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Home My WebLink About21980-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23111 Date JULY 20, 1994 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 225 BURGUNDY COURT EOUTHOLD, N.Y. House NO. Street Hamlet County Tax Map No. 1000 Section 51 Block 3 Lot 3.12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 25, 1994 pursuant to which Building Permit No. 21980-Z dated MARCU 30, 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 ACCESSORY STORAGE BUILDING IN REAR YARD AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PAUL & MAUREEN CLANCY N/A N/A N/A FOI~M NO,$ TOWN Of $OUTHOI.D BUILDING DEPARTMENT TOWN ~ No 21980 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] Permission Is hereby grante(~o: .,....;!;~..~.~ ....... ~.:.....~.~.~?~ ........................ ..... ~.~.....~~y...,.~.....~.,,.~-~'~ ...~~....~...~:....../..~. ~z..,,,.. .......... to.....~....,-~-..~.~.~ ....... ~......~~.~,~ ......... ...~.....,.../..~;;~ ......... ~; ............. ...:..~ ....... g~.~ ........ ~ ......... ~.~......~.;...~.~.~. ....... .,.~'... .................................. ......................................................................... ~.~-- ........................................... CouniyTax Map No. 1000 Section ,....."~.../. .............. Block .......~...~.. .............. Lot No......4~..,.~...5,,~,,,/~,,,,~,..,, pursuar~t to applicatiorl dated ....... ~.¢~....~...~'.../~.......,.~..~..~'"~. ................ 19....~..~., and approved bythe Building Inspector. Fee $,. ,.~..,,'~,,:,~ ........ / ¢/ Building Inspector Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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 Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of I% 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. 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-existing Buildin~ - $100.00 3.Copy of Certificate of Occupancy - $20.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary ~ertificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building....~-..i ........ House No. ~eet Hamlet Onwer or Owners of Property ................................................. County Tax Map No 1000, Section .............. Block ....... X ....... ~on .................... ....... · ~ ................ ~m±ea Map ............ Lot ................. Permit No ................ oate Of Permit .......... pplzcant ..................... Health Dept. Approval.' ...................... · .. Underwriters Approval ....................... . . Planning Board Approval ....................... . Request for: Temporary Certificate ......... Final Certicate ...... Fee Submitted: $ ..................... c0-t. o23 / ............ . ..... '"""" Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765~1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 14, 1994 Paul & Maureen Clancy PO Box 540 Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No UnGerwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21980-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. Town Hall, 53095 Main Road P. O. Box 1179 Southold, NewYork 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD July 14, 1994 Paul & Maureen Clancy PO Box 540 Southold, NY 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. xx The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 21980-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. OUNDATION ( 2n ~OUGH FRAME & 'PLUMBING INSULATION PER N. STATE ENERGY Ye CODE FINAL ADDITIONA'L COM~ENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ~.ST [ ] ROUGH PLBG. FRAMING [/~]~FINAL BLDG. DEPX TOWN OF SOUTNOLD Examined ............... , Approved .... 3/~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 197 .¢Permit No. Disapproved a/c ......... , ........................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTII SURVEY ~.