HomeMy WebLinkAbout25724-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCy
No: Z-26462
Date: 05/19/99
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2705 LIGHT HOUSE RD SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 50 Block 3 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 31, 1999 pursuant to which
Building Permit No. 25724-Z dated MAY 13~ 1999
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 BUILDING (HORSE STALL) IN THE REQUIRED REAR YARD AS APPLIED
FOR "AS BUILT".
The certificate is issued to BARBARA FALCONI SUP~ERS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev. 1/81
N/A
N/A
N/A
- -Building~nspector
FORM NO. 3
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)
PERMIT NO.
25724 Z % Date MAY 13~ 1999
Permission is
for :
hereby granted to:
BARBARA FALCONI SUMMERS
2705 LIGHTHOUSE RD
SOUTHOLD~NY 11971
CONSTRUCTION OF AN ACCESSORY BUILDING (HORSE STALL) IN THE
REQUIRED REAR YARD AREA AS APPLIED FOR "AS BUILT." 40 FT. SETBACK REQUIRED.
at premises located at 2705
County Tax Map No. 473889 Section 050
pursuant to application dated MARCH
Building Inspector.
LIGHT HOUSE RD SOUTHOLD
Block 0003 Lot No. 005
31 1999 and approved by the
Fee $ 35.00
ORIGINAL
Rev. 2/19/98
8
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Thfs application must be filled in by typewriter OR ink and submitted to the build
inspector with the following: for new buiiding or new use:
1. Final survey of .property with accurate location of all buildings, property lin
streets, and unusual natural or topographic features.
2. Final Approval from Mealth Dept. of water supply and sewerage-disposal(S-9 fob
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contain
less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar bull
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
'!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 an~ a consent to inspect sig~ed by the applic
If a Certificate of Occupancy is denied, the Building Inspector shall state th
reasons therefor in writing to the applicant.
C. Fees
i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Sw~t~,~ng pool $25.00, Accessory building $25.0
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existinR Buitdin~ - $i00.00
3. Copy of Certificate of Occupancy - = .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Co.mmercial $15.00
............ ...........
Hew Oonst ction ........... Old Or Fre- isttng Building .......
Location of Property ......................................
House No. '~ Street ~m~]et
Onwer or Ow:ers of ?roperty ....... ..- ................... ....... . ~ ........... ........ · · ---
County Tax Map No 1000, Section .... .¥.0. ......~loek .... ~ .......... Lot ................
Subdivision .......................... . ...... .. . Filed Map ............ Lot ................
Permit No .............. ~ ~ ~.~ . Date Of Permit..~/./._.~./. .~.f...Applicant .~.~.~ .......... ·
Health Dept. Approvsl ........... ...~...~. ....... Underwriters Approval ....... ~, .f,l-~- .......
Planning Board Approval....~..~.. ........... .~
APPLICANT //
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ I IN/SULATION
~FINAL
[ ] FIREPLACE & CHIMNEY
DATE
i NSPECT~*'~~
OUNDATION (2ND)
~.. IIqSPF. CT ~[ON REPORT DATE C(~IHENTS
OUG"R FRAI'iE &
PLUI'fEING
iNSULATION PElt Il,
STATE ENERGY
CODE
#
FORHNO.
TO~IN OF SOUTHOLD
BUILDING DBPARTHENT
TONNHALL
SOUTHOLD, N.Y. I]97l
TEL: 765-]802
Ol s,~t~ o,-ed a/c ..................................
BOARD OF HEALTH ...............
3 SETS OF PLANS ......... ' ......
SURVEY ........................
CHECK .........................
SEPTIC FORH ...................
NOTIFY:
CALL
HAIL TO: ...................
(Building Inspector)
APPLICATION FOR BUILDING PERNIT
INSTRUCTIONS
a. This application m~st be eempletely filled in by type~'riter or in ink and su~itted Co the Building Inspector
3 ants of plans, ancuraCe plot plan ~o scale. Fee according to scbedule.
b. Flor plan simwing location of lot and of buildings an premians, relatior~hip to adjoining premians or public
streets or areas, and giving a detailed deanripti(m of layout of property rmst be dr~m on the diagram ~hich is part oi
5his application.
c. The york covered by ~his applicatiofl may ant be cc~a~eeced before i~ o~ Building Permit.
d. Upon approval of ~hls appllcation, the Building Inspector ~rill issue a Building Permit to the applicant.
pe~nit shall be kept on the premians available for inspection thronghcot the ~ork.
