HomeMy WebLinkAbout23376-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
. Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24530 Date JULY 30, 1996
THIS CERTIFIES that the building ADDITION
Location of Property 1725 VILLAGE LANE ORIENT, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 25 Block 3 Lot 8
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 9, 1996 pursuant to which
Building Permit No. 23376—Z dated APRIL 19, 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 STORAGE SHED ADDITION TO EXISTING ONE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MARY LEE SHANAHAN
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspec r
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............. ..!............... .. 19.7.`F'.
NP 23376 Z
Permission Is hereby granted to;
A
. .......................................................
r
.. /.......1/ '...!..............
.....c ...... .ter ....... . �. , .......................
.....�c........................ ........r-%✓.. ....... . . . ........ .. ............-.....................................
..................................................................................................................................................................
................................................................................... ... .............................................I.......................
77 .
at premises located at.. �.. �?`. 9 f.:!.. f
................: ............................I......................
..................... ...........I.................... � ............................................... ............
County Tax Map No. 1000 Section ......OS.gyp....... Block....... ............... Lot No. ��....................
pursuant to application dated ............... ... l............... 19... Cam?..... and approved by the
Building`Inspector.
Fee$../...�.............
...........?;�l
/„
n Ins ec r
Rev. 6/30/80
TOt�,T 0 SOUTE?OLD
3UTLDLNG DE?a1RT`�Eti"I'
I JUL 2 619,% `' 7 65-1S02
BLDG.DEPT. -C,_-_ON =0R C:_.T_�' .� - 0_ OCCUPA CY
TOWN OF SOUTHOLD
A_ This aDpliCation ]lust be =-pled 1n by c7Tpewir-iter OR in{ and S'ubm_tted tb she build;Za
v
1=hsDector With the follCWing: for new- building or new use:
I . Final survey of property with accurate location of ail buildings, property lines,
Streets, and unusual natural or topograDniC features.
2. ^inai Aourovai from Health Dept. of Water suDDly and sewerage-disposal(S-9 form)
3. AoDroval of electrical installation fro'. Board of Fire Underwriters.
�. Sworn statement from plumber certi_7ing that the solder used in syscam contains
less than 2/10 of 17. land_
J . COmmerC_a1 pu_lO;no*, =austr_al building, muitiple residences and s_m_iar bu�?d_ngs
and h~'hscailations, a cart_f_cate of Code Co=-1_ance ==om architect or engineer
responsible for the building.
O.. Submit Manning 3card 3pprovai or comDleted site plan reQudrements.
3. For em-_sting buildings (prior to April 9, 1957) non-conforming uses, br buildings and
"pre-iexiscing" land uses:
L . Accurate survey of proDert7 Showing -=II proDert7 lines, ,Streets, buiidimg and
unusual aaturai or tonoc-raph_c features.
2. A DroDerll comDlared aDnllcation and - Consent to �mspect signed by the aDDl=cant.
If a Cart___Cata of Occupancy is denied, the Building laspeCtor shall stata the
reasons therefor in v=amg to the applicant.
C. Fees
1 . Certificate of Occ-upanc;T - Vew dwelling S25.00, Addicions to dwelii✓g 525.00,
111 rotations to dwelling S25.00, Sw illffiing pool S25.G0, Accessory building25.00,
kdditions to accessory building S25.00. Businesses 550.00.
2_ Certificate of OccupanC7 on Pre-existing Buiid?.na - 5100.00
3 . Copy of Certificate of Occupancy
!. Updated Certificate of Occupancy - �50.00
5. Temporary Certificate of Occupancy - 'Residential 515.00, Commercial 315.00
Data .J �.�Jq.b . . . . . . . . . . . . . . . . . . . . .
New Construction. . . . .`.. . . . . Old Or Pra-exi1st-i_n_g 3uilding. . . . . . . . . . . . . . . .
Location of Propert7.1� :�! . .�.L. . • Q.,. . . . . . . . . . . .. . . . . . . . . . . . . . _. ..
