HomeMy WebLinkAbout25746-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26590
Date: 07/23/99
THIS CBRTIFIES that the building ACCESSORY
Location of Property: 925 FIRST ST NEW SUFFOLK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 117 Block 8 Lot 16
Subdivision Filed Map No. __ Lot No. __
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 15~ 1999 pursuant to which
Building Permit No. 25746-Z dated MAY 25, 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 SHED IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to CARL S & LAURA M AVENT
(OWNER)
Of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Rev.
N/a
N/A
N/A
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. 25746 Z Date MAY 25~ 1999
Permission is hereby granted to:
CARL $ & LAURA M AVENT
PO BOX 149
NEW SUFFOLK~NY 11956
for :
CONSTRUCTION OF AN ACCESSORY SHED IN THE REQUIRED REAR YARD AS APP
LIED FOR.
at premises located at 925
County Tax Map No. 473889 Section 117
pursuant to application dated APRIL
Building Inspector.
FIRST ST NEW SUFFOLK
Block 0008 Lot No. 016
15 1999 and approved by the
Fee $ 35.00
Auth~r~ zed Signature
ORIGINAL
Rev. 2/19/98
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] ~LATION
[ ] FRAMI~dG [~"FINAL
[ ] FIREpI~,ACE&CHIMNEY
DATE
INSP£ '~'-CT~ ~
TOWN OF SOUTHOLD
,,, i APPLICATION FOR CERTIFICATE OF OCCUPANCY
~IDG. DEPT.
A. Tp~.~'a' [~ zust be filled in by typewriter OR ink and submitted to the builds
--- --i~'~tor with the following: for new building or new use:
1. Final survey of .property with accurate location of ali buildings, property line
streets, and unusuai natural or topographic features.
2. Final Approval from Mealth Dept. of water supply and sewerage-disposal(S-9
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
'!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 applic~
If a Certificate of Occupancy is denied, the Building Inspector shall state th~
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, Sw~-ing pool $25.00, Accessory building $25.0{
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildinm - $100.00
3. Copy of Certificate of Occupancy - ~ .25~.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
ate .%:. · ·
New Construction .... ~/. .... Old Or Pre-existing Building .................
Location of Property...~.~..~. ...... ..~.%...~..-~....~ ~ ~U~/-~'~
House Ho. Street Hamlet
Ouwer or Owners of Property ........................................ .. ... ·
County Tax Map No 1000, Section ..... 1.1.7. ..... Block....O..(~..(~...~. .... Lot .... .O.!.~. .......
Subdivision ................ .... ................Filed Map ............ Lot .............. . ·
Permit No.~..~.~..~.~..Y--~.Date Of Permit.~.-.~..~..~. ~. .... Applicant..[~...%~..~-~-...~--'--~- -~.~----- -~J
Health Dept Approval ------ Underwriters Approgal '..
Planning Board Approval ..............
Request for: Temporary Certificate ........... Final Certicate ...... ~....
S bmitted $ ~.0~2)
Feseju(~/I o ::~ ~.~ ~-~ C': ............................ ' [.~~~:'-" ~ '"'
~ C-~ ~.~p APPLICANT
765-1802
BUILDING DEPT.
INSPECTION
[ ] ;OUNDATION 1ST
[ ] ROUGH PLBG.
FOUNDATION 2ND [ ] IN/$ULATION
I=RAMING [~NAL
FIREPLACE & CHIMNEY
DATE-:/~: ,NSPE~CTO~
~ [~.~t.D~INSPECTION REPORT DAT~ C~S
OUNDATtON
O~'fl)ATION (2ND)
OUGH FRAHE &
PLUI~ING
lqSULATION PER N.
STATE I~NER~ir
CODE
FINAL
ADDITIONAL
CAreL AVE~'-~"c
FOR~NO. [
TO~] OF SOIFFNOLD
BUILDING DEPARTI~NT
TOWN NALL
SOUTHOLD, N.Y. 11971
TEL: 7~5-1802
BOARD OF BEALTN ..........
SURVEY ........................
CHECK .........................
SEPTIC FOI~M ...................
NOTIFY:
....
MAIL TO: ..................
APPLICATION FOR BUILDING PERI/IT
INSTRUCTIONS
a. lhis application m~st be completely filled in by typewriter or in ink and suhnitted to the Building Insl~ctor
3 aets of plans, accurate plot plato to scele. Fee according to schedule.
b. Plot plan m'x~ing lc~.ation of lot and of buildings cn premises, xelatiormhip to mtjoiuing premises or pablic
stxeets or areas, and giving a de~ailed description of layout of property nttst be drawn on the diagram which is part o
this applicot ion.
c. The ~ covered by this application rmy not be ~ before issuance of Building Permit.
d. Upon approval of this application, the Building InSl~tor will issue a Boilding Pemlt to the applicant. Sud
pemit shall be kept ~x~ the ~,,=u/'~es available for inspectic~ throughout the ~-k.
e. No building shall be occupied or used in daole or in part for any parpose ~/mtever tmtil a Certificate of
Occupancy slmll have been granted by the Building Inspector.
