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Home My WebLink About13455-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-15633 Date April 13, 19,87 THIS CERTIFIES that the building ACCESSORY STORAGE SHED I590 Pike Street Mattituck, New York Location of Property ............................................................... House No. Street Hamlet County Tax Map No. ] 000 Section 14 0 ..... Block 3 .Lot 18 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 23, 1984 pursuant to which Building Permit No. 13455Z dated .... .8 .e.p.t.e..m.b.e.r...2.5?.. ! .9 .8.4 .... 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 BUILDING AS APPLIED FOR The certificate is issued to JOHN F. & KAREN C. ECKERT ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ... N / A UNDERWRITERS CERTIFICATE NO .... N/A N/A PLUMBERS CERTIFICATION DATED: / l~hilding Inspector Rev. 1/81 FOB, M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N, Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13q55 Permission is hereby granted to: ..~ --~ ~ ~ ........... ./..~./Z~....~.....£.~. ............ ....... ~.~ ......... ...3...Z~ .................................. ........ ....~..~r.'z..~.z~Z~.~...~..:.~ ........ ~/?~--~ Count, To~ Mop No. ,0o0 Se:,ion ..~..~.~ ........ ~,ock .... ~..~.. ........ Lot No..~Z .~.. .......... Building Inspector. Fee ,...Z~.....~... ~. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted i~,,~,~- 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 natura~ 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: Additions $25.00 1. Certificate Of occupancy New Dwelling $25.00, Accessory,SI0.00 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 .. /?/ -- '~ -- ~ New C OhS t r u c 6 i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ... ~'..~."~7.0. ........ .' ..... ./~.././y.Z~.~'....,~'.../~. ........... Owner or Owners of Property , .~.,~ .............................................. .~/ ....... County Tax Map No. 1000 Section ~. ~/.~ ........... Block ... ~'. ......... Lot.../..~. .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/.~.~, .~.~."..'~.. Date of Permit .~-.2&" ~z/ .~/'0~../{ . .~..Q/~..~R~.'. .... 2 ..... Applicant ................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ /O , OcT_P Construction on above described building and perr0~ meets alt appJicabJe codes,and regulations. Apo cant ~'~''~'' ...~.~' ./'~'~ .......... Rev. 10-10-78 , FIELD INS?ECTI~N ~ COMMENTS FOUNDATION (1st) FOUNDAT%ON (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTtlOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN IIALL. $OUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advlae you that the job under building permit no. 13455Z ~ssued to John Eckert on __~J_~84 _ for Accessory is completed and a final inspection has ( ) has not ( x T--been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, retnrn same to the above office with a check for $10.OOpaynblc to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrnnge with this office for an inspection date Occupancy or ttsc is unlawfnl without a Certificate of Occup,qncy. Please. help n~ to clear up this matter eo that legal action doe~ not have to be taken. Thank you for yo.r prompt attention. Victor Lessard Executive Administrator VL:gnr cncl. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:2 Disapproved a/c ........ ~ ........ (Bhilffi gn Inspector) APPLICATION FOR BUILDING PERMIT 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 appb- 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 necessary insl~ectiogs. , .~ ~ ........... ~ignature of applicant, or name, if a co poration) /.' .o. ,,. f. . 4.r.'C /:. . /./. z. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises ................................. (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 ....... .~..~. ~.-/"7. .......... Plumber's License No ......................... E~ectncmn s License No ....................... Other Trade's License No ....................... 1. Location of land on which proposed work will be done .................................................. /. .... .o.. ..................... ..... ./. ./.( ............ .,,:... 4. . ........ House Number Street Hamlet County Tax Map No. 1000 Section ( ..... ~.~..O. ....... Block~. ....... .~ ......... 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 occupancy .... .(~../.~.~.'. ~.~-~r~T]~.//~ 9-" ./~...~.../f./. / b. Intended use and occupancy ~.,~:...~-..~/~. ~.'~'~.'~.' :~~i ~. 3. Nature of work (check which applicable): New Building ..... ' ..... Addition'. ......... Alteration .......... Repair .............. Removal .............. 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 mixe~ 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 ...................... 10. Date of Purchase ........... . .................. Name of Former Owner ............................. 1 1. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction vie!ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ... ................. Address ................... Phone No ................ Name of Architect .......... ! ................. Address ................... Phone No ................ Name of Contractor ......... i ................. Address. .................. Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, andAndicate 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 YORK, 'S.S COUNTY OF ................. · /...¢/.O../~'A/... 1~...,~.~.~.~/'~ ~. ................. being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. He is the ~ ~/.,4,/N/~ ~ ................................................................ (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 appbcatmn; that all statements contained m th~s apphcatmn are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before me this .................. day o ...... 19 Notary Public, , . .... County lqota/g Publ.16, gtat. e o£ iqew York i . ./ff/.'~...... ~ ............. ~. 469422~ P~ (Signature of applicant) Qualified in Suffolk County I]~ion l!lkpires Moa'ch 80, 19'~