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Home My WebLink About14573-z~ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20399 Date DECEMBER 10~ 1991 THIS CERTIFIES that the buildin~ Location of Property 1100 CASE'S LANE House County Tax Map No. 1000 Section 109 Subdivision ACCESSORY Street Block 5 Filed Map No. CUTCHOGUE, N.Y. Hamlet Lot I2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 21, 1986 pursuant to which Building Permit No. 14573-Z dated FEBRUARY 26, 1986 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 IN REAR YARD AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building~ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ALBERT J. ¥ICARELLI Building Inspector Rev. 1/81 ~o~t]~ NO. Is TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPdV~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14573 Z Permission is hereby grontedd'~x / 0 ....'Z~.~.~..~..~.~ ................................................ ..~~.~...~......q.:....!.!..~.~..~C ~-x at premises I~ted ot ..IJ..~.~ .......... ~ ............... County Tax Map No. 1000 Section ..... ,(...(~..?/ ....... Block ...... .~.~. .......... Lot No ......~/.~,. ........... pursuant to application dated ......~l~4,~....,~...J Building Inspector. 19..~.~, and approved by the ut d~ng ns~ector 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 inspector with the following: for new building or new use: ~ 1. Final survey of property with accurate location of all buildings, property lines, ~ streets, and unusual natural or topographic [eatures. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). ~ 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6.Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-exzstzng" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00,,Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupanck - Residential $15.00, Commercial $15.00 Date ~ew Construction.. . Old Or Pre-existing Building ........... Location of Property.. Z/~.~...~.~.~:$ /~/M~ .~'~.~-.~.~.~.q~. .......... , .......................... House No. Street Hamlet Onwer or Owners of Property. ~.~ ~. .... g, .,.. County Tax Map No 1000, Section ..... ~.f .... Block..~.-~. ........... Lot ......... :{ubdivision .............................. Filed Map ........ Lot ...................... ................. Date Of .................. Applicant ~ .......... !{ealth Dept. Approval../~.~.~ ............. ..... Underwriters Approval ...................... :'launing Board Approval ..................... !{equest for: Temporary Certificate ........... Final Certicate ........... 7ce Submitted: $ ............................. ............. ~ ''' ~ APPLICANT ........ INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Sen/or Building Inspector Thomas Fisher Building Inspector Gary Fish Building, Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 DEGEIVlBER 6, 1991 ALBERT J. VICARELLX BOX 620 CIITCHOGUE, W/ 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 14573-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. COMMENTS FOU__N~£T I 0_~ _ (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER No Y. STATE ENERGY ~: CODE FINAL ADDiTiONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~FINAL ~ INSPECTOR 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined *~'~t~" ' 197.~. Approved . .~.~~-.~.,~ 19ff~0. Permit No. l. tJ.~.?.~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19.. INSTRUCTIONS a. This application must be co~npletely 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 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 apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ingp~;gtion, s. , ~ __ ,~, -. ............... (Signatu~f applicant, or name, if a corporation) . (Mailing address of appiicant)d State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~.~. ~...~.~..'.~....~.-~'... - '.~/.~.'..~/~ ~-/d' · ........... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer, (Name and title of corporate officer) Builder's License No ........ ................... Plumber's License No ......................... Electrician s L~cense No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. · il~d - ,, ~ ................ ~?,. z/~ ~. ~.d~....::.,~'e.~. ...C~:~. .~.,Y. .~. . . ~&~.~.. ~o~( ~o~r~ ....... . ................. House Number Street Hamlet County Tax Map No. 1000 Section ..Z~...{~.7.. Block ..~ ............. Lot...Z~ ............ Subdivision ................ (~'a~) ................ Filed Map No ............... Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed ~onstruction: a. Existing use and occupancy .. - ................................................... ~, ~,~ ~ an~ ~ . .~.~, , ,~,~. ~ ............................................... Nature of work (check which applicable): New Building ddition Alteration Repair .............. Removal;.: ........... Demolition ............ ... Other Work ............... ~/ ,~ ' . ' (D ipti ) · es. cr on Estimated Cost ......................... i'; ........... Fee ........... , ................ (to be p~id on filing this application) If dwelling, number of dwelling units .......... ' Number of dwelling unitsion each floor ................ If garage number of cars ' If business, commercial or mixed occupan~cy, specify nature and extent of each typ~ of use ......... ~ ........... Dimensions of existing structures, if any: Front Rear ~ Depth Height ............... Number of Stories ............................. : ........................... Dtrnens~ons of same structure with alterations or additions: Front ........ ; ....i ....Rear .................. Depth ...................... Height .................. Number of gtories .. , ....... Dimensions of entire new construction: Front . ./.c~., ....... Rear . ./..,~. ,.. '5;' ....Depth . . .'~....,.. i .... Height . . .~r. ~, .......... Number of Stories ..... ./ ................. ;.. Size of lot: Front ...Zo.~.,.4 ~. ........... Rear .../'~ ~.., .7.,g.. ............ Depth .... /~.~ ./~.. .......... Date of Purchase ............................. Name of Former Owner . .i ...................... : .... Zone or use district in which premises are situated ....... ~'.. Does proposed construction violate any zoning law, ordinance or regulation: ... ~?.' iii iii ii iiiiii il iiiii Will lot be regraded ..... ~. .............. ,.. W~ll excess fill be removed~from premises' ~ Yes No Name of Owner of premises/Jr, g~..~:/J.r. ~',..~t..c.~.~...~/Address~'~,~.e,~..JA~-~. ~,~.z~..~.~'~e No..['. ' ....... Name of Architect ...........................~, ~ Address ................ ;... Phone No ...... Name of Contractor. .ff.~2/.~A~Z./~ . ........ Address ................ '... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, ind lines. Give street and block n~lmber or description according to deed, and show cate all set-back dimensions fi'om street names and indicate whether t (Contractor, agent, corporate officer, etc.)I ~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and' file this pplication; that all statements contained in this application'are true to the best of hi: knowledge and belief; and that the ' turk will be performed in the manner set forth in the application filed therewith, lworn to before me this County ~ 4s~l~, ~ Cou~,~// ~, (Siguature of applicant) E OF NEWI~YOI~Ir;., . ,OUNTY OF .... ~ .... S.S A) c,/~............................'F j~ t//di~)A~-cL/ being duly sworn, deposes' and says that he is the applicant (Name of individual signing contract) :