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Home My WebLink About15953-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Southold, N.Y, Certificate Of Occupancy No Date .......... THIS CERTIFIES that tile building ..... acc..es.sory .s.t-[.e..d.. .................... Location of Property 275 ....... Dc2qwood Lane Southold /v&~se No. " ' ' 'S'~'eei ..................... County Tax Map No 1000 Section .54 ...Block ...... .5 ..... Lot ..... 2.6. ........ Subd~ws~on ............ X ........ F~led Map No ....X...Lot No .... .X ...... conforms substantmlly to the Apphcahon for Bmldlng Permit heretofore ~ed ~n tlus office dated Aprl. 1 20, 1987 pursuant to wtuch Bmldmg Permit No. 15953Z dated .... ~ay...1, .~..9 .87 .... was issued, and conforms to all of the reqmrements of the apphcable prov]s~ons of the law The occupancy for which tlus certfficate is ~ssued is ....... Accessory shed. MARY K. McGOWAN The certificate ,s zssued to ......... (o~n'e'r.~a~[,~) ............... of the aforesaid bmld~ng Suffolk County Department of Health Approval ....... N/A UNDERWRITERS CERTIFICATE NO. N / A PLUMBERS CERTIFICATION DATED: Bmld]ng Inspector Rev 1/81 FO~M NO. $ TOWN 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) 15953 Z County Tax Map No 1000 Section/~.~.. ,,,,~....~. .... Block ..... ..~...~. ....... Lot No.....'~....~. ....... pursuant to application doted ..... ~....,,~),~,C~,. ................. , 19.~.7., and approved by the Building Inspector. Rev. 6/30/80 l:o~m No. 6 [ONN OF ~OUTI~OLD TOWN Ib%LL APPLICATION FOR C£RTIFICATE OF OCCUPANCY Th~.:, appl~.cuglon musg bu filled ~.n by £ypuwrlcer OR znk and uubmz[=ud co abe bulldlng l;%~puc[or wl~h ghu followzng: for new buzld~ng or new usu. 2. fzl~l Approval from ~Icalth b~pL. of w~E~r supply ~nd s~werag~-dzmposai(5-9 form). lcu~ ~han 2/10 o~ 1% lead. reupons~bl~ for ghc buzldAng. For ex~at~ng bu~ldmngs (przor go Aprzl 9, 1957) non-conforms, nE ua~s, or bu~.ldzngs and 1. Accura[~ aurv~y of prop~r~y showing all proporgy lines, sgr~e[$, buzid~n~ .~nd Fees 1. Ccr~z£zcatc of Occupancy - New dwelling $25.00, Add~czons Lo dwelling Alger~amon~ ~o dwelling $25.O0, Swz~u~l~g pool }25.O0, Accessory buildA~}: $25.00, 4. Updated Curtzficage of Setup.racy - $50.00 5. T~mporary Cu~'~zfxc~ of Occupal~cy - RuoidanLzal $~5.00, Comm~'cmal Con.gruc:~on ........... Old Or Pre-empt[lq- ~uildin~, I~ ............. ubdzv~.~,l, un . Filed M~p LoC ............ . I,-Jlth DcDt. Approval .......................... Underwr~-~ers Approval ....................... . FORM NO 6 TOWN OF SOUTHOLD Building Department Town Hall Soutbold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao This apphcation must be filled ~n typewriter OR mk, and submitted m~ to the Building Inspec- tor with the followmg, for new buddmgs or new use' 1. Fmal survey of property with accurate locat~on of all buildings, property lines, streets, and unusual natural or topograph ~c featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of elecmcal ~nstal[at~on from Board of Fire Underwriters. 4. Commercial buildmgs, Industrial buddmgs, Multiple Remdences and simdar buildings and insta[la- tlons, a certificate of Code comphance from the Architect or Engineer responmble for the buildmg. 5. Submit Planmng Board approval of completed rote plan requirements where apphcable. For ex~sting buddmgs (prior to Aprd 1957), Non-conformmg uses, or buddings and 'pre-existmg" land uses: 1. Accurate survey of p~operty showing all property hnes, streets, buddings and unusual natural or topo§raphm features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housmg code or safety inspection of buddmgs or premmes, or other pertment informa- tion required to prepare a cert~fmate. C. Fees' 1. Cert~fmate of occupancy $25.00 -- BUSINESS $50.00 ACC[SSOR¥ $10.00 2. Certificate of occupancy on pre-existing dwelhng $ 50.00 3. Copy of cert~flcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O._ $ 20.00 '~l / 5.Updatecl C.O. $ 50.00 Date .... ~--~. %-7. ........ NewConstructzon. ~i OIdorPre-ex]stlngBuddlng Vacant Land Location of Property ........................................................... __ 1 Street Hamlet County Tax Map No 1000 Section ~'~ - --~-- ~- ~ Block Lot ...... Subd~ws~on ...................... Fded Map No ....... Lot No ............ Permit Ilo ....... Date of Permtt ......... Applicant ................................. Health Dept Approval ................... Labor Dept. Approval ........................ Underwriters Approval ................. Planning Board Approval .................... Request for Temporary Certificate ................. Final Cert~ficate ....... ~ .............. Fee Submitted $....~ ...~,~,, LI Construction on above described buddmg and permit meets all aDphcabtgcodes and regulations pp .... 7 ................................. R~v 10 10 78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N Y. 11971 TEL. 765-I 802 TO Whom Thms May Concern, We are unable to complete your Certificate of Occupancy because of the following reasons. /~ An application for Certmficate of Occupancy is not on file. ~/05~) __/~ No Underwriters Certifmcate on fmle. /? The check ms(outdated/not on file.)