House No. Street Hamlet
Onwer or Owners of Propert7. . � . . . . . . . . . . . . . . . . . . . . . . .: . . . . . . .. . .. . . . . . . .
County Tax Hap 'No 1000, Section. . . .3loc'_c. . . . .13 . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . :..:.. . . . . . . . .Piled Hap . . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . _..
Permit Vol J•J�IO.� . .Date Of Per:- r.v Q.�. . . . .apD!icant`J1 i•�'�`!4�'�T•.�
Heaicl Depc. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Undervritars A-pprovai. . . . . . . . . . . . . . . . . . . . . . . . .
3?.annizg 3card =pprovai. . . . . . . . . . . . . . . . . . . . . . . .
Request for: Tempora-,7 Corti=icata. . . . . . . . . . . 74
__nal Car_icate. . . . . . . . . . .
^ee Submitted. 3 . . . . . . . . . . . . . . . . . . . . .
a�PT 1C��TT
O��g�FFO(,�coG
o� y�
N Z
Town Hall, 53095 Main Road p • Fax (516)765-1823
P. 0. Box 1179 y� O� Telephone (516)765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
Mary Lee Shanahan
1725 Village Lane
Orient, NY 11957
To Whom This May Concern:
We are unable to -complete your Certificate of Occupancy
because of the following reasons :
XK An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
%% The check is (;s�at-L=dtnot 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 # 23376z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
3
765-1802
BUILDING DEFT.
INSPECTION
[ NDATION 1ST [ ] ROUGH PLBG.
[ ` FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMA
DATE _INSPECTOR
-76
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION iST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS ION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMN Y
REMARKS:
DATE IN8PECT0
1x[MIT u^|I.- `13
om
STATRI
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BOARD OF IIF.AI;I'll ��. . . . . . . . . . .
12 POI(M N0. I 3 Sli'l'S 1117 PLANS . . . . . . . . . . . . . . .
F` SIIItv13Y e . . .
^! TOWN Ol SOII'I'1101.p
a 1111ll;l)1IIC IMPARTHIM-1' Clll?ClL :�c M ... . . . . . . . . . . . . . . . .
AlAl.l. SBPT1.0 CORM:' . . . .:.". . . . . . . . . . . . . .
8011'6Iofm N.Y. 11971
9LM.DEP TEL: 765-11102 HOT IFY.
TowiNl ilQLD r''' CALL
L --
hx.mirred.. �.�Z, 19/� MAIL TO: . . . . . . . . . . . . . . . . . . . .
f 1976� l'enniL No. �
Approved , .................................... . .
bisal>frr(rve( (r/c: ........................... .. ................................ ..
(Wilding; Inspector) '
P Li CATION FOR BUILDING PERMIT
1;)11le . . . . . . . . . . . . . . . 19. . . .
,I NS'l'itli(;'1'LONS'
a. 'This application ntrsL Ire cargilel.ely filled in by Lylrc:cwriter orAo iok. arxl nobmiLLed to the Wilding inspector wit]
7 sets of plansr, accurate plot' plan to scale. lee according; to schedule.
1 . PIOL plan slxowirrg location of lot: arx] of lxnildiogs on premises, relat:ionshjip o adjoining; preanisea or lxrblic
k 1I,ree s'or'aredrs, rnrxl giving; n detailed descripticnn 0 1`aycxit: of iirolrerfy 'rnust :1>e`(lr(Mi on Lire diagram wish] is part of
lhict appl ical'ic„r.
`'c. 'ihe work"covered by`Odu nplilication vny nxrt: Ire corrnreoce(1 before issuance of lkill.dini Permit.
d: =lljxi+i ajrlieovirl. of lhirt"aptiprlic:aticxn, lire Ikrilclin�t' 1nsirecCcir will issue a Ndlcliirg l'eimil' to the applicant. :,(uh
permiC slrnli be kept on the premises available fore inspection lhrarlirout the work.
e. No Wilding alnall Ire occupied or used in "whole or ill ixirt for any lmrpose whatever until a Certificate of
0cmipancy shall. have beco granted by the ikrilding inspector.
