HomeMy WebLinkAbout16653-zFORM MO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19042
Date MAY 11, 1990
THIS CERTIFIES that the buildin~
Location of Property200 BOISSEAU AVENUE
House No.
County Tax Map No. 1000 Sectio~ 062
Subdivision
ACCESSORY
SOUTHOLD, N.Y.
Street Hamlet
Block 03 Lot 07
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 27, 1987 pursuant to which
Building Permit No. 16653-Z dated NOVEMBER 27~ 1987
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 RELOCATE & PLACE ON NEW FOUNDATION EXISTING ACCESSORY
GARAGE AS APPLIED FOR.
The certificate is issued to
CARLISLE & JEAN COCHRAN
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HF2kLTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
FO~M NO. B
TO~V'N OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
........
o~.~~.....~.:.~..:......~./..~.~..~ ...... . ~
ot premise~ l~n~ed ~ ~.~.~......~.~.. .~ ................
County Tax Mop No. 1000 Section ...... ...0,...~.....~:'.. .... Block ...... ..~....-~, ...... Lot No.....q)....'/. ..............
pursuant to application dated ..... ~..~~.......~a-~.. ......... , 19.~...~., and approved by the
Building Inspector.
Fee*..~...g...: ...... ~
Building Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application'must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 1% lead. ~'
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from'architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .~.~!~ o ..
New Construction .... ..~ .... Old Or Pre-existin~g. Building ....
Location of Property...~Xg....~....~...."~.......~...
House No. Street Hamlet
Onwer or Owners of Property .......................................
County Tax Map No 1000, Section....~.~ .... Block .... .(~.~ ...... Lot....~..~ .........
Subdivision .................................... Filed Map ............ Lot ......................
Permit No../. ~. ~.~..~ ...... DateOf Permit.. 77..~?. ~.~..7....Applicant..~..~..~...~..~....~...
Health Dept. Approval .......................... Undsrwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate...~.
Fee Submitted: $.~:..~, ................... [ ~~ .. - ~. ~___~ -~ . .
qg*3 .....................................
APPLICANT
FOUNDATION
(1st)
FOUNDATION ( 2nd )
ROUGH
FRAME &
FLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS
'FORM NO. 1
'TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N,Y. 11971
TEL.: 765-1802
BOARD OF HEALTH ......
3 SETS OF PLANS
SURVEY ...........
CtlECK ..........
SEPTIC'FORM .............
NOTIFY
CALL ................
MAIL TO:
isapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PER~/IlT
Date ................... 19...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
s of plans, accurate plot plan to scale. Fee according to schednle.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
:ion.
c. The work covered by t~s 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
dl be kept on the premises avaUable for inspectioa throughout the work.
e. No build~g shall be occupied or used in whole or in p~t for any purpose whatever until a Certificate of Occup~cy
~!1 have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a B~lding Pe~it pursuant to the
dlding Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ordnances or
gulations, for the construction of bulldogs, additions or alterations, or for removal or demolition, as herein described.
e applicant agrees to comply with all applicable laws, ordina~uikling code, housing code, and regulations, and to
mit authorized inspectom on premises and ~ bulldog for nece~a*~spec~fi' ~2t ~ ~ ~/~//~/~ / '
(Signature of applicant, or name, if a corporation)
. .........
(Marling address of applicant)
ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
(as on the tax roll or latest deed)
applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) ·
&LL CON, TRACTOR'S I~T BE SUFFOLK COUNTY LICENSED
Builders, License No.~'"'"3 ~ ~ f)~,'N'~N"~ ...............
Plmnber s License No.~~./.
Electrician's License No...~:ZZTZ%~ .............
Other Trade's License No ......................
Location of land on which proposed work will be done~ .................................................
........................... . . ? ............. d ...............
lfouse Number Street Hamlet
County Tax Map No. 1000 Section .................. Block ....... ~ .......... Lot .................
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...~...~.(~ ~ .................................
b, Intended use and occupancy . "'~ '*~ .. ~A~/~ fi~
FORM NO. 1
TOWN OF SOUTHOLD CtlECK
BUILDING DEPARTMENT SEPTIC
TOWN HALL NO'~ I FY
$OUTHOLD, N,Y. 11971
TEL.: 765-1802 CALL
MAIL
~oARD OP HEALTB .... , ,
3 SETS OF PLANS .......
SURVEY ......... ,
FORM i ~
Disapproved a/c ...................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
TO:
Date ................. 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 phms, accurate plot plan to scale.I 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 descripti6n of layout of property mnst be drawn on the diagram which is pa~ of this appli-
cation.
c. The work covered by this applic0tion may not be commenced before msuance of Bufldmg Per ~t.
d. Upon approval of this application, the Buikiing Inspector will issued a Bulldog Permit to the app~cant. Such pe~it
shall be kept on the premises available f6r inspection throughout the work.
e. No building shall be occnpied o~ used iu whole or in pm't for any purpose whatever until ~ Certificate of Occup~cy
shall have been granted by the Bnilding Snspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a B~lding Permit pursuant to the
Building Zone Ordinance of the Town 6f Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
RegulatJons, for the construction of btJild~gs, adt[Jtions or alterations, or for removal or demolition, as here~ described.
~h~ applicant agrees to comply with ~Jl applicabl~,laws, ordinan~uihiing code, housin~ code and regulations, and to
admit authorized, inspectors on premisesi and in building for nece~~~~~~a~spect' ~. ~ .......
(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.
Name of owner of premises ......... 5~ ~..~~.. ' ........................ . .............
~--~ (as on the tax roll or latest deed)
If applicant is a corporation, signature ~f duly authorized officer.
(Name and title of co~oratq officer) . ' ' '
ALL CONTRACTOR'S ~S~
Builder's License No...~.~ ...............
Electrician s License No..~ .............
Other Trade's License No ...... ~ ...............
1 Iocation of land on which propose~l work will be done'. .....................
llouse Num bet Street Ilamlet
County Tax Map No. 1000 Section; ............... Block .................. Lot ................
Subdivision.
........... Filed Map No ........... Lot ...............
(Name)
2, State existing use and occupaucy of premises and intended use and occupancy of proposed construction:
a. Exisliug uso and occupancy ...... · ....