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HomeMy WebLinkAbout23771-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24902 Date FEBRUARY 7, 1997 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 695 EDWARDS LANE ORIENT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 18 Block 3 Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 1996 pursuant to which Building Permit No. 23771-Z dated OCTOBER 23, 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 "AB BUILT" ACCESSORY SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to ELIZABETH FEELY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A lng Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24901 Date FEBRUARY 7, 1997 THIS CERTIFIES that the buildin~ Location of Property 695 EDWARDS LANE House No. County Tax Map NO. 1000 Section 18 Subdivision ACCESSORY Street Block 3 Filed Map No. ORIENT, N.Y. Hamlet Lot 21 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 1996 pursuant to which Building Permit No. 23771-Z dated OCTOBER 23, 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 "AB BUILT" ACCESSORY BARN IN REAR YARD AS APPLIED FOR. The certificate is issued to ELIZABETH FEELY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 - ~ng Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall 8outhold, N.Y. C~RTIFICATE OF OCCUPANCY No Z-24900 Date FEBRUARY 7, 1997 THIS CERTIFIES that the building Location of Property 695 EDWARDS LANE House No. County Tax Map No. 1000 Section 18 Subdivision ACCESSORY ORIENT, N.Y. Street Hamlet Block 3 Lot 21 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 4, 1996 pursuant to which Building Permit No. 23771-Z dated OCTOBER 23, 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 "AS BUILT" ACCESSORY SMOKE HOUSE IN REAR yARD AS APPLIED FOR The certificate is issued to ELIZABETH FEELY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 Inspector IPOB~M NO. J TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, No ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~.7~ ,, ....... N? 23771 Z Date ........ ~... ....................................... , at premises ,o~oted at ....~...~~....~.. ..... ~; .~...~/O: ~..~)~: ....... .............................................~--~_~..~~ ~ ....... Coun~ Tax Map No. I000 Section .......... ~.... Bilk ~ Lot No. ~ / pursuant to application dat~ .................. ~~. ............... , 19.~, and appr~ ~ ~e Building Inspector. ,., Rev. 6/30/80 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 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 the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25/~Y~ Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buildingS25.00, 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 Occup,ancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date New Construction ........... Old Or Pge-existing Bui~lding ............ Location of Property .......... ~.-. ....................... ~ ................................... House No. Street Hamlet z County Tax Map No I000, Section ...... ;..~ ..... Block ...... ~....i .... Lot....~..l ................ Subdivision .. · · · · Filed Map Lot .............. Permit No ............... . Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval .................... .... Request for: Temporary Certificate ........... Final Certicate........... ~ 5 3 .P APPI ZCA T Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 '., ~ ;2PPLICATION FOR CERTIFICATE OF OCCUPANCY 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '!pre-existing" land uses: i. 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 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25,~ Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy om Pre-existing Buildin~ - $I00.00 ~/ 3. Copy of Certificate of Occupancy - ~ 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 ..,..~o~.~. Location of Property ~ ~ ~/~ ~ ~ ............. House No. Street Hamlet Onwer or Owners of ~roperty .................. . ......... ~ .............. County Tax Map No i000, Section ..... ~..~{.. .......... Lot ..................... Subdivision .................................. .. Filed Map ............ Lot ..................... . Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept Approval .... .. Underwriters Approval .... Planning Board Approval ........ Request~D~L.~for: Temporary Certificate .......... Final..~/,/ Fee Submitted: $ ........................... i 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 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 0ccupanty 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.~0.0.~ Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building~.O~, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinK Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ......................................... / New Construction...~/-- ...... Old Or Pre-existing Building ................. L tion f Property 6q~'- House No. Street Hamlet .......... ecf .... , ......... County Tax Map No 1000, Section..~..~. ........ Block...~. ........... Lot..~..{ ................ Subdivision ..... Filed Map Lot Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval . · Request for: Temporary Certificate ........... Final Certic~te ........... // j'~ rot I' ll^'t' I. ON (') ['ID } JJ- ' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I FRAMING [ .]/~iSULATION [ /-~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ ~~- DATE ~/~~' INSPECT~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR, I;ORM bi(). I TOWN OF SOUTIIOI,D BUI 1,1)IF1G l)ff. P/~RTI'II~ ttT TOWN IIA/,I, ~OIJ'I]IOLI), fl .~. ] 197 I TEl.: 765- 1802 BOAIII) ()ii' III(AI,Tll ............... 3 gl~'l'B I)t~ PI.AI~S ............... SURVF.¥ ........... ~ ............ ~.III~CK ......................... SF, Irt I~C ~()lIH .................... NOT1 FY: CAI.I ................... MAll. TO: .................... Ill Sal~l)rgved fl/c .................................. , . ................................... a. 'lhi$ aH~llcati~ ~amt I~ c~;~letely fillml in by tyl~.Wlter or in ink m~l mdx.itt~l to tl,e ~dldi.g lnsl~elor with 3 sets off pla.s, accurate plol: plan to scale. F~ acconlh~ to sch~hde. Il. [)lot plau ~h~ I~al:it~ o[ lot arxl sE la*ildi~s ~ pr~.i~s, relatim~ship to ~_joluh)g l)rouisen or lad)lie nt,'eetn or areas, mxl glvi~ a (~t'aHal ~neril)ti~m off la~lt of I)rOl~rl:y alJst t~ drm~l ~ the diogrglr ~ticl) iff t~qrt of 'lhe ~rk co. red Dy thls aH)llcati(m s,~y ~x)t lm co.trammel Imfore isstm~me of ~Jildh~ Pennlt. ,,, d. UlXS~ nl~n~at o[ this all)licatiou, the ~Jihli.8 'lnsl~cl:or will ism~ a ~Hldh~ Pe~,nit: to the nl~[;lica,,l'. ~,ch e. ~) I~,ildl.g d~all Im ¢~CUl)J~l or u~d in ~.)le or in l~trt for a)~ ~rl~se ~)at~er tmtll a C~rtlficate oF (k:caqm~s:y rJ~al t have I~e. grant~l I~ Ilm l~tilcling hmlmetor. Atq~.lf~'l'J(~ l~ II~I~ITY ~ t~ tim lh~ildi.8 I~lmrl..e.t for the ismmr.:e oF a lhHldi.g Pen.it ~rm~m,t to the I~gulati~s, for tim c~mtrtmti~ of la,ihlh,fls, mkllti~s or alteratloss, or for~al or ¢~icion, as herei. ¢~scr~l~l. II~ ol)plmant ages to cmply wH.h all a~lmnble l~s. orchna~J[~ . (~~1 ica.t, or (~s (si the taK .)Il or lal. eshle~D IP al~>licant ia a coq~ral:i~, slpff)atu~e o[ duly ~tl~)rlz~l offficer. {Nil)t? llll~l t itle of corlx~rate officer) I~Jilders l.lcense 1~) .......................... I'It~l~rs License No .......................... F, lecl rlcim~s l,ice.se ~ ...................... other 'l'ra~'s Lice.se ~ ..................... l~'at:iCm o[ ]llal'lll ~id~ p~] ~vk will I~ Ik~ .............................................................. .............. ..... ............ ............................... ,~,,,,,.,..~,,, ~,. ,,,, ~,.,~, .... l~ ........ ,,,~ .... ~. ........ ,,,~ 2 / a. Existi.g u~ at~l (~(lq~q~y ........................................................................... I~q~Hr ............ Ib~v~l ............ i. , PI,OT I) IMHIAH FOLLOWING INSPECTIONS; i FOUNDATION ~ TWO REOUIREO ' FOR POURED CONCRETE 2. ROUGH ~ FRA~ING & 3, 4. FINAL " CON~TRU~ION MUST eE COMPL~E ~R C.O. STATE CONS~U~ON & ENVY CODES. N~ RESPONSlB~ CONmUGIt(~ Ik: i, (ho. ....... ...;... O ((xll l(.Lor~ ale, em:, corlxnl~le offJr, m-~ elc.) o~ *mi(I (x~tr~l- ()r (>a~*-a) aiKI J9 (hdy atlthorJze(J Lo Ix~rfoHll OL' have I~rl'()[.~(l lite ljiij(I ~)[1~ mKi to ll~ll(~ msl J:{l~ Ihin J~)ul Jo I~h)LtL.~ thh; .......... JOSEPH H. GIBBON0 Notary Public. State of New York / No. 524618265 Oualif ed in Suffolk County ~mm,ssion E.~pires April 30. 4 CONSENT TO . INSPECTION O w~i-e~r (s) Name(s) do(es) hereby state: That the undersigned (is) (are) [he owner(s) of the premises in the Town , which is shown and designated on the Suffolk County tax map as District 1000, Section f~ , Block _~ , Lot ~ / That the undersigned (has) (bare) filed, or caused [o be filed, an applica- tion. in the Sou[hold To~ Building Inspector's Office for the following: That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply wlth all of tbe laws, ordinances, rules and regulations of the Town of Southold. Tile undersigned, in consenting to such hlspectlons, do(es) so with tile knowledge and understanding that any information obtained In the conduct of such inspections may be used as evidence in subsequent prosecutions for rio- (signature) (print name)