~I~LICATI(I~ IS mi ~ to the Bailding Ik~arO~at for the ism of a ltailding Permit por~uant to the
Bu/lding Zo~ Ordin~ce of the Tc~n of 8outhold. Suffolk County, ~ York, ~md other applicable La~, Ordinances or
P~mlatico_s. for the const~uctic~ of buildings, additions or alterations, or for rent.al or d~nolitico, as herein
described. ~he applicent ~ to cc~l~ with all applicable lga~ ordinm~ces, building code, hc~ing code, mxl
(Signature of applicemt, or mme. if a corporation)
(l~iling'addroas of applie.~t) l lC~,_r31 <"}-9
State 'wh~ther appllcast is~*~r~ !as~e, agent:, at-~itect, engi~neer, ~ceral contractor, electriei~m, plumber or buih
u qOR
Nan~ of oaner of pr~nises ' '
- ~ (as on the tax roll or latest de~d)
If a~licm~t is a corporate, sJL-r~ture of d~ly gathorized officer.
(I~ and title of corporate officer)
Builders License No ..........................
Ph~bers License No ..........................
Electricians L/ce~e No ......................
~r ~'s ~ ~ .....................
I. ~i~of 1~ m~i~ ~~11 ~ ................ ' ............ ~ ........................ ,- ..
..... ........................ .................... ..........................
~ ~r S~t ~et
~i~si~ .......... Fil~ ~ ~. .. l~r .............
(~)
' '~ ~ .............. 3'~ .......... ] ' ~, ~ ~8~ ~ ~T~' ..............
3. F~ture of ~ork (check ~hid~ applicable): Ne~ Building Additio~ x Mteration
Repair ........... Pmm~va! ............. Demolition ............ OO~r ~ ~[[~/ ~.~. .
~ ~ipti~)
~. Estimt~st.....~ ... .............. f~ ......................................... ... , .
(to ~ ~id ~ fili~ this a~li~ti~)
5. I[ &lli~, ~r of &lli~ ~its ............ ~r of ~lli~ ~its m e~ fl~r ................
If ~r~e, ~r of ~rs .......... ~
6. If ~i~ss, ~i~1 or ~ ~, ~i~ ~mte ~ ~t~t ~[ e~ ~ of ~ ..... ;.,. .............
7. Di~si~s of ~sti~ st~s, if ~: ~t ................ ~ ............... ~pth .................
I~i~t ......................... ~r of Stories ......................
D~i~ of ~ st~ ~th alterati~ or ~iti~s:
~pth .................... ~i~t .................... ~r of ~Cories ...............
s. ni~i~ o~ ~ti~ ~ ~t~i~: ~t .... J.~ ........ ~= ..... 'J~ ...... ~p~ .... t~ .......
t~i~t ~ /
......................... ~r of Stories .....
9. Si~ of lot: ~t I Ol e ~
I0 ~te of ~dm~ ................... ~ of Four ~r ,
Il. ~ or ~ district in ~i~ p~i~s a~ ai~t~ .~.(~.~- ......................................
12. ~s ~ ~t~ti~ violate ~ ~i~ 1~, o~i~ or ~lati~: ...~.~ ................
........................... ~ ~..~..~ ..... v'~-~
h of ~it~t ................................... ~ss . . ~ ~ .........
~5. Is fids ~ ~in ~ f~t of a till ~tl~? ~ ~ .......... ~ ...~..
PLOT DIAGRAM
I~cate clearly ~ distinctly all buildings, ~hett~r existing or proposed, and indicate all set-back dix~naions
from property lines. Oiv~ street and block number or description a~cording to deed, and sho~ street umaes and indicate
x~ether interior or corner lot.
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT' CERTIFICATE
OF OCCUPANCY
APPROVED AS NOTED
FEE: '~ ., BY:.~'~r-~
NOTIFY BUILDING DEPARTMENT
765-~2 9 AM TO 4 PM F~ THE
FOLLOWING INSPE~IONS:
1 FOUNDATION ' ~0 REQUIRED
FOR ~URED
2. ROUGH -' F~MING & PLUMBI~
~. INSU~ON
4. FINAL - CONSTRU~ION MUST
BE ~OMPL~ FOR
ALL CONSTRUCTION SHALL ME~
THE REQUIREMENTS OF THE
$TATE ¢ONSTRU~ION & ENERGY
~ODES. NOT RE$PONSlBLE FOR
OESI~N OR ~ONSTRU~ION ERRORS
(Na~ of individual siguitg contract)
above na~d,
(~tr~tor, ~t, co.rate offi~r, etc.)
a~l/~ti~; ~at ~1 star--ts c~mtai~ in ~is a~licatim am t~ to ~ ~st o[ his ~1~ a~ ~lief~ a~
(Signatxtre of Applicant)