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Home My WebLink About22158-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23084 Date JULY 7, 1994 TRIS CERTIFIES that the building ACCESSORY Location of Property 230 'W~KWETA ROAD ~uT~HO~E, NY House No. Street Hamlet County Tax Map NO. 1000 Section 104 Block 11 Lot 12.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 16, 1994 pursuant to which Building Permit No. 22158-Z dated JUNE 28, 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 AN ACCESSORY SHED IN '£~ REAR YARD AS APPLIED FOR. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTR APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PAUL & RITA FARLEY N/A N/A Building Inspect~ FOBM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAL/. SOUTHOLD, N.Y, No 22158 'Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ................. .~/~ ............................ Permission Is hereby granted to: ~L .~- ~.~. ...... ~.~ .......................... .......................... .... ~.~~ ........ ~./.........../zz~ ...... to....~~.~ ................ ~ ........... ~~.~,~ ............ ~..*...~ .......................... .......... ~ ............. ~ .............. ~ ....... ~~.....?~ ......... ~~ ........... .............................................................. ~_~--~..~.z~.....~ ~..:~.. ............. : .......................................... CountyTax Map No. }000.~ Sectlon.../~2...,,~... ........ BlOck.....~/.. ........... , :'.... Lot No. //"'~''..............w........... / ~ ~ pursuen, ,o applloetlon d~ted' ~/Z~ ? ....... -,:'..~9..~. end approved bythe Building Inspector. Fee $ ...... ~ ..... Rev. 6/30/80 / ~' Bui!dlng Inspector ~' / Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTblENT TOWN tULL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPftNCY This appl~ication 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 fogm). 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. 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 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-existin~ Buildinm'- $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial ~15.00 Date ............... .~. l ~. l ~ .~.' ' · ~ ' ~'¥~1 ................ New Construction ...... ~... Old Or Pre-existing Building.,.~.~..~.~.~Y, Locatio~ of Property ............. ~.~.a~./~. ~ .... ~. ...... ~ ........ ~ ~,~....~..f~...~. ......... · Hamlet House No. Street Onwer Owners of Property '~' ' '~' ' '~ ' '~'z" '~'~' '~' ' '~' '~'~ V County Tax Map No 1000, Section...~.~. ...... Block ..... ~.Z ....... Lot..~.~..~..~.~.~... Subdivisiom ........... ~ ........................ Filed Map ............ Lot .................. Permit No... ~.. ~. ...... Date Of Permit...~./.7%.~.~....Applicant..~./..~.~.'....~..~..~.~.~*.~. iiii Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate..,~. ...... Fee Submitted: APPLICANT .... ' OUNDATION { 1st) 'OUNDATION (2nd) :OUGH FRAME & .PLUMBING [NSULATION PER N. Y. STATE ENERGY CODE Fi:IAL ADDITIONA'L COMMENTS: ~'661 9 i ., 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH~PLBG. FOUNDATION 2ND [ .] I~ULATION/ FRAMING [ cT'FINAL REMARKS~ DATE INSPECTO~~ ~e.., .,9 ~ '~e~nit No..~ .~.~?~ Approved '.. ..... '. . Disapproved ale . . .' ......... .......................... a. Tiffs application must be con ise~s of plans, accurate plot' plan .tO sci b. Plot plan showing loqation of qr areas, and giving a detailed de~crJ cation. ,. c. The work cove'~ed by this apl , .. d. Upon approval of this appliea shall 'be kept on.tho' premises avall~bl, e. No building shall be occupie~ shall have' been igranted bY the.'Buildin APi~LICATION IS HEREBy MAi Building Zorie Oidinar~ce of the Tow .Regulations,'. for the construction of The applican~ ~grees to cgmply with admit authorized inspectors on premi~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 7654 80~ BOARD OF HEALTH ......... ~3 SETS OF PLANS .......... 'SURVEY ................... /'~"~ ~ ~s~ ~ ~ ';;~ ....... :: ' ':" ' .... . ,(~B~lding Inspector) APPLICATION FOR BUILDING PERMIT Date ...... ; ............ 