The URL can be used to link to this page

Home My WebLink About22141-zNo Z-23146 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCuumANCY Date AUGUST 5, 1994 THIS CERTIFIES that the building Location of Propert~ 420 JASMINE LANE House No. County Tax Map NO. 1000 Section 70 Subdivision ACCESSORY SOu'z'~OLD, NY Street Block 1 Lot Filed Map No. Lot No. Hamlet 6.9 conforms subetantially to the Application for Building Permit heretofore filed in this office dated JUNE 7, 1994 .pursuant to which Building Permit No. 22141-E dated JUNE 20, 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 AS APPLIED FOR. The certificate is issued to WILLIAM GAFF~A (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A FORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT iOWN HAU. $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) z .................. ............................ Permission Is hereby granted to: , .... ~./.,~.......~ ....... .....~.. ~......,~..... .... ....... ~...~ ......... ~'~:..y..:. ...... //..~z/.. ........... to ...... ~...~... .,~-.....: ......... ~.. .~ ........ ~/ .......... ~ ....................... ..¢....~ .................. .......................... ~/...~. .............. ~..../...Z ................................................................................ CountyTax Map No. 1000 Secflon.......?...~.. ............ Block ....... ~,,~.. ........... LotNo. ~" ''~ pursuant fo application dated .............. ~/Z,..: ............ : ............. 19...~J.., Qnd opproved b~the Building Inspector. ~ s..,.,~,~ ..... Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOICN tLALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 lihes, 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 i 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '.'pre-existing" land uses: i. 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 Buildinm - $100.00 3.Copy of ertlfmcate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.~emporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction.....~..... Old Or Pre-existing Building ................. House No. Street Hamlet Onwer or Owners of Property .............................................................. County Tax Map No 1000, Section 7~ ~ ~ O~ .~ ? Subdivision..~.~. .... .~.{~ ...g~.. ........... Filed Map ?~ .... ot ..... ~ ............. Permit No. X2 !~ .~....~...Date Of Permit..~/.~.~.l~ .~....Applicant.~/.~.~... ~.~-..~...~.4..~f- Health Dept Approval ' Underwriters Approval Planning Board Approval ....................... Request for: Temporary Certificate ........... Final Certicate .... ...~.... Fee Subraitted: $ ..... .~...~...*~.. ............... ~..~ ~.. ~.~.~.~. ' ............ ~PLIC~T~ [~ ', BUILDING DEPT. INSPECTION [ ] FRAMING ~'I:'INAL REMARKS: ~ II;SULAT~O}I PER 'N. STATE E}IERGY .' CODE ,4. Exami~!.. Approved .~..~.Z ..... , FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 197~ 19 ././. ee mlt No.. Disapproved a/c ..................................... SURVEY SEPTIC FORH .............. c^,.L %5.-.ZI.eP..- ........ . li)di~Insp ) APPLICATION FOR BUILDING PERMIT Date e...7.. INSTRUCTIONS a. Tins 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 ot 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 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 Southold, 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 appl/cant agrees to comply with all applicab, le laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaryin~p, eclior~., . r ! ~^L~ / / --' /~ignaturae of applicant, or nfiir~, if a corporation) · .F.,Q,.. !.q?/.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................ .................................................................... Name of owner of premises.. :.~..Z~M/.~.. .... ~.....~..d~'...~. ..... ~ ........................ (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 ..................... Plumber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ...................................... ' ........ ........... .... .................. ouse Number' Street Hamlet ............' County Tax Map No. 1000 Section .' ..... 7D ........ Block .... 0./ .......... Lot ..... ~.~..~. ........ Subdivision...%D.~..~.b. .... 71t~/, .~.. ...... F edMap No ...q.~.~.7. .... Lot ..... /~ ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . L b. lntendeduseandoccupancy .... .... -- ..... ; ' ,:. ,: ,- 3. Nature of work (check which applicableS, New nu;)a: ........ ' ~ ~~ Repar .............. Re,oval .............. Demolition ............ . (to be prod o n) 5. If dwelhng, number of dwelling units ............... Number of dwelling units 0n,~~~.:~:: Ifg , · · · . arage, number of c~s .... ~ ..................... 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use .................. 7. Dimensions of existing structures if an,,' Front .... ~ , J ................ Rear .............. Depth ......... igl mb ..... He ~t ............... Nu erofSto~es ........................................ . ......... ~ensmns of same structure w~th alterations or additions: Front ...... 2 .......... Rear ................. ~pth .. .... ~.... .......... i'" HeiSt ......... ;~ ........... Number of Stories .................... 8. ~o~sions ~entire new c~s~mction: Front ..... /.~ .... ;. Rear .... /~ ....... Depth ... ~. ..... "* ...... , ~ .......... l~umber of Sto~es ........ ~ ....... 9. Size of lot' Front ~3, ~. . Re r .... '~ ............... ~';.h ...... ):.~..... 10. Da' ~"' - '" ~2'- '~ "x~ ...... a ....... ~1 ............ Depth ..i~7~...T..ly~t~Z 11. re o~ rurcnase .... ~ .... ~ .............. Name of Fomer Owner .... ~ ........... one or use district in wluch p~emises are situated ................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: . ~ ............ ' ' ' 13, Will lot be regraded ' ~O ........ ' ............. ...... ~ .................... Will ex~ess ~11 De removed from premises: Yes Na e ~ .... ' ' ......... ~ · ~ · ~q~-none mo. .~.o. r ~.*~.r..,... m Osarcmrect ......... .................. Address ................... Phone No ............... N~e of Contractor ........ ; ............. ; :... Address ................... Phone No ................ 15. Is chis proper~y wtehtn 1300 feet of a t~dal wetland? eyes ........ No.~... ~I~ yes, 8outhold ~own Trustees Permit may be required. PLOT DIAG~ Locate clearly and distinctly ~I build~gs, whether existing or proposed, ~d. indicate ~I set-back d~ensions fro& prope~y ~nes. Give street ~d block[number or description accord~g to deed, and show street nines and ~dicate whethdr interior or corner lot. STATE OF NEW Y, OI~-., . ~ , ,,. ?. .... //.. ............. .... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, i i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly!authorized to perform or have performed the'said work and to make and file this applidation; that all statements contained in this application are true to the best of his 'knowledge and belief; and that the work will be performed in the manner set forth in the application flied therewith. Sworn to before me this Zor ~. 00, .lA SM/NE N L=/03.54' LANE FlED TO' .'AM GAFFGA BANK OF NEW YORK ERIOR ABSTRACT CORPORA TION - S-~45958-16 AREA= 14,278 sq. ft. in accordance with lhe minimum for lille surveys as established .I.A.L.S. and approved and adopted use by The New York S/ate Land ;oclallon. =r supply and sewage disposal ~or /his residence will conlorm ~ndords of The Suffolk County nl of Health Services. /ions o! we/Is arid cesspools shown hereon ore from ~ns and or tram data obtained tram olhers. SURVEY OF LOT 16 , "MAP OF $OUTHOLD VILLAS' FILED JUNE 25, 1992 MAP NO. 923. A T SOUTHOLD TO WN OF SOUTHOLD SUFFOLK COUNTY, NY. 1000 - 70 - 01- 6.9 Scale~ 1"= Oct. 23,1992 ~f/nal) :~!~-,'!