AMIACAHON iS I/iitl'sRY ME to t)re ikrilding Depr<artmeot for Ole iasonoce of a lkrlldhT, Petrnit ixnrnmaot to the
I dIdinrg 7cnre Ordbuince of the '1'cxm of Southold, Scnffolk (:onrl:y, New York, aril other aplAlcable laws, Onlinances or
itegulaticxrs, for the carstruction of lxrildings, a(kliLlmn or alL•eratioon, or for rennoval or (1011101kion, as herein
described. 'fire applicant agrees to coillily with all ahlilicable laws, ordinances, Wilding code, I►ousing code, arrcl
regulatioon, Dix) to .(Bait androrized inspectors ors prouises Dix] in Imilding fo necessary inspectlorrs.
(Siprrnture ( olgrlicant, or nacre, if a corlrcrrnHon)
.........
........ ....... .... ....
Wailily; mitivess of oiliticant)
State whether upplicanL is owner, lessee, agent, architect•, engimer, geoeral cootracLor, elecLrician, planner .or Wilder.
...............::..._................ . ._................_..•:.................... ................_..................__.._
Nacre of (xwr)er of. premises N�a, '. C.Pi. Q►.�4t �►.�1............................... ........... .....
(as )4r the t:ax"roll or latest deed)
if nij)lic:apiL. ,is.a corixrratior, signature of doily mnt.lxrrized officer.
°(R-:21 ;:uxl;,Lifle.of corixrrate,offices)
Ikrilders License No.�t —Tv5
Ploillrera License No. ....._. ............. ..... °, ',r .:q 6 •...``F
lilectriciarns License W.
Other '1'rade'a l.]ceose Nr). .................... \I "
I. Location of: larxl or which proposed work will. be ckrrre.?�.d�.J....rt 11� ��!4�h�..........................
...................................................................... ........... ��°�...................
(louse tJrrrirer Street
A ilanleL
Gxnrty 'I'nx P1:yr Mi. I(XX) PiecC icxn L��.���.... Block ................ gal' ....,...........
Sulxlivisi0o ...................... ................ Filed Map tb. Lot ...............
(N le)
2. Stake existing use atxl occup>amy of premises arxi inl:erxled use and occupancy of: inrooppossedconstrucLiom
`a. LxisCirrg; use ,r c nxl octgrarrcy;, ��'+�7 1. ........ ��QQi . 1! -S.Y..................
b. interxled use aril occupancy .............................. .. '{ ?"............_., _ ..y....._...........
ffn,t0
7. 1jIIuI( of tx►11( (r:IK:cic t:AIIdI 111J)Hl:allln). fk:,j Mild* h Ai Id t!
Il(: xll r Itrnlloval Ik�lnl i C lou (II her lhn l( �'•'°"
l
I.. .
}� ('ik rti i l 4. Ial:lur•Iled Cosl: ......... fee'.. . .. ..... ......... . � ' . , HIM
(to Ix: paid on fi1inll Ihis alrpitc,y��; c , •s:_.=
.'! 5 4�l
f (kx:l l Inll, Ix,tlJrer of (knell iI till ••.....
11 - IknJ>er of Ihx:lllnll uniln oil each "fi(xrrsd'�M .l� {�'�-
II` llurulle, otsiber of cars ................. .. .. .. .. .... ..... ... .
h. IP Ixlsltresa, cc mercial or mixed o(:cul►aocy, slx:cify oahire aIxl exlenl' of each lylx! of une...... ..�..`�.... .. ...
tt ` �•+
7. Ilinx!nai(xls of existing utrticturea, If uuy: 1�ra1C.1.�'L�, . .. .. . .. . hear
Ik:iolL :12....... .......... Ikni►er of Slol-lea .. . .. .. .
