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Home My WebLink About22224-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23145 Date AUGUST 5, 1994 THIS CERTIFIES that the building ~DDITION Location of Property. 45845 COUNTY ROAD ~48 SOUTHOLD, NY House No. Street Hamlet County Tax Map No. 1000 Section 55 Block 2 Lot 17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~LY 13, 1994 pursuant to which Building Permit No. 22224-E dated AUGUST 1, 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 A SHED ADDITION TO AN EXISTING COF~ERCIAL BUILDING AS APPLIED FOR AND TO .r~ CONDITIONS OF '£~ SUFFOLK COUNTY HEALTH DEPT. The certificate is issued to PETER & DIANE LU~S (owner's) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A FORM NO.3 TOWN OF $OUTHOLD BUILDING DEP,AgTMENT TOWN HALL $OUTHOLD, N.Y. NO_ BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22224 Z Date ......... ~/._._.;.~. ..................... Permission Is hereby granted to:/') / .......... ~...,,/.,~z,..~.....~,-,i ...................... ....... ~ ~~.~...../...¢,..'.% ............. to ...... ~¢.,~../..~.....~., ....... ~.;~.~.. ...... ~.,~..~..~..:../.~.~......~..,~m..~'/., ~.~.~2¢ ...... ~~. ~ ~. ~.,. A ./... ~Z/.,~......~.~.;.£~.~' ..~.~ ....... ~ ........... ~.....~ .............. . ............................. ~. ....... ~....~ ...... ::::::::::::::::::::::::::::::::: ..... ~Z~'.'.'.~i~'~.'.'.'.~;.'.'.'.'.'.EZZ'.'.'.'.'.".'.'.'Z'.'Z'.'.'.'.'.'. ............... : ......................... ~a~.o....~./....~..,..~ ................................................ CounlyTax Map No. 1000 Seotion ......~.~... ........ Book ....... ¢~, ............. Lot No..../..?/.. .................. pursuar~tto application dated ................. ~..C~.....,/...~......./....~... ....... 19...2..¢., and approved bythe Building Inspect~ Fee ~../.~ ............ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOI~ HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Ao 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 4 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. B. 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-existing Buildin~ - $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 $15.00 Date ...... ?//~.... ~ ..................... New Construction ........... Old Or Pre-existing Building .... Location of Property... . ...................... House No. Street Hamlet ........... Onwer or Owners of Property...~ .... ~.~. ........ .~.~.~.. County Tax Map No 1000, Section .... ~-~ Block .... ~ Lot . .~. .... Subdivision ................................ Filed Map ............ Lot .................... Permit No ................ Date Of Permit ...... .......... Applicant .......... · ................... Health Dept. Approval ........... Underwriters ............... Approval ....... . ........ Planning Board Approval Request for: Temporary Certificate ...... Final Certicate ........ FOUI~DATIOX'.! ' f2nd ) ~0UGH FRAME &. .... ~ ..:.: ::~.~,~ .: UMBING [NSULATIO~I PER'~. Y. STATE E}IERGY .' CODE '- ADDITIO~IA'L .C0,~J~E[.;TS: · · Oo SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 15 HORSE BLOCK PLACE ~ FARMINGV~LLE, N.Y.-41738-1222 ~ "This PERMIT 'SHallb~""~ER'MANEN~Y DIsPlaYED E×etreS on m 0e131/94 ........ · ,' ,,?:.:,,r' 'l ' '. ,' ' . '. :~ ."." ~- ~¢~1 ~HORELINE TRUCK AUTOHOTIVE 4584~ NORT~ RD '~'" 2 ~50 O~ne~ Phone... '" be m~int~ined in GGOD ~opkin~ oPdeP. , 2055 ANCHOR LN ce to ~acilit¥ shall be Ppovided'" ' ' n~m~tta~ i ?OOTHOLD NY ~97~ to ~CHD$ between the houP$ oF 8:00 am and "'" ~': cC.", /-.h 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ .] FOUNDATION 2ND [ ] I~ULATION [ ] FRAMING [~/]/FINAL REMARKS DATE INSPECT~ ~ Illll ~: TOWN OF SOUTHOLD" ~'URV~Y .................. ~1 .1~]~ J 3 ~99~ ~ ~UILDING DEPARTMENT . ~CIIECK .... ,] .............. t t TOWN HALL S~TIC FOR,, ............ ~.DEP~ J J SOUTHOLD, N.Y. 11971 ' ~ ~ ~O~OLD ~ TEL.: 765-1802 ~,.~,,~.. ~,,2~ . ; ~ ...~.-~:..~7. .... "~'''7 ....... '*~'~' / ,' HAIL TO' Approved ........... 19 e~mit No i ................ '" · Dis~p~roved a/c ............................. ' .. ', ....................... }//. (BuildJn~ Inspector) / ,' ~'' -. Date . INSTRUCTIONS a. T~s application must be completely filled in by Wpewffter or in ink and suDmitt~d"to the Build~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot pl~ show~g location of lot and of build~gs on premises, relationship 't~ adjoining premises or pubic st?eets or areas, and giv~g a det~led description of layout of property mu~t be drawn on the diagram which is pa~ of this appli- cation. c. The work covered by t~s application may not be commenced before issuance of Building Pe~it. . d. Upon approval of this application, the Building Inspector will igsued a Bufld~g Pe~it to the apphcant. Such pemit sh~ be kept on the premises ava~able for ~spection throughout the work. e. No bulldog shall be occupied or used in whole or in p~t for any purpose whatever until a Ce~ificate of Occup~cy shall have been granted ~y ~e Building Inspector. APPLICATION IS HEREBY MADE to the Bulldog Dep~ment for the issuance of a B~lding Pemit pu~uant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other app~cable ~ws. Ord~ces or Regulations, for the construction of.bufld~gs, additions or alterations, or for removal or demolition, as here~ described. The appEcant agrees to comply with all appEcable laws, ordinances, ~ufld~g coda,housing code, and regulations, and to admit authorized ~specto~ on premises and ~ bulldog for ne~essa~ ifispections [. · ..................... (Signature of applicant, or name, if a corporation) .. ~.~ x.b.cT. :%~ v2O~... M,~...zz.~ 1 .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. N~meofownerofpremises . ~.¢~...~ ~ [~Z ~ If apphcant .... ~s a corporatmn s~gnature of duly authorized officer. ~ollFY~'~SUiLDiNG BY:~DEP~ENT~ ...... ~a~ :nd btle of co,orate officer) ' ~[~Ng ~P~t~O~ FOR THE Builder's License No. Plumber's License No ..... 3. Electrician's License No ....................... O~hor Trade s Lmense Na. . .................... I. [o~tio. or~ o~ w~i~ p~opo~e~ wo~ wi. ~'don~...¢~¢¢[.. ~.~~~ .... llouse Num her Street Hamlet Co.ntv *ax ~ap ~o. ~000 section .... ' .... h~i~ ......mock ...... ~ ......:... ~ot .... 4 Z ............ Subdivision " ' ........ (~'a;~;~) ...... Filed Map No ............... Lot ...... : ........ ~; Sta~e existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ' (~ ~':?:O ~e~ b, l~tcnded use and occupancy ....... . '3. Nature of work (check which ~pPlicab e~. x,~. ~u:,.,ff.. i :b."F,.'i'" :j{- ................ aemoval .............. Demolition ·: ........ Other Work ..... 4. Estimated Cost .......... [~ ' (Description) °i' F ' ( o be pal(l.~qrf flli?~g~qYis a lice i 5. Ifdwelhng, number of dwellintr un t~ . ~ ~ ::. :~.l~7i~wo¥ pp t on) · If garage, number of cars ... '~t ...... ' . rtumt)er oluwelhng umtg.ot~l.~i~elC~flo~or:-g7t ........... · . . . . ~- ,..,~t. upaat, y spec!w nature and extent of.each t ..... . .......... Height ~ ....... Rear ...... ............... Number of Stories ..... ' ...... Dimensions of shine structure e ............................... ~ ith alterations or additions: Front .................... Depth ' i ~' Rear ' Heigb. t ................................. 8 ...................... ' .......... , · umber of Stories '' '~ Dimensions of entire new cons/ruction: Front ' Height Nunlber of Stories .............. ~ Rear ............... Depth 9 Size of lot: Front ................ ,', ....................... ' ................. · · ...... Rear ' I0 DateofPurchase '":~ .................................. Depth ' ' Name of Former Owner .................. 11' ' ......... ................... · Zone or u~'e district in which pr~emises are situated .... ' ' ............................ 12 Does proposed construction violate any; zoning law' ' · ' ordinance or regulation: ............................. 13. Will lot be regraded ....... '. i ................ Will excess fill be r oved from premises: Yes ' No 14. Name of Owner of premises.. ~ ...... ; ...... i~:ldress ....... em. .... Phone No .... Name of Architect ~ " ....... ' ......... 4 ............. Address ........ ;v · · Name of Contractor. ~ ................... Phone No ................. 1.5.' within 00 fe a tidal wetland* Yes ........ No. ?. ...... ' ~I£ yes,'Sout:hold Town Trustees Permit may be requ±red. .' "·. i PLOT DIAGRAM' Locate clearly and distinctly alii buildings, V~heth~r existing or proposed, and, indicate all set-back dimensions from property lines. Give street d block number or description according to deed, and show street names and indicate whether interior or corner lot, STATE OF NEW YORK~f'b~- - fi cou~i OF ........ .S.~ (Name of individual signin¢ contract) lbove named. . . . ......... being duly sworn, depose.s and says that he is the applicant " ' (Contractor agent ....................................... I 'porate officer etc ) ,f said OWner Or owners, and is dtdy fiutl'~orized to perform or have performed the said work and to make and file this pplication: that all statements contained in tbis application are true to the best of his knowledge and belief and tltat the .'ork will be performed in the manner s(t forth in the application filed therewith. worn to before me this j' Notary Publio, State of Ne~ Yodrq; x (Signature o f applicant) No. 4822563, Suffolk, CouhtyQ//{~' Term Expires Oeco~nber ~1 19.-&./ -