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Home My WebLink About14900-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupnncy No. 2-16055 Date August 14, 1987 THIS CERTIFIES that the building ACCESSORY STORAGE SHED Location of Property .... 6. 6. g..S.c.h.o. 9.1..H. 9 .u.s.e...R 9.a.d. ....... .C .u.~.c.h. 9 .g.u.e. :. ?I.e?...Y ?.r.k. .... House No. Street Hem/et Connty Tax Map No. 1000 Section 102 ..... Block 05 .Lot 0 12 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 15, 1986 14900 Z ....................... pursuant to which Building Permit No ...................... dated May 19, 1986 wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ACCESSORY STORAGE SHED The certificate is issued toWAYNE & MARY MOTT ..................... ?o¥,,'d., ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A B uildd~g Inspector Rev. 1/81 FORM NO. Il TOWN OF $OUTltOLD ~UILDJNG DEPARTMENT TOWN HALL SOUTHOLD, Fi. Y, BUILDING PERMIT O"HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~.o 1~00 z ................................................................................................................... County Tax Map No. 1000 Section ...... ./~...~-,.... Block .... ~...,~... .... Lot No....(~./~. ........ ~.~.o., ,o ~p~licotion do,ed ...A~.~./..~ ......................... , '~., BuiJdln9 Inspector. Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hail Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, end 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: I. Accurate survey of pzoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 1. Certificate of occupancy New Dwelling $25.0,0, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.v~o~nt Land C.O. ~ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property , ~.~/~...~ ~. ~L) /~.y~ House No, Street i-lam~et Owner or Owners of Property ,.~..~..¢~..,..~..~. ??.[ .~.o..0~...~.~_.../.~.......~;C?. f.~ .~... ........... County Tax Map No. 1000 Saction ... ]D..& ...... mock ...~. ......... Lot.. t.$. ........ '.. Subdivision ................................ Filed Map No ........... Lot No .............. Perm t No '.L[ .C/O. O .~. · Date of Permit ,~. ~/.~../~.~, ......... Appli cant .................................. 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 applicable codes and regulations, Rev, 10-10-78 Applicant .~~.~. ...... ~ ........................ [ ] FOUNDATION ZST [ ] ROUGH PLBG. [ .] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~ ] FINAL REMARKS: DATE f/~,~ ~ IN: FIELD,,INSP~CTION COMMENTS __ FO~_NDA_TIO__N~ (1st) FOUNDATION {2nd) ROUGH FRAME & PLUMBING INSULATION FEN N. Y. STATE ENERGY FINAL C, ADDITIONAL COMMENTS: ~/~APP, ROVi[D AS 'No,'rED ~ ' ~ F0~[OWING INSPECTIONS: -. ~ FOR POURE~ CONC~ ,/~ ~ ~.~-& ~1~ 4. FINAL - CON~ ...... b~ ~'T ~ ,, ~ .~,/ / ,J,, BE COA~PLETF FORC~Q ~ - L CON~RLt~ON SHALL ~ THE REQU[REME~S OF T~f~ N, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL £OUTHOLD,, N.Y. 11971 ReceJ. ved ........... .19... Disapproved a/c ................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely iii/ed in by typewriter or in ink and submitted to the Building Iuspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan ~ffbwing location of lot and of buildb~gs 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 remises a ' ' '" · · P variable for ~spe. ctmn throughout the work. e. No tmilding shall be occupied or used m 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 zuune, if a corporation) ,, (mailing address 9f applicant) ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...0 .Wf!¢,-. ...... . ..... ........... ............................................ (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. ( amc and title of corporate officer) . Builder's License No ' Plumber's ]license No Electrician's License No ....................... Other Trade's License No ...................... House Number Street ................. Ham/e~ 3 ................. County Vax Map No. 1000 Section ... J .O.g.. Subdivision ......... , .................... (Name) State existing use and occupancy of premises and ........ Block ......... L t ........ Filed Map No ............... Lot ............... intended ~se and occupancy of proposed construction: ' . ......... / ..... g ....................... b. ntended use and occupancy ........... ' ' '/' ' 3. Nature of work (check which applica,ble): New Building ...\ .~'. .... >, Repair Removal 4. Estimated Cost ..... ~.~. ....... , ..... 5. lf dwelling, number of dwelling units ..... ,on .......... Alteration ......... .... Demolition .............. Other Work .............. .~...~..~."-',¢.'~., ..c (Description) ........... Fee. . (to he paid on filing this application) ....... Number of dwelling units on each floor ................ If garage, number of cars ....................................................................... 6. If business,.commercial or mixed occupancy, specify natnre and exte,~t of each type of use .................... 7. Dimensions of existing structures, ifhny: Front ............... Rear .............. Depth .............. I-leight ............... Number Of Stories ....................................................... Dimensions of same structure wtth aiterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 8. Dimensions of entire new constmctibn: Front . fl.O ......... '. Rear .. ~J ......... Depth ...~ .......... Height .~ ........... NumberlofStories . . ~6~ ..... 9. Size of lot: Front .............. ........ Rear ...................... Depth ...................... 0. Date of Purchase ............................. Name of F~ner Owner . ............................ 1 Zone or nsc district in which premis~es are situated ((.e.~id gx ~5~. 2. Does proposed construction violate ~ny zoning law, ordinance or regulation: ................................ 3. Will lot be regraded ............ ................ Will e~cessSill be. removed fXom, preqfises Yes No Name of Architect .......... ~,..' .....~ ........ Address ................... Phone No ................ Name of Contractor . ......................... Address ................... Phone No .... ( ........... 5. I8 chi8 property located within 1,00 feet of a tidal wetlaml? * Yes ..... No .?... · If yes, Southold Town Trust~es Permit maybe required. .~ PLOT DIAG~M Locate clearly and distinctly all bt~ild~ngs, whether existing or proposed, and, indicate all set-back d~lensions from cope~y ~nes. Give street and block number or deschption according to deed, and show street n~es and indicate whether tenor or corner lot. ' q/"M'" ~< ~Kd'tZZ ' . ..... being duly sworn, deposes and says that he is th, ye named. ~aid owner or owne~, ~d is duly authorized lication~ that all statements contained fi~ this application a~ true to the best of Ms knowledge and beUef; · k will bc perfonued in the manne~ set forth in the applicallen filed ~hercwith. ~m to before me this Notaw Publio, 8181, ~ Now lm~ ................ applicant td file this ad that the f applicant)