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Home My WebLink About23508-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24437 Date JUNE 18, 1996 THIS CERTIFIES that the building Location of Property 1375 GIN LANE House No. County Tax Map No. 1000 Section 88 Subdivision ADDITIONS SOuTaOLD, NEW YORK Street Block 4 Lot Filed Map No. Lot No. Hamlet 11 conforms substantially to the Application for Building Permit heretofore filed in this office dated MAR~H 18, 1996 pursuant to which Building Permit No. 23508-E dated JUNE 16, 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 DECK ADDITIONS & ENCLOSE PORCH TO EXISTING OWE FAMILY DWELLING "AS BUILT" AS APPLIED FOR. The certificate is issued to JAM~S & PATRICIA KIMBIS of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A ~ing Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUIL4)ING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. C~RTIFI~ATE OF OCCUP~CY NO Z-24438 Date JUNE 18, 1996 THIS CERTIFIES that the building Location of Property 137S GIWL~E House No. Street County Tax Map No. 1000 Section 88 Block 4 Subdivision Filed Map NO. ACCESSORY SOUTHOLD, NEW YORK Lot Lot No. Hamlet 11 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 18, 1996 pursuant to which Building Permit No. 23508-Z dated JI~NE 16, 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 STORAGE SHED "AS BUILT" ~PFLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JAMES & PATRICIA KIMBIS N/A Rev. 1/81 FORM NO. II TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT FI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.°23508 Z Dote ;[~. ........................................ , 1~...?.'0/ ~ ~o~ ~ Permission is hereby granted to: . ~ j~, , .) , ~:~:.=_:~ ....... ~ ............. ..~ ~....~~.~.....~:., .............. ~ ..... ~.....~.,....~...,....~~'~, , ~o ~ ,, co,,~ ~ ,~p No. 10o0 s~,~, ...~ ............ ~k ......... ~ ........ Lo, No ...... fZ ............. Building Inspector. ~ee ,.....'.7..~ ......... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-i802 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: i. 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 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 requirementsj For existing buildings (prior to April 9, i957) non-conforming uses, or buildings and Vpre-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, A1 aerations 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~ - $I00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 Date ............................... ~ew Construction ........... Old Or Pre-existing Bu±lding...I-¢~... .......... Location of Property ............ .-~. .~.~ ................... ~ ............... House No. Street Hamlet Onwer or Owners of ~roperty .... ~.~ .. Y.c ..... h~ .[ .......................... co=~y r~ ~p ~o ~0o0, s~o~..~2 ........ ~o~k...~ ........... ~o~..I.~ ................. s~a~o~ .... ~r..t~a-~ ................... ~ ~p...~ ........ ~o~.../~ ................ Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ....................... Request for: Temporary Certificate ........... Final Certicate.... Fee Submitted: $.~,?~. ...................... ~._.~ I ~/~0 (j APPLrCANT 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 ali 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 ail property lines, streets, buiiding 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 Buiidinm - $100.00 3. Copy of Certificate of Occupancy - $20200 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...~'..~'.. ........... Location of Property .... .-........... - ................................... House No. Street Ramlet Onwer or Owners of Property ......... · £ .......................... county Tax No i000, Section.. . ........ ........... Lot..L ................. Subdivision ~ .~ Filed Map ~ Lot ~ .... Permit No Date Of Pemit ...... Applicant ................... Health Dept Approval Underwriters Approval .. Planning Board Approval .. "~equest for: Temporary Certificate ......... .. Final Certicate..~... .... Fee Submitted: $~,.Q~. ...................... PL CANT ii ro~,-&o t,l ! /,.// I' FOEN NO. I TOI4N OF SOUTHOLD BUILDING UEPARTt4~ET TO~'N HALL SO~)'ITdOLD, N .1i'. 11971 TEL: 765- 1802 APPLICATION FOR BUILDINO PEEHIT I~STRUCTIONS BOARD OF ilEAI.TII ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: CALl ................... HAII~ TO: .................... a. lhis application mast be ccmpletely filled in by typewriter or in ink and sulraitted to ~he Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. , b. Plot plan sl~y, rlng location oE lot aud oE baxldlngs on premse~, relatxonshxp to adj?lm.ng p~x.