The URL can be used to link to this page

Home My WebLink About21791-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22736 Date NOVEMBER 22, 1993 · THIS CERTIFIES that the building Location of Property 985 ELIJAH'S LANE House No. Street County Tax Map No. 1000 Section 108 Block 4 Subdivision Filed Map No. ACCESSORY MATTITUCK, N.Y. Hamlet Lot 7.5 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 16, 1993 pursuant to which Building Permit No. 21791-Z dated NOVEMBER 18, 1993 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 SHED "AS BUILT" The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JOSEPH & CATHLEEN SHIPMAN / B~z~ding Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N_O BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....z~..~/...~..~..~.,. .......................................... 21791 Z Permission Is hereby granted to: .................. ........ ~',..~ ....................... · :::::::::::::::::::::::::::::::::::: at premises located at ....... ~.,~,..~,., ............................................................ CountyTax Map No. 1000 Section ....... .~.~...~ ...... Block ....... ~ ........... Lot No, .... ,~.~.~,~..~.. ........... pursuanl'~o application dated ......../,,/, ............................................. 19..~.....-~.. ...... and approved bythe Building Inspector. ./ ~/ 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/i0 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. 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....... %1./.~. ~ l~,~ ..................... .. New Construction ........... Old Or Pre-existing Building ......... ~ .... Location of Property ...... ~.~.~7 ~'~'-Y'z"jI~ ~ z/~ ./~...z~.~7~. (.~'..~.~.,/~ House No. Street Hamlet Onwer or Owners of Property ........... ! 7~/- { ~ ....... County Tax Map No 1000, Section...Z~. ...... Block....~..~. ......... Lot.. ~O$, f~. Subdivision ................. Filed Map ...... Lot .................... Permit No..~J2~!..~. ..... Date Of Perm .............................. it Applicant . Health Dept, Approval ...... .6~,./~ ............... Underwriters Approval ......................... Planning Board Approval ...... ..~.(~ ............. Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ............................. xoq )l ........................ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1197~1 TEL.: 765-1802 Examined . ? ......... , 19 ~t:~... /./.~. ~. 19~. Permit No ~/7~'/.~ Approved ............................ Disapproved' a~.~g wr~%.,~,~ ~[~em ........... ' .~J~*- ,,J.',:a.~ ~-.~ ~ ,.T[~I~~ ~T ......... ~ · · · ~/ ....... ~-. ...... 'i(~;~-~8~9 *.~ ?:~F~ '~'D 4 PM FOR t'H[ . ~uildi~nspector) t. F(;U',~::~A'P('~k, 'YqcVF> ~lf~'tl.IIRE~PPLIcATION FOR BUILDING PERMIT ¢.. ,., , ~,- ~ INSTRUCTIONS 3 SETS OF P~NS .......... survey ................... c. cK .................... SEpTiC .............. C^L g -gY ......... blAIL TO: Date.. z .......... 19 a~ =~'E COM~LE'['[ FOF.~ Ck;Z . · ,~,~m~.,A~t~c~on,mus~ be, comolo-tely filled in by Wpewnter or in ink and submitted to the Bulldog Inspector, with 3 sots o~n~L'~}~,[~'"p~.~;s¢~e,~'e~ee according to schedule . ' . b.~e ~9~~'~'1 at~o~'o - · ~and of bulldogs on premises, relationship to adjo~mng premmes or pubUc streets or are~L~p~ g~. a ~[~[~ip~9~ of layout of property must be drawn on the diagram which is pa~ of this appH- catz°~ES!GN 08 CONST~UC'rIOh~ E~IRORS c. The work covered by t~s application may not be cbmmenced before issuance of Bugding Pemit. · d. Upon approval of thls application, the Building Inspector will issued a BuQd~g Pe~Jt to the appQcant. Such pemit sh~ be kept on the premises ava~able for ~specdon throughout the work. c. No building 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 by the ~uilding Inspector. APPLICATION IS HEREBY MADE to the Bulldog Dep~ment for the issuance of a ~ldin~ Pemit pu~uant to the ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other appUcable ~ws, Ord~ces or Regulations, for the construction of bufld~gs, additions or alterations, or for removal or demolition, as here~ deschb~d. The appeLant agrees to comply with all app~cable laws, ordinances, bufld~g code, housing code, and regulations, and to admit authorized ~spect0~ on premises and ~ bulldog for necess~ inspections. . . ...................... ~(Sigffature of apphcant, or ~ame, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . . .~.~./.¢.. F)...~.L)....~.~.T.P/.4 ~/.-z..~...,.,.,.,.,.,.,.,.,~.. ,~ !'~j:?~7 .,:¢'~. '. .......................... (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. ~ ~ L/~ . Plumber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No... .................... e' 1. Location of land on which proposed work will b done ..... ....... T.r..L ........ UT:. .......................... House Number Street Hamlet Cou'nty Tax Map No. 1000 Section ... ;./.g/?. ......... Block ....~.~... ' Lot..~.'.~. ? :.~.~ ......... Subdivision../~../.~b].zS..~..~...~fl./.-~. ............. '. Filed Map No. ~.~..~:.¢~. ....... Lot (Name) 2: Stat~ existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ' .,,,~'-/-O,q~ ,~ /.~. .... ~..~ , ~.~. ~o.' T~.Od,~ ~ .~.~... , . b. Intended use nd occupancy ..................... ' ............... ,,.,..' .': .'; .......... . ................. · 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .... ; ..... Repair RenlovaI Demolition Other Work I ' ' ~' (Description) 4 Estimated Cost ]/~. ,.~-o ' ' · ' .... Fee ' (t b paid o fill g this ppli tion) [ o e n n a ca 5. If dwelling, number of dwelling units ............. Number of dwelilng units on each floor... Ifgaag numb of cars ] '' ' .... 6 Ifbusi i lormix~d .......................................................... 7' ness, commerca . , occupancy, specify nature and extent of.each type of use ............... , ..... · Dimensions of existing structures, if any: Front.. ,:~..O~ '.. Rear ~.~.' ' Hight 1~..~ -~'.ff~). N mb r of Sto / i ........ Depth /.~ Dim si fshme t ctue v~ith alteration addition Fro ..................................... en ons o s ru r s or s: nt i ................. Rear .................. Depth .... ~ ................. He .......... · ........ ;.. Number of Stories .................. 8. Dimensions of entire new cons ction: Front ............. Rear ........ De ...... ........ pth ....... ight ~N nib .He ............... u er of Stories ......................... . 9. Size of lot: Front · ·, i ........ ~.. Rear .... 2¢7.o ..... Depth ............. 10. Date of Purchase ........... .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated .... ~ -~.,,6.: ......... ·. . . .12. Does proposed construction violate any zoning iaw, ordinance or requlation.'~ '~b .................... 13. Will lot be regraded ;o o ...... ° .... ' .... : ;, ....................... ~ ......... ~ ............ ; L ..... wm excess Illl De remove(] trom premises: Yes (Nfo~ Name of Architect ........ ?& ................ Address ................... Phone No. Name of Contractor . ~'. t . _,, · .......... : .... ....... · ............. ^uuress ................. Phone No ............... 15. I.s this property within 300 feet of a tidal wetland? *Yes ........ No..g~.... ' · If yes, Southold ~own Trustees Permit may be required. '' PLOT DIAGRAM Locate clearly and distinctly all ibuildings Whether existing or proposed an& indicate all set-back dime ' roe ' ' [ . . . nslons from .p, p. rty lines. Gl.ye street and block number or description according to deed, and show street names and indicate whether mmnor or corner lot. i . · . STATE OF NEW Y~,J2~ (6..S.S COUNTy OF... ~.~... above named(.Name of individual signin~ contract) ..... being duly sworn, deposes and says that he is the applicant (Contractor agent cori~orate officer etc ) ................ of said owner or owners, and is duly ~uthonzed to' perform or have performed the said work and to make and file this application; 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 s~t forth in the application filed therewith· Sworn to before me this ........... /~;..~7...day o£C/~x,.~,~//~(/(..'......, 19~?: . ' ·.._. .:. . . ' · ' . . of." Vo. ' . 'F ...... .... :" ', .... : , _ NO, 4879§06 ..... ~r 4 t~lgnature o~ applicant) . ,, ' . ~ion E~plres December 8~ 192/~. '