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Home My WebLink About25121-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25905 Date: 08/21/98 THIS CERTIFIES that the building ADDITIONS Location of Property: 3645 MILL RD (HOUSE NO.} (STREET) County Tax Map No. 473889 Section 67 Block 2 PECONIC Lot 11 (HAMLET) Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 21, 1998 pursuant to which Building Permit No. 25121-Z dated AUGUST 21, 1998 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 AND SHOWER STALL "AS BUILT" ATTACHED TO AN EXISTING GARAGE AS APPLIED FOR. The certificate is issued to CHARLES PETERSON & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 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. 25121 Z Date AUGUST 21, 1998 Permission is hereby granted to: CHARLES PETERSON & WF. 3645 MILL RD. PECONIC,NY 11958 for : CONSTRUCT A CHIMNEY "AS BUILT"; CONSTRUCT AN ACCESSORY SHED AND SHOWER STALL ATTACHED TO A PRE-EXISTING GARAGE, "AS BUILT" AS APPLIED FOR. at premises located at 3645 County Tax Map No. 473889 Section 067 pursuant to application dated AUGUST Building Inspector. MILL RD PECONIC Block 0002 Lot No. 011 21 1998 and approved by the Fee $ 110.00 Building~ihspecto~W' ORIGINAL Rev. 2/19/98 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 submitt'ed 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 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 buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of c6mpleted site plan requirements~ For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildlng and unusual natural or topographic features. 2. A properly completed application End 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 $Z5.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR 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 Date ............. . .... ~ ....... ~...~ ......... New Construction ........... Old Or Pre-existing Building,.. Location of Pro~ert~ 30 ~ , /L~C~ /~/~ ~...~.~. House No. Street Ha~et 0~r or o=~r~ o~ ~o~er~..~d5.54,..~ ~o~ ~ ~ ~o ~ooo, ~o~ .... ~.-~ ..... ~o~ ..... ~ ...... ,.~o~...~/ ...... ~ ......... Subdivision .................................... Filed Map ......... ~..Lot..~ ....... Permit No ................ Date Of Permit.. ~ ............ ~Applicant ........ ~ ........ ~ ......... ~ · Health Dept. Approval ................... .... ... Underwriters Approval ...................... ~,. Planning Board Approval ........................ Request for: Temporary Certificate ......... Fee .Submitted: $ .......................... 'C. .. Fina~ o. > 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] IN.~ULATION [~INAL ~~~ [ ]/~,'IlNG [ l,~ FIREPLACE & CHIMNEY REMARKS: FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z5~63 Date .$~2temb.e.r o ., . ...................... 1...,.. 1973 THIS CERTIFIES that the building located at }.{iJ.~L. ,Lane ................ Street Map No.Peconic Shs 131ock No. XX .Lot No. ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... .g. gy.. 3.~ ........ , 197.1.. pursuant to which Building Permit No. ~.2.73E.. dated ....... .g.a.y...3., ......... , 19..7.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. P~.±va.t.e one. £am&q.y dw. elSLJ, n ..................................... The certificate is issued to ...O.h.a?.], .e ~..~ ~. P.e.t e 1' ~o~ ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. UNDERWRITERS CERTIFICATE No...P.e.rq.d.i..~g ........................................ I IOUSE N UMBER ..... 36k.~ ....Street...~I$~_.1, .Lgiq. e .................................... ............................................. Peeo~J.e ............................ Building Inspector FORH NO. I TO~/N OF SOUTIIOLD IIUI l,l)] NG DEPARTNENT TOI4N IIA1.L SOUTIIO1.D, It.Y. 1197 I TEl,: 765- 1802 Dis~pprbved a/c .................................. · ( lull(ling Inspector)'' ' ~:~ BOARD OF IlEAl. TH ............... 3 SETS OF PI~AIiS ............... SURVEY ........................ CllECK ......................... SEPTIC FORIt .ROTIFY: CALL .................. HAIl. TO'. .................... APPLICATION FOR BUll.DING PERHIT '1 DSTRIICTIONS a. 'lhls application ntmt be ccmpletely filled in by type~.~rlter or in ink and wahnitted to the ~dldlag lns~ctor with 3 ~ts of plans, aconrate plot plan to scale. Fee according to schedule. b. Plot plan ~ing I~atlm of lot aM al Imildings m prmlms, relatimship to aljoinlng ~mlses or ~bllc ,tr~ts or arean, ami glvi~ a ~l.ail*l I~Pg]ripl i~l al la~s,: of p~erty mint le draa~ m the dtn~an ~Hch ia lmrt of this appl icatlon. c. 31m ~rk c~ml by Ods ~licati~ ~ ~)t I~ ct~ed I~[ore iamm~e oF I~dldi~ Pemlt. d. ~ appn~al, of this all)llcati~*, the l~dhli~ql Inslmctor will is~ a ~fildhg ~mlt to the a~llcant. ~ch l~it ~mll Im k~pt ~ tie ~mi~s ~ailable for ins~ctio~ thr{~l~tt the ~rk. e. ~ ladldi~ ~mll ~ ~pled or uml in ~ole or i. fart for a~ D~r~ ~mt~r tmtil a (~rtificate of ~o~n~ Mmll h~ I~n ~ant~l I~ Om lkHldh~ ln~ctor. · dhli~ 7~ Onllm~me al Om 'I~ o~ ~tlmhl, ~fffolk C~mty, ~, York, a~ oOler a~llcable l~s, O~im~es or ~datlms, for tle.~mt~tlm al ladldi~s, akllticms or alteratlm% or [~al ~lition, as Im~in t~mril~. 'lira a~hcm~t ~s to c~ly ~ith all am>licable 1~, o~im~e~l~eJ Imshm c~le, ~1 re~,lations, a,~ to .~it .,O~rlz~ ins~tors ~, praises a,*, in Ix, ildh~~~tm. ~ .~e) 7&s-- ~'¢~v - -r~~-:: .......... ~::..:- Slate ~t~etlver applicant is ~mer, lessee, agent, ardl|tect, engineer, general cca~tractor, electrician, printer or Imilder. ................................ ~'; ........................................................ ~0 AS~B ....... · ~ ~r ........ . ,......~ .................................... ~.. .................. ~,~,,..=~... ~,., .,.~~,,,,.,~, (as ~ tie t~ mil or latest deed) F~ 110~ O0 If a~llcant is a ~r~ratlm. si~t~re of (hdy mitlmrlv~ officer. N~ B~NG (~ m~ title ag ~rate officer) 1 ~A~N - ~ REO~ED ~ h~rs IA~en~ ~ .......................... 4. FINAL - CONSTRUCTION ALL ~ONSTRUCTION SHA~ ~ET Ele~ri~nn~ Li~en~ ~ ...................... THE REQUIREMENTS OF ~E STATE CONSTRUCTION & ~E~Y Otl~r ~'e 1A~en~ ~ ..................... ~ODE~, NOT RESPONSiB~ .......................... ~// ~ ~ ~.~. ~ ............................................................................ 1~ ~r Strut l~let ~ ;~ ~, ~. m~ ~,,, ....... ~.7... m~................~ ,~ ..//. .......... ~]lxllvlsi~ ...................................... Fil~ ~ap ~ ................ l~t . x ............ (~) 2. State ~isting u~ m~ ~o~ al pr~i~a ami inte~l~ u~ taxi ~o~ of ~! cmstmct~a~ 15. fi. If Ixmi,~s, ~u~rcJal or ~.i~d ~:~]l~a[~y, almclf~ iloltlrfi at~] extent: of ead~ rylm of use ...................... 1. IH.~n~Htsss of existing atn~turea, if m~y: Fr~fl ................ I~ar ............... ~pth ................. I~i[~sl ..................... ..... ~,,l~r of 8rories ..................... PI.OT I~x:ate clearly a,xl distinct'fly all I~H'hlis~,s, sJmtlm'r exlsl'In~ or prolxmc~l, taxi hxlieat:e all set-lmek dimensions frou property lines. I:~iw atreeli arxl blcx~k [~.~i)er or deueripl:ic~l aceotdhs[~ I:o deed. m~l sho~ street n~,les taxi indicate sJmtlmr i.terior or ~:on~er lot:. ] ({z~nlrsctor,~" ~al~eOl'~ corlx~rl,te ol'l:it:er, etc..) ' Ouahf~ed m SuWOl~ ~