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Home My WebLink About21957-z TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Mall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23630 Date MAY 11, 1995 THIS CERTIFIES that the building Location of Propert~ 250 6TH STREET House No. County Tax Map No. 1000 Section 126 Subdivision ADDITION LAUREL, NEW YORK Street Hamlet Block 1 Lot 10 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Fa%ROH 23, 1994 pursuant to which Building Permit No. 21957-Z dated MARCH 23, 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 ADDITION WITH FIREPLACE TO EXISTING ORE F/%MILY SEASONAL DNELLING AS APPLIED FOR. The certificate is issued to ROBERT & ALISON KELLY (o~ners) of the aforeeaLd building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A Building Inspector/ FORM NO.$ TOWN OF $OUTHOLD BUILDING DEP~RTMEHT TOINN I~,~,L L $OUTHOLD, N.Y. N~ ~1957 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF 'THE WORK AUTHORIZED) Permission is hereby granted to: ' . .~ , ........ ........ ........... ~.~ .................. ~ ............................. ,, ......... ~... :.....~ ~ ............... ../?.......Z. ...... ~ ........... ~....~...~./.,~.....'~,,,,,,....,..'. ............................................................................. .............. ~ ......... ..h..f.F~...~.~ ................................................................................... Coun~Tax Map No. ]000 Section ......................... BIo¢~ .......................... LotNo. p~rs=nt to app,,cot, on dated ........ ~.~..¢Z~ ........ ~.~. ....... ' ~..~.l... ..... a~d appre~ed b~t~e Building Inspector. Fee $....,~...',~.. .............. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 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 6he following: for new building or new use: 1. Fins1 s~raz~_-y--~-~c~p~t~y_with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Appr~r4~m-~-DeF~e-f-~ater supply and sewerage-disposal(S-9 form). 3. _~~f c!cetri~a~l--i~rst~l~-~_of Fire Underwriters. 4. $~or~a--statem~ko~--from-~lumbcr--~r~gify~ that the solder used in system contains less than 2/10 of 1% lead. 5. Comm~4~_.' --' ~ indusf~'f~f'building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. >6. .~DJ~0i~4~l~anni~g-Be~d--~p~l~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 n~al 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 i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling~$25.00,>/ Alterations to dwelling $25.00, Swimming pool $25.00, Accessory build~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 ~lding ...... Location of Property ..... ~...~. ............ House No. Street Hamlet 0nwer or Owners of Property ...................................... . County Tax Map No I000, Section../.~2~. ..................... .. Block .K. 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' $. ~'~ ~ , .......... 765-1802 BUILDING DEPT. INSPECTION DATE /~//~ ~/'~/,,~; INSPECTOR FOUNDATION -(IST) ~_~_~ =- COmmENTS FOTurNDAT~ON ROUGH FRAME & ii PLI~4BING ii STA~ E~R~ CODE FINAL ADDITIONAL CO~4ENTS: T SUNDAY - APRIL 24th, 1994 Or, D Z S 20'46'50" E N 20'46'5ff' W BRAY AVENUE ./ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ?.?.., Disapproved a/c MAIL 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FI,~,MING m pLUMBING 3. INSULATION · 4. FINAL - CONSTRUCTION MUST BE COMPL~=i.- FOR C.O. ALL CONSTRUCTION 8HALL MEE'I~, THE REQUIREMENTS OF THE N.Y: STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR. 1. Location ofland'on which proposed work will be done ..... DESIGN OR CONST(.~CTION ERRORS House umber * Street Hamlet County Tax Map No. 1000 Section ...... Block ............ .Lot .... Subdivision .......... ........................... Filed Map No. ' ~ Lot (Name) ................. ..-Tx ........ State existing use and occupancy of premises and intended use and occupancy of propg>s,~d,~onstruction: a. Existin- Use a . . ,--~.- . ~ r'7', -~ ' ' '/.- 'X ..... ': ~; .'r ..... ~ .... · Intended use and occu ..... .... ...... ,, · . , . .... U' ) Plumber's'License No...f.~.~./~. ................ Electrician's License No._ .~./~. ............... Other Trade's License No../..X/.. './2)-. ............. Build 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 publ~c 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 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 p~t for any purpose whatever un}il 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 pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app[icable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or or remocai or demoutmn, as herein described. The appl/cant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary .~r~pections. (Signature of applicant, or hame ;t2 ~ )-~,~-,~L~-:': x '" ~/////~Maumg auaress of apphcant)////~/-'~ State whether applicant is owner, f lessee, agent, architect, engineer, general contractor, electrician~,pluCber or builder. If applicant Isa corporation, signature of duly authorized officer. FEE: · NOTIFY BUILDING Dg.~.ARTMEN? AT ........................................ 7~-1802 B AM TO · PM FOR THE · (Name and title of core'rate officer) FOLt.OWlNG INSPECDONB: 3. Nature of work (check which Pphcable): New Building Addition / ' .......... · ......... 3dteration ........ Repair .............. Removal ............ Demolition Other Work .[... 4. Estimated Cost . .,~. '7' ~-~"~".? ..... ~,._o (Description) 5. (to be paid on filing this app)ication) Ifdwelling, number of dwelling units ................ Numberofdw, · , · · If garage, hum Der of cars --~ elhng umts on each floor ...... If bus ness, Commerc .~----' ~ ' ................................. , . 7. ,,- ,-,, mtx~eu occupancy, specify nature and. extent of each type of use .... 7T:'.. , . . ' .... Dimensions of existing structures, if any' Front · '. · Rear ...... Height -, - - ' .......... '. Death ~,. ' .......... p~umoer orStories .. . r .............. Y' · . . Height ........ . ...... Number of Stories. . ~.4~.~.. 8. Dimensions of entire new cons[ruction: Front ........... ; ·.. Rear ....... "· ..... Depth .... Height . .' ............. Nuinber of Stories .. '"' ............. .... · ............ Depth ........... 10. Date of Purchase .......... .......... . ........ .flame of Former Owner I 1. Zone or use district in which premises are situated. 12. Does proposed construction violate any zoning law,'/~'.T.~..O... ' ........ :. .................... 13. ordinance or regulatlon: .. ZV"~;:l .............. , ......... 14. M .... ,. ,, - T ' ' '? .... ! .................... Will excess fill be removed fro,, .... ..... ,. u,,.,wner olpremlses . i ....... ^.~4 ....... r ....... ,.o. iYes No Name of Architect . i - · ~..~ ......... ,~re~s ................... Phone No . ....' ..... t~ame oI~ontractor ~ .... ~ ...... .,,o.~ ~u .... 15..zS tnls property wxthln :300 feet of a tida¥ ~tla~d?~ '--;ili.';.'.'.'...' 'Nroa.°.ne'.~... · 'i ...... yes, Southold iTown Trustees Permit may be required. "'. i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or prot~gsed, and. indicate all set-back dimensions from property lines. Give street and i . . . interior or Corner lot. block!number or descnptmn according t? deed, and show street names and indicate whether being duly sworn, deposes and says that he is the applicant ' (c ht .......................... ~ ontractor, age , corporate officer, etc.) ......... : ........ of said owner or owners, and is duly huthorized to perform or have performed the said work and to make and file this iapplication; that all statements contaiffed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner sbt forth in the application filed therewith. .Sworn to before me this i · Qualified in Suffolk CoOnt~ ~ ~ ...... ~.' ..... ~ ........ Commission Exptre,s Decemb~lr 8, lg/.,.~ t-'qgnalure of ~ppJican t)