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Home My WebLink About23424-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCcumANCY No Z-24535 Date July 30, 1996 THIS CERTIFIES that the building accessory Location of Propert~ 8440 Main Road, East Marion Rouse No. Street Hamlet County Tax Map No. 1000 Section 31 Block 07 Lot 03 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 25, 1996 pursuant to which Building Permit No. 23424-Z dated Ma~ 9, 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 a two ear ~ara~e accessory in the rear yard as a~lied for The certificate is issued to John Whitehead (owner, lessee or tenant) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/a N/A Building Inspecto/ FORM NO.3 TOWN OF $OUTHOLD BUIL~tNG OEPAR~MEN~ TOWN HALL SOUTHOLD, N.Y. N~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] Date '"~ 23424 Z Permission Is hereby granted to: .............................. .'. .......................... to...~~, ............ ~........~ ........ ~ ................. ~ ................. ~.: ..................... .~?~-/ ......... ~......~..,...~ ....... .,..~...~...J .......... ~ ................... ...,~..~4-~ ......... /~..~ ................................................................................................................ at premises located at .............. ........ ~:..'¢........:....~;..-. ............................................. ............................................................. :.~z ....... ~ ....................................................................... co~n~o~MopNo. ~oo0 sectio~.....~./... ........... ~,oc~ ........ ~? ........ ~otNo ...... ~ ............ pursuant to application dated ...~...~./~...~,. .......... ~ ...................... 19....Z~.~..., and approved bythe Building Inspector. F ee ~ ......................... Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN RALL 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 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 $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing 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 ....... ~.~ .~.~ F.~.. ·~. ..................... New Construction......~..... Old Or Pre-existing Building ................. Location of Property...~.Y~ ......... ~.'~.< .~. ~].~...~... [~].. ~. ~.~.~. ~ · .~.~F..'f-f. ~P~] ./~..~.~.~ House No. Street Hamlet Onwer or Owners of Property....~..z~..~..~. ~'.. ~ .......... ........................... County Tax Map No 1000, Section....~./. ....... Block .... .~.~. ........ Lot .... .~D..~.. ............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No.. ~.~..~..~..~z...Date Of Permit.. ~.~.%~. ~.~....Applicant. ,~.~.~..~...~.~ . .~..~..~.~] · .~. · ~ · Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate. /- Fee Submitted: $ ............................. I !;111^'1 Il)Il I'lilt I). Y. ~ COllIE F I Il^Il At)l) 1 T I OIIAI, CIJIII ii.~lrj.,~j: Li' 765-1802 /~UILDING DEPT. / NSPE TION ~//~/FOUNDATION 1ST [ ] ROUGH PLBG. ~/] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~//~'~,~ ~~~ INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH [ ] FOUNDATION 2ND [ ]~IN~ATION [ ] FRAMING [/_.~qNAL [ ] FIREPLACE & C~EY REMARKS: (~ r ~"~_~ DATE///~/~ INSPECT~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-180~ Approved ., 197~mermit NO.. ~ .~..~: .,~.~"-' Disapproved a/c ..................................... Application No .................. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation· c. The work covered by this application may not be commenced before issuance of Building Permit. ' d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit 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 Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. - The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. _ (Signature of applicaff[, or name, if a corporation) . ox. 72. , u (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or builder· ..... ................................................................................ Name of owner of premises .... .~ .~),0.. ~,A~,i4¢~O.r~ J ................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... /.~...~ .~..~. Pt. [ ........ Plumber's License No ......................... }iJ~/ ~J~ 2 5 ~6' Electrician s License No ....................... [ BLDG. OEI~. L Tow. OF SOU*.OL.O Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ~.*)~' .~.. ~ .°~.4 ............................... ............................. lqo.,d .......... House Number Street Hamlet ' C~hnty Tax Map No. 1000 Section ...3/. ........... Block ..... O..7.. ........ Lot .... 157.$ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which a~plicable): New Building ~ .ot?3.~.G~. . Addition .......... Alteration .......... Repair .............. Rempval .............. Demolition .............. Other Work ............. ~ ' (Description) 4 Estimated Cost .... ~./. ,J. q .0.(~?..O. ........... Fee .............. (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ............... Number of d.welling, units on ~ach rio.or: ............... If garage, number of cars .... i 7('z~.q ..cfi.v? ................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structur~ :s, if any: Front ............... Rear .............. Depth .............. Height ............... Nun tber of Stories ....................................................... Dimensions of same structure [th alterations or additions: Front ................. Rear .......... ~. ...... Depth ................... ~ .. Height ...................... Number of Stories ................ . ..... 8 Dimensions of~ntire new construction: Front ~,~. Rear Depth ,Z f. ' Height /.o~.. Number of Stories 9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ..................... 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................ 11. Zone/)r use district in which pr'~mises are situated .................................................... 12. Does proposed construction vie!ate any zoning law, ordinance or regulation: .... /~/'¢ ........................ 13. Will lot be regraded .... /M'.4.4 ....... , ............. Will excess fill be removed fi.om premises: Yes 14. Name of Owner of premises ~,~/~ ua..~.~o/q~c~.... Address ,~,~?.~./t~.~../~..~. ~.'.~Phone No. ~2.2..~.~?.3..-~."~.. Name of Architect ......... ................. Address ........... .,... [... Phone No ................ Name of Contractor .~-~q~.[oo'J..'~n~ofi0!.o.m. ..... Address ~[/-,~. ~'.'~0~v~... Phone No. 2tf, E-.~'.2/..7~... Locate clearly and distinctly all property lines. Give street and block interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEBr YORK I ~ ........................... .................... being duly sworn, deposes and says that he is the applic~t (Name of individual sigm ag contract) above named. He is the ~°a ~ ~)°~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have perfomed the said work and to m~e and file this application; that all statements conta ned ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ne~ set forth in the application filed therewith. Sworn to before me this ~ ................ day o ........... , Nota~ Public, N CERTIFIED TO, ESTATE of MILDRED DIESERUD ,~APBARA HOI$1NGTON COMMONWEAL TH LAND TITLE INSURANCE COMPANY PRUDENTIAL HOME MORTGAGE SURVEY OF PROPER T Y A T EAST MARION TOWN OF SOUTHOLD SUFFOLK CO_UNTY_, N. Y~3 1000 - 31 07 - Scale 1" = 30' Oct. 25, 1990 AREA = 25,820 sq. ft. Prepared in accordance with the minimum standards for title surveys as established by the L.I.A.L.S. and approved and adopted for such use by 7'he New York State Land Title Aesociation. N.Y.S. LIC. NO. 49618 (516) 765- 5020 P. O. BOX 909 MAIN ROAD N. Y. 11971 -t