e. No buildlng shall be occupied or used in ~hole or in part for any purpose ~tmtever until a Certificate of
APPLICATI(~I IS ~ ~ to the Building Depa~h~t for the issuance of a Building Pet~ait parsu~t co the
Building Zone Ordinance of the To~ of Sout;hold, Suffolk Co~y~ ~ York~ and other applicable La~s, Ordinances or
Regulatlc~s~ for the const-ructlofl of buildings, additions or alteraticr~, or for removal ~r de~oliticn~ as herein
described. Ihe applicant agrees ~o cc~piy ~ri~h ail applicable la~, ordinances, building code, housing code, and
regulatic~s~ and ~o ~,t~it authorized inspectors on premlans and in building for necessary inspections.
............
gnature of al~licant, or nam, if a ¢orporatim)
........... ~----/I- · · =----'~-- -=,- .¥-~-. ~; ~Z~--~- -~ · -~- ~'~
(l/ailing a&iress of applicant)/
State ~hether ~pllcant i le~, agent, architect, englaner, ganeral contractor, electrlelan, plun~er or bulh
.............................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
~ ~ DEPAI~ENT/AT
'~-1~ ~ AM TO 4 I~1 FOR THE
title o[ corporate o [ ee=>OCCUPANCY OR
USE IS UNLAWFUL
Builders License No ..........................
Pl r,No ............. CERTIFICAT£
Electricimls License No ......... OE-OCCUPANCY
Other Trade's License No .....................
FOIADWII~ IN~FEClION$:
I FOU~D~rK)N - TWO REQUIRED
t ~~.~ ~ & PLUMBIN6
4. FINAL. CONS?RUCTION MUST
BE COMPLETE FOR C,O.
ALL CONSTRUCTION SHALL M~.,
THE REQUIREMENTS OF THE
1. Location of la~d on ~hich proposed ~ork ~ill be
~ ~ O ~ L ~ +
(~)
3. F~ture of ~ork (check ~hich applicable): ~ Building .......... /~clition ......... -r-- Alteratior~ ..........
Repair ............ Pamaaval ............. Remalition ............ Other tlork ...~..... ~.....~.~c...~.. ...........
.(l~eacription) ~ ~
4. Estimated Cost ............ ; ............ fee ..............................................
(to be paid on filing this application)
5. If daelling, nmt~r of Oaelling ~mits ............ hlanber of d~lling mits on each floor ................
If garage, ntwrl~r of ears ......................................
6. If hmineas, t~mmercial or mixed occupancy, specify nature and extent of each type of use ......................
7. Dimensions of existing structures, if arty: Ih:mt ................ Rear ............... Depth .................
tleight ......................... Naif*er of Stories ......................
Oimensioos of sa~ structure with alterati~ or additions: Froot ............... I~ar ...............
r~epth .................... tteight .................... Nmt~r of Stories ...............
8. llimensiom of entire r~; construction: Front ................ Rear ............... Depth ..............
lleight ......................... Nu~er of Stories .....................
9. $i~e of lot: Front .................... Rear .................... I)epth ....................
10. I~ate of Purdtase ..................... IGanae of Former O~er ........................................
I I. Z~e or use district in *ffnld~ premises are situated .................................
12. Does proposed construction violate any ~oaing las*, ordinmace or regulation: ........................
13. ~ill lot be regraded .................... Idill ex~ea fill be rem~ed fr~n premises: YES tO
14. N~mes of O~er of pi~ises...... .... ................. ffu:ldress ............................ . . Phone No ............
~ of Ard~itoct ................................... o Address .............................. ~ No ............
N~ne of Co~tractor ................................... Address ............................... Pho~ No ...........
15. Is this property within 300 feet of a tidal ~etland? * ~ .......... NO ..........
PLOT OIAGR/~ ,,
locate clearly and distinctly all buildings, ,ahether existing or proposed, and indicate all set-back dimensions
f-mm property lines. Gix~ street and block number or &scriptioo according to deed, and sh~ street ms and indicate
xdeether interior or comer lot.
1~ is the: .....
(~t~ctoz,., '~5;.l~rate officer, ete.~
of ~id ~r or ~ks, ~ i~tJ'~thori~ to ~rfom or I~ ~r[o~ fl~ ~id mA ~ to m~ ~ file this
a~l icatia~;
that ~e ~ will ~ ~r[~ ~ 'it~m~r ~t [or~ ~ ~e a~liatim [i1~ ~.
~m te ~[ore
OuaN~d ~n S~tolk Oou~