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Home My WebLink About24094-zFORM NO. 4 TOWN OF SOUTEOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Bouthold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25181 Date AUGUST 4, 1997 THIS CERTIFIES that the buildin~ ACCEE$SORY Location of Property 3590 OLD NORTH ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 2 Lot 25.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 18, 1997 pursuant to which Building Permit No. 24094-Z dated MAY 2, 1997 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 STORAGE SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HE~J~TH APPROV~ UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED MICHAEL J. & JOY DOMINO N/A N/A N/A Rev. 1/81 FO~M' NO. fJ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o ~40§,i Z ..... ~~...~.~..Z/...~? / .............. .//. .......................................................... et premises located at ........ ~ou~, Tox Mop ~o. ,000 S,~t,o~ .... ~..~...~ .... ~,oc~ ..... ~ ........... Lot ~o.....g..~..~... put~uont ,o opplicotion doted ....... ~../...~... ......... , 19.~....~,., ond approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 statement from plumber certifying that the solder used in system contains less than 2/I0 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: 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 applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to thc applicant. 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 Buildin~ - $I00.00 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 New Construction...~... - .... Old Or Pre existlng Bgi%ding ................. ~oca~io~ of Property.....Z~..?.O....0/~. ,L2..~ .... .~ ......... ~.O. ~l~ .............. Rouse No. Street Hamlet O~wer or 0=ers of Property..~..~..~...~...~V,../.~ County Tax Map No i000, Section..~....~.. ..... Block...~. ......... Lot Z~ .~.....~-/ Subdivision .... Filed Map .; Lot Permit No....~..~. ~. ~..~...~. ate Of Permit.~. ~.~.~?. 2 .... Applicant.~ ....... Health Dept. Approval................... .... ... Underwriters Approval ......................... Planning Board Approval .. Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ~ ~..~--~s~. ~ ~ ......... .c~. ?.~ .................. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD May 29, 1997 Michael Dominio P.O. Box 75 Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is XX not on file. (Enclosed) No Underwriters Certificate on file. The check is (not on ftle.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 24094-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 765..1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ] IN~SULATION [~FINAL REMARKS: FIREPLACE & CHIMNEY , INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] IN/SULATION [ L,~NAL [ ] FIREPLACE & CHIMNEY REMARKS: FORN NO. ! TOI4N OF SOUTHOLD BUILDING DEPARTI4ENT TOI~ HALL SOUTBOLD, N.Y. 1197 ] T~L: 765-1802. INSTRUCTIONS BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ................... .. .. · CHECK ......................... SEPTIC FOIRt ................... NOTIFY: · DaLe a. ll~is applicatioo most I~ completely filled ia by tTpe~riter or in i~ ~ ~tt~ to ~ ~ildi~ In~tor 3 ~ts of plus, ~ate plot pl~ to ~le. F~ ~c~i~ to ~le. b. ~ot pl~ ~ l~atim of lot ~ of ~ildi~ ~ ~s, mlatim~ip to ~]oiuing ~i~s or ~blic st~ts or areas, ~ givi~ a ~tail~ &~rlpti~ of l~t of ~r~ ~t ~ dr~ ~ t~ di~ ~i~ is ~rt of ~is ~liati~. e. ~ ~d ~ ~ ~is ~liati~ ~ ~r ~ c~ ~fom is~ of hildi~ Pe~t. d. ~ ~1 of ~is ~liati~, ~ ~ildi~ In~ct~ will is~ a ~ildi~ ~t to the ~limt. ~t ~all ~ ~pt ~ ~ ~s ~il~le f~ in~ti~ ~t ~e ~rk. e. ~ ~ildi~ ~1 ~ ~i~ ~ ~ in &le ~ in ~rt f~ ~ ~ ~atmr mtll a ~ifi~te of aI~ IS ~ ~ to & ~ildi~ ~t br ~ isae of a ~ildi~ ~t ~mt to t~ ~ildi~ ~ ~i~ of & ~ of ~ld, ~folk ~, ~ Yo~, ~ other ~lie~le ~, ~{ims, f~ t~ mstmtlm of Mildly, lltims or alterati~s, ~ for ~al or ~liti~, ~ ~rein &~i~. ~ ~liemt ~s to ~ly ~th ~1 ~li~ble 1~, oMi~es, ~ildi~ ~, ~i~ ~lati~, ~ to ~it m~rir~ in~t~s ~ p~,~s ~ in ~ildi~ for ~as~ in~ti~s. ...... State daether applic~t is o~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Imilder. of o_ of L. .. ..................................... (as on the tax roll or latest deed) 'If applicant is a corporatloa, si~tur~ of duly authorized officer. (l~n~ and title of corporate officer) ~il~rs Li~ ~ ........................ El~trici~s Licm ~ ................ ... ]o I0. II. 12. 13. 15. (to ~ ~id on filing this a~li~ci~) garage, t~r of care ..... ~...~ ........................ business, ~mrcial or mi~ ~y, s~ci~ ~tura a~ ~tenC of each ~ of u~ ...................... ....................... ,. ~a~r of ~tories ~ . .............. I l~s propel const~ti~ violate any ~ing 1~, o~li~e or regulati~: ~ .................... ~ of Arddt~t ~ of C~tractor .. ~/~ ..................... ~klrees ............................... H~ ~ ............. this pm~rty within ~ f~t of a Cider ~tla~? * W3 .......... ~ ..~.. PLOT 1Y[AGRAN locate clearly and dietinctly all buildings, ~hetlmr existing or proposed, sad indicate all cci-back dimensioda property lines, give street and block madu, er or description according to deed, and slmw street nares and indicate xd~ether interior or corner lot. I ~I'A'IE (IF i'~ Y(RIK, ' ~ ,-,. , , I ...................... , .............. I~[ng duly ~re, doling8 and ~78 that Im is tho appllc~nt (~ of individtm[ algning contract) I ...................... .a ......................................................... (Cmltractor, ngent, c~r~rate officer, etc.) of aa~d ~mr or ~rs, and la duty ~thor~ to i~rfonn or have porfo~ tim said ~rk and to nuke a~ file this nl~)licati~; tlmt all star--nra conLqi~ in this al~}l, ication are trim to the Imst of his kt~l~ md Iml ief~ atxl tlmt the ~rk will Im ~rfon~l Je th~ ,umner ~t forth in the appl. icatlon fil~l tlmr~ith. (Signal-ere of ^ppi .. /