HomeMy WebLinkAbout8052-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold,
CERTIFICATE OF OCCUPANCY
No Z-23498
Date FEBRUARY 15, 1995
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Property 4600 OLD NORTH ROAD SOUTHOLD, N.Y.
House NO. Street Hamlet
County Tax Map No. 1000 Section 55 Block 2 Lot 6
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 1, 1975 ~ursuant to which
Building Permit No. 8052-Z dated 0T~LY 7, 1975
was issued, and conforms to al~ of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is ACCESSORY METAL STORAGE SHED
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
GREGORY & ANNE L. CAHILL
N/A
N/A
/jld~g Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH'OLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
8052 Z
Permission is hereby granted to:
~r.~.~..t',.e~t ~...Fi~z.Da.t~.~k ..........................
................. ~J~.~...I~.....R. oa~ ....................................
................................ .~.o.u.~h .q]..d .............................
to ...b:ci~..r~w...e~c.c e. as.~r~... Lto~l...s.t.o~a&~.)...b~i3 ~l:t~g ..................................................
at premises located at ...,..~..6..QQ.,....O...1-d....~.[.°...~.~-h...~.9.{%~ .......................................................................
pursuant to application dated ......................,~1~:......1~ ................. , 19...~.~'., and approved by the
Building Inspector.
Fee $..1.~).?.0..9. ...........
Building Inspector
Form No. 6
TOWN OF SOUTHOLD
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
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. Conmaer~iai building, industrial buii~zng, 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.
For existing buildings (prior to April 9, 1957) non-conforming uses, er 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.
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 Buildin~ - $I00.00
3. Copy of Certificate of Occupancy - $20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00-, Commercial $15.00
.... n .................... u~a Or Pre-existing Building .................
Location of Property. Li.~00. 0.'.~..~.~.~.&. .
House No. Street Hamlet
Onwer or Owners of Property. .~.zb1 ..........................................
County Tax Map No 1000, Section..~5.~ ....... Block...~.~ ........ Lot .... ~ ..............
Subdivision .
.............................. ~iied map ............
................ pate
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approwll ........................ J,
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submitted: $ ~ Oo
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765~1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
January 27, 1995
Mr. Gregory Cahill
524 East 20th Street
New York, NY 10009
Re: 4600 Old North Road, Southold NY
BP~8052-Z - Accessory Shed
**** SECOND NOTICE ****
To Whom This May Concern:
We are unable to complete your Certificate of
because of the following reasons:
XX
Occupancy
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.
xx No final inspection has been made.
No Plumber Solder Certificate on file.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT ~ 8052-Z
Please contact our office on this matter.
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
** - ACCORDING TO THE CODE OF THE TOWN OF SOUTHOLD, IT IS
UNLAWFUL TO OCCUPY OR USE SAID STRUCTURE UNTIL A
CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED.
Thank you for
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no, ~0~ issued to ~F~. f~4~./ ~'~z~4~Ck
on ~l~/~ ' for ~ ~ ~%£. ~Oi~!',~q is completed
a final inspection has ( ) has not ( ~)~ been done.
and
In order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for ~/O-p°--- ~payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very truly yours,
Victor Lessard
Executive Administrator
BUILDING DEPAIrTMEHT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
o ...............
Disapproved a/c ..~.-..~ .........
APPLIGATION FOR BUILDING PERMIT
INSTI~UCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building
Inspector, with 3 ~ of plans, accurate plot plan to ~ale. 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 ofproperh/must be drawn on the diagram which is part of this application.
c. The work covered by this application moy 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 ~S~rUl~nCne of ~ BuJldilin~c~ ~eermit pursu~ntnt~ th~
Building Zone Ordinance of the Town of Southo d, Suffo k County, New o , a dot er app cub · Laws, Ord'na es o
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 nscessa~/inspections. ,~
......... i~i'~'r~'~,~;' ~' '~,'1~i'i~ ~ ~ t, ~~J ........
.................................................... ................... .......
(Address of applicant) -- ~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of pre,,,,~o ................... ~, ..............................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ............................................... ~ ~ :
Location of land on which proposed work v/ill be done. Map No;~ .................. ~.......~ .............. Lot No....:...~ ...............
~-~oo ~)~-o AJo~r~ ~o~o a ~o~o~, ~. ~ ...
Street and Numar ............................................................................................... ~ ..............................
M~icl~liw
State existing use and ~cu~ncy of premises and intended use and ~cu~ncy of p~o~d construction:
a. ~isifing u~ a~ ~cupancy ~ ~ ~. ~.~.~. ........ ~ ........ ...........................
b. Intended use and ~cu~ncy ...... ~.~...~..~-~.~.~ .................................................................
3. Nature of work (check which applicable): New Buildi g.. ................. Addition .................. Alteration ....:[..~..~...~
Repair .................. RemoYal .................. Demolition .................... Other Work .................................. ! ..........
...........................................................~.~ / ~ ~ (Description)
.t,mated ost · 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 af cars ............ ~ ...........................................................................................................................
If business, commercial or mixed occupancy, specifl/ nature and extent of each type of use ....-~..~ .....................
D,mens,ons of ex,st,rig structures, if any: Front ....... ~! .............Rear ....... .~...o...! ................ Depth ....~....~....I. .......
Height ...... ~..~...~. .......... Number of Stories ....... O...~....~.. ..............................................................................................
Dimensions of same structure with alterations or additions: Front ~).....~..M.~.~..~.~.. Rear ....~ .......................
Depth .............. "~.-~ ................ Height .....-T..~ .................... Number of Stories --' I
,
Dimensions of entire new construction: Front ............ ~J~ ................... Rear ........ [~..! ............. Depth .....~. ................
Height ......~...! ......... Number of Stories ......... [ ....................................................... ::~:~. ....... ;~ ....................................
Size of lot: Front ...........J..I..~. .................................... Rear ....... .[..!..O.,~i ....................... Depth ~-oO ~
Date of Purchase ...~1...~...~.....~...°......~.~.7...~.. ............. ~o.~q~ ofj~o,_.rm.e.r Owner ~.'~....~....~'...~....~.?...~.....~.....~...~...~'....~.....~...~...I.~r
Zone or use district in which premises are s~tuated ...... ~.~.....~....O~... ...... ~, ..............................................................
Does proposed construction violate any zoning Iow, ordinance or regulation: .... ~...O. ............................................
YVJll lot be regraded ...~ .~.....~... ............... Will excess fill be removed from premises: ("-)-Yes (---} No
Name of Owner ~. ~ ............... ~., ................................................
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.
12.
13.
~3
~TATE OF NEW/YORK.
~-OUNTY OF ....N..../~....~...~....~....u. ........ ~',..'-.-'
....................... ................ being duly sworn, deposes and soys tha(~he
is
the
applicant
(Name of individual signir~g contracf)
above named.
~He is the .................. ..O....~/.....~....~....~,. ..........................................................................................................................................
(Contractor, agent, Corporate officer, etc.)
of said owner or owners, and is duly authorized to perfomn or have performed the said work and to make and file
this application; that all statements contained Jn this application are true to;the best of his knowledge and belief; and
tha~ the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
................ ..... day .....................
Nota~ ~ub ~c, ..~... County · q ............... ~... .....
N(OTAI~ PUBLIC, State of tlew Yorl~
No. 30-955150
(~ualJfied
&"O '