0111hensi0lls of srr»e stit►rture will) alteraLions or additAons: Itear
Ik:Pll► . ................... Ile iI)it tJtnher ril Stories
II. Illnik!Ilti I(M18 of ent l t'e new Uxlat.rlxa: oo-. I!r(Kll. ✓✓�C, ... • •.. .•_, .... Dept II
IkWIt: ........... ............... Pkrll►er of 91oriieeli .......... . . .. ..... . .
9. Size of lot: hronL ..........,... .. ..I. Rear
10. Nit ol` INII-clifine C7(^,.� 31�,aS•.. 11m1I: of I"ornler Wi ter
11. Z(xle or use distrit-L In ldddl preuisea the aftuate(I
12. lkien prolione(I coosl:I-IK:tI(xl violate any uxlinll ltlu,.ordinaiwe or relltllal:loo: 1...........
H. Will lot he rellrailed ..m- ............. Nill excess fill he I-moved from prcaninea: Yl:u 0
Ill l4ulen of (knler of pronlseu ...... ......... ..........
Haile! of Atchilecl: .............. ... ............... Arklrc:is 111o11r tk►. .. ...
N;ale of Cont:racl'or 1 . ..... .d .......1 ., ►-. ''S'2.
15. is this property tilll►in 3W feel' of o tl(lal liet:lnlxl? * YI?S . , .. sari
*1P YES, SUIIM1) 1114N 'IMIS-1115 tIAY HI3 REfIl111t1i1).
PLOT IIIAGRAH
lcx:al.e Clearly alxl distinctly all Ixllldinlls, t•Alelher exisl:lna or proli0sed, alxl Lxlicnt:e all set-back diuteoniona
fr(ru prolrerty lines. CivekstrleeL' aril block IxnJxr ur (kscrl 1 l l:o deed, n(xl tlllcx+ al:reeL' nrrllea nlKl hxlicale
tdu!ther iulerior or corsx:r lot. L!I
` UNDERWRITERS CERTIFICATE A
P TOTED
REQUIRED DAT .P#
2. FEE:I�OTIE T
755-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
• '5� It91i I. FOUNDATION - TWOREQUIRED
F c;� jF; try FOR POURED CONCRETE
€ i s �e� `► A U 2. ROUGH - FRAMING 8l PLUMBING
����f ;.� t � 1 INSULATION
, � � it €i �� 4. FINAL
<< ,: CONSTRUCTION MUST
_ BE COMPLETE FOR C.O.
I ,V ALL CONSTRUCTION SHALL MEET
%L4#` THE REQUIREMENTS OF THE NX
STATE •CONSTRUCTION & ENE
COTES. NOT RESPONSIO RO
MMIF IN W.14 YWK, q DESIGN OR CONSTRUICfiIQN�HOWR
(XXIIIIY (R1. .....
being; dtlly sworn, delionea alxl nays that he its the appl icunl.
(Ih•rlu of ilxlividoal. oiguinll colll:t•acl:)
a1x►ve n;ur:tl,
.. . ...... .. .... .......:......: :h¢Q ..... ...`. .. .. ..... . .. .. .. .... .. .... ..................
(C)oL'rnclor, agent, corlx►rule of:flCer,
of maid o%nmr ur (xdlxwl;,` nlKl in duly ru►ihorizc:d co lx!rfonu or halve (K!110rl►r:d the void ")dt alKl to ur•du: suxl file 111111
nppliroLion; Olill. n11. IlLatuileuta conlaim-d in thin appliraiion use LISK! to Ihe.•Ifeat: of hill ItIK"IetlII(! rllxl Ix!Iief; rIIKI
III;IL the w()li( wi l l be perfornled In the s11i1111K!1' net forth ill the appl icliiAlfn, I'Lle I lherewrlth.
AIlll 10 1)( fort! nw I.his
.....day
tkN.ury I'(Ihl is .. .... .---
ROBERT I. jCOTT,J (Sil;nacure f Appl icanL)
NOTARY PUBLIC, t of N.Y.
No.4725089.Su ik Couv
Term Expires y 31 1, 19