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Home My WebLink About9968-z0 FOR~/ NO. ~ TOWN OF $OUTHOLD BUILDING' DEPARTM~NY TOWN CLERK'S OFFIGE SOUTHOLD, N~ Y. BUILDING PERMIT. (THIS PERMIT MUST BE KEPT ON COMPLETION OF THE WORK ^UTHbP, I~ED) : Permission is hereby granted to: at promises located at ............ pursuant to opplicatio~ ~ated Building Inspedtor. O0 / ooo Form No. 6 'A~0 ~ w ~0 ~ APPLICATION FOIl CERTIFICATE OF OCCUPANCY A. 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: I. Final survey of property with accurate location of all buildings, property lines, streets, and nnusual 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 nsed in system contains less than 2/[0 of 1% lead. ~5. Commercial building, industrial building, multiple residences and similar buildings and iustallations, 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 beildings (prior to April 9, ]957) non-conforming uses, or buildings aud "pre-existing" land uses: 1. Accurate survey of property showing ail property lines, streets, building and uuusual 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. ]. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swin~iug pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. CarLificate of Occupancy on Pre-exist]nE 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 New Constraction ........... Old Or Pre-ex:[sting Buildlng ................. Location of Property. . $. House No. Street Hamlet Onwer or Owners of Property ..... !'~... ~.~T.~ ~.c..~.?...& .~] .~. ~ . ................... Connty Tax Map No [000, Section....~-~.'...~..~....Block ...... ~..'~. ....... Lot ..... ./?. .............. Subdivision .................................... Fi] ed Map ............ Lot ...................... Permit No ................ ])ate Of Per,nit...~.~.'f'..~--.J/fT.~Applicant Health Dept. Approval .......................... Underwriters Approval ......................... PJanuing Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765 -1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD February 1, 1996 St. Patrick's R.C. Church 52125 Main Road Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of because of the Occupancy following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $50.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 9968-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ADDITIONAl. COHHF. N'I'$: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ]FOUNDATION 2ND [ I FRAMING [ ] INS~L~-ATION [~NAL REMARKS: ] FIREPLACE & CHIMNEY DATE INSPECTOR TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ii:ii:::iiiii~:i~19 ........ ~ermit No~& ,...~.,.: - Approved .................................. Application No' . . , Disapproved a/c ..................... ~ ........................ ............................. (§uii~ing Ins~;ctor)' ~' .................. APPLICATION FOR BUILDING PERMIT Date .............. ; ................ 19 ........... INSTRUCTIONS o. This application must be completely filled in by typewriter ge 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this applicotlon may not be commenced before issuance of ~uilding 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 o 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 ir~ buildings for necessary inspections. ........................ ....................... ................. (Signature of applicant, or nome, if a corporation) ....... ...... ..... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... : ......... : ................ If applicant is a corporate, signature of duly authorized officer, (Name and title of corporate officer) Builder's License Ho ............................ Plumber's License No. ~-)/2~>~u~ Electrician's License No. ~'~¢'f~r~ Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: ........................................ Lot No ......................... Street ond Number ............................................. ./~,,..,~,,..!..,/~... .............. ../?....~..,,~.,,-? ................................................... Municipality State existing use and occupancy of premises and intended use and occuponcy of propos~ construction: ~ a. ~xisiting use aha occupancy ........................................................... ,~/ ............ .,. ........... h ...................... .~ .............. b. Intended use and occupancy ....................... ; ............................................................... ../j,.. .,,, ~',.~'; ......................... V 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................. Repair ................. .),Removal .................. Demolitior ..................... Oth,e r~ Work ................................................ .... !/: / --i. / ' i) (Description) 4. Estimated Cost ........... '. ................................................ Fee .......................................................................................... (to be paid on filing this application) 5. ff 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 of each type of use ............................ 7. Dimensions of existing 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 .......... ; ................. Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ [0. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 I. Zone or use district in which premises are situated ..................................................................................................... [2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded . ................... Will e. xcess_ ~i,~l be removed from premises: () Yes ~( ) No , , ......... v - 14. Name of Owner bf premises .....4~... ...... ~..~....~, ............................ Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome 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. STATE OF NEWY-~R~_-~k("'~,..~I~/~- / ./ , / , -- .............................. i ........................ ./. ......... '. .............................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. He is the ............................... .~.~.~..~.b ........................................................................................................................... (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 thor the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~ ~ ~ / ~ ~ ~ ~ ....... .................................... ~. ~UBLIC, St~to oi - ~