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Home My WebLink About24349-zFORM NO. 4 TOWN OF SOUTMOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25280 Date: 09/24/97 THIS CERTIFIES that the building ACCESSORY Location of Property: 1400 LIGHT HOUSE RD (MOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 50 Block 5 Lot 3 SOUTEOLD Subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JULy 31, 1997 pursuant to which Building Permit No. 24349-Z dated SEPTEMBER 12, 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 REQUIRED REAR YARD AS APPLIED FOR "AS BUILT" The certificate is issued to PEARL BULSE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPAi~TMENT OF MEALTM APPROVAL UNDERWRITERS CERTIFICATE NO. pLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A Building leo~a: NO. 11 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. N? BUILDING PERJGIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted_to; ..~, ~.~ ..................................................... ./.~/~ ...~~.~./:.~....././..~z./.. ....... ..~.~.~..%~.~.~.~..~.~..~/~..9 ........ .... ~....~..~~/~ .......................................................................... co..~ Tox Mop No. ~000 S.~,,o. ~j~j ..... ,~ .~ ............. ~o, ~o..~ .............. Building Inspector. . ~ii~~ ............... Rev. 6/30/80 TOWN OF SOUTIIOLD TOWN lbkLL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~hu following: for n~w building or ~=w uu=: for ~ho building. For exisuing buildings (prior =o April 9, 1957) nan-conforming uses, or buildings and Fees 1. Carnifiea~o of Occupancy - New dwelling $25.00, Additions co dwelling ~25.00, Alterations go dwelling $25.00, Swi~mning Addi~io~u ~o acne,mary buildin~ $25.g0. ~=~ ... 9.%~ 1~.~..- ..................... Cons[ruction ........... Old 0r Pre-exi::tin~ ltou~ No. ,:~,,~ ~, ~, ~o ~oo~. ~=o~ .... ~Q ..... ~ ...... ....... ~o~...~ ................ :uUd ivi~ion . . Filed ~tap Loc ........ .'~:rmic No Boca Of Purmi~ ' Applicant' .'tanning Board Approval ........................ ~.o~(_~CCe%~c.~ ~.~ &~ 5~3q '~'"~ ........... 765-1,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNn)ATION 2ND [ ] I~ULATION [ ] FRAMING ~ [~::INAL [ ] FIREPLACE~/~NEY~,~ INSPE 765J.802 BUILDING DEPT. iNSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] ~NS~LATION [ ] FRAMING [~INAL [ ] FIREPI~.ACE/~H~NEY REMARKS~ ~ JUL 3,q~ 199'f 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ToWN HALL B~ARD'OF HEALTH 3 s'~is or eLA~S suRvs¥ ......... SEPTIC tonal h'OT I FY ~ CALL ........... , . HAIL ;J: INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Ins~pector, w 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 st' or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is p/irt of.this a &ation. c. The work covered by th-is application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such pe 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 Occup: 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 Building Zone Ordinance of the Town of South61d, Suffolk County, New York, and other applicable Laws, Ordinanc- Regulations, for the construction of buildings, additions or alterations or for zemov~emolitio~, as herein descri. The applicant agrees to comply with all applicable laws, ordinances, b~ ICfng/cC'~e,t/no)~?fj~dregulations, an, admit authorized inspectors on premises and in building for ne~ ' ....<...... (NIailing address of applican~ Stat.~ whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or bull, of owner ofpremisas...¢'? .".- ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.' ~ (Name and title of corporate officer) guilder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ................ . ...... Location of land on which proposed work will be'done .... . .... House Number Street Hamlet county Tax Map No. lOOOSection .:.~.~.. ' Block i.,..~.. ....... :... Lot...~ ............ ' Filed Map No Lot Subd~msmn ........................... (Name) Stat~ existing use and occupancy of' prem scs and intended use and occupancy of proposed construction': a. Existing use and occupancy. :.~\ .¢-.~.[% .~..~,~..'~.~..~ k .~ ........ , ...................... ....... ....... ........ ............ b. Intended use and occupancy . ~ " d] Alteration .... .3. Nature of work (check which applicable): New Buil' g ......... Addition .......... Repair Removal Demolition · Other Work ..... (Description) 4 Estimated Cost ' Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ' ..... Nuh~ber Of dwelling units on each floor.. ............ · If garage, number of cars ............ , .......................................................... 6. If business, commercial or mi){ed occupancy~ specify nature and extent of.each type of use ............... ,... 7. Dimensions of existing structures if any: Front ,~,~.~..w',~..'-(. Rear .............. Depth ............ Height ............... Number of Stories ,.. ~, i .............. .... ' ............................ Dimensions ojis~me structure with alterations or addition~: Front ...[O..~. ! ........ Rear .. }q~): .'~.1 ....... Depth .... '.~..o..~. ! ........... Height ....... '.. ~: ........ ; , Number of Stories ...... '. '. ........ 8 Dimensions of entire new construction: Front ' Rear Depth .Height ............... Number of Stories ........................................................ Size of lot: Front ..... [.~..~. t. ......... :.. Rear ..... ]. ~ .~...t.~ .... ~... Del}th 3" .l ~Ib./. ......... Date of Purchase .......... ~..~.~..... ......... Name of Former Owner ... ~ .~D.. ...... ;.~: . ~ ..... Zone or use district in which premises are situated... ~..~%, ~,~.~ ~-~.~ . . ' Does proposed construction violate apy.,z_oning law, or~i'nance o'r'r;~;lation:', ii. ii ~i i i i. Will Iht be regraded ...... ,; .....~ ........... Will excess fill be reanoved from premises: Ye~ Name of Owner of premises t }"ac~.\ ~...... Address ...~'~-~..% .~3~ .... Phone No. ~.~. .'/.'. 9.O.O~'.'~ Nara~ of Architect ...................... ;.... Address ................... Phone No ................ Name of Contractor .......................... Address ............ : ...... Phon~,.~o ............... · Is this propar~y within 300 feet of a tidal 'wetland? *Yes ........ No .... ~- .... · ~ *If yes,~Southold Town Trustees Permit may be requirad. PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed, an& indicate all set-back dimensions fron properly lines. Give street and block number or description according to deed and show street names and indicate whethe 10. 11. .12. 13. 14. 15, interior or corner lot. ocCUPANCYOR' APPROVED AS NOTEQ. ,765-1802 9 AM ~PM FOR FOLLOWlNG 1, FOUNDAT{ON . ~0 R~QUIRED' ~O~ POU~D CONCRETE 2 ~OUC~H., F~AM~NG ~ PLUM~NG C:'~t3ES ~OT .RFSPONSIBLE OFA~N ~R CONSTRUCTION ERRORS STATE OF NEWJfORK-- , S S " (Name of individual signing contract)~ i .' above named· He is the . .~. · ~ ~9.*~ ~ .... ~ ................... ' .............. ~Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authored t0 perfa~ or have perforated the said work and to m~e and file this application; that all statements contained ~ 'this'applicati~ are {rue to the best of his ~owledge and belief; and that the work wfl[ be perfomed in the manet set forth ~ the application filed therewith, Sworn to before me this ...... ..... ...... .................. ~ wY~ cfa I cant · Nota~ Public, State~NcwY~ ' ~ ~ (S~natur~ of applies . ' No. 52-8125850, Suffolk Co~ ., ' ' ,~ ' I ~ K ] . Term Expires Omober 31, 1~ ~ ~ ~ .J