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Home My WebLink About23111-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCuumANCY No Z-24202 Date MARCH 8, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property 1345 OLD MAIN ROAD LAUREL~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 122 Block 7 Lot 7.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 27~ 1995 pursuant to which Building Permit No. 23111-Z dated NOVEMBER 16, 1995 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is i~ued is ACCESSORY STOI~A~E S~ED IN '~REARYARDI%S APPLIED FOR. The certificate is issued to JAMES T. HI~x (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A - /~ Bullding Inspector Rev. 1/81 FORM NO.3 TOWN OF $OUTHOLD BUff. DiNG DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 23111 Z BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Building Inspector. Rev, 6~30~80 ................................ Form No. 6 APPLICATION FOR C~CA~ 0~ 0CCU~A~C~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. ~. 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 qpre-existing" land uses: 10 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~ - $i00.00 3. Co~y of Certificate of Occupancy - $20~OO 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Locatmon O Property ................... ~¢.'.,,,,-....n. ~,...,:. ............... ............... House No. Street Hamlet Onwer or Owners of Property .... ~.~./~..~..~.....?~..4../~../..C~..~..~.~. ~./.. .... ' ...................... county Tax Map No 1000, Sectiono./~.~. ...... Block ..... '.~. ......... Lot...~.{../. ............. Subdivision Filed Map Lot ..... Permit No ate Of Permit ............ app±icant. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval .................... Request for: Temporary Certificate ........ Fee Submitted: $...~..~.. ................ . Final Certicate... · C; ...... .... /?lgl,l') IN.<;PI~C'[*I. ON I{I~I~'f)IFI' DATE COHHENTS FOIIHDAT ION ( J S'I' ) / FOUNDATION (2ND) ROIJCI1 FRAHI~ A o. PLIJHB l NG INSULATION PER ~. Y. STATE I~NERGY .........tl COI)I~ AI)I)IT IONAI. COHHENTS: 1992 Morton Buildings, Inc. I4¸ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] IN.~,ATtON'~ ["~INAL []FIREPLACE&CHIMNEY .~MA.KS: DATE ,~ (~2 I~::~ '"SPECTOR~~~ 765-1802 BUILDING DEPT. [ INDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS:' ' DATE _ INSPE OCT 27 1995 i~, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT,. TOWN HALL ~ SOUTHOLD, N.Y. 1197~1 ~,~', ,:,i~,t;:~i ', I:~; .,~ ~!~' TEL.: 765-1802 Approved .... B~ARD OF HE^~TI! ......... 3 SE~S OF PLANS ......... SURVEY .................. CIlECK ................... SEPTIC FORH ............. CALL MAIL TO: · .dd,/'L.~.5..~.,./q/./.¢.,,'¢..~/ INSTRUCTIONS a. This apl~lication must be completely filled in by typewriter or in ink and submitted 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 l~uildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed 'description of layout of property mu~t be drawn on the diagram which is part of this appli- cation. c. The work covered by this application ~nay not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued 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 Southbld, 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,/aj3d reflgU~s~tions, and to admit authorized inspectors on premises and in building for necessary inspect~ja~: -- ' Jgnature of appil~e, ifa corporation) . ...,4,.~. (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder. ............ .......................................... . ........................... ............ ..... W../. i ..... ............................. ' ........... Name o f o w nero f pr em i se, /, ~< '..~./'... (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. l.~., .'~.7.~.. ~('T_... ......... Plumber's License No. "~-'"- Electrician s L cense No ................ . ....... Other Trade s Lmense No ...................... I. Location of land on which proposed work will be done ................................................. .~. 7.~ . . . ~ ...... ' ..... ~ ~ . ~¢~. .~. . ~e*.z. . .' ................ ./v. .~ .z:.~. ./.~ ~. ........ ' Itouse Number Street Hamlet Con'nty TaxMapNo. 1000 Section ../..~..'.-?. ........ Block .....,/~. ........ ' Lot .... Z/ .......... Subdivislon ..; ..... . ............................ '. Filed Map No ............... Lot ............... (Name) ~ 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ' /~/~/~- i ............ b. Intended use and occupancy .................. ' ............................................... .3. Nature of work (check which ap,plicable): New Building ...... Addition .......... Alteration Repair .............. Remdval .... 4. Estimated Cost 5. If dwelling number et'dwelling gnits ......... Demolition .... : ......... Other Work .......... (Description) (to be paid on filing this application) · If garage, number of cars .... 7~'kkf,7? . , Number of dwelling units on each floor ................ d ify ' 6. If business, commercial or mi.xe . occupancy, spec nature and extent oLeach type of use ................... 7. Dimensions of existing structure~, if any: Front ............... Rear e ...... igl . . · ....... D pth He tt ............... Nnmber of Stories ...... ' ........ itt · ' Dimensions of same structure w ~ alterations or additions: Front .. ............... Rear .................. DD%th'.'''";.""..' ......... .'i'Height ....... ~'.;.'., ........ '..NumberofStories . . .2 . . 8. menstons ot~ntlre new consmlction. Front . .,,~-. ~'~ n :- ~.~ · ....... '~ / ', ...... · .... ]~lt/,q I ' · ·, ....... ; .xear .. .~-r.~ ........ Denth . .~<.~, .height ../~..~ ....... Numl~er of Stories . .i~::~1~__ t- · · . ........... 9. Size oflot: Front .~..~-f.~?'i -' ' p~" /~;..,>'; ........ ' .............. :,4';~',~'~ ........... ..... · -J '~ ' ?,' :-; ' ',',~'--; ................................ Depth .. ~ 10. ~ate ot~urcnase . ~2./.. ~' ................ · ' 'r~"44:'.Z..,~/t:? ....... '. Name of Former Owner /;~.~ ~:9~ ~ ~',~, · . .......... 1 1. Zone or use district in which pre~dses are situated..,~./ ...................................... i [ ....... 12. Does proposed construction violate any zoning law ordinm~ce or re ulation .,,:'.'.'.'.'.'.'.~. ~ '13. Will 16t be re,reded ,,t'/,~,~ ,,. g~ , ' ' ' ~ ....................... ' ~., o ~ o ~ ' ' ': ...... ;; ..' ~.-~.' '_~.--' '/,' ' '.'~ L.'>, ~lil eXCeSS I111 De removed from premises: Yes ( 14. l~ame et owner o~ prem,ses .~,,~"~. 7./.4~../.~./(~/~. Address .~',~.,.~..op.~..4',t'-'~/.4/..a~.~ Pl~one No..'~.~ 7~...8)Q. Name of Architect ........... ~ ............ Address .......... .....~--. · .a_..,Phone No ............ : .... Nmne of Contractor ./~~ ~ ..... Address ~'.422>X ../-~. (,,la,~-.-('..~-]. Vhone No..~..~ ........ 15. I,s this property within 300 feet of a tidal 'wetland? *Yes ........ No ......... ' · If yes, Southold T~wn Trustees Permit may be required. .... PLOT DIAGRAM i Locate clearly and distinctly all bnildings, whetlmr existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~TATE OF NEW YORK. 20UNTY OF S.S! (Name of individual signin~ contract) bove named. te is tbs ..... . ........................... . ......................... i (Contractor agent corporate officer etc ) ............................ .f said owner or owners, and is duly atithorized to perform or liars performed the said work and to make and file this pplicafion; that all statements contained in this application are t'rue tO the best of his knowledge and belief; and that the turk will be performed in the manner setI forth in the application filed therewith. worn to before me this HELENED. HORNE i ' ' ' · ...... Notary Public, State sf New york . ~i~;e'!; applic;n't) . No. 4951364 , i Oualifie,d, in Suffolk C, ofinty Commission Expires May 22, 19