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Home My WebLink About13767-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No COZ20113 Date JULY 25~ 1991 THIS CERTIFIES that the building. ADDITION TO ACCESSORY Location of Propert~ 2885 INDIAN NECK LANE PECONIC House No. Street Hamlet County Tax Map No. 1000 Section 086 Block 05 Lot 14.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 11~ 1985 pursuant to which Building Permit No. 13767Z dated MARCH 21~ 1985 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 ADD TO AN EXISTING ACCESSORY SHED. The certificate is issued to PETER STOUTENBURGH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 lt'Om'M~ bO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13767 Z Permission is hereby grante~ . :::::::::::::::::::::::::::::: .... ~..~....,...~..,%:. ........................... ,o pursuant to application dated .....~.~ ......... iJ .................... , 19.~..~'., and approved by the Building Inspector. Building Insl~-'tor Rev. 6/30/80 Fo ~-m No. 6 TOI~N OF SOUTItOLD BUILDINC DEPARTNENT ~ i. This application taus: be filled in by type,~riter OR ~nk and s~ai~a ~0 the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of ail buildings, property lines, streets, and Unusual natural or topographic features. 2. Final Approval from Heal~h Dept. of Water supply and sewerage-disposal(s_9 form). 3. Approval of electrical installation from Board of Fire Uuderwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Co~ercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code C~pliance from archiuect or engineer responsible for the building. 6. Submi~ 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: i. Accurate survey of property sho~ing all property lines, streets, building and unusual natural or tOpographic features. 2. A properly completed application and a consent to inspect signed bv the applicant. If a Certificate of Occupancy is denied, the Building Inspector sh~il state the reasons therefor in writing to the applicant. :- Fees 1. Certificate of Occupancy - Ne~v d~eiling $25.00, Additions to d~elling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessorv building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pro-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, Co~crcial $15.00 Date . . . ....... ~'~ Construction .... Old Or Pre-existing Building ...... .. Haml e ,,~ ~,. , ' ...... ~ ........ ,o~.....:~..~.1 ..... ~.~ ~ alth Dept. Approval ......... . ...... Uudcrwriters Approval. .. i g Boa d Appro i ...................... iues~ for: Temporary Certificate ........ Final Carticate. TOWN OF SOUTHOLD OFFICE OF BUILDING IN~PEC'rOR P.O. BOX 728 TOWN fIALL SOUTItOLp, N.Y. 11971 JULY 15, 1991 TE~.765-1802 To Whom This May Concern, We are unable ko complete your Certificate of Occupancy because.of the following reasons. /X_--~ An application for Certificate of Occupancy is not on file. ENCLOSED /5/ No Underwriters Certificate on file. /~ The check is~o~a~l~Y~a~/not on file.) $25.00 /Z/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please co'tact our office on this matter. Thank you for your cooperation. Building Permit tl 13767z Z ACCESSORY Buildinq Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD,INSPECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: COMMENTS ,.~ / ? t ,/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 ~isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. Ttfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ts 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 : areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ttion. 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 :all 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 ~all 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 ~ilding Zone Ordinance of the Town of Southold, Suffolk County, ~ York, and 9~her applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alteratigffs, o~] for remo~fl:'or demolition, as herein described. ~e applicant agrees to comply with all applicable laws, ordinanggs, bg~i/Ci~g codo~ta6ust~g c.o~e, and regulations, and to [mit authorized inspectors on premises and in building for neces~ry~i~/f/_~ E 7,~3 V~ i t - It' ~'/ ~ . I~ '~~' . . '&'-~' ·. I' ' V' ~' ' ~4 ~r e ~.s*~,~e ~ ~ ~/' (SignOre ot/f~a~plica~, or-~an~e, if a cbrporat~on) (Mailing address of applicant) /r~'~9/27 ~ rate whether applicant is owner, lessee, agent, architect, enl~neer, general c~}o~, electrician, plumber or builder. .............................. ............................... amc of owner of premises r~ ...... ; .