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Home My WebLink About21372-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No ~-22297 Date MAY 3, 1993 THIS CERTIFIES that the building. ACCESSORY SHED Location of Property 1250 VILLAGE LANE, MATTITUCK, NY House No. Street Hamlet 107 Block 11 Lot 7 County Tax Map No. 1000 Section Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 26r 1993 pursuant to which Building Permit No. 21372-Z dated APRIL 27~ 1993 was i~sued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY SHED "AS BUILT" AND ANCHORED TO CODE. The certificate is issued to EILEEN A. ABATE (owner) of the ~foresaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH A?PROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FO~e NO. ~ TOWN OP $O~T~OL~ BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJVtlT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2137~- Z Doto .....~...~.~..Z ...................................... , ~9~..~ .................................................................... ..................................................... County Tax Mop No. 1000 Section ...... /..~....~.. .... Block ......... ././.. ....... Lot No ........ ..~.. ............ 19~.~..., and approved by the pursuant to application doted .....~..~...~ ....................................... , Building Inspector. Fee $ ........... ~ Rev. 6/30/80 APPLICATION FOR CERTIF%CATE OF OCCUPANCY TOWN OF SOU~HOLD BUILDING DEPARTMENT TOWN HALL 765-1802 A. 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: ~ I. 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-~onforming 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, Additio~[s 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 - $10.00 4.Updated Certificate of Occupancy - $50.00 5. Templrary .~..~.o/~. ~. Certificate of Occupancy- Residential $15j~00, Commercial $15.00 ~ Date .... · ..................... New Constructmon ....... Old Or Pre-existing Building ................. Location of Property. (.~.~.d. ~ ~.~.~,- .~.~. ~ ~-~'O~-~( .~. House No. Street Hamlet Onwer or Owners of Property ............. , ......... ~ ..... . .............. ~ounty Tax Map No 1000, Section .............. Block ...............· Lot ...................... ~ubdlvlslon .................................... Filed Map ........... . Lot ...................... ?e o ................ Date Of Permit ................ Applicant... lealth Dept. Approval .......................... Underwriters Approval ....... ?lanning Board Approval ....................... . ~equest for: Temporary Certificate ........... Final Certicate ........... ....... ' ............. ;OU~ DA~IO.N ( 1 s t ) ~UNDATIO:; (2nd) ~UGH FRAME & .PLUMBING ~$ULATIO:~ PER N. Y. STATE E~;ERGY CODE FI;;AL ADDITIONA'L COMME~TS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS~ULATION FRAMING ['~INAL DATE ,, ~//~f/~ INSPECTOR facilJt!o~ ~'~' '.ht~ ~', ~ have been ~s~ec%e8 k ..... :x ,,e~i' -:mn~ and fo~d to be sstisfactc~t. C~ief of' General Engineeri~ LICENSED LAND SURVEYORS '>J' GREENPORT NEW YORK SUFFOLK CO. HE,~L'J'H DEPT. APPROVAL H.S. NO. 14-50-27 STATEMENT OF INTENT THE WATER SUPPLY AND SEW,AGE DISPOSAL .SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT S~JFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY DATE: H.S. REF. NO.: APPROVED: . SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: DEED: L. ~/~ P. TEST HOL~ STAMP ' ' SEAL · 3. Nature of work (check which apPhcable ..... i;.. . . · Removal .,. new nuuamg .......... Addition .......... Alteration ... ;.. ~. Repair .............. . ............. Demolition . :..: ......... Other Work~t~ 4. ~.-,.c, ' ' ' E~.~5'-j~ ~ (Description) Estimated Cost ........ . ........... Fee ............................ $. If dwelling, number of dwelling units ............... Number of' (to be paid on filing this application) If garage number of ears . dwelling units on each floor ........... i ' ' ' 6. If business, commercial or mixed occupancy specify ..... ' ........ "· · 7 Dimensions of existing structures if any: FrOnt nature and extent of each type of use Height Numt~er of Stories .... t .......... Rear .............. Depth Dimensions of si~me structure with alterations or additions: Front Depth ' Height Rear Number of Stories ' Di n wf i,ru 8. H mensions oft ction: Front .............. ; Rear ............... De · eight ....... ~[Iglf..~'.i~.~rffiTlber of Stories .......... pth ii ...... ~'i'i'i 9 Si fl i .................... 2:: .... . · zeo et: Fro'it ..................... Rear ............... Depth .. 