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Home My WebLink About23303-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24266 Date APRIL 8, 1996 THIS CERTIFIES that the building ALTERATION Location of Property 1695 OLD WOODS PATH SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 87 Block 1 Lot 22 Subdivision Filed Map No. Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 1996 pursuant to which Building Permit No. 23303—Z dated MARCH 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 REPAIR & ALTER EXISTING RAISED CONCRETE PORCH WITH WOOD PLATFORM ON EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to W.S. BALLENGER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A lee d' g Inspector Rev. 1/81 FORM NO.3 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.................. j./... ..................... 19. .,E•�� N? 23303 Z Permission Is hereby granted to: a, 4x a......... . .................................................................................................................................................................. � ........................................... ....................I.............................. .....................I.........dr at premises located at............&(... ........e2fs...... .. ........ .. i &......................... ...................... .............................................. 1 . ....................................... ............ County Tax Map No. 1000 Section .. /.............. Block.....!/' ........... Lot No. ......A�............ pursuant to application dated ....... ......4V'l................... 19.....�&/,,,., and approved by the Building Inspector. r Fee$......<. .............. .............. ............. ... . . ........................... B ding Inspector Rev. 6/30/80 TOWN OF SOU'iHOLD . U t►J BUILDING DEPARTMENT N TOWN HALL APR 5. k 765-1802 � __ BLOC.DEFT. APPLICATION FOR CERTIFICATE OF. OCCUPANCY " - —TOWN OF SOUTHOI-fie A. This appi`n 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 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. a '. For existing buildings (prior to April 9, 1957) nor-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 $15.00, Commercial $15.00 Date . . New Construction. . . . . . . . . . . Old Or Pre-existing Building. .. . . Location of Property. . `.�.�.5. . . . . . . . . C7 1,• •C�t�._ . .�] . � � . . . . . . �;��'�c� . . . . . . . . . . . House No.`` Street Hamlet Onwer or Owners of Property. . lO. JI�:P�, ;�,�. . . . . . . . . . . . . . . . . . . . . . . . . . • County Tax Map No 1000, Section. . .� . . .. . . . .Block. . . . 1 . . . . . . . . . . .Lot. . . .Z • • • . .• .. .Subdivision. . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . .Filed Map.. . . . . . . . . . . .Lot. . . . . . . . . Permit No. . . . . . ..�• . . . •Date Of Permit. . ./.�.S. (�1.�• . •Applicant. :�:J, /;�?;;'; Health Dept. Approval. • )�. !..'• . • • . . • • . . . . • • • • •Underwriters Approval. . . . . . . . . . . . . . . . . . : . . . . Planning Board Approval. .�_ . . . . . . . . . . . . . . . . . . . . Request for: Temporary Certificate. . !!. . . . . . . Final Certicate. . . . . . . . . . Fee Submitted: $. �.�:� �. . . . . . . . . . . . . . . . .` . ..� r• APPLICANT ., o��g�FFO�,�co o� y 2 Town Hall,53095 Main Road p • Fax (516)765-1823 P. O. Box 1179 y O� Telephone (516)765-1802 Southold,New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD April 5, 1996 Environment East Inc. P.O. Box 190 Peconic, NY 11958 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file.. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being Issued after April 1, 1984) . BUILDING PERMIT # 23303-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. 3 v3 M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG:'� [ ] FOUNDATION 2ND [ ] :NAL U ION [ ] FRAMING [s`� [ ] FIREPLACE & CHIMNEY REMARKS: . ,--A DATE ` �; ►�$�! '' INSPECT ' " � FIELD 110;1,1;�c 1:1.011 101,11MVI, D ATE 1"(11INDATION 1";,1*) ----------------- ------- C7., FOUNDATI Oil On) ROUGH FRAME I NG INSULATIOtl N. Y . STATIF FURRGy ------------------ --------------- ------------------ F I IIA 1. ---------------- -------------------------- ------- 0 ADDIT1011AL COMHI�tj'rS: - ------------ ------ --------- 0 .......... BOARD OF HEALTH . . . . . . . . . . . . . . . _1 �_(� -FORM NO. 1 3 SETS OF PLANS ; . . .. . . . . . s . . . . , s `.--- , TOWN OF SOUTHOLD SURVEY : . .: : : . . .. . ... . . . . . . . . . . BUILDING DEPARTMENT CHECK . : : . . MAR 1 21996 4' TOWN iIALL SEPTIC FORM. . . . . . . . . . . . . . . . . . . ."� SOUTHOLD, N.Y. 11971 TEL: 765-1002 NOTIFY: BLDG.DEPT '7 l'rV11sy;OF SOUTHOLD CALL :73cy Ex mined......3�A: ...., 19!.� MAIL TO: . .. . . . . . . . . . . . . . . . . . Approved......1IZ5 ....., 19& Permit No. ..-.... 330 ............................... Disapproveda/c ....:.............................. ...................................... ...................................................... ....(Buildnspector)........ APPLICATION FOR BUILDING PERMIT ((�� / ..Dated!ll. :I J R . . . ... 19. . . . INSTRUCTIONS a. 'this 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 public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 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 IE>;RM- K=- 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'otbier 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 inspections. 