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Home My WebLink About13358-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17805 Date FEBRUARY 28~ 1989 THIS CERTIFIES that the building ACCESSORY Location of Property 10290 COUNTY ROAD ~48 House No. Street County Tax Map No. 1000 Section 108 Block 2 Subdivision Filed Map No. MATTITUCK, Hamlet Lot 001 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13, 1984 pursuant to which Building Permit No. 13358-Z dated AUGUST 16, 1984 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 SHED AS APPLIED FOR The certificate is issued to THOMAS StDOR (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~~~Bui~lding Inspector Rev. 1/81 ~0~ NO. ~ ?OWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ~ r~ ^ ..~~ ........ ~..L~.~. ................ "(' ............... "'T ..... '~1 ............................................. ...t~ ..~.~~ ............ ~ ........... ~/.~ ......... ot premises located at ...~.....0.....o~...~...~.. ....................................... County Tax Map No. 1000 Section .... .I...?.....~. ........ Block ........ ~ .........Lot No ........ .C~....~......~.. - ...~~~ ?..~ pursuant to application dated ...... !,...~ ........... , 19. ., and approved by the Building Inspector. Rev. 6/30/80 Braiding Department Southold, N.Y. 11971 765 - ~802 APPLICATION FOR CERTIFIcATE,- OF Instructions A, This application must be filled in Wpewrlter OR ink, and submitted ca ~ to the Buildino ln~pec- tar with the following; for new buildings or new usa: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unumal natural or topographic features. 2.Final approva~ of Health Dept. of water supply and ~ewerage 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 Coda compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site pian requirements where applicable. B. For existing buildings {prior to April 1957). Non.conforming uses, or buildings and "pre-existing" land uses: 1. Accurate ~ey of p~perW showing ail property lines, streets, buildings and unu~al 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, o~other pe~inent informa- tion required to prepare a certificate, '. C. Fees: . ' 1.CertilicateofoccupancV ~cu D~ell~n~.~25.O0, Acce~no~y ..~10.00 ~u,~ne~l 550.00 2. Certificate ~f occupancy on pre-existing dwull'ng ~ 50. 00 3. Copy of certificate of occupancy $ 5.'00, ove~ 5 yea~ ~10.00 4.Vacant Land C.O. $ 20.00 5.Uodated ~.O. $ 50.00 Date .......................... 6. Alteration $25.00 Location of Property ........................ Y.~.~T~ ~GC~M~[~ ~v~d , ~I2.~ Ha/n/et HoumNo. O/ ,~ O ~ ~t~M Owner or Owners of Property County Tax Map No, 1000 Section ............... Block ............... Lot ................ ~ { ~ ~; Filed Map No ~ Lot No ~ ~ubdw~smn ................................................... . , Date . · .. ............................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Planning Board Approval Underwriturs Approval · Request for Temporary Certificate ..................... Final Certificate ....................... Submit,ed s.../.cz. .................... FIELD {NS~ECT ION COMMENTo FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & ?LUMBING INSULATION PER N. Y. STATE ENERGY C,ODE ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL $OUTIIOLD, N.Y. 11971 TEL, 7650802 Thla il; Lo ndviae you chat the job under building Dermlt no. 13358Z issued to Stella Radford on __~J.%6/~4_____. for Accessory is eomp~'eted a final inspection has ( ) has ~ot ( x ) 'been done. and [. order to complete thio file, it is necessary Chat :t Certificate of Occupancy be issued. Please fill out the enclosed form, return spme Co the above offlee wlth a cheek for $10.OOpayahlc to the Town of Southold, Please indicate to Whom the Certificate of Occupancy ia. to be mailed, and orrnnge with this office for an inspection date Occupancy or uae ia unlawful without a Certifieste of Occupancy. Plent~e. hc)p u.q to clear t,p ch~s matter so that legal action does not have to be taken. Thank you for yo,r prompt attention. Very truly~, Victor Lessard Executive Administrator VI,: ga r one/ ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examine Approved~.~ ~;i~ i, 19J.~..Permit No..).' .~.~. :~.'~...'~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ReceiI 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 stYeets 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 b6~'ote 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 construct/on 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 inspections. ,~ . (Signature of applicant, or name, if a corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 ...................... Location of land on which proposed work will be done. . House Number Street Hamlet County Tax Map No, I000 Section .... ~ ......... Block ...6. .......... .......... 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 .... /D..O.,~ .L~' ......................................................... b. Intendeduseandoccupancy ...(d.~..f/14~. d/.O.~'O/ ~'S..~,3r',4f. 6:' 3. Nature of work (check which applicable): New Building ..~/...' ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... . ~ c.~ (Description) ~ ~ ......... ~ ~ ~ ' (to ~e para on ming th~s apphcat~on) , ~ ~;t If~ng~ ~mbe~ o~ ~welhng umts ............... Number of dwelhng units on each floor ................ l~~~ ~r mixed occupancy, specify nature and extent of each ~ype of use .......... ~..~ ....... i 7.~~[n~ ~tmcture~, if any: Front .... [). ~ ....... Rear . .~4 .......... Depth... ~¢ ......... .......... ~.. Number of Stories .... ~ ................................................... D~ensions of same structure with alterations or additions: Front ................. Rear .................. Depth HeiSt Number of Sto~s 8. D~ensions of entire new construction: Front ............... Rear ............... Depth ............... Height . .............. Number of Stories ........................................................ 9 Size of lot: Front . Rear Depth 10 Date of Purchase i Name of Fomer Owner 1 I. Zone or use district in which pre¢ises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or re~lation: ...... D~ ..................... 13. W~l lot be regraded .......... , ' ............. . ~ f .... Will excess fill he removed from premises: Yes. 14. Nme of Owner of prem~ses~¢/(c .~rl4t.~... Address . ~O.~g4~(~ .... Phone No ............... Nme of Architect .......... :. · ~ .............. Address ................... Phone No ............. N~e ofContractor..~~ ...... Address .................. Phone No. ~q P~T DIAG~M Locate cle~ly ~d distNctly ~1 ~bu~dMgs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions f;~m property ~nes. Give st~et and block number or desc~ption according to deed, ~d show street nines and indicate whether interior or corner lot. o ¢ ? ? 9 STATE OF NEW YORK,qo°.° COUNTY OF ................. (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the.. ....................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duis' 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 that the work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this .............. [.~...~.....day of .... Notary Public, . ........ ~..~, · .~..~., .~..~. County · HELEN K. V0E ~ ..................... N0tAR¥ P0O[IC, ~at~ of New ¥0r~ (Signature of applicant) No. 4707878, ~ff01k ' Term Exl)*res March 30, 19~