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Home My WebLink About14684-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold~ N.Y. CERTIFICATE OF OCCUPANCY No Z-22803 Date DECEMBER 17~ 1993 THIS CERTIFIES that the buildin~ Location of Property 44075 MAIN ROAD House No. County Tax Map No. 1000 Section 75 subdivision ADDITION TO ACCESSORY PECONIC~ NEW YORK Street Hamlet Block 1 Lot 20 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 20, 1986 ..pursuant to which Building Permit No. 14684-Z dated MARCH 20~ 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 ADDITION TO EXISTING ACCESSORY BARN AS APPLIED FOR. The certificate is issued to OSPREY DOMINIOR CO. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-280569 - JUNE 22~ 1993 PLUMBERS CERTIFICATION DATED SEPT. 15, 1993 - CHAiALES W. RUMPF Rev. 1/81 I~OB, 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) l~[~S4 Z Date ...... .~.~...,,~....0.. .................... County Tax Map No, 1000 Section ...... .C)..~....,~'.. ..... Block ........ ..C~..../. ....... Lot No.......~m..~. ............ pursuant to application dated ...... .~.Dl~r..~..-'~.....~.. ............... , 19..~....~., and approved by the Building Inspector. Building In.~ector Rev. 6/30/80 orm No. BUILDING DEPARTMENT TOWN ~LL 765-I802 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 features. 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. 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 Occupancy - Residential $15.00, Commercial $15.00 Date ....~.~.~.~..~'...~.?/../..~.~..~. .................. New Construction ........... Old Or Pre-existing Building....~.. ........... Location of Property,...~..~.O..~.~.. ...... ../~..~/..~.....~.~. ............... ~..~.~.~..o..~. !..(.. .......... House No.~.~O~z/ ~ Street. ~ Hamlet 0nwer or Owners of Property .... ~¢~_.~r~/...~%7%~.... ....... ......_.,,.,.., ..... County Tax Map No 1000, Section .... -~ ~7~7.~. ......Block ........ /. ........ Lot ........... '' .~. O' ''' ' Subdivision .......................... Filed Map Lot Permit No.~~ ...Date Of Permit ......... Applicant.~ t//"J~>z~J Dept. Approval ........................ Underwriters Approval...~...~.~.?.~.~? ...... Health . . Ilanning~ Approval ................. Board ..... quest for: Temporary Certificate ......... Final Certicate ........... / THE NEW YORK BOARD'OF~FIRE-U , BUREAU OF~ELECT ~ 85 JOHN STREET NEW YORK NEW YORK THIS CERTIFIES THAT ' , · ~ ~. on~ ~he e~ectrJcal eq. ~pme~t as described b~low and a~troduced I~y, the applicant nar~ed on 16,1993 RANGES ~!~' FIELD INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE COMMENTS FINAL ADDITIONAL COMMENTS: FROM THI~ OF~FICE OF P.O. BOX 287 CUTCHOGUE, N.Y 11935 PHONE (516) 298-4891 OCCU?ANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED ~.: a~". ,-" ~v; ¢' ¢.L, NOTIFY BUILDING DEPARTMENT AT 765-18o2 9 AM TO 4 PM ~R THE FOL~ .OWING INSPECTIONS: / .... ~, ,~."~-~t ~I,tALi ?.n~ZFT FROM THE ~FFiCE OF P.O. BOX 287 CUTCHOGUE, N.Y. 11935 PHONE {516) 298-4891 .4, INSPECTORS Thomas Fisher Building Inspector Gary Fish Building 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 CgRTIFICATION Building Permit NO. I'd.//6 ~.~ t..// Z (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this /~ da~ of 3~eee~/~- , ,9 ?_~ Notary Public, ~L~ County Notary Public · ,'FORM~O. 1 ' * TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N,Y, 11971 TEL,: 765-1803 A~roved....~1 ~J,..~.., l~. ¢. Pe~it No../.¢ .C. ?. ¢..~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received.../. ...... ,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 buildh~gs on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property mhst 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 applicable laws, ordinances, building code, hofilsing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in~~~ ~ (S~i6ant, or name, if a corporation) ?. .... ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .../~..~..~'A...~./.~. ~7...~..~ ............................................ (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 License No ....................... Other Trade s License No ...................... 1. Location of land on which proposed work will be done .................................................. .. 7.77..?~7 ..... e~.rt,.~.. ~..o. ......................... .P.~.c~t ~ .................. House Number Street Hamlet County Tax Map No. I000 Section ..... Z.~7 ......... Block .... / ............. Lot .... '.27'...~.' .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy i~ b. Intended use and occupancy ...~.~...~...~)? .... .L.t)..~.~.\...~...~.'?..~. ~.~.~. ..................... Nature of work (check which applicable): New Building ' Addition ...N"...... Alteration .......... Repair .............. Removal .............. Demolition ....,,,~ ..... i. · · Other Work ............... (Description) 4, Estimated Cost ....... L?C'.IM .......................... ee~.. ~, .... ~ .......................... j/ (to be :paid on filing this application) 5. If dwelling, number of dwelling units ........ Nu bet of dwelling units on eac.h floor. . If garage, number of cars ............ .m. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... 7. Dimensions of existing structures, if any: Front ..... ~.O. ....... Rear ....~..c9.! ....... Depth i i '.~. 21 ...... Height , ,/~. ........ Number of Stories '2- . Dimensions of same structure with alterations or additions: Front ...0'..O ....... i ..... Rear .... ~..O. ......... Depth ....... .~:.~. ............ Height .. ?.~ / Number of: Stories . . Dimensions of entire new construction: Front ..... 1~ f ....... Rear .... I ~ .~ ....... Depth ...I .-4...~ ......... Height ~ H ~ Number of Stories J . 9. Sizeoflot: Front ....~'~. ~... ~. .... Rear ...................... IDepth ..................... 10. Date of Purchase . .I.q.c(.O ...................... Name of Former Owner .!.~..~.O. ~ .................. 11. Zone or use district in which premises are situated .... .1~'.(~....~.. ..... .~'. ~ .~2r.v:~ ............. . ........ 12. Does proposed construction violate any zoning law, ordinance or regulation: .....N~.~. .................... /... 13. Will lot be regraded ...:..~?C9. ................... Will excess fill be removed from r>remises Yes ~-~,~ No 14. Name of Owner of premises ...~.~7. ~ .~-~2..~..67. f~5!.~;'.~-~-_-_Address .2~u~ ~ .~.~r~ff!..i'.~.. Ph~one No..7.~.~. Name of Architect ..... .~.~ .Ad.~- ............ Address ...... . .~. Z'iTt. Phone No. Name of Contractor . .~O.C.t',~...../~...~..~... ...... Address fo. ~. CZ-. ~.S'~i iii i i i Phone No. ~.' ~'F.".' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether ,r or corner lat. ~. - S~ATE OF NEW YORK, COUNTY OF ................. S.S · .~ ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ................................................................................' ....... . (Contractor, agent, corporate officer, etc )i of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best ofhi~ knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Public ............ t~.z'l :. gd.~'....."TV... County I~V i,~. ~ ~1~ v~ No. 470~78 ~k ~ Te;~ ~ptr~ Ma~h 30, ~9