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Home My WebLink About16687-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z-16522 Date December 22, 1987 THIS CERTIFIES that the building .... .C.o.n..s .t ?.~. c..t. Ac. c..e.s?.o. ~..y. ?.~. ~..~.d.i.~. g. .......... Location of Property .... 3..9.5..M.a..i.e.r..P..1.a.c.e. .... Southold, New York House No. Street Hamlet County Tax Map No. 1000 Section 55 . .Block 6 .Lot 25 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated De. ceraber 17, 1987 pursuant to which Building Permit No. 16687 Z dated D e c emb e r 18, I 987 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 BUILDING AS APPLIED FOR The certificate is issued to MARGARET SP I C IARI CH ..................... /oh;n'~'r, ~,l~¢~ ~f,~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ......... .N./.A. ............................. UNDERWRITERS CERTIFICATE NO ................ N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-] 6687 z Permission is hereby granted to: .o.~,~..~.~....~~ .............. ~.~..-...~.L...~,,...qx~.......~ ........... C5~...~.....o....%~.' _ ~=-.~. ................................... . ,--, .~ , ~.... .,~'~ at premises located at ....~....e}..~.. .... ~.. ~ .............................. County Tax Map No. 1000 Section ....... ~...~'....~'.. ...... Block ........ .~...~. ..... Lot No......'~...~'... ........... pursuant to application dated ~.c.~-)~,.~....J...~ ............. , 19..~..'7.., and approved by the Building Inspector. Rev. 6/30/80 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 ~ ~ 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 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 825.00 1. Certificate of occupancy New Dwelling $25.00, Accessory,~10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 Dec. 17, 1987 5.Updated C.O, $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of PropertY.House ~ No. ~'~ ~'~" " ' . . . ./~. ~./ 7~)¢., , . .~, ,~, ,/~. . .d.:, /._.~_.Street ......, '' ~ ~ ' ~ ~ 4~ ~e~ Owner or Owners of Property ....... ~ .............. County Tax Map No. 1000 Section 55 Block 6 Lot. 25 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant Ma r. g a r e,t. ,S? i.c. i .a r i c h . Health Dept. Approval ........................ Labor Dept. Approval ....................... . Underwriters Approval ........................ Planning Board Approval ................... ... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... J .0...0.0. .................. Apphcant ~.,. Rev. 10-10-7e ) / OUNDATIO:~ (1st) OUNDATIO~ (2nd) OUGH FRAME & PLUMBING ~:SULATION PER N. Y. STATE ENERGY CODE FILIAL . ADDITIO~;A'L COMMENTS: BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examine~. ~ .~.., 19I~ .T Approved .~.~..1.~.., 19 .~.3. Permit No..I..~.~..~.~..~.,~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING 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 pIans, 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 admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) ........ . ........ 4 ........ ' ~, (Mailing address of applicant) . ,,,, State Whether alSplicant is owner, lessee, agent, architect, engin~~dct~m~a~, Pl~nber'o/r b~u~der. Name of owner of premises ..... ~'~' '/~' '~' ~' ' '~' '~" '~'~' ' ' '~'/F/' '~'/' ~"~?' ' '~'J' "~/', (as~n the tax roll 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 LI'CENSED 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 .................................................. ............. ...... .... :.. House Number Street ' .Hamlet ~/_ County Tax Ivlap No. I000 Section ..... .~..'~."~. Z ....... Block ...../'~.. .......... Lot .... c~,~..'.'~.. ..... 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.' ......... ,~_:~ .... ~). f..~... ........................ :.~ ..... b. Intended use and occupancy ......... 7 ................................. i .................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteratio~n ./~ ........ . Repair ........... Removal .............. Demolition ............. Other Work ~ ...... ~ : (Description) 4 Estimated Cost · (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 .... i .................................................................... 6, If business, commercial or mix{d occupancy, specify nature and extent of each type of use,. ......... · ........... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Number of Stories ' ' Height ........................................ ~ ...... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth.. ~.~. ' ' .......... ~;¢.i.. ]... Height ...................... Number of Stories ...................... '-. 8. Dime.n~ions of entire new construci~ion: Front .......... . ..... Rear ............... Depth ............... Helgh~t ~~.'?.~,'~;".~' ;; .i i'..'-N~ibe~ of Stones Size cJf lot. ~,¥6n ............... Rear 10. Date of Purchase .......... i ................... Name of Former Owner ............................. 11. Zone or use district in which p~emlses are situated ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......................... t ....... 13. Will lot be regraded ........ . .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. ~ .................. Address ................... Phone No .............. Nmne of Architect i Address ................. Phone No. i . ........... Address .... ; .............. Phone No. Name of Contractor ........ , ..................... 15. irs this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Tr'tstees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly al buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY 0R USE IS UNLAWFUL W)THOUT CERTIFICATE OF OCCUPANCY STATE OF NEW ~R~ II ,o o il' '" coumv tg... (Name of inUividual sigaing contract) above named· He is the ..... ~. ~ -~. p. t.~.1...U. [ (ContraCtor, agent, corporate Officer, etc.) of said owner or owners, ~d is duty authorked to perform or have perfomed the said work and to m~e and file this application; that all statements cont¢ined ~ this application are true to the best 0f his knowledge and belief; and that the ' work will be perfomed in the m~n{r set forth in the application filed therewith. Sworn to before me this ~ - - .......... ........ .. :, ~ .. ~I~8~8'AN~N~I~E ' ' ' / (Si~ature of applicant) ~ of N~w York Term Expire80otob~r al,fl ~ -. ' --