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Home My WebLink About9228-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPAR~4ENT Off~ce of the Buildmng Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19964 Date JUNE 11~ 1991 THIS CERTIFIES that the building ACCESSORY Location of Property 7025 PECONIC BAY BLVD. MATTITUCKr N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 10 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 25~ 1977 pursuant to which Building Permit No. 9228-Z dated MAY 4, 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 SHED IN NEED OF REPAIR The certmficate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTHAPPROVAL N/A UNDERWRITERS c~TIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A CATHERINE E. SMITH Rev. 1/81 //' B{lll lng Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. 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. Fees ,'1, Certificate of Occupancy.~_~dwelling $25.00, Additions to dwelling $25.00, ~ Alterations to dwelling~O,~Swimming pool $25.00, Accessory buildzng $25.00, Additions to accessory buzldi~ $25.O0. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Build:ng - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 P ~, 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......................... ~ew Construction ........... Old Or Pre-existing Building.~Z~Y~~..~.z~./~.~ .ocation of Property.. ~ ~.~yf~. ~..~'~~. House No. Stree~ z~. ~/ . Hamlet 'ounty Tax Map No 1000, Section..2~.~i ...... Block .... ubdivision .................................... Filed Map ............ Lot ...................... ermit No ................ Date Of Permit ................ Applicant ............................. ealth Dept. Approval .......................... Underwriters Approval..~'.i ................... lanning Board Approval .... ~ ................... equest for: Temporary Certificate ........... Final Certicate ........... ee Submitted: $. ¢~.~ .~'..~...~. .................. f'? 765-~802 BUILDING DEPT- iNSPECTION ~ FouNDATION ].ST ~ ~ RouGH PLBG. ~. ~ FOUNDATION zND [ ~ iNSULATION [ ~ FINAL REMARKS: ~ ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... ......... , ..... i~xamined Application No. Approved .......................... ..~..~ ......... , 19.7..Z. Permit No ..... .~. ................... .~...... APPLICATION FOR BUILDING PERMIT' Date ................... ~/?.'.:.'.'../. ...:?..~Z., INSTRUCTIONS a. This application must be completely filled ~n by typewriter or in ink and subm,tted ,n triplicate to the Buildin 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 premmes, relationship to adjoining premises or public streets c areas, and giving o detailed description of layout ofproperty must be drawn on the diagram which is part of this opplicatior c. The work covered by thss apphcation may not be commenced before ~ssuance of Building Permit. d Upon approval of this application, the Building Inspector w~ll issue o Building Permit to the applicant. Such perm 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 Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulahons, for the construction of buildings, additions or alterahons, or for removal or demolition, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and ir~ buildings for necessary inspections. (S~gnature of applicant, or name, if a corporation) ~ .,, m, , ~ , / ..::.:5.?....~..X...c:. ~:~..~.~....&.~../:~:!,:.~/.,..,.~.~. (Address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde Name of owner of pram,sas . 2 .r.q/.5.~...~.: ........L: .... ~ ..... .~..~....//. ...... '...r~./f.~.~.~ ..................... If applicant is o corporate, s~gnature of duly authorized officer. ............. i'~;;,'~';"~;,'~":ti't¥'Zf"'~/~'o';'~T;";;iE;~';i ......... .L.~,~,.~ ~~, '- B~i,der's L,c~ ~o .................................................... ~ f" ~~°~-'~ Plumber's L,cense No ................................................ ,, : ' ~ ~ X"7~-('~// Electrician's License No ............................................. Other Trade's License No ............................................... 1 Location of land on which proposed work will be do~e. Map No ........................................ Lot No ...................... Street and .............................................................. ~. ............................................................................... Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construchon: a Exisitmg use and occupancy ....... ~.~i.~.X~.~.~. ...... ~F..~. ..................................................................... ...... ..... ............................. ................... ....................... 3. Nature of work (check which applicable) New Building .............. Addmon .................. Alteration Repair .................. Removal .................Demolmor ................... Other Work ............................................... (Description) ~, Estimated Cost ..........~:].~.'~.U. ...................................... Fee .../~..'..~ ....................................................................... (to be paid on filing this application) 5 If dwelhng, number of dwelhng umts .... Number of dwelhng umts on each floor ......................... If garage, number of cars ' 6. If business, commercial or m~xed occupancy, spec~ nature and extent of each ~pe of use 7 Dimensions of exmt~ng structures, if any: Front ........................... Rear ................................ Depth .................... Height ........................ Number of Stones ....................................................................................................... D~mensions of same structure with alterat,ons or addmons. Front .................................... Rear .............. Depth ................................ Height .................... Number of Stones ~ ~ 8 D~mens~ons of entire new construction: Front ............. / ..................... Rear ............................ Depth He,ght ....... ¢/.L ...... Number of Stories ........ ~/.(~ .................................................................................... F 1~ R l~ ~' ~ )c' /~ 9. S~ze of lot. rani ....................................................... ear ....................................... Depth ........................ 11 ct ~n wh are situated ... ~ ............. 12 Does proposed construcbon violate any Tatung law, ordinance or regulabon ..................................................... 13. W~II lot be regraded ............ ~.~....~. ..... Wdl excess fill be r~o~rom premises: ( ) Yes ~ ( ) No 14 ~ .................................................................. z ............................................... Name of Arch,tect .~c,~.~ .. ~.~...~.L(.~. ........... Addre~ 'J:....(:~.~::~'/.~.::..~o~' fro ..................... Name of Contractor ....................................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and d~st~nctly oil buildings, whether ex~st~ng or proposed, and indicate oil set~ack dimensions fror prope~y hnes Gwe street and block number or descnphon according to deed, and show street names and ind~cat whether interior or corner lot STATE OF NEW YORK, ~ c c counTY OF,_ _ ..................... ................ ..L~....~....~:¢..~..~.....c ........ ~~ .............. be,ng duly sworn, deposes and says that he ,s the apphcar (Name of indmdual signing contract0 above named He ,s the .......... ~....(-...~.,) .............................................................................. ¢' 't/C,/ (Contractor, agent, corporate officer, etc ) ¢ said owner o~own=rs, and is duty authorized to Derforrn or have performed the sam work and to make and fil this applicabon; that all statements contained in thru apphcot~on are true to the best of his knowledge and behef, on thor the work will be performed m the manner set forth m the application filed therewith. Sworn to before me this ..... of .............. Pub,c, ............. ............ (Signature of opplicQnt) Term £xp,res A~arch 30,