Property. .4W/,.j . . .. .. .. ./:./.5.5 . �/.� 5. 4k"W. . . .. . . .. . . _�12��st� � /. _. , . . .
House No. Street Hamlet
ti
Onwer or Owners of Property.. . ..elr l ... . . . . . . . . . . . . .. . . . _. . .
County Tax Map No 1000, Section. .IdDO . . . ...Block. . . . J.� . . . . . . . .Lot. . . ®S . .�J. . . . . . . . .
Subdivision. . �1.�tj$sf�/� /�tf/tJ. SJ�J�/ . . .. .Filed ?yap.. A�7. 7. . .Lot. . . .f . . . . . . . . . . . . . . . .
Permit No. .a36M?.r. .Date Of Permit-'.. -ADD 1icant.,Yl .i/�. . �eh.J�����• • • . • • • .
Health Dept. Approval. . . . . . . . . .. . . . . . . . . . . ... . .Underr.ari.ters ?approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . .. . . . . . . . . . .. . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . �!, . . . . . .
Fee Submitted: S . . . . �. . . . . . . . . . . . . . . . . . . .
.� �
LCANT
s OW 3
FIELD INSPECTION REPORT DATE --_____------____ COMMENTS
(=OUNDATZON ( l ST
if
-ODNDATION (;ND
II I V
----------
IF
ROUGH FRAME &
�n
PLUMBING
'III
Tr_ il
-------------
�� II �
INSULATION PER N. Y.
ra
STATE ENERGY
CODE
it 't
II y
II " u:fti
"
FINAL
ADDITIONAL COMMENTS:
En
� l
ti
I O
I z.
I
I
I
I
I ��
3RO
T65-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] IN 6TION
[ ] FRAMING [ FINAL
REMARKS:
l
67
DATE 4' INSPECTOR
T65-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH P G.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING IS
[ ] FIREPLAC 8 CHIMNEY `
R ARKS:
N
liJ2�
DATE " INSPECTO
T65-1802
BUILDING DEFT.
1 ECTION
0 DATION iST [ ] ROUGH PLBG.
[ OUNDATIQN 2ND ( ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE 8 C111MNEY
REMARKS:
DATE l �� INSPECTO
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] F NDATIAN 2ND [ ] INSULATION
[ FRAMING G�Y- [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE / 13 INSPECTOR
BOARD OF l(e:AU111 . . . . . . . . . . . . . . .
FORM N0. I :3 SI I'S OF PLANS . . . . . . . . . . . . . . .
r 'TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
IIUIi,DTNG DEPARTMENTCHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN IIALL SEPTT.0 FORM . . . . . . . . . . . . . . . . . . .
A(o1� SOUTHOL.D, N.Y. 11971
~ 6 TEL.: 765- 1802 NOTIFY:
CALI. . . . . . . . . . . ... . . . . . .
I.�� -�r/ •--...., 19A G MAIL TO: . . . . . . . . . . . . . . . . . . . .
IA�. fermiL' No. 0.� .
Disal)proVed a/c .................................. ....................................
......................................................
(Building isle . , /
APPLICATION FOR iSUILDiNG PERMIT q
Date. 1� .y . . . . . . . . . , 10V
1 NS'TRUCTTONS
a. 'ibis application must be coarpletely filled in by type(ariter or in ink aril su1xnitted to the iluilding Inspector wil
t3 sets of plans, accurate pl0f.plan to scale. Fee according to schedule.
b. Plot plan slxx-Ang location of lot and of Wildings on premises, relationship to adjoining premises or lxrbl is
streets or areas, and giving a detailed description of, layout of property Tmist be drawn on the diagran wir.ich is part: of
Otis application.
c. 'lbe work covered by this application Pviy not be ca)menced before issuance of Building Permit.
d- Upon approval of this application, the Building Inspector will issue a iuilding Pennit• to the applicant. Such
permit: shall be kept on the premises available for inspection thr(xighout the work.
e. No Wilding steal-l. be occupied or used in whole or in-Vnrt for any lxurpose whatever until a Certificate of
(k_culknrx:y ,luaLl. have been granted pry the Building Inspector.
