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Home My WebLink About16391-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16184 Date September 17, 1987 THIS CERTIFIES that the building ACCESSORY SHED Location of Property 515 Maier Place Southold New York /~S~ ~JOi ................................................... Street Hamlet County Tax Map No. ] 000 Section .... 0.5. 5. ..... Block 0 6 .Lot 2 6 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated A u g u s t 24, I 987 pursuant to which Building Permit No. 1639 I z dated...........Au g u s t' .... 28 .............' 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 SHED AS APPLIED FOR The certificate is issued to JOHN P. MILCET ICH ..................... ?oYn'o;, Yfs~ ~frfifx ..................... of the aforesaid building. Suffolk County Department of Health Approval lq/A UNDERWRITERS CERTIFICATE NO. N/A N/A PLUMBERS CERTIFICATION DATED: B~ tor' ........ d' g I s ;c' ............... Rev. 1/81 lvOR~ NO. ~ TO~N OF SOfT'OLD 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_ ?~;;?l Z Permission is hereby granted to: ...... ~.~ ............... ~. .~.~,~ ......... !..¢..:.~.....~..~..~.....~.. ............ ..... .? ..... ........ at premises located at ....~...../...~........../../..t..~~'-~..'~...~ .................. County Tax Map No. 1000 Section ..... .~ ..... Block ....... .C)..(~. ...... Lot No ........... ~. ........... pursuant to application dated .... ~r:~./~l,~....~......~,....~. ...... , 19..~...1, and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,¥, 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ ~mmamma 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 p~emises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 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 5.Updated C.O. $ 50.00 Date .......................... New Cons truct ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section ............... Block ............... 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,_permi~t meets all ,applicable codes and regulations. ...... . ................. Rev, 10-10-78 FIELD INSPECTION FOUNDATION (1st FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY COMMENTS ADDITIONAL COMMENTS: 1'GS-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS: FOUNDATION ZND [ ]/INSULATION / FRAMING [/J FINAL BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK ....... h~- - BUILDING DEPARTMENT SEPTIC FORM' ' . ............ TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 CALL ................ ~(~ TEL.:765-1803 MAIL TO: f Examined ~.d,~.~'..~.'~., 19~ 3 Approve~,14~..~...~., 1 ~.~.. Permit No. } ~'~c[ I ~ ............. ........... r~ '5? '~ 51 5~ Disapproved a/c .................................... [ iii('! ]~U~ 2 a 195[ (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 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 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 ~he Building Inspector. ' I~' 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 const~cti0r~ pf buildings, additions or alterations, or for removal or demolition, as herein described. Tbe applicant ag~:ee~ ~o c~)~p'ly W}ttl ail applicable laws, ordinances, building code, housing code, and regulations, and to · admff authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whetber applicant is. owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · 'W~ ~ ~t t~O,-.~E '~e' ~ (¥ ..................... Nameofownerofpremlsesx . . . ~ ............................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate 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 ...................... I. Location of land on which.proposed work will be done. ............ : .................................... ~5-13- ~"////~r~ -Pc,~'~' ........................... : ............. House Number Street Hamlet County Tax Map No. 1000 Section . . .'~..~ ............. Block . . .(a .............. Lot .~.~. ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended hse and occupancy of proposed construction: a. Existing use and occupancy ........................ , ......... :;',, ;~2.~....,~..;... :::. ;;'..::~.2;, i .............. b. Intended use an;l occupancy ·: ................... : '~ '.t~' '9 :,~,.;,,~.4~.,~ ~'.~,~.,'~,~.,,~,,-'~-; ........... 3. Nature of work (check which applicable): New Building ition .......... Alteration .......... ~ Repair ........... Removal .............. Demolition .............. Other Work ............... ',~ .~ (Descriplion) 4 Estimated Cost ~ ~ ~ ' i (to be paid on filing this application) 5. If dwelhng, number of dwelhng umts ............... Number of dwellingunits on each floor ................ If garage, number of cars .... i ...................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use'.... '..'.... i .......... 7. Dimensions of existing structures, if any: Front Rear Deptg Number of Stories ' " Height ....................................................................... Dimens!ons'of same structure With alterations or additions: Front ................. Rear .................. Depth .................. ;... Height ...................... Number of Stories .......... ......... Dimenmons ~f,~ntire new construction: Front .... / ........ .;, Rear .... /.": ......... Depth .. ~, ........... Height ... o ........... Number of Stori6s ......... · [. ............................................. 9. Size of lot: Front .......... i ........... ' Rear :...: .... '...... ~ ........ Depth ...................... 10, Date of Purchase .......... ~ ................... Name of Former Owner ............................. 11. 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 remoKed from premises: -, Yes No 14. Name of Owner of premises ./v/?p.~., .~.,-~(c./.~,..~-.?/,(.t-~.~ Address~./p~.../~..A.t?..~..-~. ?..e~ Phone No.'~.~..SY..~...~.~.,?. · · Name of Architect ...... i .. 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 TrBstees Permit maybe required. i PLOT DIAGRAM Locate clearly and distinctly afl buildings, whether existing or proposed, and, indicate ail set-back dimensions from property lines. Give street and bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. cou Y . .~ .................. being duly sworn, deposes and says that he is the applicant /~ (Name of individual sigfling contract) ~ove named. He is the ............................ : ....... ~.~( ~ .~5.~ .... ~ ................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly a~thofized to perform or have performed the said work and to m~e and file this application; that all statements Con~ained ~ this application are true to the best of his knowledge and belief; and that the work will be performed in the m~ncr set forth in the application filed therewith. Sworn to before me'this~ ............. .... N~W Publ~ 8te~ ~ N~ Y~ Q~ ~ 8~ ~u~ ~ ~ ' ' "f~' ' . (Signature of applicant)