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Home My WebLink About23105-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N.0 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date..../...~./~. ........................................ 19...~1,...~...-~. 23105 Z CouniyTax Map No. 1000 Section ......... ~.~_...'~.. ..... Block ......,-~... .............. Lot No ..... .~...~..../.. ......... pursuant to application dated .~,~-~..... ~.~ ................................ Building Inspector. Fee $..~..~.~.. 19..~.~..i...'~...., and approved bythe Rev. 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25106 Date JUNE 24, 1997 THIS CERTIFIES that the building Location of Property 375 CAT ALLEY House No. County Tax Map NO. 1000 Section 75 Subdivision ACCESSORY Block 2 Filed Map No. SOUTHOLD, N.Y. Street Lot 17.1 Lot No. Hamlet conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 26, 1995 pursuant to which Building Permit No. 23105-Z dated NO%q~4BER 6, 1995 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 NON-HABITABLE STORAGE BUILDING AB APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED CAROLE L. CAVAGNANO N/A N/A N/A l~d ng~nspector Rev. 1/81 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 ~re-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 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 ............ .~./) .~ .~.~. .................... New Construction ........... Old Or Pre-existin~ Building .............. Location of Property....~.~. ~ .... .~.~.~.~......~>.~ ........ [. i .......... [ .................... House No. _~treet Hamlet Onwer or Owners of Property .... ~.U~.~.-~.~ .... ..~.~p....~.. ................... 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 Certicate ........... Fee Submitted: $ ...... .......... c .zc. 5 APP iC 7G5-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU~,.ATION [ ] FRAMING ~/]~FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ DATE {lstl ~2ndl FOUNDATION FOUNDATION 2. ROUGH FRAME & ~?LUMBING' INSULATION PER N. STATE ENERGY CODE~ FINAL ADDITIONAL COMMENTS: FORM ,NO, 1 TOWN OF $OUTNOLD 13UILDING DEPARTM EN'F.. TOWN tlALL SOUTIIOLD, N,Y. 11971 TEL: 7615-1802 Disapproved a/c ................................ . BLDG. DEPT. TOWN OF 8ou'rHOL D INSTRUCTIONS BOARD OF IIEALTII 3 SETS OF PL,'~?IS ....... SURVEY CIIECK ................. SEPTIC FORH H^ ][ 1, TO: a. This application must be completely filled in by typewriter or in iok and submitted to the Building Inspector, will sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot phm showing location of lot and of buildblgs on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl cation. c. The work covered by this application may not be commenced before issuance of Illi ding Permit. ti. Upon apploval of this application, the Building Inspector will issued a Building Penni( to the applicant. Such pern 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 pti(pose whatever until a Ceitificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Buikling Department for the issuance of a Buikling Permit pursuant to t Building Zone Ordinance of the Town of Sou(hold, Suffolk Corm(y, New York, and other applicable Laws, Ordinances Reguhdions, for Ihe construction of buildings, additions or alterations, or for removal o'r demolition, as herein describe The applicant agrees to comply with all ap >licable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises al{i:l, in building for necessary inspections. (Signature of a~Ephcant, or name, If a corporalion) State whether applicant Js owner, lessee, agent, 'architect, engineer, general contractor, electrician, plumber or builde of owner of premises . .%~ ~%~¢.~ ....................................... Name ( ~ ~ ,~ (a~n Ibe lax roll or latest 'deed) If apl)Ii(ant is a c )rI oration, ~'~l~a~[tue of duly authoriied officer. (Name and .l~i'lle of torpor te officer) t'uilder'sLJeense~o. ~ ~ Plumbeds License LleclHc~an s Li~ ()thc r ~J~n~ N I. Location o[bmd on which ~ro>osed work will be done. . . . .. ' ............... ~ .......... ...................... ~.(~ .... : ................. Ilouse Number Street llamlet Cou,lly Tax Map No. 1000 Section .~ .......... Block . .&. ' Lot Subdivision ........ . ............................. Filed Map No ............... lx)t ............... (Name) 2. Slate exisling use and occupancy of premises ami intended use and occupancy of proposed construction: a. ,,,d . J .......... . ............................ b. ,,,,d '.:(' ........................................ 3. Naluie tit work (check which applicable): New Buihling .... ~'~ . . . Addilion ,. ......... Alteration .......... Repair .............. Removal .............. Demolition .... : ......... Olher Work ............... ~ ~ ' ; (l)escdplion) ,t. Eslimatml Cost ~ ' ' .............................. Fee ..................................... (to be paid on Rling this epplica/ion) 5, If dwelling, number o[dwelling units ................ Nt robe' ut lwelhng ums on each floor ................ , If garage, ~lHmber of ~ars ............ K~ ~. ...... ' : 6, I1' business, commercial or mixed occupancy, specify nahue and extent o[eacb t~ypo ol'use 7. Dimensions of existing structures, ir any: Front ................ Rear . . .~.. ......... l')eptb ............... lleigbl .......... ~ .... Nmnber of Slories ... ' ~ ............................. Dimensions of shine slruchu'e wilh alteralions or addilions: Fronl ........... ' .... Rear ........ (8[) I)imensions of eolb'e n~w ~pnstruction: Iq'oat .......... Rear ~ Depth I leigbt ............... ~umber of Slories ....................... ,.. ~. ............................. 9, Size oflol: Front .............. Rear ..................... l)elHh ...................... I0, Date of Purchase Name of Follilor Owner: . . I I. Zone or use district in which premises are situated ........................... [ ous l)lOj)OS~d COI1S[IIIC[IOii vlolale ally ZOBIIIg JaW ordlllallCO o' 'egt at ol ,, , · ........................... w excess hll be remo~e( from pre nises: Yes CN6' 1,1. ~ame ol Owner of premises .................... Address .............. [ ..... Pboue No ................ ' Nanm of Architect ........................... Address .............. ~ ..... Phone No .............. Name of Contractor Address . Pbo 15. Is this proper~y wlddn 300 feel of a ~]tlal 'weelaml'l ~Yes ....... ~o..~ ..... ~'[~ yes, fiouLho]d 'l'o~n 'l'rus~ees Per.dc may be requLred. -. P~OT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, aod, i'n(licale all set-back dimensions fi'om I)roperly~ lines, Cive street and block ml~ber or description according to deed. ant s iow street names and indicate whed~er inlerior or corner lot. ~(~ q, ~, . '~65-,t802 9 AM TO 4 P~¢ FOR TFE~ FOR POURED 'C, ,?, ~OUGH - FRAMING ~ PLUMBING 4, F}NAL CONe ~RJCT~ON MUST 8E CO~) PLE ~ E FOb ALL (.ON~'~FRUCIlON SHALL THE REQUIREMENTS OF THE N,Y. ST~'E CONSTRUCTION ~ ENERGY (&DES. NOT RESPONSIVE FOR DESIGN OR CONSTRUCTION ERROt~S (Namu el il~dividu,fl s~ning contr,ml) ~Contraclor, agmlt, cor'l)oral¢ officer, ale,3 ...... ,f said owner or owners, and is duly authorized to perform or have l)erformed the ~aid work and lo make and file this pplication; that all statements contained Jn this applicadon are t'rue to the best of ' lu.s knowledge and belief; and that /u,k will be performed in tile manner scl forth in the application filed therewith. ~ ' wo]u ti) bc[oru mc lids ', .day of Nota~ Public, State of New York ....... ; ~ ...... No. 4951384 (Sig~Iure of applicant) Qualified in Suffolk County ~ Commission Expires May 22, 19 g x