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Home My WebLink About12103-zNO. 4 TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT Office of the Building 'InSpector Town Hail 8outhold, N.Y. CERTIFICATE OF OCCUPANCY No Z17655 Date J~qUARY 5/1988 THIS CERTIFIES that the buildin~ ACCESSORY Location of Propert~ 1480 SIGSBEE ROAD MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section 144 Block 0t Lot 07 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DEC. 07 1982 pursuant to which Building Permit No. 12103Z dated JAN. 12, 1983 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 TOOL SHED ACCESSORY BUILDING. The certificate is issued to GERALD B. GALLA~HER (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building ~nspector Rev. 1/81 (THIS PERMIT ~UST BE 'KE~T Co6APLETION OF THE ~, of P~emlses located at ..:., CO~ty :TaXx Map: No. ]OOC p~ ant t~o application dar~[K:I B~l'lc~lng Ir~$pector. i[ ~ ~: ...... and: approved by the APPLICATION FOR CERTIFICATE OF OCCUPAN~ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 Instructions I I987 BLDG. TOWN OF ~t~..~ A. This application must be filled in typewriter OR ink, and submitted t ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ................ · .......... NewCOns truc finn ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~Z~, ~.~,...~~. ~ .... ~,~ ,~, ................... Owner or Owners of Property ..~..~?~~.. ~.~.~..~ .......... County TaxMapNo, 1000Section- ,~,,..~ Block ..,,~// .......... Lot .... ~..~.7 SubdDision ................................. Filed Map No ........... Lot No .............. Permit No, , ,l. ~,/,Q ~g, Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an,~l permit meCs all.ap/plicable code,~and regulations. .............. APPLICATION FOR CERTIFICATE OF OCCUPANC FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 Instructions A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire UnderWriters. 4. Commercial buildings, Industrial buildings, Multiple Re{idences and similar buildings and installa- tions, a certificate of Code compliance from the Architect Or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable, B. For existing buildings (prior to April 1957), Non-cor~f0rm n~g Uses, or-~ildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property line% streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truct ion ...... Old or Pre-existing Building ...... ...... Vacant Land ............. Location of Property ~Z~. ~.~.... '~.~. ~.. .... ~..~ .~. ......... ~- ......... House No. ..// _ -- Street /). ~ ~' Ham/et Owner or Owners of Property .~.~./~.. ~~ .......... County Tax Map No. 1000 Section"~, ?.,. ~ Block....~'// .......... Lot .... ~. :. 7 Subdlvisio)~ ................................. Filed Map No ......... .-.Lot No .............. Permit No...1. J./.Q ~. Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board .Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an,¢ permit meCs all ap/pliCabl,e code,~and regulations. ........... 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ~/~INAL REMARKS: DATE FI~LD~,IS PECT I ON COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTHOLI) OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 January 20, t987 TEL. 765-1802 Mr. Gerald B. Gallagher 33-28 190th Street Flushing, New York 11358' Dear Mr. Gallagher: This is to advise you that the joab under buildinm permit no, ]2103Z issued to DANIEL KEOUGH (Owner: Gerald Gallagher) on 1/12/lw~ for Accessory Tool Shed is completed and a final inspection has ( ) has not (Xk) been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.00 payable to the Town of Southoid. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Victor Lessard Executive Administrator VL:gar encl. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 xa ined , . , . ., ^pplicatio No, , ....... (Building Inspector) APPk[CATIO~ FOB BHIkD[NG INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted 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 of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 building for necessarydaks~eetions. / j/ .... . .......... (Signature of applicant, or na~C-if a corporation)/) State whether applicant is owner, lessee, agent, architect, engineer, gene 1 contrac~ plumber or builder. lc~ ectrician, Name of owner of premises...~.~'..,F..~.~..(..LT....~....~.~.]W.~.~..~..~.,~..~. ...................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...f~./Y~. ~/./. ~ Plumber's License No ......................... Electrician's License No ...................... : Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. . . ./ . . ............. s L p House Number Street Handet County Tax Map No. 1000Section .... ! ............. Block .................... O / Lot. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupanc, y, ..... .~... ~-..~.~.~./i (.~...~.. (d.' ...... b. Intended use and occupan~.O.4-.~. .~..J/A'/?. .... · .~-~..~. i~.' 'L'~' .~.~i i i ~~~.' .... 3. Nature of work (check which applicable): New Building ...... Addition .......... Alteration .......... Repair .............. Remogal .............. Demolition .............. Other Work ............... 4. Estimated Cost ............................... Fee .................................. (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 of each type of use ..................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ........ [ ...... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ...... . ......... Number of Stories ........................................................ 9. Sizeoflot: Front ........... J ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... i ................. Name of Former 9,w2l~etp ........... 11. Zone or use d~stnct ~n which Premises are muated ........ , .. ........ ~ ............ / ..................... 12. Does proposed construction violate any zoning law, ordinance Or regulation: ../~.~..d..,~'. ...................... 13. Will lot be regraded ......... ! ................... Will excess fill be removed fr6m premises: Yes No 14. Name of Owner of premises ...: ................. Address ................... Phone No ................ Name of Architect .......... i ................. Address ................... Phone No. . Name of Contractor ........................... Address ................... Phone No. ~.~ PLOT DIAGRAM Locate clearly and distinctly all i 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 NEW Y~RK,/'-~I I ] --- , ! ~-- , cou ¥OF !s.s .... ~~ .... ~.~. ~.~... M. ~ ~ .... being d~y s~orn, deposes and says that he is the applic~t (Name of individual signing contract) above named. He is the .. .................... i~~ ...................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e and file thi application; ~at a~ statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~n{r set fo~h ~ the application filed therewith. Sworn to before me this Public, NOTaRy PUSLtC, ~Mte, 52-8125850, Suff01k r~rm ~×~lres March .... / ~ N((Slgnatured~plicat