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Home My WebLink About7797-zFORM NO. 4 TOWN OF SOUT~OLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25915 Date: 08/24/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 6565 INDIAN NECK LANE PECONIC (MOUSE NO.) (STREET) (PLAMLET) County Tax Map NO. 473889 Section 86 Elock 6 Lot 25 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 2, 1975 pursuant to which Building Permit Nc. 7797-Z dated APRIL 4, 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 BUILDING AS APPLIED FOR. The certificate is issued to SHIRLEY M. HOMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A Buildin~'~nspector ~ Rev. 1/81 POEM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) Ne 7797 Z Permission is hereby granted to; J~s..~le~.Z~..W~,~e~ .................................. ........... .T, nClau..~enk .P,~. .................................. to ..ku..~**l.~.. ~ .e.~..~ .c**c. ~..~.p.~,...~..t,**o.:~g~...b~.lO,~ ................................................................... et premises located at ....~]/.~.,,~.~.~,~--~.,~e~..~oa,cl ............................................................. i .......... ...................................................... ~.eeon.lO.....~., ¥, ........................................................................... pursuant to application dated ....................... ~%D.~~r~ ....... 2 .......... , 19..~.~., and approved by the Building Inspector. Fee $1'.0. ~ .O.O ............ .......... ~"'~'~'~;ii~/;;'~"in~¢tar .... 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 i% 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. For existing buildings (prior to April 9, 1957) non-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,~sso79 ~uildi~25.O0-~-~ Additions to accessory building $25.00. Businesses $501~O]-- .... 2. Certificate of Occupancy on Pre-~istinK Buildin~ - $100.00 3. Copy of Certificate of Occupancy - ~ .25C. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Co~ercial $15.00 ................ P Y ..... ~ ''~ '~ ............... I ........... ~ ' House~_~.~ ~ ~ ~N°' ~ - ~lStreet ~ Ha~et Onwer or O~ers of Propert~.:~)~-...n~.~., .............. ~./ .......... ' ...... County T~ ~p No 1000, Section. ..;.~ ............ Log...~ .................. Subdivision Filed Map .... Lot Permkt ~o .... ... ... Date Of Pemkc ...... .. ...App~kcan~ ..................... ..... ... Health Dept. Approval .......................... Unde~riters Approval ......................... Planning Board Approval ........... .......... ... Request for: Fee Submitted: Temporary Certificate .......... Final Certicate ...... I~OEM NO. 1 TOWN OF $OUTSOLD BUILDING DEPARTMENT TOWN CLERK'5 OFFICE SOUTHOLD, N. Y. ?....., Examined ....... ~ 19~'~' Permit No. '72 7Z 7~ ~proved .............................. /. ........ , .................................... Disapproved a/c ..... ~~.~;: ......... APPLICATION FOR BUILDING PERMIT Date ................................................ , INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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 location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is port 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 for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Regulations, 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. ( / (Signature of applicant, or name, if a corporation) L./ JNBIAN NECK ReAI~ PEOGNIO~ NY (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ................................................................................................................................................................................ (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Name of owner of premises ..... ~J.AM£.S..~.~...&...Af~NA...I..;..,KN. eg/t-E.S. ................................................................................ If applicant is a corporate, signature of duly authorized officer. Electrician's License No ............................................. Other Trade's License No ............................................... 18 QIL._p sT 7 1. Location of land on which proposed work will be done. Map No.: ....J,~.,..-.....~...J.~J'..../.. ....... Lot No .......................... Street and Number ..I.N.QJ.~bl..~E.C.K...~.AI~ ................................................... e..Eg.e.N.l.¢. ............. /~.~./...~ ....... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........ ~L~)~I.E .............................................................................................................. TOOL STQRAGE b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building......~ .......... Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................... (Description) 4. Estimated Cost ....... .~...~r~.00 ................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ...NO .................... Number of dwelling units on each floor ............................ If garage, number of cars ........ NIII ................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature end extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ....~6.t .................. Rear ......~6~ .................... Depth ....~,~1.1 .......... Height ..t4.1. ............... Number of Stories ..... 1 .......................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~1.~ ..................... Rear ....~.1 ............... Depth ...~.:1. ........... I-leight .'.'~1 ............ Number of Stories ....~ ............................................................................................................... 9. Size of lot: Front ....~jO...l~ ......................................... Rear ..... ~)0...! .......................... De~th ....~7~...t. ................ 10. Dote of Purchase ........ ~lg#.....~l.~¶ ..................... Name of Former Owner ....[~[i.N..~iI~i~,i,?i .............. . 11. Zone or use district in which premises are situated ........ ~..~...~ ................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ............................................... 13, Will lot be regroded ......1~.~ ................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises '"'~l~'$'~';'"K~l~l;l~fl ............ Address ~l~l./~N...~K...fj~j~no No. ~,~4,~,,~... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and d stinctly 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 6r corner lot. STATE OF NEW YORK, iI,.S I - ,..~.~.-¢],''<~ . COUNTY OF ................................ f~' ......... ..i.,~...l~,-...l~,~,~,,~ .................................. '- ......... J'.:.,.~eing dul¢'"s~orn, deposes ~nd Cays that he is the applicam ~a~ ~ai signing contracf)r above named. He is 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ ................................... ....... ...... ..................... ~oto~ Public~ . .................................................... Coun~ ~ (Si~noture of opplic~nt) ~er~ Expires Marc{~ 3[), lgJ~