-~ .......... ::::' SEPTIC P 0 R,'I ............. CALL (~,o ~ qb INSTRUCTIONS Date ...... , a. T/tis 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 o' · ,, cation, ozvm,, a detailed description of layout of property must be drawn on the diagram which is part of this appli- c. The work covered by this application may not be commenced before issuance of Building Perrait. d. Upon approval of this appllcation, 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. · c. No building shall be occupied or used in whole or in part for any purpose whatever un}fl a Certificate of occup~mcy 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 applicant agrees to comply with all applicable laws, ordinances, iCuilding cqde, housing code, and reguJ~tion% and t,' admit authorized h'~pectorS on premises and in building for n~cessary in~[~n~ s_. ,_ ..... t..:.5~..,...%~ ....... ~ .... ' (S~ a~g~e of applicant, or ~ame,ff a ~;io'n') .... - (Mailing address of applicant) State whether applicant is owner, 'lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N meofownerofpremises ........... .,ff.. ' (as on the tax roll or latest deed)/$[b[~ie~:i}'~ii J~}~tb ....... If applicant is a corporation, signature of duly authorized officer. (Name and title of corpbrate officer) OCCUPANCY OR NOTIFY' BUILDING O~PART~EnT AT 765-1802 ~ AM ~ ~ PM FOR THE FOLLOWING INSPECTIONS:.. Builder's License No....... ."? ........ USE' IS UNLAWFUL .... FOR POURED CONCRETE Plumber's'License No ..... : .....WITHOUT CERTIFICATE '~' 3, INSUI A'flON Other Trade's License No .... ~ ......... BE COMPLETEt FOR C,O, ALL CONSTRUCT ON SHALL MEET ' THE R~QUIBEMENTS OF TI,l[ N.Y, 1. Location Ofland'on which proposed work will be done ..................... ~&~[ .CONSTRUCTION & ENERGY ' ~ ~( f/~ ~GN OR CONSTRUCTION ERRORS House Number ,' ....... g ................................................... ' ............. Street Hamlet · f/ County Tax blap No. 1000 Section .. Block ~ - t .... o, ............. 2. State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and ' occupancy ...... b. Intended use and occupancy . ' : . ................ 3. Nature of work (check whic~ applicable): New Building ..... Addition · ! · ... i... Repair ........ '~e .... R~moval .............. Demolition ............ ' (Description) 4. Estimated Cost .......... ~ .................. Fee 5. If dwelling, number of dw .! . (to be paid on filifig~'l~S'.hp~lication) lC ....,- . . empg un,ts ....... . ........ Number of dwell ng units on each floor ....... 6. If business' c°mmercial or mi.~ed occupancy, specil'¥natu/reandextentofeae t~;eofuse ......... 2 ...... 7. Dimensions of existing structures, if any' Front.. ?e~O. . . Rear ~.(~_ ~ 13,. He ght ..... Ntt - ~ 'fi' //:LJ ...... ~.pth . ~ ...... .......... i mt~er of Stories ..... ~. ...................................... Dimensions of same structure iwith alterations or additions Front .... Rear . . o. ,ulnlensions o f ent;,-~ ........~ -. ... ..... ,.:'? ......... mumoerot ~tones ....... ,., 2e'gnt...''''¢' ......... Ntt, mberofStories...(j '' jj ............ .:" ....... uepth ..o~: ............ ,, .. - ...... u,~nc[ m wmcn premises are situated .,,~'~-.~t'l~7-4%C~)t ...... . ..................... ~.~ ~oes proposed construction v~,~*~, ......... , ...... · , . ' .............. ........................... Adaress ................... Phone No ................ Name of Contractor ........ i~"-; ....... ' ...... Address ..., .... : ...... n_~._N Is this property within 300 feet of'~ tidal wetland.. *Yes ....... ..Pho o ................ 15.. *If yes, SoutholdlTown Trustees Permit may be requirgd. No..~r ...... · ". I PLOT DIAGRA/Vl .Locate clearly and distinctl}, all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and b ocl5 number or description according to deed, and show street names and indicate whether · interior or corner lot. . ~ ~r ~,~;,;~,,;~ ~:--. '(~'_'_; ' '~ .... :,~.'*,v ~:. ~,,, '~m,g~ duly sworn, deposes and says that he is the applicant , aoove named He is the ........... . ............. ~ (Contractor agefit ............................. corporate officer etc ) .......... of said owner or owners, ~d is duly. mthohzed to perfom or have'perfo~ed the said work and to m~e and file this application; that all statements contai~ 2d ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~ner s}t forth in the application filed therewith. Sworn to before m~ ........................ day of..~ ., 19 HELENE D. HOR~E Nota~ Public, State of New York . ' Qua Commmmon Expwes May ~2, ~ ~ (Slg~alure of apphcant)