APPL.1CNrION IS IIEWHY WE to the Building Department for the issuance of a Building Pennit pursuant to the
iuilding 7xxw 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 dc-lrx)lition, as herein
described. 'Ihe applicant agrees to comply with all appl.icabl.e laws, ordinances, building code, iror.rsing code, and
relnilations, and to adnit authorized inspectors on premises and in Wilding for necessary inspections.
._.. ..... �.7 .tom.. .......I...........
(Sign -ure .of applicant, or if a corpx)rat:i(m)
(Mailing address of: appl.ic±�f►rt:)
Stage cahether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plrnber. or Wilder
19
------- G�.vf.................. ................... . ......'.......:........._.....--•--...... ..........-----
Nana of #o1no.niFWs .....!//-�ICZF,,S...IAN .....�Z®L�/�i[/(f-: :t.!. .... ............................ ...
•. ,j/ '.
(as (xr the tax rol l or I acest.de(A)
If appliati Signature of: dirly aul-horizc-d officer.
--.----. ... . :. � ......
(Nrnm ax)rate officer)
Builders i.icense No. .........................
Pluibers license No. .. .�'��1�
........
p��l✓'
Ilectricimi. License 13o. _ , 7. -.......
Other Trade's License No. ....................
I. Loc.at.ion of land on wlriclr proposed work will be done..............................................................
u� . �...................C'�L. .'s.: -Y............................-��
Ikxuse timber. Street Ila»let
Gxrnty Tax Map No. lOOO Sect' l ..... .... i31 cx k ... �.-...-.. Ln1t'�...'
Sulxlivision AIM �'/��...._ Filed Map No. _..� ../.... 1oC ....... .......
(Nano)
2. State existing use and occupancy of prerni. s arid intendeduse arxi occupant' of proposed construction:
a. Existing use and occupancy ........ ... r cl..v......................................................
h. Intended use and occupancy .......... .......• �, .........................................
1. N•llme of t,m)tk (check wllidi alq)licahle): R-%j Milding ..... ..... Addition Al✓Leralion .. . .. .. ...
N!pair .. ...... .... 1(cmvval .......... ... Dcm)IiLion ..... ...... . Other 1•kltk .. ....Gat(./.2_..4eg5l �.. . ......
(Descr i 1)1:i cx))
�;. I?sl.mated Gist: .....1O 00U............ fee ............................ .................:
(to Ixa paid on filing 1..his application)
'i. If: Ax.11 ing, rx)t)ix_r of dtxill inf; units tkirirer of (heel I ing ullirs oil each floor .... ..... . ......
if garaf;e, txnlxer of cars ....... ....6WI . .....
li. If Ixrsiness, caunercial or mixed occupancy, sllecify nature arxl extent: of each type of. use.......... ............
� G
I. Dillm`imitxls of: existing strmAtives, if airy: Front:.. ... .. . ..... it,,, _2.S7. . .... . ..... . ......
Ik:i C ......1� ............... Mnrt)er of Stories .....==rF........... . .I)illensi(xrs of seine strtrc.ture with alterations or addiLions: Front ... ";(.5... . ... •Itear ....VI.. ......
Dept It .... � Ikij;it: .. ..../.5........... Umber of Stories ...../........
It. Ilimensioos of: entire txx+ constrtx,l:ion: Front: . ..../S .. ..... Rear ..IG.. .. ...... m-plh .. .PQ ..... ..
lleigl)l. ...... ..IS.............. lard)Lr of fkories ...../......... . .. ..
9. ` Size of, loll: Flot)1: Rear ..... ......... .. .... I).)tll ............... .....
10. Dare of 111rchase ..................... IJexlle of Fornler Maler ..... ...... ........................ .... . r
II. 7cxle or use discricL in i-A►di pretuises are situated .................................... ............... ... . .... . . .
