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HomeMy WebLinkAbout13827-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19197 Date JULY 9~ 1990 THIS CERTIFIES that the building Location of Property CENTRAL AVENtIE House No. County Tax Map No. 1000 Section 10 Subdivision ACCESSORY FISHERS ISLAND~ N.Y. Street Hamlet Block 1 Lot 8.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 1~ 1985 pursuant to which Building Permit No. 13827-Z dated APRIL 2~ 1985 was issued, and conforms to all of the requirements of the applicable prouisions of the law. The occupancy for which this certificate is issued is ELECTRIC SHOP ON EXISTING FOUNDATION AS APPLIED FOR. The certificate is issued to GOOSE ISLAND CORP. (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 building InspeCtOr' ' / ffOEM 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) NM 13827 Z Permission is hereby grant~l-to~ ,~ ~ . ~_)~~.......c._i~ ....... ......................................... ..................... ~..& ....... .~ .............. .~.~... ~ ~.....~...~....::...: ......... ,,~ ......... ~.,~ ..... ,_;.._~:.. .............. at premises located at ...~...~....~~...~ ............. County Tax Map No. 1000 Section ..... ..~..~...~ ......... Block ........ ..~.,.~ ....... Lot No ....... .~. .............. pursuant to application dated ...................................... , 19.~..,~.2 and approved by the Building Inspector. Building Inspector 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 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 statemen~ 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: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. "f 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 - $t00.00 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-exi~tin~ Building ................. Locatio~ of Pr°perty''~gg~g'~''~'''~~''~~'H~ Onwer County Tax Map No 1000, Section..~..~. ..... Block ..... ~.f ....... ~Lot ..... ~.~.~ ........... Subdivision Filed Map Lot Permit No..~ .~.ZZ-Date Of Pemit.~/~./?.~plican~.. ~~.. Realth ~equest for: Temporary Certificate ........... Final Certicate. FIELD ~NSP~CTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION FEE N. STATE ENERGY ODE FINAL Ye ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL,: 765-1802 Examined .~0~.. ,,2~, .... i9~.g.~ Approved .(~'~.. '~ , 19~. f. Permit No.)..~.¥.~. ?...~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ?i.~..oN..31, ........ 198;5. INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter 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 tiffs application may not be commenced before issuance of Building Pernfit. 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 applicabPe laws, ordinances, building code, housing code, and regnlafions, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) 06390 · .p,.o.... i)9.x..~!'5.~Z,..~.'~her.s..~$an~,. ~..X,.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises . ii{.a,Y.n?..ri.ri W. Edwqrds ............................. (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. 1297 E Other Trade s License No ...................... 1. Location of land on which proposed work will be done...R.e.G.r..M.o.b..~.1..S.~..a.~.l..o.r) ~..C.e.n. ~.z'.a.3: .by.e.:, ........ ............................................. F.i.~bj.e.ra..ID.J,a.n..d.,..bleW...YQrk ................. House Number Street Hamlet County Tax Map No. 1000 Section ........ O..19 ....... Block . . ..0.1 ............. Lot...0.8. .............. 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 . . .Op.e.n...f.o.u. r) .d.a.~.i.o. r).,..8. 'J..b.l.o.c..15 ...................................... b. Intended use and occupancy ........ .E. 1. e. 9?.~.o.~).i.c' .~p.aj, r.. ~.h.o.9 ................................. 3. Nature of work (check which Opplicable): New Building ..... ' ..... Addition .......... Alteration X.X.X.X..X.X.X.X.. Repair .............. Re$oval .............. Demolition .............. Other Work ............... , (Description) iq© Fee 4. Estimated Cost ... $50.0.° ............................................................. ~ ~'~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ' 6. If business, commercial or miied occupancy, specify nature and extent of each type of use .Comm.~r¢l~l. ........ 7. Dimensions of existing structures, if any: Front...1.4. ' .......... Rear .1.4. ~ ........... Depth.. $ .6.' .......... Height 3. .-.6 [ . Number of Stories ................... Dunenslons of same structure with alterations or additions: Front ................. Rear .................. Depth. 16 ' ~... Height 12 ' ... Number of Stories 1 8. Dimensions of entire new conitruction: Front ....1.4. '. ........ Rear .... 1. 4. ! ........Depth . ...1.6.' ......... Height ~t ~ ' Number of Stories 9. Sizeoflot: Front ...2.7.4.!.. ~ ............ Rear....2.5.0~ I ........... Depth..2.99.' ................ 10. Date of purchase ...7.;:~..3.-.8,4. .................. ~q'ame of Former Ow2kr 9.qq.dr.~.qh.. 5.n.e. rg¥ ........... 11. Zone or use district in w ~ch premises are situated ..... .I37.1. ............................................ 12. Does proposed construction viblate any zoning law, ordinance or regulation: .. NO · 13. Will lot be regraded .... 1~). i .................... Will excess fill be removed from premises: Yes XXXNo 14. Name of Owner of premisesR..l .~.ct.w.~rqt.~ ......... Address .Bp.x..i.~.1.3. .......... Phone No. 7.8..8:-.7.5.6. ? ...... Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ......................... Address ................... Phone No. ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& 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 interior or corner lot. As ilnclosed plot diagram STATE OF NEW YORK, S.S COUNTY OF .................. ............................ i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..................... : .................................................................... ' ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly 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 of his 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 ........................ day ~f ...................... 19... Notary Public ................................. Count~ ~ (Signature of applicant)