~/O oo /5/ No Health Dept. Approval on file. /Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~umlding Permmt # Z Building Dept. ***/Z/ NO Plumber Solder Certifmcate on fmle. ( all permits involvmng plumbmng being issued after Apr!l 1,1984 ) OUNDATtON (1st) 9Ur~DATION (2nd) OUGH FRA~IE & ?LU~{BING NSULATION PER N. Y. STATE ENERGY CODE ADDITIO~IAL COM~E};TS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: DATE INSPECTOR BOARD OF HEALTH .~1~-.. 3 SETS OF PLANS ....... SURVEY FORM ............. FORM NO 1 TOWN OF BOUTHOLD BUILDING DEPARTMENT SEPTIC NOTIFY CALL MAIL TO: TOWN OF TOWN HALL $OUTHOLD, N.Y 11971 TEL.. 765-1802 Examined ~'~/2 ~ ·] .... . i~ ~:~ Approved ")Of){:~/.~. ;19~?:~;r~t"Iqo / 3~,~ ~-~..~: Disapproved a c ....... . r -' .... ~; (Building Inspector) APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a This application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, wit sets of plans, accurate plot plan to scale Fee according to schedule b Plot plan showmg location of lot and of buildings on premises, relationship to adjommg premises or pubhc sir, or areas, and gtvmg a detmled description of layout of property must be drawn on the diagram which is part of this ap cation c. The work covered by this apphcahon may not be commenced before issuance of Braiding Permit. d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the apphcan, t Such pe~ shall be kept on the premises available for mspection throughout the work e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occups shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmlding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New_York, and other applicable Laws, Ordinanc~ Regulahons, for the construchon of buildings, addltlons or alterations, or for removal or demolition, as here~n descnl The applicant agrees to comply with all apphcable laws, ordinances, bmldmg code, housing code, and regulations, am admit authorized inspectors on premises and m bmldmg for necessary insp, p~c.,t~ns ,.~ .~. ~, ,~ /¥/. /,./ . . (Slgnature'of applicant, or name, ~f a corporation) (Marling address of applicant) ! t'~ ?! State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bulh +x. .......... Name of owner of pre]roses ......... (as on the tax roll or latest deed) If apphcant ts a corporation, mgnature 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 .. Locahon ot land on xvtuch proposed work will be done ltouse Number Street County Tax Map No I000 Secnon ~'~ ~ Subdivision (Name) Hamlet Block .... Lot .. Filed Map No .. Lot .... 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy b lntended use and occupancy ~TOt"--LA,,.~I,I~ . .TOOt... .~...63. ~T I-'~ ....... 3. Nature of work (check which applicable) New Budding .~ . Addition . gJteratlon Repmr Removal Demolition Other Work /77 q9 (Vesc ption) 4 Esnmated Cost .... t .......... Fee ......................... (to be pad on fihng this apphcatmn) 5. If dwelhng, number of dwelhng umts ...... Number of d~g umts on each floor ........ If garage, number o[ c~s ............ , ~. ~ ... ................... 6. If bus~ness, commercial or mixed occupancy, specify~ ~__ __~,~~t~of~a~ ~t~e of use ........... D,menaonsofexistmgstmctures,~fany Fron~eV~'f~~ U~,~CDepth . . . 7. Height ....... Number of Stones ~--~ ~,~ ~ ~,~X~ ........... D~ensmns of same structure w~th alterations or~{~s~o~ ~I ~ ~'' Rear ......... Depth ........ ~. Hel~t /1~ ----9 ~ ..~1~ .~[PfStones .............. - & V,mens~ons ofah~[~ 8tmcnon Front . .,~il~9l~ar..Ir~m.... ..... Depth .......... a , at ......of ..................... . .. Re~~.'.'-. . v~pta ~P?.~ .... ..a. lg~ DateofPurchaseS~ze°fI°t Front ...... ~[~a~Fo~erOwner ........... 11 Zone or use dmtnct in which premises are s~tuated .................................. 12 Does proposed construction wolate any zomng law, ordinance or regulat~on ..................... Nme of Archttect ................. Address ................. Pkone No .............. N~e of Contractor ~9.~4. ~RK.W~O ~tt~ess ~. ~q~ Phone No ~'~.~,. i5. Is thSs property locaeed wzth~n 300 feet of a tidal ~etland? *Yes ..... No *If yes, 8outhold Tom Trustees Permi~ may be required. PL~ DIAG~ Locate clearly and distinctly all buildings, whether existing or proposed, and indicate gl set-back dzmenaons fron property hnes Give street and block number or descnptmn according to deed, and show street names and indicate whethe interior or corner lot. H STATE OF NEW~-'~RK, COUNTYOF . .. S,S ... /~/~Y~ ,,~., /~lC &.;~ . belng duly sworn, deposes and says tha~e is the apphcani (Name/of lndl~ ~dual sigmng contract) above named. eisthe .. . ~~ ................... (Contractor, agent, corporate offmer, etc ) of smd owner or owners, ~d m duly authored to perform or have perfomed the said work and to m~e and file t~' apphcat~on, that all statements con(tuned m th~s apphcatmn are tree to the best of hts ~owledge and behef, and that work will be perfo~ed In the m~ner set forth m the apphcatmn filed therewith Sworn to before me tlus . .~.~ . dayof ~,,] ..... 19 ~' Not~bhc, .~D~' ' ~ff' County ~