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Home My WebLink About22138-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. (~RTIFICATE OF OCCUPANCY No Z-23069 Date JDNE 24, 1994 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 11130 SOUNDVIEW A~EN~E SOu'£~OLD, NY House No. Street Hamlet County Tax Map NO. 1000 Section 54 Block 6 Lot 2.4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~umE 6, 1994 pursuant to which Building Permit No. 22138-Z dated JDNE 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 FOR AN "AS BUILT" ACCESSORy S~m AS APPLIED FOR. The certificate is issued to PETER Lu~uu~ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 B/A FOgM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOll~l HALL SOU'[HOLD, N.Y. N_o BUILDING PERMIT ITHIS PERMIT MUST BE KEPT ON THE PREMISES UNllL FULL COMPLETION OF THE WORK AUTHORIZED) o~,~ .......... ~/~ ..................................... ~...?~ 22:1.38 Z Permission Is hereby granted to: .... £~...~,~ ............................................. .... ~~..~..~../........../..~.~,~ ................. ~...z'~.,~ ........... ~.: ....... ~~._. ........... ~.~......--~ .............. ~i'. ........ .... ~ ............ ~,~ ............ ~-~,~.: ........................................................................................ Rev. 6/30/80 ,.,.. JUN - 6 BLDG. DEPT. .... TOWN O,F SOUTHOLD Form No. 6 TOWN OF SOUTIIOLD 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~Underwriteys. 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. e For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and 'Tpre-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 ~ Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in.writing to t~e applicant. Fees i. 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 - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.O0 4. Updated Certificate of Occupancy -.$50.00 5. Temporary Certificate of Occupancy'- Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ...... ~.. ..... Location of Property...~. ~.~.?.~!~ .~... ~.~.~.. ..... .~ ~ ~. .................... House No. Street Hamlet Onwer or Owners of Property .... F~..~.~..~...~..~...~.(.~..~J.~.~?. ~.~.~. ...................... 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: $ FOUU TI Ol.! ' (2nd) STATE EHERGY CODE .4. FINAL ADDITIONA'L C 0 M.kI E 1,; TS: 76S.1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSU~ION FRAMING RIrMAR~/ ? , /i Approved .~). ......... 19 (.~ermit No .......... Disapproved a/c · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.¥, 11971 TEL.: 765-1803 (Bui!/dif~g Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTII 3 SETS OF PLAbI$ -'SURVEY ' CALL . 7 · .~ ...... . , Date .................. , 19... IN. STRUCTIONS h. 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~Jvm=*' ' * 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 Bu/Iding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, trod 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 ail applicable laws, ordinances, building code, h.~sing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~p.e~tinns. (Signature of applicant, or flame, if a corporation) (Mailing address of applicant) <~0.1~ td.y State whether applicant is owner, .lessee, agent, architect, engineer, general .contractor, electrician, plumber or builder. mine of owner of premises ...... . .~. r.¢.& ..~....~...~. ~ .0.~.~...'~....¢..0. ~.~--%.. (as on the tax roll or latest deed)~l If applicant is a corporation, signature of duly authorized officer. DAT~ (Name and title of corporate officer) Builder's License No .... '. ~ .0.CCUPANCY OR PI ber''L, No - USE !$ UNLAWFUL um s cense ............ Electrie,an's License No ....... -- WilIt0UT' CERIIFICATE ".'qJF' [JCCLJPANCY Other Trade's License No ...................... NOTIFY BUILDING DEPARTMENT AT 76~.1~11~ 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMSING INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHA~.L MEET ',':,. THE REQUIREMENTS OF THE N.Y. I. Location ofiand'on which proposed work wili be done ........... STATE CONSTRUCTION & ENERGY ......... ~'ODES.' ' NOT' ' RESPONSIBI'e · F~R. · · //~/..~. ..... ~....~..L) ..... /..~. ~ .... ~ ~/..~_~_. ..... {~1~,~ C/~O~,~TRUCTION ERR(~I~S }louse Number , Street Han,det County Tax Map No. 1000 Section ...... ~ .~..~. ....... Block ...... ~. ........... Lot .~....~....~.'.~.... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constr.uction: .mu . ' a. Existing use and occupancy .... .~..~.... ./.:,. ~ ; ..................... b. Intended use and occup~tncy ~ ~.~5~ ";".: .... 10. I1. 12. 13. 14. 15. Locate clearly and distinctly property lines. Give street and blocl . interior or corner lot. 3. ,Natu.re of'~ork (check which applicable): New But ding ..~ .~.~.. Addition '! ....... :ov ................ ~emoiition · .. O'th~fk ' - l~ (Description) ! (to be pai~~;n.) ' 5. If dwelling, number of dwelli~g units ........ ~ ...... Number of dwelling units on each floor. · If garage, number of cars .... :....-:-.. · ........... ~. IDfibusiness, commercial or mi~ed occupancy, specify nature and extent of each type of use ............ · io 'exi ti gst tq if F ......... ' ...... R ......... mens nsot s n mc res, any: runt ear ..... . ......... De ... H.eight N~mb fSt i pth ............... ere ores ........... . . . ' ........ D of c with alt ti dditio ......... lmellslons same stmctur era ons or a ns: Front D pti ........... Rear e ~ Hight .............. ' .................. [ · · · e .................. Number of Stories ............. ~. ........ 8. Dimensions of entire new conitruction: Front ., / -z--- R /~.~ H 'gl · .' ............. N imb f St · · · / .......... ear ...... . ...... Depth ./.o. ........... ez ~}1 u ere orieSsi .................... ;-. ............................ zee ct: Front ......... i Rear ................ ' ' Depth ............. Date of Purchase ..... ~ Name of Former Owner Zone or use district in which Premises are situated ......... .'. .................... Does proposed construction violate an" zonin- law - ~''' ......... : ............. / ....................... ~ ~ uruznance or regmation. .A~.P. . ................... excess i111 De removed from premises- Yes · ' '1 .................. ~muress ................... Phone No .............. ~. Nane of Contractor · Is this property within l300 feet of a tidal wetland? *~es'.'...'.'.'.'.' ......... · If yes, SoutholdiTown Trustees Permit may be required. PLOT DIAGRAM buildings, whether existing or pro!5osed, and~ indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether · r,. .. '., ,~ .~! ~. .c,.- ..i ........ ~z' 15~m II deposes · (~NJme~ ~f'm~ftvjct,,u,~l~lg~lmg contract) ~%~'~ ~g~, ~d says that he is the applicant ae is the ..:2 " "'-'O ~ ', ~: (Contractor agent corporate officer etc ) ................ of sai~ 'owner O~ "" ' owners,.~d 4s daly~huthorized to perfom or have perfumed the said work and to m~e and file this application; that all statements contaihed ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfumed in the manner ~et forth in the application filed therewith. ISwom to before me this .............. · ~ ........ day of. NOta~ Public '~ .... x ...... County . ..... . .'. ...... . ............. Nota~ Public, State of Now Yo~ ' No. ~952246, Suffolk Coun~ ~: (Signalurc of applic~O Term..Expir~ June ~ 2, I ~ ~z~ 0z ~o o < 0 8 CO<~