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Home My WebLink About20366-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMenT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20451 Date JANUARY 8~ 1991 THIS CERTIFIES that the buildin~ Location of Property 195 MATTHEWS LANE House No. County Tax Map No. 1000 Section 84 Subdivision ACCESSORY CUTCHOGUE~ N.Y. Street Hamlet Block 1 Lot I5 Fi]ed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore flled in this office dated JANUARY 6~ 1992 pursuant to which Building Permit No. 20366-Z dated JANUARY 6~ 1992 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 TOOL SHED AS BUILT. The certificate is issued to MICHAEL FINNICAN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A - ~uilding InSpector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 20366 Z Permission is hereby granted to: ~~ i../~L. --2~~/;. ,~....~ ....... at premises located at .... ./.....~... ~ ...~Z ~ .... ................................................ County Tox Map No. 1000 Section ...~....~., ........... Block ......... .~ .......... Lot No ....... /....~.~ pursuant to application dated .... .~ ........... ~ .............. , 19...~.~nd approved by the Building Inspector. Fee S,.~.~...~,..~ ..~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN NALL 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 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. 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-ex%sting" land uses: 1.Accurate survey of property show{ng 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.O0 3.Copy of Certificate of Occupaacy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupanoy - Residential $15.00, Commercial $15.00 · .ow Cunseruetion ........... Old Or Pr -existing Buil~/ng ...... ./.. ,.o~a~io~ of ~roperty. . . /£?. . ................. d~.z. .4~. .~. . /~. ~. ./~. .~.~. liouso No. ' ........... · ..... ~nwer or O~ners of Property ..... . .. . ~ :°u°tY Tax MaP N° 1000' Secti°n''~'''~· ...... Block ..... ~ ......... Lot ....... ubd ivision. 7. :' ........ ......... Filed ~ p. .Lot ........... 'erin,. No. to of Pormit.. .: Z..-:.. :ealth Dept. Approval ................ Underwriters Approval !,rasing Board ApProw~l .... .'~.. equest for: T'emporary Certificate ........... Final Certicate .... .../... Submit ted: $ .... ~.~ .~..~. ' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................. 19... Approve~... ~.. .... [9 ~t~l~ermit No.. ~..~..S.~. ~ 7_ Disapproved a/c ..................................... BOARD OF HEALTH '.~.~.2 .... 3 SETS OF PLANS~._,..~. . ClIECK ................. SEPTIC FORH .............. CALL ................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis 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 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 cbmmenced 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 part for any purpose whatever until 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 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 altergtions, or for removal or demolition, as herein described. The applicant 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 necessarf~ction~, ~. , ............ - ' (Signature of apl~liea'nt, or name, if a corporation) / q.:. .~. .45¥<~ ~. .... . .~. . . .~. :?.~. .... ~¢. . ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..../~..7.~..~...~./.....~/...~..I.d.S..,~. .............................................. (as on the t,ax roll Or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... .~..~..~.e~:::: Plumber's License No .......... ./ 1 Electrician's License No ....... ?. ............ Other Trade's License No ...... (.... .... : ....... 1. Location of land on which proposed work will be done .................... ' · ../f.~. ...................... ~..~. · .:. · · ~ ............... dm:..¢...,~. ~. ?.~': .......... House Number Street Hamlet County Tax Map No. 1000 Section .... ~...~. ......... Block ...... [ ........... Lot ..... ./..~.. ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ..... 3. Natureofwork(checkwhichappl'icable): New Building ... ddition .......... Alteration .......... Repair Removal Demolition Other Work ' '~ ~..~.~--/--~'"~..~ (D ripti ) 4. Estimated Cost. . Fee .... ; (to be paid on filing this application) 5. If dwelling, numberofdwellingunits, .......... ..... Numberofdwellingunitsoneachfloor ................ If garage number of cars 6. If business, commercial or mixed 9ccupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ...... : Depth Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ! Height Number of Stories 8. Dimensions of entire new construdtion: Front Rear .............................. Depth ............... Height Number of Stories 9. Size of lot: Front ............. i ......... Rear ...... Depth ........ I0. Date of Purchase .............................. ............. ....... ......... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........... i ................. Will excess fill be removed from premises: les No 14. Name of Owner of premises .~('.iz.z.z.z.z.z.z.z.z~../. ,~x,u'~,/(,¢-)~ .~ .... 'a~'~/'~4~rJ~--t-) ~ -'J-- ~,- .~ ~1~, ."~..~..~7.~.-~.~d~.. Name of Architect ........ ..~..~L .~-g-,~... .......... Address ................... Phone No ................ Name of Contractor ........... i ............. Address ................... Phone~,~o ................ 15. Is this property within 300 feet of a 't'idal wetland? *Yes ........ No.. *If yes, Southold ToWn~ Trustees Permit may be required, w{~ .... PLOT DIAGRAM Locate clearly and distinctly all bdildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or descriptioh according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEVktJI~RK, S S COUNTY OF ..~ · ......... . (Name of individual signing ontract) ~bove named. being duly sworn, deposes and says that he is the applicant te is the .................... ~ ...................................... i (Contractor, agent, corporate officer, etc.) ................... )f said owner or owners, and is duly aulthorized to perform or have performed the said work and to make and file this tpplication; that all statements containec1 in this application are true to the best of his knowledge and belief; and that the york w//1 be performed in the manner seti'forth in the application filed therewith. ;worn to before me this ............ ~7-. 2~-5-3~.~..day of / I ...... ......................... ~qo, ~.8~2~8fi.o,_ ~t~u~ ( (S~gnature of applicant)