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Home My WebLink About13602-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15885 June 25, 1987 Date ................................. THIS CERTIFIES that the building Accessory Garage & Breezeway Addition 4045 North Road Greenport New York Location of Property ......................................... .' ..................... House No. Street Hamlet County Tax Map No. 1000 Section 035 .Block 2 .Lot 6 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Noveraber 28, 1984 13602Z ...................... pursuant to which Building Permit No ...................... dated.........N°veraber ..... .......30' I984 ....... was issued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ACCESSORY GARAGE & BREEZEWAY ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to MARY WIGGINS BLACKMAN ..................... roi ,tgx ..................... of the aforesaid building. Suffolk County Department of Health Approval ... N/A UNDERWRITERS CERTIFICATE NO. N 8 14700 N/A PLUMBERS CERTIFICATION DATED: Bmldxng Inspector Rev. 1/81 TOWH OF $ou'rHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FU, LL COMPLETION OF THE WORK AUTHORIZED) No- i3602 Z p~rsuant 'o application dated ....... ~..~.....~ ................... , 19...~...~Z~., and approved by the Building Inspector. Rev. 6130/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 Bg,a[d,appi:,ovaLo~f~cccJ3plated~sJte,plan_r, equir, ements-where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pm3perty 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 requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 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 Newconst~'uc~±on ..... Id or Pre-existing Building ............ Vacant Land ............. House No. Street Hamle't County Tax M ap N o. 1000 Section .... (~. ~ ~.~ ..... B lock ...... ~.. ...... Lot ....... .~. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ~ ...Labor Dept. Approval ..... . .'~... '-~ Underwriters Approval .'.~f..~ ].~J.'~..O". .......... Planning Board Approval ...................... Request for Temp~/ry Certificate ..................... Final Certificate ....................... Fee Submitted $~..~..~.*.-~ ............ Applicant Rev. 10-10-78 /~ TOWN OF SOUTHOLD OFFICE OF BUILDING INsPEcToR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because.of the following reasons. /_~z~An application for Certificate of Occupancy is not on file. __//~o Underwriters Certificate on file. ~The check is(o~d/not on file.)~l~--D /Z/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Dept. ~'/~tz59~ ~o~0 ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) THE NEW YORK BOARD OF FIRE UNDERWRITERS [tS BUREAU OF ELECTRICITY ~ Garag~ DRYERS FURNACE MOTORS FLUORESCENT FUTURE APPLIANCE FEEDERS TIME CLOCK MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V I C NO OF NEUTRALS OF NEUTRAL 8a~ P~ato G~e~ort~ MY Lic~lO~9 GENEEAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incdrrect, Inspecto, rs may be identified by their credentials. FOR BUILDING DEPAR1 4T. TH S ALTERE~D IN ANY MANNER. FIELD INSFE~TION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY ?DE COMMENTS ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 13602% issued to Mary Wiggins Blackman on 11/30/84 for Addition is completed and a final inspection has ( ) has not ( x ) been done. An Underwriters Certificate is needed 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 $25.00 payable to the Town of Southold. 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. Very truly y~, Victor Lessard Executive Administrator VL:gar encl. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING REMARKS'- [~/J/FINAL ~ ~. ~.< ~.~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:3 ~Examined..~...t~.., ~..., Approved..~.. · .~. ·..~J.. .... 1~.. Permit No. Disapproved a/c ........................... /~ ...... / ~(..B~4ilding InspectOr) APP~c-ATioN FOR BUILDING PERMIT Received ........... ,19.. · INSTRUCTIONS a. This 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 authorized inspectors on premises and in building for necessary inspectio)~ :f~ ,. admit (Signature ofj~6plicant,-- --or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~.~g>j .... .... ~. .......................... ~ ~'(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 ........~...'. ............. Plumber's License No ......................... Electrician's License No ..... ?..~ .[.. ... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......... ..........v. .... House Num Street Hamlet County Tax Map No. 1000 Section ...... (~. ,~. '.~7~ ..... Block ...... ~. .......... Lot ..... -- ~..9.'..~.. .... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 4,; a. Existing use and occupancy ..... :: .... 7 ..... ~'~ .... Y ....~' ........... ~ ................ b. Intended use and occupancy .................. : .....~ ............ ~:.o.,,.,~. :......~,.~- ............... 3. Nature of work (check which applicable): New Building .... 'Addition ...... Alteration .. ........ Repair ............ Removal .............. Demolition .......... /~.~ Other Work ............... (to he paid on filing this ~]i~tio~) 5. If dwelling, number of dwelling units ............... Number of dwelling uniis on each floor ................ If garage, number of c~ ...... ~ ................................... i ............................ 6. If business, commercial or mixed occupancy, specify nature ~d extent of each type of use ..................... 7. D~ensionsofexistingstmcturcs, ifany: Front ............... Rear ....... .~. ...... Depth .......... ..... Height ............... Number of Sto~es ............................ : ............................ D~cnsions of same structure with alterations or additions: Front .i. Rear D p~ ~ Hight Number of]Stories S Dimensions fentir~n wconstmction: Font ~4 Rear ~ Height ] ~ Number of Sto~es - 9. Sizeoflot: Front .... [~ ' Rear ... l0 Date of Purchase Name of Fomer Owner 11 Zone or use district in which premises are situated 12 Do sp pos d t tionviolate y oninglaw ordi gulation . e ro e cons ruc an z , nance or re : .... ~ ......................... 13. Will lot be regraded ...... ~ ...... :.: ...... :... Will excess fill be r~mo~ed, from premises: ~ No Nme of Architect ......................... ,. Address .............. ~ ....Phone No ................ PLOT DIAG~M Locate clearly ~d distinctly ~1 bufld~gs, whe~er existing or proposed, ~d. indicate ~1 set-back d~ensions from prope~y Hnes. Give street and block number or description accordfl~g to deed, ~d show street nines and ~dicate whe~er interior or corner lot. STATE OF .N~W'~OR~, , ,d S S COUNTY OF~,~.,c~.~ 'tx ..... g-. a~'~ ff~' .~. .......... being duly sworn, deposes and says that he is the applicant (Na~ of individual sighing contract) above named. He is the ........................ ' ' ~ (Contract~gent, corporate officer, etc./, of said owner or owners, ~d is duly auth~erform or have perfo~ed the shid work and to m~e ~d file application; that all statements contained ~ this application are true to the best of hfi knowledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this .............. ~: . .day of .... Notaw Public~ ~. ·4 ......... ~~.~o~ty/ , , .om~ e~l~ ~ ~ ~ ~ ' ~, (Szgnature of applic~t) C r%