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Home My WebLink About9457-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19112 Date JUNE 6, 1990 THIS CERTIFIES that the building Location of Property 725 TERRY LANE House No. County Tax Map No. 1000 Section 65 Subdivision ACCESSORY SOUTHOLD, N.Y. Block 1 Filed Map No. Street Hamlet Lot 17 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 29, 1977 . pursuant to which Building Permit No. 9457-Z dated SEPTEMBER 19~ 1977 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 APPROVED BY ZBA #2332 The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PHILIP & LOTTIE BARTH N/A N/A N/A / ~uildi~'-' g Inspector ~ ~ BUILDING i~E~A~TMENT · '* TOWN CI~RI~'S oFFiCE SOUTHOLD, H.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 9457 Z Permission is hereby granted to: .. ,-%~, ~....;*..~; .......... ~,,~ '~;.'~ - 4 ~. · · -~ ~ ~.~t ......................... ............. .............................................. ! ot premises locoted ot ~ ..... ~,~ ~t~c; ......................................... ............................................... ~c ~:~ ~*'..~,~......h.,. ~ .. ................... ~ ........... pursuant to application doted ................................ .~* ...... c~ ........... ~9..~?~,., and approved by the Building Inspector. Fee $....~(;~) ......... Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~st 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 ac£urate 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 conta~s ~ less than 2/10 of i% lead. 5. Commercial building, indus, trial 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 "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 o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees i. 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 Temp°rary Certificate °f Occupancy - Residential $15'0~ C°mmercial $ii'00 'Date////~ New Construction ........... Old Or Pre-existin Building ........ Location of Property..., ..................................... House No. Street Ha~mlet Onwer or Owners of Property .......... - County Tax Map No 1000, Section.........,...-% .Block .............. · . Lot ................... . .. Subdivision ...................................- Filed Map ............ Lot ...................... Permit No..?A ~.~: ..... Date Of Permit. ...7....Applicant. Dept. Approval ......... Underw .~./..~ ~eal th .....· . ......-... riters Approval ..... Planning Board Approval Request for:.Temp°rary Certificate ........ ... Final Certicate ......... .. Fee Submitted: APPLICANT applicant is a corporate, signature of duly authorized officer. Examined ........................................ , 19 ........ Application No ................ ~ ............. Approved ...~....X.~ ......... , 19~...Z.. '.it No.....~... ............... ~.. ............................ .......... _ .................. ....... ~ /~t~ ~ APPLI~TI~ F~ IUI~ING PE~IT ~ ~~' ~e ....... ~ ~ 19.~).,.... o. This o~licati~ m~ ~ c~e~ly fill~ in ~ ~ew~ter or.in ink ~ s~mi~ in triplicote to t~ BuiSi~ In~or, ~h 3 n of p~, ~e pl~ pl~ ~ ~i. ~e ~1 ~ ~ule. b. Plot plon ~ing I~on of lot ond of build his ~ prem ~, ~lationship to ~joining prem ~s or public stree~ or or~s, ond givi~ ~ d~oil~'JHpfion of I~ ~p~ must be drown ~ t~ di~mm which is ~ of t~is opplicotion. c. ~e work c~r~ ~ th~ o~li~ti~ ~y n~ ~ comme~ befo~ issuance of Building Permit. d. Upon opp~ol of ~is ~li~i~, ~e Buildi~ I~tor will i~e o Building Pe~it to the ~pplicont. Such permit sholl be ~pt ~ the p~mi~ ~il~le ~r ln~i~ th~h~t ~ ~rk. , ~... No ~uildi~ ~11 ~ ~cupi~ or u~ in whole or in ~ for ony pa~e wh~er until ~ Ce~ifico~ of ~cupancy sno, hove ~en gmnt~ b ~e Buildi~ In~r. ~ ~PLI~ATION IS HERE~Y ~DE to the Building De~ment for the i~uonce of ~ Building Pe~it u~uont to the uiro~ng ~on~ O~i~e at the T~ of ~thold, ~f~k C~n~ New York --~ ~ ..... "-~' ' P - - x~u~at~ons, rot the constr~ ~ ~ buildings, ~ltin or olter~~-- ~ for ~1 ~ ....... ~e applicant ooes to c~l~ -~+~ -fl -~=--~- ~-.- ~. ~ ...... o~ ~mo,r~, os ne~Jn oescri~.~ ~.~ ' ~ oi"~ii ............ '~' ............ Sto~ whe~er o~licont s~e, ~ent, o~hit~t, engineer, ~eneral c~tractor, el~tricion, plumber or builder. Name 0f owner of premiss ........ ~ .... ~ .. .~. .......................~.~/ ....... (Name and title of corporate officer) Builder's License No ........... ~.~_~..~....."-~. .................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on whichproposed work will be done. Map No.: ................ Lot No Street and Number ..~.....Zz~.~......./..~,~..,~/,~z.~,~- ................................... iiiii..w~ '.~"~i;'~iiiii Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....................................... ~:~t~.... ~.ff./.Z ............................... b. Intended use and OCcupancy ....~,~.~.,~......~..::~...~.C~-~.~'...~c::~)~--~4...?..~.ff~.. / ...-.-.?. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~/ (Description) 4. Estimated Cast ............................................................ e .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent o~f eocJ~ type of use ............................ 7. Dimensions of exis~ting 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 ...... ~...~----.:..,~....~.. .......... Rear ...... ~,....~....,z._~....~....... Depth /O 1~::) Height .....~'........~.. Number of ~tories ......................................................................................... ~,j..,~,:.~..~ ........... 9. Size of lot: Front ......... /~...[. .............................. Rear ..... /.~...~...~ ..................... Depth ......~-~....~..~.. .............. 10. Date of Purchase ~ ........... ./...~...Z.~ ........................... Name of Former Owner .~../~'.,~¢~.~.~.(~....~.. .......................... 11. Zone or use district in which premises ore situated .............. .c~,,~...1.¢. .......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~...~.. .................................... 13. Will lot be regraded ......~/..~ ......... W)II excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of prem,ses~.~'~.~T/~-~.~J.~::...~..~..~-.. AddressT~..'~?~... Phone No.~...~........~...~.. Name aT Architect .............................................................. Address ........... ~: .................. Phone No ..... . ............ Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposedi 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. STATE OF NEW YORK, ! c ¢ .~.hL/l'' ~' I~/~'~(' be ng duly sworn, (~?pases and soys that he is the applicant (Name of-individual signing contract): · - · above named. He is the ........ ~ ~J ~ ................................ (Contractor, agent, corporate officer, etc.) of said owner or Owners, and is duly'authori~;ed to perform or' have p~rformed the said work and to make and file this app!ication; that'all statements con;rained in this application are true to the best of his knowledge and belief; and ti,df th~ work will be performed -in the manner Set forth in the application filed therewith. Notary P~u~ic, . ............. ~ .................................. County ............................................ ~.~ --~RY:~-~', DA'"~~ ...................... (Signature of applicant) J~OTARY*"~UBLIC, St~lte of New York , No. 52*4643721, Suffolk Coun. J~.