-.. (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..~.ff.'Y.t~/~~. ./~..~..77~..--...~/.~.~..~. Plumber's License No ......................... Electrician s L~cense No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done . . ..~..~..~./.c~..~....~..~.~, .~..~.~?.~... House Number Street Hamlet County Tax Map No. 1000 Section ... 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 ....... ~ .7 .......................... b. Intendedwse and occupancy 3'. Natureofwork (checl~h~ichaprlicable): New Building .......... Addition ~. .... ~. \Alteration ......... .... Repair ,. ........... !: Rempval .............. Demolition ........... ,Other Wo--~dF~r ~../P..o.q~./.~.,7. ~ ~ : o/' ~r~m~ ~ed (Description) 4 Estimated Cost ' (to be paid on filing this application) 5. If dwelling, number of dOelling~ units ............... Number of dwelling units on each floor ...... ~ .......... If garage number of cars ~ 6. If business, commercial or mixe~d occupancy, specify nature pnd extent of each ty~%of use ................. 7. D~ensions of existing structures, if any: Front /~ ~ ~ Rear ~¢ Depth ~ ? Height .... ~t ........ Number of Stories~. .... / ................. ~ ...................... ., ......... D~ensions of same structure ~ith alterations or additions' Front .g~'. . Rear .... ~ ~ Dep~ ........... /O~ .... ~ . HeiSt ~r .......... Z ............... Number of Stories .... ~ ................. 8. Dimensions of entire new construction: Front ....... ¢.~ ..... Rear .... ~ ....... Depth ...~ .......... ight ~ t / mb / He ...... ~ ...... Nu er of Stories ....................................................... 9. Size of lot: ~t .. ~,. 3. ~ ..... Rear ...................... Depth ...................... 10. Date of Purchase .......... ~ .................. Name~ofFomer Owner ............................. 1 1. Zone or use district in which premises are situated ....... ~.~ .~ ....................... 12. Does proposed construction viohte~ny zoning law, ordinance or regulation: .... ~... 2~.. ~.. ~2~ 2~[~ j~ 13. Will lot be regraded ......... ~O ................ Will bxcess fill be removed from premises: Ye( . ~ 14. Nme of Owner of premises ~ :~qC.~: ~2~ ~4o. ~hone No. ~- 7~ Nme of Architect ........................... Address ................... Phone No ................ Nme of Contractor~0ag,O* *.~.~O*$r .~ ~,.. Address ................... Phone No ................ PLOT DIAG~M Locate clearly ~d distinctly ~1 build,os, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from prope~y lines. Give street and blocklnumber or dese~ption according to deed, ~d show street nmos and ~dicate whether interior or corner lot. ~ , STATE OF NEW YORK. IS S COUNTY OF...~.%.P'. ?.9.L-..~.... i ' ... (Name of individual signing contrac[5 above named. ......... being duly sworn, deposes and says that he is the applicant He is the ............................ . ....... ! ~-;ntra~t o~r~gent, ~'~l~;a't; 'o'f~;.) ....................... of said owner or owners, and is duly authorized to perform or'h'ave performed the .said work and to make and file this application; that all statements contained in this application are true to the best ofh~s knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to be'fo~e this ......... ~' ~' ' '~' .......- rm day ofi .j~O:.t..~.. i .... ~OTARY PU~LiO, lS~ato ol ~ew York No. s2.~s247n --~~"~ - - " (S~gnature 0fapplicant) : Qualified in Suffolk Count ,. COmmission Exoiris March 5 APTZ .,~ ..u /,-_S NOTED ,IF, B h. I~ g ~ ~ I , ~'S: FOR ~ ..... - - TWO REC'UIRED ,~.-". D CONm~, . ,.E~-~ - 2. ROUGH - FRAMINc ~ p~ ~ ,~,.. o UMBING ALL C STATE CON?RL'~'m, J: "¢ ..... a .... Eh': qGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ,-': / AP?ROY:0 AS N~TED FE~ ~_C,.~¥: ¢'~' NOTIF'¢ BUILDING DEPARTMEN~ A~ 765-180~ 9 AM TO a PM F~R TH~ ~OLLOWING iNSPECTIONS: 1 FOLiNI~.T!ON - ~0 FOR pOU~ED CONCRETE ~ ~' L*,UST 4. FIb ALL C'~' THE P:~ :. ,~,,~c ~c THE N.Y. DESIGN ~ C '~)~TR~JCT10~ [RRO~ / , ~..~: DATE: