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Home My WebLink About23235-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-24286 Date APRIL 17, 1996 THIS CERTIFIES that the building Location of Propert~ 56600 MAIN ROAD House No. County Tax Map No. 1000 Section 62 Subdivision ACCESSORY SOUTHOLD, N.Y. Street Block 3 Filed Map No. Hamlet Lot 38 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 18, 1996 pursuant to which Building Permit No. 23235-Z dated FEBRUARY 1, 1996 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 EUILDING IN RKAR YARD AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF NEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 JOHN & IP/4A HUTTER N/A Building Ins~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN FALL 765-1802 A. 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 2/10 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 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 the applicant. C. Fees i. 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~ - $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 ......................................... ~ew Construction ........... Old Or Pre-existing Building ................. Location of Property ................................................................. .. .. .... House No. Street Hamlet Onwer or Owners of ~roperty...~ ............................................................. 3ounty Tax Map No I000, Section .............. Bock ................ Lot ................... Subdivision .................................. .. Filed Map ............ Lot ...................... Permit No.J~f. . . ..~...Date Of Permit .......... ~///F~.... . . Applicant. ................ ~/D~//0/.... ~......~z~77-~.. . Health Dept. Approval ...................... ... . Underwriters Approval ......................... Olanning Board Approval ........................ lequest for: Temporary Certificate ........... Final Certicate...?....... gee Submitted: $ ...................... . .. .................... "(1'~1.1) Ii'I,'HHCi,:*IJ [()ti IN."HII.^'I'[O{'! ]'Ell H. Y. S'I'A ]'1'~ I~i'11~1~,(~¥ C()I)I~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. INSPECTO~ ~O1LM NO. I ' TONN OF SOUTHOLD BUILDING DEPARTHENT TOI~N HALL SOUTHOLD, N.Y. 1197 I TEL: 765-1802 BOARD OF HEALTH ~-~'3 SETS OF PLANS "'""SURVEY .~._. ~ ~ ~ .... CHECK ~ ..................... SEPTIC FORH , .................. NOTIFY: CALL NAIL TO: APPLICATION FOR BUILDING PERHIT INSTRUCTIONS '-Date ................ , a. Ibis ~pplieati~ mst I~ ec~pletely filled in ~ ~iter ~ in i~ ~ ~tt~ to ~ ~ildi~ ~s~tor 3 ~ts of pl~s~ ~ate plot pl~ m ~e. F~ ~i~ to ~e. b. ~ot pl~ ~ l~ti~ of lot ~ of ~ildi~ ~ ~s, ~lati~ip to ~joini~ ~s ~ ~lic s~ts ~ ma~ ~ givi~ a ~t~l~ ~<riptim of l~t of ~r~ ~t ~ dr~ ~ ~ diem ~i~ is ~rt of ~is ~li~ti~. c. ~ ~ ~M ~ ~is ~li~tim ~ ~t ~ ~ ~fo~ is~ of Mildi~ PeMt.~ ,d. ~ awk~ of ~is ~lieati~, ~ ~ildi~ In--tot rill isa a ~ildi~ ~t to the ~li~t. e. ~ ~ildi~ ~1 ~ ~i~ ~ ~ in ~le ~ in ~t ~ ~ ~ ~at~r ~tll a ~rtlficate of, ~ ~1 ~ ~ ~t~ ~ ~ ~ildi~ In~t~. ~I<~ IS ~x ~ to ~ Mfl.di~ ~t f~ ~ is~ of a Mildi~ ~e ~t to ~ati~, ~ ~ ~st~ti~ of ~ildi~, ~iti~s ~ ~terati~s, ~ ~ .~1 ~ ~llti~, ~ (Si~ of ~limt, ~ ~, if a ~atim) .................................................................................. ~ m ................. 766-1802 9 ~ TO 4 PM ,FOR THE If applie~t is a eoqx~tio~, slg~at~e of daly ~thorir*-d officer. (Name ced title oi corporat, o~ficer) OCCUPANCY OR USE IS UNLAWFUL FOLLOWING INSPECTIONS: 1. FOUNDATION o I~/0 REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. I~ULATION 4. FINAL - CON~T~UCTION MUST BE COMPLETE FOR C~O. ~l~r~ L;~ .o ...................... WITHOUT CERTIFICATE¢.~ CO.ST.UC~,O".EQ~,.=,~E.T. $.A~o; ~'==~"-~. ~rs Lic~_. ~ ...................... ~ nrrU~,~[~V STATE CONS~UC~O" ~ ENE"GY El~_r~c~ L~ ~ ~ ..................... CODES. NOT RESPONSlB~ FOR uu~U/nliU/ ~ ~'s ~ ~ ..................... DESIGN OR ~N~U~~ I. ~ti~ of 1~ ~ ~i~ ~ ~ ~ill ~ .......... ~ ............................................. ~; ~ ~ ~r~ ~~' '. ....... ~, ~ ~ ~. ,~ ~,i~................ ,,~ ...~. ........ ~, ~.., ...... ~ivi,i~ .... ~ ..................... ~il~ ~ ~...<~i~'. .... ~t .~ ...... a. Msti~ ~ ~ ~ .... ~-¢-~-~ ............................................................. b. ~t~ ~ ~ ~ ................................................. .................. -.. · -- · -- - Nature of work (cheek ~dch n~pltcable); ~ l~ilding .......... ~iti~ .......... A~terati~ .......... ~ir ......... ,,. ~al ............. ~litl~ ............ Oflmr ~ .................................. (~ripti~) 4. Esti~mt~ ~st ..~/ ................... (to ~ ~id ~ fili~ this ~li~ti~) 5. If &llt~, ~r of ~llt~ : ~its............~'~ 6. If ~imaa, ~reial or mim'M ~, ~i~ ~e ~ ~tent of e~t ~ of ~...~ .............. 7. Dim~t~ of ~$ti~ st~l:ee, tf ~y: ~t ................ ~ar ............... ~pth ................. I~l~t ....................... ~. ~r of Stories ................. Pth .......... , ......... ~l~tt ............... ~r of Stories fl. Dlm~l~ of entire~ ~t~tim~ l~t · ........ -- .. · .. ~ar .......... · · .. . ~pth . ......... ... . ~1 t ....................... +. ~m~r of Stories ..................... 9. Si~ of lot: ~t ... , ~ ~ar ......... ~pth lO. ~e I of ~ ............. ~ ....... ~ of Four ~r ....................... ~ ................. II. ~ or ~ district tn ~idk nr~i~8 are 8i~t~ . · . ~ . ~ -,~ ....................................................... 12. ~s pro~ ~t~l~ vmla~ ~y ~i~ 1~, o~li~e or remdati~: ~o. .. ~ of addt<t ,.,..,.7~,9 ...... , ............... ~,, ..... ~ .......... .. . . .. ~ ~ ........ 15. ,Ia this p~r~ ~thin ~ f~ of a till ~tl~? ] PLOT DIAGR~ I~ate cl~ly ~ disti~tly ~1 ~ildi~a, ~mr ~isti~ or pro~, ~ i~i~te all. ~-~ dimwits ~ p~r~ li~s. Gi~ at~t ~bl~ ~r or &acripd~ ~mrdinfi to ~, ~ ~ stz~t ~a ~ i~i~te ~tl~r interior or ~r lot, (l~m of individual signing al~ of ~id ~r or ~rs~ ~ ia a~licati~; ~ all a~t~ta ~i ...... No, 4879505 Qualifiad in Suffolk CounW Commission Expires Oeoember 8, lf.. .......... being d~ly l~orn, deposes and nays tlmt Im is the applicant ~rate officer, etc.) thorized to perfom or Imve performed the said work and to make a~l file this and in ride application are trtm to the Imst of his kno~ledg~ and belief; and ~nnar ant forth in tim application filed therewith. (,%~.nar.re of a~llcanr)