10 D fP ' ' ' · ate o urchase .............. , . ' ...... · ............... ..... amc of Former Owner ..................... 1 1, Zone or use district in which premises are situated ............. '. . . ,Does proposed construction violate any zoning law, ' ....................... j · · 1.2; ordinar~ce or regulation: ................. ~o.' .... '. 13. .. . Will lot be regraded ; ...... : .......... : ......... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ................ Address ................... Phone No. · - Name of Architect ..................... " Address .......... Phone No ...... -. Name of Contractor ..................... Address ............ : ...... Phone No ................ 15. I.s this property within 300 feet of a tidal wetland? *Yes ........ No ....... · If yes, Southold Town Trustees Permit may be required. ' ° .... PLOT D I AG PoMM Locate clearly and distinctly all buildings, v~hether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to d&ed, and show street names and indicate whether interior or corner lot. APPROVEDASNOTED. DATE: - B.R # ' FEE: - ~v. NOTIFY BUILDING D~P,~'RTMENT A'I~ 765-1802 9 AM TO ~. PM FOR THE FOLLOW!NG INSPECTIONS: .' I, FOUNDATION - TWO REQUIRED t~OR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL "· CONSTRUCTION MUST 'SE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ;TATE OF NEW~dO~RY~ :ouyrv oF....-s:o, t-. t.o.c. ¢. .... (Name ofiddividual signing contract) ' ' bore named. (Contractor agent corporate officer etc ) ....... f said owner or owners, ~d is duly authorized to perfo~ o~ have perfo~ed the said work and to m~e and file this ~plication; that all statements contained N this application are true to the best of his knowledge and belief; and that the ork wgl be perfomed in tbe"~nner set forth in the application filed therewith. ' .yom to before me this/.~ ' NOT~YPUBLIC~'~v - . ' (S~gnature of a licit . N ~' " PP ) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD'OF HEALTH 3 SETS OF PLANS SURVEY CIIECK ................... SEPTIC FOg~l SOUTHOLD, N.Y, 11971 ' / ' TEL.: 765-180;] ' E× "· ~Z/~ ~ ~ . ' c,~ ~.~V..V ..... :. anlme~ . [~ .~ .~ ....... , 19 , . . -- ' ', MAIL TO: ~ , ...... ,..,,, : ........... , ....... , Disao ..... ' · ~ , / I~ ~ m m . ~. ~ '~ ............. ........................ ' ........ : ...... .'. ...... ,,ta ' ' ~ ' ' INSTRUCTIONS a. Tlfis application must be coCpletel7 filled in by ~pewHter or in ink and submitted to the BulldOg Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. . b. Plot plan show~g location ~f lot and of bulldogs on premises, relationship to adjoining premises or pubic streets or areas, and giv~g a det~led descfiptioh 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 n~t be commenced before issuance of Bufldin~ Pemit. d. pon approval of thru apphcChon, the Building Inspector will i~sued a Bufld~g Pemit to the applicanL Such pe~it sh~ be kept on the premises available for ~spection throughout the work. e. No building shall be occupie,id 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 Buildi;ng Inspector. . APPLICATION IS HEREBY MADE to the BuildNg Depmment for the issuance of a B~Iding Pe~it punuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other appUcable Laws, OrdN~ces or Regulations, for the construction o~bufldNgs, additions or alterations, or for removal or demolition, as hereN described. The applicant agrees, to co~ply..with all applicable laws ordinances build' code housin code and e-u · . , ,, ,~ .,' · ~, ~, .... , g , r =lations, and to adm,t authorized ~spectofl on pr~m!ses a~d m budding for necessaw ~ns~ ' . State whether applicant ' 'essee, 'agent, architect, engineer, generai contractor, electrician, plumber or builger. Name of owner of premises ' · ~ (as on'the tax roll or latest deed) If applicantds a corpofatioh,, signatuie of ,duly authorized officer.' (Name and title of corporate officer) ' Builder's License No ...... ' ......... Plumber's License No ....... Ele tnclan s License No ..... Other Trade's License No.... LocaU,.on of land on which proposed work will be done ........... : /~'.?.o. ~ .(..~..'.e House Number Street Hamlet 100 [.o..7. ' :ti 7 Couhty Tax Map No.0 Section .......... Block ........ ' ·. Lot ............ ' ..... Subdivision .;. · p N ........ . ......................... '. Filed Ma o ............... Lot (Name) ............... Stat~ existing use and occupancy ~f premises and intended use and occupancy of p[oposed constructioni a. Existing use and occupancy ........ *.-:.~.~. ~ ~ }{ ......'. . ~,.. o :-';~ ........ , ..... 8