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Home My WebLink About14686-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26531 Date: 06/30/99 THIS CERTIFIES that the building ADDITION GREENPORT Location of Property: 71305 MAIN RD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 45 Block 2 Lot 7.1 Subdivision Filed Map Ne. Lot Nc. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 20, 1986 pursuant to which Building Permit No. 14686-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 CONCRETE HANDICAP RAMP ADDITION TO EXISTING CHURCH. The certificate is issued to ST. PETERS LUTHERAN CHURCH (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Building Ins~ctor Rev. 1/81 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 AUTFtORIZED) Permission is hereb¢ ...~.~r..~..~ ..................... ..~..~.~.....~.;..~..,......u...~...~..! ....... ~o...~.~.......~....~.~.....~ ............... ¥.d .... ~ .... ot premises Iocoted ot ................................................................................... ~ ................................. County Tax Map Iqo, 1000 Section ....... C)..~...~.~. .... Block ........ I~...~... ..... Lot No ..... ~ ................ pursuont to appJicotioi'l dated .... ~J~,,~,...,.,~,...~, ............ , J9.,~..(~., ond opproved by the Building Inspector. ~...~.~;:;..' ............. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Th£s application must be filled in by typewriter OR ink and submitted to the buildin inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of ali buildings, property linea 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 build~ 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 a Vpre-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 applican If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. es 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. Certificate of Occupancy on Pre-existing Buildinm - $t00.00 Copy of Certificate of Occupancy - = .25~. Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 -- Date ~RA/F~ / /~ .... New Construction ........... Old Or Pre-existing Building ........ Location of Property ..................................................... House No. Street Hamlet Onwer or Owners of Pronertv ~'~ (.~..~¥? ooo. ......... ......... .............. Subdivision .................................... Filed Map ............ Lot .................. ............. Applicant ~Z'./?z~ LP'Z~ .. Permit No..~f.L~ ........ Date Of Permit ...................... z~v~ Health Dept. Approval .......................... Underwriters Approval ..................... Planning Board Approval . . . Request for: Temporary Certificate ........... Final Certicate...~. ....... Fee Submitted: .UO .5 31 APPLICANT COMMENTS FIELD INS[~ECTION 1. FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] INSULATION [ ~FINAL [ ] FIREPLACE & CHIMNEY INSPECTOR 'FORM NO. 1 TOWN QF SOUTHOLD BUILDING' DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 ~ TEL.: 765-1802 Examined...~ .o¢,,.~..-~...~.., 19~.~. Approved., .~...o~..~..~.O.., 19~.'~,. Permit No.)..L/.~. ?.~...~.. Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets of plans, accurate plot plan to scale. Fee according to schedule· b. Plot plan showing location of lot and of buildLngs on premises, relationship to adjoining promises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par~ of this appli- ' cation. c. The work covered by this application may not be commenced before issuance of Budding Permit. d. Upon approval of this application, the Building Inspeclor will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No budding 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, housing~code, and regulations, and to admit authorized inspectors on premises and in building for neces~e~/~ons. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 ...................... Location of land on which proposed work will be done .................................................. .. .................. ar. ...................... House Number Street Hamlet County Tax Map No. 1000 Section ................. Block ~ Lot ~.. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) · 2. State existing use' and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .... ~ ......... .~]....~.. ....... ¢.~. ,~k..~.). ........... ppli ): ' ~.. 3. Nature of work (check which a cable New Building .......... Addition ...... Alteration ......... Repair .............. Removal .............. Demolition .......... , .... Other Work .............. , ~(~0~ . (DeScription) 4 Estimated Cost Fee (to be paid on filing this application) 5. If dwelling~ number of dwelling units ............... Number o f dwelling unlits on each floor ............... If garage, number of cars ........................................... ~ ................. 6. If business, commercial or mixed occnpancy, specify nature and extent of each type of use i ~ .' '.e~.' i ....... 7. Dimensions of existing struct~ures, if any: Front ............... Rear ...... ........ Depth ............... Height ............... Number of Stories ........................... i ............................. Dimensions of same structure with alterations' or additions: Front ........... i ......Rear .................. Depth ......... ............. Height ...................... Number Of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ....... i ........ Depth ............... Height ............... Number of Stories ........................... i ............................. 9. Size of lot: Front ...................... Rear ...................... . Depth ...................... 10. Date of Purchase ............................. Name of Former Owner i ............................. I 1.Zone or use district in which premises are situated: ....................... i ............................. 12. Does proposed constructkm violate any zoning law, ordinance or regulation: ...i ...................... !3. Will lot beregraded . ,~.~. . · i . ' ..... · ....................... Will excess fill be re~noved from premises: Yes No 4. Name of Owner of premises .................... Address .............. : ..... Phone No ............... Name of Architect ......................... ~...~..~., Address ................... Phone No ........... ~· .~.~ .q4. ~ ~ .' ..... Phone No. ~ (0.'~.~>.'g. ~9~. Name of Contractor . · .vS..~ :. Address ................ PLOT DIAGRAM Locate clearly and distinctly all bufld/ngs, whether ex/sting or proposed, and~ ihdicate all set-back dimensions from ,roperty lines. Give street and block number or description according to deed, and show street names and indicate whether aterior or corner lot. / FATE OF NE3~ Y~K, ,~ _s.s · A~A4ffS. 24t..:gf2,r-~4x~-. q_~g.'. ..................being duly sworn, deF ases and says that he is the applicant F (Name of individual ~ning contract) )ore named. e is the ~ : (Contractor, agent, corporate officer, etc~) ~ said owner or ownem, and is duly authored to perform or have perfo~ed the haid work and to m~e and file this ,plication; that ail statements contained ~ this application are true to the best of his knowledge and belief; and that the >rk will be perfomod in the m~ner set forth ~ the application filed therewith. ~om to before me this ......... ~ ...... da~o~.~&.~ . ~..; ...,.; 19~ ................ ~:? .... ~ .......... ~m**.~., ~,~,,~ ~, *o, ~ (SYgnature of applicant)