HomeMy WebLinkAbout8118-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26163
Date: 12/10/98
THIS CERTIFIES that the building ACCESSORY
Location of Property: 455 LINNET STREET
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 48 Block 2 Lot 38
subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 31, 1975 pursuant to which
Building Permit No. 8118-Z dated AUGUST 1, 1975
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 ACCESSORY STORAGE SHED AS APPLIED FOR.
The certificate is issued to BENIGNO DEJESUS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
Build~ing I~~
FOR~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
N°.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
8.8 z .,e ................... ~~t'""l ....... ' '~"?'"~:
Building Inspector.
Fee $./....~i~ii... ......
Butldmg Inspector
............ ~ TOWN OF SOUTHOLD
' i ~ ~ f 'i TOWN HALL
t~ ~" 765-1802
,/~F~iCAT~O~ FO~ C~CA~ O~ OCCU~C~
BLDG. DEPI
~OWN~F~OU~OLD _j ...... in b- t,,~ewriter OR ink and submitted
Three'application ~s~-~oe [[~ ~ :v to the building
inspector with the following: for new building or new use:
1. Final su~ey 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 fo~).
3. Approval of electrical i~stallation from Board of Fire Unde~iters.
4. Sworn statement from plumber certify~g that the solder used in syst~ contains
less than 2/10 of 1% lead.
5. Co~ercial b~ilding, ~dnstrial building, multiple residences and s~ilar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submi~ Plann~g Boar& Approval of complece~ site plan requir~ents.
Fom ~iscing b~il~gs (prior ~o ~ril 9, 1957) non-confo~ing ~ses, or buil~gs and
Vpre-~ist~g" land uses:
1. Accurate su~ey of property sho~g ~1 property lines, s~reeCs, budding and
unusu~ natural or topographic features.
2. A properly completed application an& a consent to inspect si~ed by the applicant.
If a Certificate of Occupancy is ~e~ieG, the Building lmspector shall state
reasons therefor in~iting to the applicant.
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~m~ng pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildin~ - $100.00
3. Copy of Certificate of Occupancy - ~ -25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy'- Residential $15.00, C~mercial $15.00
..... : ...................
Construction... ~ ..... Old Or pre.-ex~stigg Building ..... ~~ ".
~ _ ~cr-~d .7/Y/,~ .~....~.. .......... ~ ............
i~atlon or ~roperty.z.~-.v ......................... ' / Hamlet
House.~-~~/a No. ~ ~ Street
[ ~bdivision ............. ' '
....................... Filed M~p ............ Lot ........ ~ ...........
.o.. ....
~ . .Underwriters Approval.. ~. .................
~.alth Dept. Approval .....
':Lanning Board Approval .......................
~*.quest for: Temporary Certificate ........... Final Certicate ....
FOB NO. Y �j
TOWN OF SOUTHOLD .
BUILDING DEPARTMENT �?y +
TOWN CLERK'S OFFICE
99 SOUTHOLD, N. Y. 7� 0
Examined ... .1...I..... .. 10... Application No. .. (.,.. .............
Approved ............... .. . ............. 19Z Permit No. 6F/.*/..
Disapproveda/c ............ ...... ..................................... ..............
......................................................................................... .............................
... ....... ......... .. ..... ................. ......................
Building Inspector)
I �y PPLIC ION.FOR BUILDING PERMIT,
Date .............. ... ............... ..
IC I IONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building
Inspector, with 3'sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing locatiort of lot and of buildings on premises, relationship toyadjoining 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 HEREBY MADE 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 other 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 buildings for necessary inspections.
(Signatur�a*�*��i*c�n**t*,or na e, i. a corporation
... �.1: V.`..L..LI.`I.�.. ..✓. I....... ... ..I...u...Y.J/. ..(l.�J�..•:;••/
(Address of applicant)
State
)I whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............................... ..........I................................................................................................
n __11
E � U..T... ... .. ...............................................
Name of owner of premis
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. ............................................
OtherTrade's License No. ..............................................
1. Location of land on w i roPas("dworkwill be done. Map No.: ....�.�.1 ...................... Lot o. .�..... ............
Street and Number � .... 11�..? ..... .. .. ... .... .....................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancylo.D -)�............................
b. Intended use and occupancy ... ...� .. ......5 ................................
3. Nature of work (check which applicable): New Building- ..X....... Addition .................. Alteration ..................
Repair .................. Removal .................. Demolition;....,....:.......... Other Work ................................................ ....
1 I : � (Description)
4. Estimated Cost ..............................Fee 0--
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor ............................
Ifgarage, number of cars ......................... . ...... .................................................. ..........................................
6. If business, commercial or mixed occupancy, specify-nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front ............................. Rear ................................ Depth ....................
Height ........................ Number. of Stories .................................................................................................................
Dimensions of some structure with alterations or additions: Front ....................:............... Rear ............................
Depth ................................ Height ............................Number of Stories .....................
8. Dimensions of en,tkr_e new construction: Front ........ ........................... Rear ....��................. Depth .....� . ............
IT
Height .....10.......... Number of Stories ................................................. .....................,...................... ........
9. Size of lot: Front ..... i c)...�.................................. Rear .......� .......................... Depth ...�.`,�
10. Date of Purchase .......1.q.t...j...............................Name of Former Owner .. .�:]('. �. ..1.. .. ....
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed constru tion violate any zoning law, ordinance or regulation: ...i��Acc>....................:..................
13. Will lot be regraded ......................... Will excess till be removed from premises: ( ) Yees�r, �9�10
14. Name of Owner of premises �k v.!:`�. . ... ��ddress C���.1 .. Phone.No. . TI.—W4
Nameof Architect .............................................................. Address ................................ Phone No. ......................
Name of Contractor ............................................................ Address ................................ Phone No. ......................
PLOT DIAGRAM
pt
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 descriptioncrding!,to deed and show street ames and indicate
whether interior or corner lot.
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fro?6Se- �J
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5 ATE OF NEW t
COUNTY OF ' . ...j S.S
.............. .... ................being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract
above named.
Heis the ............................................... ............................ .............................. ................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file
this application; that all statements contained in this application' are true to the best of his knowledge and belief; and
than the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
. ... .
Notary �t4 .. .e/1�L ..
�i0 PU C OF NEW YORK
(Signature of "pplicant)
esiding in Suffolk County
Clks. No. 52.9366350
My Cpmmission Expires March