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Home My WebLink About16369-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17513 Date NO--ER 15~ 1988 THIS CERTIFIES that the buildin~ ACCESSORY Location of Propert~ 2000 PI~E NECK ROAD SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 070 Block 09 Lot 04.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 20, 1987 pursuant to which Building Permit No. 16369Z dated AUG. 22{ 1987 was issued, and conforms to aL1 of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY BUILDING. The certificate is issued to ANTE & LJUBICA LONIC (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ' Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 16369 z Permission is hereby granted to: . /") . , 0 ......... ..~.~..-...~J.~:....~..o...i...,.?... .............................. ~.....,~.. .~....?.~.,.....u..~.t,.~ ........... ~ 5-) at premises located at .~...~:..J....~......~...~-d~...~.: ...... .~2~-~- ~._.,.- ....... County Tax Mop No. 1000 Section ...... ..~...?...~.. ....... Block ...... ..(~.....~ ....... Lot No......~...4.;.I ........... approved by the pursuant to application dated ..... (~' '~~...?.....~-..~.. .............. , 19.R.../..,<~' and Building Inspector. Fee .... 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 Wpewriter 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 $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100. O0 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 .......................... NewC°nstruction ...... ~/ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~. ~,~. ~ .~..~...' .'.~..~.-/~ ."~.~.. ~. ~. ..... Owner or Owners of Property (~ '" County Tax Map No. 1000 Section .... Zq ........ Block . .0..~ .......... Lot., .~.~ .(. ......... Subdivision .............................. :..Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all a~plicable codes and regulations. Applicant .. . .............. Rev. 10-10-78 17 '/3 FIELD INSPECTION COMMON TS FOUNDATION FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [//]~INAL REMARKS: '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 .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ Disapproved a/c ............................... i~..' ' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........... ~.~ .~. ?.., 19 87 INSTRUCTIONS sets of plans, accurate plot plan to scale. F b. Plot plan showing location of or areas, and giving a detailed cation. c. The work covered b d. Upon approval o: shall be kept on the e. No building shall have been granted APPLICATION IS HER] Building Zone Ordinance Regulations, for thee The applicant agrees to This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 to schedule. relationship to adjoining premises or public streets drawn on the diagram which is part of this appli- before issuance of Building Permit. g Permit to the applicant. Such permit the work. part for any purpose whatever until a Certificate of Occupancy Department for the issuance of a Building Permit pursuant to the Suffolk County, New York, and other applicable Laws, Ordinances or additions or alterations, or for removal or demolition, as herein described. 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) (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 ....................... State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder. ........ (2..~. ¢d~~r( ~ ~:'~'~ ~:~ ~ ...... .............................................. ~ .......... p,,~.~,~.~.,~ ~,,~ ~. · . * Name of owner orpremises fl~({'..~ .... ¢.~/~d... 4~ ~( ............ ~; ~ ........... (as on the tax roi1 or latest de~)~ __ ~/~,.~[~ If applicant is a corporation, signature of duly authorized officer. ~07~F';~ .~'~_)k ~'~dt ~)fuu~f4r~[~T ~' 1. Location of land on which proposed work will be done..~"000 ....... ,((.~. ¢.. ~.~:~ ~.. [¢.¢~ ................ House Number Street Hamlet County Tax Map No. 1000 Section 10.~07.70.': ?.:9'.t ! mock .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ....................... ~ ............................ q 3. Nature of work (check which applicable): New Building ' Addition . .t,<~.. ..... Alteration Repair .............. Ren)oval .............. Demolition .............. Other Work ...... ~ ........ i (Descrip~ior[) 4. Estimated Cost ~. ....... ' ...... Fee ...................................... I ' (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 m~xCd occupancy, specify nature and extent of eaah type of tl~e i :. '. .... ~-. ........... · 'ng structures if Front Rea D pth 7. Dimensions ofemst~ , any: ............... r ............... e ............... Dimensions'of same stracture 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 ......... ' Re Depth 10. Date of Purchase .......... i ................... Na~ne of Former Owner ............................. 1 1. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction violate any zoning law ordinance or regulation' 13. Will lot be regraded ........ ..................... Will excess fill be removed from premises: Yes No Name of Architect ......... : .................. Address ................... Phone No ................ Name of Contractor ........ , .................. Address .... : .............. Phone No ................ 15. Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLO~r DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed,, and. indicate all set-back dimensions from property lines. Give street and block number or description according todeed, and show street names and indicate whether interior or corner lot. ..... being duly sworn, deposes and says that he is the applicant STATE OF NEW YORK, COUNTY OF ................. S.S (Name of individual sigmng contract) above named. He is the ..................... ~ ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements con!ained in this application 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. Sworn to before me this ........... ~.~ .......... day of ..... ~ .......... , 19~. Notary Public ...... ~-~F~.. ~ ~..~..~'/~' ~' County ' ItREN It I~ V0£ . i (Signature of applicant) NOTARY PUBLIC, State of New Yolk' Ne. 4707873, Suffolk T~rm ExCms M~mh 30,19--.~L7