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Home My WebLink About23497-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-27210 Date: 07/26/00 THIS CERTIFIES that the building ACCESSORY NEW SUFFOLK Location of Property: 6390 NEW SUFFOLK RD (HOUSE NO.) (STREET) (HAMLET} County Tax Map No. 473889 Section 117 Slock 4 Lot 35 Subdivision Filed Map No. __ Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16, 1996 pursuant to which Building Permit No. 23497-Z dated JUNE 12, 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 SHED IN REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to COUNTY OF SUFFOLK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A tho~ z~d~0nat re Rev. 1/81 IK)RM gO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK/AUTHORIZED) N.° 23497 Z Vano... Z.~ ................................... ..... ~.~6' Permission is hereby granted to: ..................... at prem,ses ,ocated at ......... ~.~..~..C~. ....... ~~.-~.~....~-'~ ~........~. ..................... County Tax Mop No. 1000 Section //7 Block ~ Lot No....~...,..'-~....,~... pursuant ,0 application dated ...... ~./.~. .................................. , 19..~..~ ,~and approved by the Building Inspector. Fee $.~/x~ Rev. 6/30/80 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 elect~ica~ installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/I0 of I% 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 (pr~,or 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 censent 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. 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~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 4 . Old Or Pre exlstin D%::lj~''![':JJ~' .~ ..... New Construction ......... -- ' g "~'g~ ' " ' ' '~'~ ' Location of Property .... ~..~..~..~. ...... ~..~~---'''~''! ...... House No. Street Hamlet Onwer O=ers of Froperty· " ' County Tax Map No i000, Section..............Block..-...----..--..Lot ...................... Subdivision Filed Map Lot ....... Date Of Permit Applicant ....... Permit No... ................................................ ... Approval Underwriters Approval Health Dept ..... Planning Board Approval ...... Request for: Temporary Certificate ........... Final Certicate ........... APPLICANT 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INS~JI~ATION [ ] FRAMING [~FINAL [ ] FIREPLACE & CHIMNEY REMARKS:' _ DATE INSPECTOR F3[~.~,~_.D ].INSPECT[ON REPORT DATE COMMENTS ADDITIONAL COMMENTS: - BLDG, DEPT. TOWN OF//~OLJTHOLO ..... ...... , A~,,~./..~/.Z..~./ .... , / FOPJ, i NO. I TOIOI OF SODTHOLD BUILDING DEPARTIqENT TOTal lt&LL SOUTHOLD, N.Y. 1197l TEL: 765- 1802 BOARD OF HEALTH . j3 SETS OF PL&~S ............... ,----',SURVEY o SEPTIC FORM ................... NOTIFY: Fen~it Bo ........ Disapproved a/c .................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application mst be ccmpletely filled in by typewriter or in ink and sul~nltted to the l~filding Inspector with 3 .sets of plans, accurate plot plan to scale. Fne according to schedule. b. Plot plan showing location of lot and of beildings on premises, relationship to ~djolnlng premises or pt~llc s~re~t$ or areas, and giving a detailed description of lay~at of property mast be drawn on the diagram whid~ is part of this application. c. The work covered by this application may ~ot be cmmneced before issuance of B~ilding Permit. fl. Upon approvml of this ~ppllcatlon, the P~ilding Iospector ~.zill issue a B~ildlng Pennit to the applicant. Such pe~mlt shall be kept on the premises available for inspection throat the ~k. e. No lmilding shall be occopied or used in whole or in part for any p~qoose whatever until a Certificate of Occt~pancy shall have been granted by the P~ildlng Inspector. APPLICATIC~I IS Bg[~BY ~ to the P~ilding Department for the ismmnce of a Building Permit I~rcsuant to the Ik~ildi~g Zone Ordinance of the Town of ~outhold, S~ffolk Coonty, New York, and other appllcable l.