HomeMy WebLinkAbout11235-zFORM NO. 4
TOWN OF SOUTHOI~D
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No...Z. 7.I.6.8.9.5. ....... Date May 23, 1988
THIS CERTIFIES that the building ACCESSORY
Location of Property 55980 Main Road Southold, N.Y.
House No. Street ........ ~t~r~/e~
County Tax Map No. 1000 Section 06 2 ...Block 0 3 .Lot l 0.3
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
u ne 17, 1981 pnrsuant to which Buildiug Permit No. I1235 z
dated . . ?.u. 1..y..I.,. i ! .9.8.1 ............ 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 .........
ACC'ESSORY STORAGE BUILDING
The certificate is issued to RICHARD MULLEN JR.
..................... /o¥.'o;, ¥t fi¢o .....................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED:
N/A
Building Inspector
Rev. 1/81
Permission is hereby granted to:
Bui,
SOurHO~D, ~. Y.
(THIS PERMIT MUST BE KEPT bN ~HE PP,~/
:COMPLETION OF THE WORK AUTH~Ri~ED~
: pate ,.?.~
iS UNTIL ~ULL
~....../ ................... , ~9.~./.
,
Cobhty Tc~x Map No, 1000 'Section ,~ .. BI ~, .....
pdrs~ant 3o application'dat~d ../.. ~ - ' and ;approved by the
B~il~lng I~spector.
F~ ~.Z..~ ................ ' ~
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ~ tammmmma 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 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.
C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00
1. Certificate of occupancy New Dwelling. S25.00, Accessory .$]0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0
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 .... .M.a~. J.9.,..1.9.8.8 ..........
NewConstructi°n ...... Old or Pre-existing Building ............ Vacant [.and .............
55980 Main Road Southold New York
Location of Property ................................ '
House No. Street I-lam/et
Owner or Owners of Property RICHARD MULLEN JR.
County Tax Map No. 1000 Section 62 Block 03, Lot ..... 1.0.3
Subdivision ................................. Filed Map No ........... Lot No ..............
PermitNo. ~1235Z Date of Permit 7./1/8.! Applicant Mullen Motors Inc.
Health Dept. Approval .. NA NA
...................... Labor Dept. Approval ........................
Underwriters Approval NA Pla ni g Boa d Approval NA.
........................ n n r .....................
Request for Temporary Certificate. .Final Certificate lO. 00
Fee Submitted $ ..... [0. :0.0
Rev. 10-10-78
r,/I
FIELD INSPECTION
1.
FOUNDATION (1st)
FOUNDATION (2nd)
2.
COMMENTS
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C~DE
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
A TOWN HALL
SOUTHOLD, N.Y. 11971
/~ TEL.: 765-1803
Examined ~. Z ..... ,19 .<¢../.
(Building Inspector) ;
APPLICATION FOR BUILDING PERMIT
Application No. lZ'.~'.c*t~..~.~. · .....
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi
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 5o adjoining premises or public stre~
or areas, and giving a detailed description of layout of property must be drawn ou the diagram which is part of this ap[
cation.
c. The work covered by this application may not be commenced b~f0re issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such peru
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 Occupan
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 t
Building Zone Ordinance of the Town of Sou~hold, Suffolk County New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alteration~s, 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
admit authorized inspectors on premises and in buildings for necessary inspections.
... ,~.~.z~.~...,Z~, .~....~ ~. ............
(Signature of applicant, m; name, if a corporation)
· ~,,,,,. ~ .,,.. ~.~-: ~.~..
: ' (Mailfng address of al~plicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~
(as on the tax roll or latest deed)
If applicant-is a corporation, signature of duly authorized officer.
.... ~.~.~.~..../~.~:.~.~....4~ ........
(Name and title of corporate officer)
Builder's License No ~
Plumber's License No .........................
Electrician's License No ..... ~..c?. A_)~ .........
Other Trade's License No ......................
1. Location of land on which proposed work will be done .................... ............................
...~3~ ~ .............. z~.,.~../.~,~.~. ..................... .2¢(~. ~ ~.~ ~. :~..V.
House NumberStreet Hamlet
County Tax Map No. 1000 Section .. F-)&/' 2'~ ..... Block ..... ~ .~. ......... Lot..q.~..~.~. :..~. ......
MapNo Lot
Subdivision : Filed ' -~
(Name)
2. State existing t{se and occupancy of pre~nises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... d~2,-~ ~ .~.~....: ...............i .......................
.... ~._q(~..~ ..... ::.~.o~..~... ~z~...~,~77.~ ..
Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Remoyal ............ Demolition ............ Other Work ...............
(Description)
Estimated Cost .~. Fee /.
(to be paid on filing this application)
If dwelling, number of dwelling Units ............... Nmnber of dwelling units on each floor, ....... : .......
If garage, number of cars ..... i ................ : ................................. ' .................
If business, commercial or mixed occupancy, specify hl~tum and extent of each type of use .....................
Dimensions of existing structure~, if any: Front ..... i' ......... Rear .............. Depth ...............
Height ............... Number of Stories .......................................................
Dimensions of same structure wiih alterations or additions: Front ................. Rear .................
Depth .................... :.. Height .......... ' ............ Number of Stories .....................
Dimensions of entire new construction: Front ....... : ........ Rear ............... Depth ..............
Height ............... Number of Stories ....... ' ................................................
Size of lot: Front ...................... Rear ...................... Depth ......................
! Name of..[}ormer Owner
Date 6f Purchase .....................................................
Zone or use district in which premises are situated .........../~/~..':.{ .................................
Does proposed constructionffi~olac~q any zoning law, ordinance or regulation: ..........................
Will lot be regraded ..... ~..'7.. ~ ................... Will excess fill be removed from premises: '< Yes
Name of Owner of premises ...i ................. Address ................... Phone No ........ -'
Name of Architect .......... i ................. Address ................... Phone No ................
Name of Contractor .......................... Address ................... Phone No ................
PLOT DIAGRAM
Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from
roperty lines. Give street and block ~umber or description according to deed, and show street names and indicate whether
~terior or corner lot.
YATE OF NEW YORK,
OUNTY OF .................
! being duly sworn, deposes and says that he is the applicant
(Name of individual sig~ing contract)
)ore named.
e is the ..................... ! ....................................................................
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is du!y authorized to perform or have performed the said work and to make and ffl~ this
)plication; that all statements contgined in this application are true to the best c~f his knowledge and belief; and that the
'ork will bb performed in the manner set forth in the application filed therewith.
worn to before me this
/9 ......
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Houhe '& Her. fy
'consulting
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