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Home My WebLink About21922-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY NO Z-22885 Date MARCH 2~ 1994 THIS CERTIFIES that the building Location of Property 485 SECOND STP~ET House No. County Tax Map No. 1000 Section 117 Subdivision ACCESSORY Street Block 9 Filed Map No. NEW SUFFOLK~ N.Y. Hamlet Lot 24 Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 24, 1994 pursuant to which Building Permit No. 21922-Z dated MARCH 2~ 1994 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 INSTALL WOOD STOVE IN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to GERALD & PAMELA S. PICHER of the aforesaid building. SUFFOLK OOUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO.3 TOWN OF $OUTHOU) BUILDING DEPARTMENT 1'OWN HAU. $OUTHOLD, N.Y. BUILDING PERMIT (TH~S PERMIT MUST BE KEPT ON THE PREMISES UNI1L FULL COMPLEllON OF THE WORK AUTHORIZED) N-° 21922 Z Permission is hereby granted to: J4cCarth3~ J4anagement Inc. - P~cher, GeraJd & PameJa P.O. Box 62 Nattituck, N.Y. 119.52 to ........... ~.".~."3?:..~.~.?.~...s.?~.~.~..~.".~...~..."~...E~..~.~.~.~.".~..?~..??.?..~..~.?.~.~.: .......... t-- ' 485 Second $~reet, Ne~ Su[folk at premises oca ea a? ...................................................................................... 117 9 24 CounlyTaxMapNo. 1000 Seo~lon ......................... Block .......................... LotNo ............................. pursuant to application dated Jan. 24, 19,... ~ ........and approved by the Building Inspeotor. 35.00 Rev. 6/80/80 ,v Building Inspector Examined ................. 19... FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ................. 19... Permit No ............ Disapproved a/c ..................................... BOARD OF HEALTH ......... 3 SETS OF PI..~S .......... SURVEY ................... CIIECK .................... SEPTIC PORH .............. t;OT I MY: CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application 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 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 cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ~hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or [egulations, for the constractlon of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code,ja~ing code, and regulations, and to :dmit authorized inspectors on premises and in building for necessary inspecti(~~- ........... - (Signature of applicant, or name, if a corporatiop). ....... .cX. £.a.. (Mailing address of applicant) it, ll .w.~it~ii.i~li.c~yI .ii.~xi~ii,.liiiei: .a~.~..~t.,. ircyitect'[/[~t.- engineer, general contractor, electrician, plumber or builder. q'ame of owner of premises ......... .~..;.C.~].'~ ~.... ,...6..~. ~ .~.C/.~. .... .~...~..~...~. ~ ................... (as on the taxx roll or latest deed) f applicant is a cot. Ill'ion, signal, urge of duly al4thorized officer. .......... (Name and title of c~orporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work . _._ .~ ne.w2be~o' . .......................... . .............. ................... ..... ....... ...... .............. House Nmnber Street Hamlet County Tax Map No. ,000 Section '.t :7. B,ock ot. ............. Snbdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy [.~tot~(~.."t3..~.-tl'~.C?. . 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration'. ......... Repair .............. Rem o~v}al .............. Demolition .............. Other Work ............... ht /~O r, (Description) Estimated Cost ............ ~...~ ..................... ---- Fee .................. :.: ................. 4. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Dateofmurchase ............................. NameofFo~[~n~erOwner .'~."i!i!i!!i!!!!!!ii! i i 1 1. Zone or use district in which premises are situated ............. ~.: .~.0 .... ' 12. Does proposed construction violate any zoning law, ordinance or regulation: .. i 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether 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 comer lot. [5. STATE OF NEW YORK, C' ,/'P_ e e COUNTY OF .......... %_.?..C{.~.17' o.a / / ............. ~ ~ .~. ~ ~ ......... being duly sworn, deposes ~d says that he is the applicant (Name of individual signing contract) above named. ~ ~. He is the ..................................................................................... (Contractor, agent, corporate officer, etc.) )f said owner or owners, ~d is duly authorized to perfo~ or have perfomed the said work and to m~e ~d file this tpplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the .york w~l be perfomaed in the m~ner set forth ~ the application filed therewith. ¢wom to before me this ............... ... ........ c .t' /t// v ..... .:p - ..--... · ~- (~ature of applic~t) Form No. 6 TOWN OF SOUTHOLD BUILDING DEPART~tENT T0 N 765-i802 APPLIGATION 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 Ypre-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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 ever 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....... f~. L ['~- ~. !~ !~. ................... New Construction ........ ... Old Or Pre-existing Building....~ .... .'£-- 'Y' r~z' i[/ Location of Property ............... ' ~..a..D ............... ~ ~. ....... House No. Street Hamlet 0nwer or Owners of Property .............. . ........................... County Tax Map No 1000, Section ...... '- --~l.'7 .... Block.....~. .......... Lot..9.~. ................ Subdivision .................... Filed blap Lot . Permit No ................ Date Of Permit.'.' .............. Applicant..~?.~.~. -~. ~ .~!.~'.~l. ?...~.'.~[.~..:. Health Dept. Approval ......... ~/~: .......... Underwriters Approva .... ~'./~.. ............. I/~ Planning Board Approval ...... l.~Jl' .~. ........... Request for: Temporary Certificate~ - ........... Final Certicate.~.' ...... Fee Submitted: $ ............................ ' ............ ~' ~ 5 ' ' .....~{ APPLICANT - ----_3 ~65-J,802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING~ [/~INAL DATE INSP ;~//~U,CD,.,~ O.'T. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ I~.AT~ON [ ] FRAMING [ ,¢]~JNAL REMARKS: ~'~'~ ~ ~ /