~ws, Ordinances or P~gulatlons, for the construction of b~ildings, additions or alterations, or for ra~oval or demolition, as herein described. ~he applicant agrees to comply with all applicable laws, ordinmmes, b~ildlng code, honslng code, and (Slgeature of applicant, or nmue, if a corporation) (l~ailing ~ddress of applicant) State whether applicant is owner, lessee, ~gent, architect, engineer, general contractor, electrician, phraber or b~ilder. N~e of o~er of premises ............. (as on the t~x roll or latest deed) If ~pplicant is a corporation, signature of duly authorized officer. (Nmre and title of corporateofflcer) l~ailders License No .......................... Plmt~ers License No .......................... Electricians License No ...................... Iz~ation of land on which proposed work will be done .......... ' ................................................... Donse l~ber Street T. .. No. ti. .... ...... ..... ........ .t ...... ,~Hv~o~ ...................................... ~iled ~ No ................ Lot State existing use ~ ~ of ~m%~ int~ ~ :f ~ c~tmctim: ~. ~ti~ ~ ~ ~ ........... L.~x57._~...~.~.s ~.~; ............................ 15. N~tnte of ~ork (clm'ck MHch ai~lJcabie); l~l~ir l~al ,.. ~ ......... 1~1 i tkm Other ~rk ~.U~ .~,~ ~.. [ .., ~ (l~ripti~) ~ [~ ~8~i. Gt~l ~G~ ....................... f~ .............................................. i (to If ~mlli~. R,~tmr of &mllilg' units ............ ' If I*mirm~. ~l~reial or mi~l ~oqm~my. s~i~ tml:ure a~ extent of ead~ t~ o~ u~ ...................... Di,~n8i~m of existing atnmU~ea, if an~: ~t ................ ~ar ~pth .............. i ~.~tmr o~ Stories ...................... Iki~lt ........................ ... IHn~nsi~8 of sam stnmtur~ ,{th alter~ti~ms or ~ition~: Front ............... ~ar ............... I~pth .................... l~i~lt .................... Rmlmr of Stories ............... ' ni,en~i~m of entire ~ ~st~riau t~t ..... [.0 ........ I~ar ....... (. 7.... ~pth .............. ....................... ,. ~dmr o~ Si~ o~ lot: t~mt ..... ~ ......... I~ar ...... [ ~.' ....... mptl~ .................... ....... ........... ~ill lot I~ regr~ ......... ~ ........... ~ill ~mea o[ ~r o~ p~s ...~ ........................ ~lre~ .............................. ~m ~ .............. ~ of C~tr~tor I Is this p~rty within ~ f~t of ~ ti~l ~mtlmwl? ~ ~ .......... ~ .......... PI.OT I)][AGRAM l~mate clearly ae, d distincrlyJall Mildings. ~lmtlmr existing or pro~. a~l i~llcate all ~t-I~ di~mnsions f~ pro~rty lirms. Gi~ st~t aM bl~k m~ttmr or ~M~crlpti~x ~eording to ~1. a~ M~ street ~ms a~l i~licate x~mtlmr anterior or corer lot. ~P~OV~ AS ~OTE~ NOTIFY BOIL,Df~ DEPA~ AT 765-~8(}2 9 AM ~ 4 PM FOR THE FOL[ OWING IMSPECTJONS: ~.FOUNDATION ~ ~0 REQUIRED FOR POURED CONCRETE 2,ROUGH - FRAMinG & PLUM~fNG a. iNSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL THE REQUIREMENTS OF ~E N.Y. STATE CONSTRU~ION & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CONS~UCTION ERRORS (C~Cractor, agent, cora)rate officer, eLc.) said ~mr or ~rs, a~ is ~ly ~a~thorlz~l to i~rfonn or bare imrfor.t~ Ihe said ~rk m~l to nmke a{~licati~; tlmt ~ll star.mats c~t~b~l in Ods al~l icatioe are tam to the Imnt of his k~l~lge ~ I~ilie[~ a~l Ihat the ~rk w~ll I~ ~rfou~lhe .w~mmr ~t forth in the appl icatloa filed tlmr~[th. ~ NOTARY P~BL~. S~e ~ N.~ No. 472~89. Su~lk Cou~