~.s o~. pabhc streets or areas, and giving a detailed description of layr~t of property gmat be drama on the dlagr~n x4aich zs part of < this application. ·c. lbs ~rk covered by this 'applicatlon may not be comenced before issuance of suildlng Pemlt. d. ~ appreval of this application, the Building Inspector will issue a lhildlng Permit to the appllcant. Such pamlt shall be kept an the prenfises available for inspection threugh~t the x~ork. e. Ixb buildlng shall be occupied or used in ~hole or is part for any purpose *~hatever until a Certificate of Occupancy shall hav~ I~n granted by the lhildlng Inspector. APPLICA'IXON IS ~tt~lff 14bile to the Buildlng 1)epartra~nt for the issaanee of a Buildlng Petmlt pursuant to the lhildlng Zone Ordinance of the To~a of Santhold, ~fffolk County, ~ York, and other appllcable La~s, Ordinances or Eegulatlans, for the construction of buildings, additions or alterations, or for m~at or demolition, as described. ~ applicant agt~ea to co~ply with all applicable la~, ordlnanees, buildlng code, housing code, and regulations, a~d to admit anthori~d inspectors un premises and in building for necessary ioapectlons. (~{ge~m of *pphcnnt, or ~, if a corporatmn) (t4aillng address of applicant) //~ State ~ether apphcan is cs~er, lessee, agent, architect, engineer, general contractor, electr~c~a , plm/oer or builder. ~ .~..~. f.C ; ............................... ' ............................. ~ of o~er of prendses .... -~-.~..--~. .!¢.t~ .... ~ ............................. (as an the tax roll or latest deed) applicant is a corporation, signature of duly aufl}orised officer. (I~sne and title of corporate officer) Builders License No ...... Plumbers License l/o ........ Electrlci~s License I'Io ...................... Otber Trade's License Itu .............. ...... · I. Loeatian of laed on ~aich proposed ~ will be done .... ~ ......................................................... . ' !2 1,3 Z ~. . , ,. .~ ..~ .-e ..................... ~'. .... ;fid, g'd ' :" ' " ........ ' .... tlonse Na~r St~t Co~raty Taxlffap No. I000 ~etian .... ~. ....... Block ....~.., ........ Lot ..... [.{ ........ .... ................. .... ........ 2. State cresting, line aed, o~.of pranises and intended t~se and oceupaacy of proposed eonstractwn: a. ~sti~ ~ ~ se~.'.¢;~,&-g~.~b~.~ .................................................. ,. *te .se ...,. ........... 3. Pmure o[ ~o~k (dmck Mdch applies ~le): Nos Ikdldi~ .......... ~litim~ ...~.. Mteration .......... [st ingit~l Cost .. ~ r.~. ~ .... : .~.. ~ f~ .............................................. li ~lli~, ~d~r o~ l~llh~ Inl~[l ............ tlld~r o~ ~t~l l tng tmiti ~ i~l ~r ................ I~ I~mhm~, =mr~tM or mi~ ~y, ~l~ei~ n~tum t~l eitent of e~dl ty~ of tree ...................... Ifi,~n~i~m o~ ~i~ting ~tnwture~ [i~ ~n~l ~t ................ ~r ............... ~pth ................. I~i~lt ......................... ~dmr o~ 8tori~! ...................... Dbmn~ium o~ ~ ~n~mri .ifil Olter~tt~m or ~ltlon~ ~ront ............... l~r ............... Npfll .................... I~i~t ~ ................... ~tt~r ~ff Storlen ............... Din~n~i~m l~ilO~t ......................... W~d~r o~ 8torie~ ..................... ~i~ of lot: l~t .............. ~ ..... ~r .................... ~pt'h ............... ..... I ' , I. ~m or u~ dietriet in ~td~ ~r~u,~e e~ ~i~t~l .............................................................. ~ill lot I~ W~m o~ ArdtJteet ............ ,.., .~ .................... ~lre~ .............................. ~ ~ ............... · ~m of C~trnetor ........... ~ ........... I~o~ ~ ............... ,,, ~ .................... ~lre~ .................... l~te ele~rl~ ~ dJ~tJ~tly ~ll~l~[ldii~e, ~mtlmr exleting or propel, m~l t~lie~te ~ll ~t-I~k dhmnMon~ gI'KIE (IlF ltl~ ........... ,~.+~ .....t .... ~ ........ ................... Iminl; duly s~x)rn, delx)Sea and says that he ia II~e applicant (Cxmtraetor, agent, e~rlx)rste officer, etc./ eEpl ic:ation; that all stata~nt, c(mt6ii~l in this al~)lic:ation are trim to lite Imllt of his k,~l~ge Ihat the ~)rk wltl I~ ~r~on~l in thd roi. mr ~t forth in the applical:io, fil~l tlmr~idl. ,%o, m Lo Imfore n~ this I ' k~)tary t~btic .. ~ ......... WAYNE ULRICH NOTARY PUBLIC, STATE OF NEW YORK QUALIFIEO Iff NASSAU COUNTY ~11880 COMM. EXI~IRE$ MARCH ~0 I~_~ (S~l:ure of ^pplicant) i 'a,Of,kSoL~'H