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Home My WebLink About15458-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22329 Date MAY 17f 1993 THIS CERTIFIES that the building Location of Property 410 AIRWAY DRIVE House No. County Tax Map No. 1000 Section 115 subdmvlszon ACCESSORY MATTITUCK~ N.Y. Street Hamlet Block 1 Lot 2 Flied Map No. Lot No. conforms substantially to the Applmcation for Building Permit heretofore fmled in this office dated OCTOBER 28~ 1986 pursuant to whmch Bumldmng Permit No. 15458-Z dated OCTOBER 31r 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is mssued Ks 42'x 60' ACCESSORY BUILDING AS APPLIED FOR. The certmfmcate is issued to (owner) of the aforesamd bumldmng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED J. PARKER WICKHAM N-834830 - SEPTEMBER 29~ 1987 Building ~n~p~ct6r' -' Rev. 1/81 ~eO~,M NO. · 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) 15458 Z Perm~ssron ~s hereby granted to' ~.~....~.:.~. ...... i, ,o .. ~.-~..... ~-....~....~~ ~...~.~~....~....~~ ~ ........................... ..~ ........... ~ -;~-. ~ ...... ~.~..-; ............... ;. ...... ~, ~,,~,,~,ed ~,...~/.m...~~.~.- ...... ~~~ ...... ~..~., County Tax Map No 1000 Sect,on . .. J j ~ Block .....~...l ....... Lot No. ...~...~....: . pursuant to apphcatlon dated ..~P,~.~-,-~.... ;~.~ ..... , 19~(~ , and approved by the Building Inspector Fee $ P~.~-- .,~... ) Rev 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building mnspector with the followmng: for new buztding 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrmcal installation from Board of Fmre Underwrmters. 4. Sworn statement from plumber certifying that the solder used mn system contamns less than 2/10 of 1% lead. 5. Commercial building, mndustrial building, multiple residences and similar buildings and installations, a cert~fmcate of Code Compliance from architect or engineer responsible for the bulldmng. 6. Submit Planning Board Approval of completed smte plan requirements. For existmng buildmngs (prior to April 9, 1957) non-conformmng uses, or bumldmngs and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buzlding and unusual natural or topographic features. 2. A properly completed applicatzon and a consent to mnspect signed by the applmcant. If a Certzficate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applzcant. C. Fees 1. Certmficate of Occupancy - New dwelling $25.00, Addmtions to dwelling $25.00, Alterations to dwellzng $25.00, Swimmmng pool $25.00, Accessory buildmng $25.00, Addmtzons to accessory bumlding $25.00. Busmnesses $50.00. 2. Certificate of Occupancy on Pre-existmng Buzldmng - $100.00 3. Copy of Certmficate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certzficate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... ~. K~..'~.~..~ ...................... ! New Constructzon .... .~. .... Old Or Pre-existing Buzldmng ................. Location of Property ..... /~....~.....~..~.. ...... ~.~?..~..~/..~.~..~....~.. ........... House No. Street Onwer or Owners of Property.....~..-~-.~.......o......~/~~.,... ......................... County Tax Map No i000, Section.../J~. ...... Block ..... .~..~ ....... Lot...~.~. ............... Subdivision .......................... F~led Map ............ Lot ...................... Permit No. ~.~.~.~..~. '~] [~2~e Of ~ermit[i~. ~/J.~. ,Applicant,~///~.~f..~.~..~. · ~- .~...~?~.. Health Dept. Approval ...... .................o..Underwriters Approval.../~...~.~..~.~...O. ...... Planning Board Approval .................... .... Request for: Temporary Certificate ........... Final Certmcate.f .~.. ...... Fee Submitted: $ ....................... .. .... ~ ~. .................... .~UPANCY OR L,.;E 18 UNLAWFUL ~]'HOUT CERTIFICATE OCCUPANCY _ JNDATION (1st) ~NDATION (2nd) ]GH FRAME & PLUMBING ~ULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: \ _~. ....... _/ I~1 ~ I .PLAN \ T~i~ ~ I I / ~ I~ n / II '~___ I I "Tn .... ~t ----/ " I I ELEVATION/~RE~N~ 9'- ~" C;ONORETE FOUNDATION \ UNIT TO BE ENCLOSED IN A SELF SUPF'ORTED WEATHER PROOF INSULATED HOUSING. TYPICAL OIL PRESSURIZING UNIT W.O. Ne ................ Draw, n by.T B.K~I'~,A, App d by .......... H,,.$:: ,.o,,.x® ,.....,. LONG ISLAND LIGHTING COMPANY 175 EAST OLD COUNTRY ROAD HICKSVILLE, NEW YORK Office of Engineering JC&binet No. IE×HIBIT 5 IPAGE 9 IFolder No. Approved FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.. 765-1802 ReCelYed ........... ,39. Disapproved a/c (Buflding Inspector) APPLICATION FOR BUILDING PERMIT Date ........ 