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Home My WebLink About16684-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18423 Date SEPTEMBER 26, 1989 THIS CERTIFIES that the building ADDITION Location of Property 345 BRAY AVENUE LAUREL, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 126 Block 02 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 15, 1987 pursuant to which BuiLding Permit No. 16684-Z dated DECEMBER 17. 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 CHIMNEY ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A RICHARD & LAUREL MAGILL Rev. 1/81 Building Inspector I~OR~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALl. SOUTHOLD, N. Y. BUILD'lNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_;6684 Z Permission is hereby granted to: n ...t..~.~.~....~~......~ ................ ....'2~~.....~..:~.........L~..~.~.~.. , , _ _~,..,0./,C7)...' t ................................... at premises located at ...~...~.~.......~...~d~:~......: ....... ~...~ .................................... .............................................................................................. County Tax Map No. 1000 Section .../.....'~....~.. ........ Block ..... .?......D~.. ...... Lot No../...q. ............... pursuant to application date~~4~Tz~....~....../..*~.. ........ 19.~..'~.., and approved by the Building Inspector. Fee $..~..1~...:.....~... ...... Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPART~IENT TOWN HALL SOUTHOLO, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Lo t£o ....... ~. ~¢~E,~ ............ HOUSE NO./ STREET HAMLET County Tax Map No. 00 Se t - ak . .. Subdivision ....................... Filed Map ........ Lot .......... Permit No ........... Date of Permit .......... Applicant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Fee Submitted: Certificate ................ C o ~ ;~q~3 rev. 10/14/88 FORM NO. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765 - ]802 APPLICATION FOR :ERTIFICATE OF OCCUPANCY INSTRUCTIONS A. 'This application must bt ~iled in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildln s roe g , p p rty lines ;~re~ts, and unusual [natural or topographic features. , ' 2. Xnal approval of Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters, 4. Sworn statement fromlplumber certifying that solder used in system contains less than 2/10 of IZ leadi ' 5. Commercial buildings~ industrial buildings, multiple residences and similar buildings and nstal~at~ons, a certificate of code compliance from the Architect or Engineer responsiSle for the building. 6. Submit Planning Boar~ Approval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957~ non-conforming uses, or buildings and "pre-existing" landluses: I. Accurate survey of p~operty showing all property lines, streets, buildings and I . unusual natural or tqpograph~c features. 2. A properly completed iapplicat~on, a consent to inspect signed by the applicant and a certified abst=act of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, ]95?. . If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing clode or safety inspection of b~ildlngs or premises, or other pertinent informatio~ required to prepare a certificate. C. For Vacant LandCertiflc~ate of Occupancy: ]. An application for valcant land Certificate of Occupancy shall be submitted, and a certified abstract of title issue'd by a ~itle company showing single and separate ownersblp o~ the entire lot prior to April 9,, I957 shall also accompany the application. If ~ Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwe:lliug $25.00, Swimming Pool, $25.00. Accessory buil~ Addition to Accespory buildings, $25.00.- Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $]0.00 ~. Vacant Land C~rti~ieate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certiflmate of Occupancy - $25.00 Residential $50.00 Commercial APPLICATION ON BACK rev, 10/14188 OUNDATION (1st) OUNDATION (2nd) OUGH FRAHE & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FILIAL ADDITIO COMMENTS: ~~ ~----------~6S-1802 ~ _.BI~DING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~r~'~AL DATE INSPECTOR .~~~//~ BLDG. DEP1. TOWN OF SOUTHOLD Examine~. 1 .'1., 19~ .~. Appro~..~.~, 19~?. Permit No, [..~ .~.~.~ .'~ BOARD OF HEALTH ...... 3 SETS oF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SE?TIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUlL. DING PERMIT 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 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 Riving a detailed description of layout of properW 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 app~ovai 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 apphcable 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. Name of owner of premises ;¢,kl, ............................ ' ' (as on the tax r~dl or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No.~.z}l..~/~.. · · . 7~,~-'. · · . I. Location of land on which proposed work will be done .................................................. ...... .... .................... ..................... House Number Street Hamlet County Tax Map No. 1000 Section .... ./...~-..~? ...... 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 . .(~, ,¢"/.~... /. . . . ~--. .............................. b. Intended use and occupancy ........... ~ ................................. 3. Nature of work (check which applicable): New Building ' Addition. 'i ........ Alterat/i~, ,...~. ....... Repair .............. Removal .............. Demolition ........... t... Other Work t.~..,,~zz.~.~/ ...... ?ff..~..~. Q (Desc~ipJion) 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 ................ I~ garage, number of cars ......................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... i ....... Depth ............... Height ............... Number of Stories ............................ ~ ............................ D~ensions'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 oflot: Front ....... . ............... Rear ...................... ]Depth ...................... 10. Date of Purchase ............................. Name of Foyer Owner . ............................ 11. Zone or use district in which premises are situated ......................... ~ ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ............................ 13. Will lot be regraded ...... ~ ................. ~ ...,~Will excess fill be r~move~ from premises: Yes No 14. Nme of Owner of premises ~ ~ ~&~~/~dres~*~.~ ~hone No ................ Nme of Architect .... i ...................... Address ~(¢¢~ f~. ~.ff.. Phone No .... ; ........... 15. [s this property locate~w~th~n 300 feeC of a tidal wetland? kY{s ..... ~.. - ~If yes, South~ld Town Trustees Permit maybe required. PLOT DIAG~M Locate cle~ly ~d distinctly ~1 bufld~gs, whether existing or proposed, and. indicate ~1 set-back d~ensions from prope~y ~nes. Give street ~d block number or description accord~g to deed, ~d sro, street nines and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY P STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, depqses and says that he is the applicant (Name of Jndivid ual signing con tract) above named. I Fie is the ............................................................. i ............................ (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that al/ statements contained in this application are true to the best ofhi.~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .$..7 HII.~N & ~VOE .... (Signature of applicant)