19... INSTRUCTIONS letely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 e. Fee according to schedule. lot and of buildings on premises, relationship to adjoining premises or public streets lion of layout of property must be drawn on the diagram which is part of this appll- .cation may not be commenced before issuance of Building Permit. ion, the Building Inspector will issued a Building Permit to the applicant. Such permit fgr inspection throughout the work. or. used in whole or in part for any purpose whatever until a Certificate of Occupancy ,~ Inspector. . , . >E to the Building Department for the issuance of a Building Permit pursuant to the ~ of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or mlldings, additions or alterations, or for removal or demolition, as herein described. all applicable laws, ordinances, building code, housing code, and regulations, and to s and'in building for necessary inspections. (Signature of applicant, or name, if a corporation) ~ i ' , , ' (Mailing address of.applicant) State whether lapphcant m, oWner, lessee, agent, architect, engineer, general ~contractor, eleetncmn, plumber or builder. ' tO''l''-''~t~rooo-~, '' ' ~' ,: ,.fame of owne~ o~fpremmes .. .... [~ '. ................................... .. : ' (as on the tax roll or latest deed~,,~ ~ ]~ If applicant is a Corporation, signatur~ of duly authorized officer. . -~/p~ DA~, ,~/~ ,77~.P.~ w' B~laer's License ~o: ,' USE IS UNLAWFUL , : '" ...... '~ .... WiTHOUT'CERTIFICATE Plum. her's/~/cense No ...... , ,, 'OF'OCCUPANCY Eec, trician's gi ense No.' ..... .om .U,L.,.G DE.A.T.E"T A~ 7654802 S AM TO 4 PM FOR THE FO'~O~"G,"S"ECT"~"S: 1. FOUNDATION - TWO REQUIRED FOR ~URED C~R~ 2. ROUGH - ~MING & ~BING ~. INSU~ON ~ 4. FINAL- CONSTRU~ION:MUST . Other trade s L,zcense No.' '.'..;. Location of land 'on which pro Itous¢ Number Cmmiy Tax IVlap No. 1000 Sectio ,' BE COMPLy:, ~ FOR C.O. ' -' .............. AIA.' CO, I~S'~RUCTION SHALL MEET work Will be done. ~ ................. JsTATE .~8IEUCIION~ · .~NRR~.. F~ A LCODES, NOT RES~NSIBLE FOR Street Hamlet /.0..q. ............ Block /t( Lot S Idi ii ' ' Fil dM pNo Lot..' .... ....... : (b amc) 2. Sthte existing use and 0cc.p~ancy ~f premises and intended use and occupancy of proposed constn etlon: a. Existing use and occuparicy ..................................... b. lnt~r~ded use and occupancy ..~ ................ ' ............. Repair ...... ' ........ Rex~qvaf · ........... Demolition O 17~~~'~'( ' ..... ............. t er Work--J..T'TT~T~'~"~ ..... 5. Ifdwell'n~ g, nUm,,'' ~ .... .~ ~.oer~o~ awemn~ rmts ............... u ~ c.,,,, , ,~~ ~,um ocr o~ uwemng umts on.~ae~~O'. ..... 6. If.b~s~ness, commercml or mtx~4 occupancy, specify uature and extent of each type of use . .~ .............. Q7. Dimensionsofextstingstmctur?~ if any: Front ............. Rear .............. Depth ........... tleight .... .... .... Number of Stories Dmlens~ons of same structure W~h alterations or add t OhS' Front Rear Depth ....... ? ............ ]. ~. Height ...................... Number of Stories ..................... Dm~ens~ons of entire new const,r~chon Front .... . ~ ,~: ~ . .... Rear .... ~ ....... Depth ..~7~. ..... Height ...:.~... ~;.,.Number0fStories / " S~ze of lot Front ' ~ Rear ............. . ~, '. ......... ~'~ ............................... Depth ........ 10. Dat.e of purchase ..... . ....~ [. ~ ................. Name orFormer Owner ............... ~ ............. 1 1.. Zone or use district in which pre nises are situated ..................................... 12. Does proposed construction vidl~te any zoning law, ordinance or regulation: . ~5( (:~... ~Name or Owner o~ premises ~e~ ~ ' ~'~ ....... · . : N~e of Contractor i5. Is'?h~s property,'W~chSn )0 feet of a ~dal ' , ~If y~s.~ Southoid >wn Trustees Permit may be required. ~ .. PLOT DIAG~ Loca.te clearly and distinctly ~ >uild~gs, wheiher ~ proposed, an&indicate ~I set-back d~ensions from property lines. Give..street and block .umber or description accord~g to deed, and show street nines and indicate whether intehor .or, corner mr... vnuAqua30 HO ~ (Name~of~nO' I" ~'~g cont~) ............. g Y , d0pos ~s mu, says [hat lv~ is the applicant (C .... oI sam o~ner or to perform or have perfo~ed the said work and to m~c and>.file tlfis application; that all slatem ~ this application are true to the best of his ~owledge and belief; and that the wor~ WUI be t~c,m forth in the application filed therewith. Sworn to before mo this; (':' ', ' · · . ay of ', ' ' N.aWPubIio, Stat. of Ne' ;RE.NE O, HORNEYork ' · ............ ~;;;e ;; a;plicant) ...... , No49fi1364 ~' Qualified In Suffolk'Cra ~ =O,z ~ , Commt~ion Expires Ma~ 2~, 19