19. INSTRUCTIONS a. TI'us apphcahon must be completely filled m by typewriter or ~n znk and submitted to the Bmlding Inspector, wttt- sets of plans, accurate plot plan to scale· Fee according to schedule b. Plot plan showing location of lot and of buildings on premmes, relatmnshlp to adjoining premises or pubhc sire. or areas, and giving a detmled descmption of layout of property must be drawn on the dmgmm wtuch m part of flus apl: cation. c. The work covered by tins apphcatmn may not be commenced before msuance of Building Permit d. Upon approval of this apphcahon, the Bufldmg Inspector will issued a Building Permit to the applicant Such pern shall be kept on the premmes available for znspectlon throughout the work. e. No budding shall be occupzed or used m whole or m part for any purpose whatever untd a Certfficate of Occupan, shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to tl Buildzng Zone Ordinance of the Town of Southold, Suffolk County, New York, m~d other apphcable Laws, Ordinances, Regulations, for the construction of bmldmgs, addltmns or alterations, or for removal or demohho,n, as hereto describe The apphcant agrees to comply w~th all apphcable laws, ordznances, building cod_e~ousing code, a~d regulations, and admit authorized inspectors on premmes and m building for necessary ~nspechon~s~ / -- J . . (SlgnaCire of applicant, or name, ff a corporatmn) ................ ..... .<. . :.V) . .C .*-:: '' ' ~mailifig fidd3es~ of appll~an~) ' ' State whether applicant i~ lessee, agent, axch~tect, en~neer, general contractor, electrician, plumber or bufide (as on the tax roll or latest deed) If apphcant m a corporation, s~gnature of duly authorized officer '' (Name' and t,tle of corporate ~ Bmlder's L~cense No. ~. ..... Plumber's L~cense No / ..... Electncmn's,L~cense No/ . . Other Trade s L~cense ~o ~ . Locahon of land on which proposed work wall be done ttouse Number Street County Tax Map No 1000 Sechon /i.~' Hamlet Block ~ t Lot ~ ~ .. Subd:',us:on Fded Map No .. Lot (Name) State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed constrUchon a Existing use and occupancy gt~/l~/") O..ff.4~. .................. b. Intended use and occupancy 3 Nature of work (check wtuch apphcable) New Building Repmr . Removal 4 Est,.mated Cost . .~..~/o.~..o, ~ 5. If dwelhng, number of dwelhng umts . .. Addition .... Alteratmn Demohhon ......... Other Work (to be prod on fihng thru apphcatmn) Number of dwelhng umts on each floor If garage, number of cars ., .': : ......................................... 6. If bumness, commercial or m~xed occupancy, specify nature and extent of each type of use ,.,~'~t,~/~$ .o. ~'~4~_.. .... 7. Dlmenmonsofex~stingstructures,~fany Front. .~.O~. . . Rear ./~' ...... Depth ....~.~/~.~. .... Hmght . . ~ t ..... Number of Stones . ~'. ....................... Dnnenmons of same structure w~th alteratmns or addlt~ons Front ... -----r-'. ...... Rear Depth ....... Height . .-:- .. Number of Stones ..... 8 D~menmons ofenhre new construction Front ...':w- ...... Rear ......... Depth .......... Height . ~ .. Number of Stones 9. Size of lot Front ~ .. . Rear ............ Depth ............... 10. Date of Purchase . .--:w.. ......... Name of Former Owner ................... 1 1. Zone or use dmtnct ~n whtch premises are s~tuated . ~cL,~,t.~.' ~,~'~.. 12. Does proposed construction vmlate any zomng law, ordinance or regulatmn . .~t~ .................... 13. WIll lot be regraded . ./O~.....} . Wall excess fill be removed from premises Yes (~ 14 Name of Owner of premises . d'0.,P~ cc2'/~ ~..~tl~ . Address . t~4'UF, Tc-*~/~.... Phone No. ~..~ Name of Architect ............ Address ............... Phone No ............. Name of Contractor .................... Address .............. Phone No .............. 15. Is this property located withznt00 feet of a tidal wetland? * Yes · .... No .~.. · If yes, Southold Town Trustees Permit may be required. ~;4-~o -- PLOT DIAGRAM Locate clearly and dmtmctly all bmldmgs, whether ex~stmg or proposed, and~ ~nd~cate all set-back dnnenmons from property hnes. G~ve street and block number or description according to deed, and show street names and lndmate whether intoner or coruer lot. STATE OF NEW YORK, S.S COUNTY OF ........ ... c~.-~ ~'~ .~ ~.~-J be~ngduly swom, deposes and says that he m the apphcant ~Name of ~nd~v~duaI mgnmg contract) above named He ~s the , ~ ~'~ (Contractor, agent, corporate officer, otc ) of smd owner or ownem, ~d m duly authomed to perfom or have peffo~ed the smd work and to m~e ~d file ~s apphcatmn, that all statements contmned m thru apphcatton am true to the best of hm ~owledge and behef; and that the work will be perfomed m the m~ner set for~ m the apphcatmn filed ~erew~th. Sworn to before me thru .... ........ Not~Pubhc, '~.~~.'.~~... County ~ TLO~r~r~ ~ P~ ~ 4J ,, .,~ .... :". ~ ............... t,o , ~,~ 3 ~ (S~nature of apphc~t) OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY