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Home My WebLink About6074-ZFOPd~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22217 Date MARCH 26~ 1993 THIS CERTIFIES that the building ALTERATION Location of Property 10095 (lB) MAIN ROAD MAT~'ITuCKr N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 142 Block 1 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 24{ 1972 pursuant to which Building Permit No. 6074-Z dated AUGUST 24~ 1972 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 ALTERATION TO STORE #lB FOR PUMP HOUSE & WAT~I{ TANK The certificate is issued to ALAN CARDINAL~ (owner) of the aforesaid building. SU~'~'OLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ' Buildi~'g 'Ins~ect°r- ' Rev. 1/81 FOII~ NO. ~ TOWN OF SOUTHOLD BUILDII;IG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: )/~ ~o ................................................ ~.....~ ..................................... ~ } ......... a~e~ed by P1 at premises located at .,~.~[.&.~..~J ................................................................... pursuant to application dated ..[ ..................... .~.~l~....~J~ ............... , 19~1~..., and approved by the Building Inspector. Fee $~..~..e....~... ........... FOrm No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT iTOWN HALL 765-1802 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"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 9pre-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 ~ew Construction ........... Location of Property../~.~~.~~..~...[.~.....~..,.~.~..d./~..~...~.. House No.. ~ Street Hamlet ' )nwer or Owners of Propgrty..~..~..~. .... ~.~-_~..~i .... ;. ................ ~ ..... :ounty Tax Map No 1000, Section ........ Block .............. Lot... .............. ~ubdivision ............................ Filed Map ............ Lot ...................... 'ermit No.K~.'.'~i ..Date Of Permit ................ applicant..~.~.~x... [eaith Dept. Approval .......................... Underwriters Approval. ..... .L~.... 1.~5~ ..... .. ianning Board Approval ........................ .equest for: Temporary Certificate .......... ' Final Certicate ........... 'ee Submitted: ...................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMINT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... ....... ........ , Examined , proved ' " " z- ........................................ , 19 ........ Pemif No ............................... Disapproved a/c ................................. 7-.. ............................... t ...... .~" .. .............. APPLICATION FOR BUILDING PERMIT Application No .............. ~. .... August 2W 72 Date ................................................ , 19 ............ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspecto ith 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 area~n~e~ giving a detailed description of layout of property must be drawn on diagram which is part of this application. ~i c. The work covered by this application may not be commenced before issuance of Building Permit. n~ d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept o 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 Bui!ding 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, Suffoik County, New York, and other applica~ble 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 necessary inspections. Ma t t i t. LLc. ~;...~)3.(~ $p.;LDg ....C...e.~.e..~...[~g ....................... (Signature of applicant, or name, if a corporation) (Address of applicant) Sta. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; ................................................ ~wae~ .................................................................................................................................... Name of ~ -. · e.~....~a,~.~.~uel~..~h~p~,~.n/:..o~ev...Z.n~ ................................................................. ~ If a~~of duly au th or izod officer. ~ · ............. .!. Location of land on which proposed work will be done. Map No.: ....XX ........... Lot No ...... ,xz~ ................................ Street and Number ...~..a.~..n.....~...o..a..d....~....F..a..c...t..o...r.y.....&..v..e.. ........... .~:;.a...t..t..i...t..~.c .~.. N ..~.... ................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~S~h~[3~i~n~g~c~e~n~t~e~r~(~?~r~c~a~n~t~i~l~e~b~[~ .......................................... b. Intended use and occupancy same with pump house & water tank for fire ~rot. Nature o ~check which applicable): New Building ....~ ............ Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost .........~D.~0D.Q....G~ ................. Fee ...1.~,0~0 ................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .0.. ....... 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 ...... .~...c..c..~.~.s..Q~. ......... 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 ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front .-..,~0-.-I,...~--.. Rear .....2..~....+....~ ........ Depth ...1.~...~...~. .............. Height ..~FL.£.~ ................................... Number of Stories ......................................................................................... 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. Height ....~ ............................................... Number of Stories ...................................................................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ...~,~l......b~,~iz~e.s~ ................................................................... 12. Dnes proposed construction violate any zoning law, ordinance or regulation: .....o.o...~%~p~c~e~...~y....~.],..~d ........ 13. Will lot be regraded ................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ...~.~..~.~,~LC~..~.b.o. pp./.~&..CP.,p.~.~:...T~,c. ........... ~[t:~t,~J~g.+,o~,.,~;,a. ................. (Address) (Phone No.) Name of Architect ....~.,.....~..e.~.~,~.. ............................................................................................................................. (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 wheth- er interior or corner lot. See filed plan STATE OF NEW YORK, ............................. ~.....~.~.~.3_]_~. ...................................... being duly sworn, deposes and says that he is the applicant above named. (N~art~ of'individual signing contract) He is the ..................................................... Ce~o.~,.O~.~.i~e[a .......................................................................................................................... (Contractor, agent, corporate officer, etc. } of said owner or owners, and is du~y.autl~7'd~l ~-c$1~l~qrm or have performed the said work and to make and file this application; that all .... ,yom p . ' ' r statements contained m th~s apphCa~n~r~PU~ {~tffn~be~t~ q~is knowledge and belief; and that the work wdl be performed m the rnanne __' ?"~'U~44963 Suffolk ~ u set forth in,the apphcation filed trsme~ Ex r o