12. lk>Ls propose:cl conslrtxaion violate any zoning law, ordinance or regulal:ion: . .. .. .....................
17. Will to(: Ix-- regraek.d ........... ......... Will excess fill. Ix-- roiloved f:,rrccxn pronises:/f`, US 1JO �j
16. Nallies of Owner of prollises /.lk��t� S Z'..!?�!Y.Qsj�,J Acklress ./.".'�!!.%�/�y3...4f/:�!�YI)0oe Pk). 7:! ' 4�yU
Nem! of Architect: ............... ... ..... ..... . ....... Acklress .. ....... . . 1'llone No. ... .... .. P....
N:nKe of (:(xll:racror ................. .................. Acklress .. . ............................l1ux►e No. . ...... .. ....
is this prnlx!rly within W) feet: of it tidal taetlland? * YES .......... a.... ......
*If? YIiS, S()1yll"j) 'I"m 'must S ['11--RMI'1' MAY Ifl: 1upl[ll;l).
1'LOT 1)TAGRAM
Icx.a(e clearly arxl disLineLly all Imildin8s, ekether existing or prolx)sed, arxl itxlicate all. set-back dimensions
from property lilies. (give sLreeL arxl block rxni)er or descripL'ion according to deed,-arxl slim, sLreee"t: mines and imlicate
t-Aletler interior or corner ]oC.
AP ED AS NOTED
FEE: - BY:
-r'v_
?� r,Zfry e65-1802 9 AM TO 4 W��:' FOR T11-11
. Zv'";;h= ,:r�i7Z"v r; fJ PROVIDE 3/4 HR. FIRE FOI..i,..OWMIG IlispEc'r o
RATED SEPARATION TO 1. FOUN -IAA) REQUIRED
F(3C�aP�I3�Frs� s`�'ISDs:;f��aI'E
�sE Vow il�i:� PART. f) (1) OF 6 _ �,
2. ROUGH I �'e,�� N48%G ;,`�,` i'Ie1..II�:�iil�v`G
F° 0CC, fRP 011�'��� N.Y. STATE BUILDING CODE. 3. :l�s-r�.�
d . F fl"UI L CUONS,�7 RUCTION MIIL)s r
7, BE COMPLETE FOR C.O.
UNDERWRITERS CERTIFICATE ALL CONSTRUCTION SHALL MEET
REQUIRED THE REQUIREMENTS OF THE N.Y.
STATE C'ONSTRUCTTION & ENERGY
CODES. NOT RE RESPONSIBLE FOR
:crn'rn. ()r Ian x, DESIGN'OR CONSTRUCTION ERRORS
(lfA1NIY (R' LIG' .. . ... :1...
C��fiYl� �� �' '•iti/
. ... . ... 1•. . '•`!..�.�. ..... . .. ..Ix!ing duly ;-warn, delloses alxl says (hall he if; the applicant
(Naule of hxlividual siI fit,, conL.racC)
"lx)ve luxivd,
(lk)1llraclor, agent:, corlxtrate officer, el.c.)
of said owoer or owrx!rs, mxl is dtrl.y aulhorized to perfonn or have fx!rfornr!d the said wc)rlc mxl to Write arxl file II)if;
"pill ical-ion; (.hal. it l st.alEmlits contailled in Ibis appl ication are l.ttie Lo the IWSI: of 111a krx)wlcxlge arxl I)eI ietf; ";KI
Ih"l. Lhe work will. be perfon)x-d in the s4snx.r set forth in the appl.icatior filed lherewid
`>\.n t n l to I xt o r s ur3 l h i:; �� � �'�
.. ..__ .. ly of ................. 19.. .....
Notary lhl) .1( .........
.......... ... . ............ ........
CLRc1RE L.GLlafil (Signe tit of Applicant.)
.Notary Public, State of New York
Qualilied in Suffolk County
Comm'Issiora expires December 8,19