1 �K sJ rr e'".► 4- .................. �....... ................ (Signature of acpplicant, or name, if a corporation) 3,0 -..��..�..�..L...................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .........�~.{'\�.:'::':d...��J.` 1�:` 1L1.4C.7?:�--...........................................A�� Q.� .QT��.. .. c ,,� / " 3,/� B.P.# Name of owner of premises ....?.:� :�`.a!!�°'( fL:....................... .. .. (as on the tax roll or latest deed) FEE: � NOTIF� BUILDING DEPARTMENT AT I ' appli it t' " , i Lure of duly authorized officer. 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: „,,,,,,,,,,,,,,,,,V,t;L�� 1. FOUNDATION - TWO REQUIRED � d� �" �� and title of corporate officer) FOR POURED CONCRETE nR 2. ROUGH - FRAMING & PLUMBING c~ l 3 INSULATION Built `s License No. .. ..7. ��---�/�USE I UNLAWFUL 4. FINAL - CONSTRUCTION MUST ��I TU � '�� BE COMPLETE FOR C.O. Plr;!laet 3 License No. ......................... �'� LL CONSTRUCTION SHALL MEET z- ......... F ^CnUPAr, THE REQUIREMENTS OF .THE N.Y. rlc�triu'lans License No. ......... STATE CO��aTRL1CTION & ENERGY Other Ti,ak's License No. .................... CODES. NOT 'RESPONSIELE FOR DESIGN OR CONSTRUCTION ERRORS I. Location'of land on which proposed work will be done....' ........................ ._ _. .................................. ........�. ` `�)............... .t��.. I, n�.`.... ... .....................61. 11.................. • 1 house hXvbec: Street hamlet Cotmty Taos glop No. 1000 Section ................. Block .....(...........Lot ... ......... Subdivision ` .................................... riled Map No. ............... Lot .....a... ... � (Nave) 2. State existing uev and occupancy of premises and intended useand occupancy of proposed construction: a. Existing use an�A_occupancy ... ..:.Y��!Yll. `." ..:'-� :yell. ► ........................... .................. b. intended use and oc�C' y ... ..(1 ... )�.. d tu 3. Nature of.Woyli!(cleck chid► applicable): New Building .......... Addition .......... Alteration .......... Repair .. Removal ............. llen►olition ............ Owner Work ... ............ ............ .(Description)..-. 4. IsstiuraCed Cost .z ...'............. fee .............................................. (to be paid on filing this application 5. if dwelling, nni)er of dwelling units ..I......... Nu►ber of dwelling snits on each floor ................ Ifgarage, ri<nber of cars ...................................... 6. If business, cannercial or mixed occupancy, specify nature quid extent of each type of use...................... 7. Dimensions of existing structures, if any: Front.....W W. -- Rear ............... Depth ................. nedght ......................... Umber of Stories ...................... Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Deigl►t .................... Umber of Stories ............... a. Dimensions of entire new construction: Front .�.� A...C ' q'.R .......... Depth .............. Heigd►t ........ Umber of Stories 9. Size of lot: Front .... Rear .................... Depth 10. Date of Purchase ...................... Name of Former Owner ....... , . / ...... ........ IL. Zone or use district in which premise:; are situated �.. � .!.LrPI ..!!�-;,,,,,,, 12. Does proposed construction violate any zoning lass, ordinance or regulation: ...'�J v.................. 13. Will lot be regraded ........ ... Will excess fill be removed frompremises: YES NO 14. Names of Owner of prenises f ��1��! .......... Address �d 1'!�!�`'��6�!�k111�d( �tJ f fl 19 Name of Architect .................................... Address .. ... . Phone No. . N�n►e of Contractor .1 ,1(ZQh?ic;';� � !- .... Q ' 7 ..1 . Address�8:i6.iqU 96 NBC;. .�...... ..3 F1►o►Sie�N ..... y.... 15. ,Is this property within 300 feet of :s tidal wetland? * YES .......... NO ....... *IF YLS, SOIli"D-mm IMBI1 9 FuMIT MAY ISE REQUIRLq). FLOT DIAGRAM Iocate clearly and distinctly all b►.ildings, sd►ether 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 wl►ether interior or corner lot. STATE OF NEW YORK (`� SS cOUNTY OF . . . . ..�.it111�� :. . . . Tc. . .�'� �tra .:�:......... being drily sworn, deposes and says Chat 1►e is the applic+ant (Nave of individual pi fain g' ct) r alxwe named. J lie is the ....... ........ ................................................... ................ . ........... (Contrdctor.•agent, corporate officer, etc.) j of said owner or s; and is duly•authorized to perform or have performed the said work and to mak Yamd file this application; that all statements contained in this application are true to the best of his knowledgerfand belief; and that the work will be performed',in the manner set forth in the application filed therewith. Sworn to before me th' .... . .. of' .A"Ck ... ...... . Notary Ft►lul ic, .R�SBEiiC 1. t OTARY PU LIC.State of X No.4725089.Suffolk u t �(Si1;naS tire�of�aSt)lic�ant)�� Term Expires May 3 ,1� 1 f-:EFL-ACE SMAI✓L- SEC-no�-t R��sE� . cal•>,cr�.�E-:-�oFzGt{ � sT-ems. I \N'Tlt-t Ac '"o C3 P L'rF0 p-M w/ T'4 G I1 Rc41 l_S /RDo� f'cR� �xIST. — N� C�l*4hlGE 9v l � OCCUPANCY OR USE HS UNLAWFUL OF OCCUPANCY �\ Te ur,--1 r -,AX 4 f>OSTS AtyD FTGS (` To 3'-p" C3 E-Lo yq I r— SCALE: APPROVED DRAWN BY Cf� DATE: 3 10, no r r DRAWING NUMBER ..1= CHARRETTE PRO-FORM 920PF PRINTED ON 920H CHARPRINT VELLUM