The URL can be used to link to this page

Home My WebLink About20373-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPAR%~MENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20743 Date MAY 20, 1992 THIS CERTIFIES that the building. Location of Property 1435 WILLOW DRIVE House No. County Tax Map No. 1000 Section 22 Block 5 Subdivision Filed Map No. ACCESSORY EAST MARION~ N.Y. Street Hamlet Lot 9 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 2, 19992 pursuant to which Building Permit No. 20373-Z dated JANUARY 9~ 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 STORAGE SHED IN ~ YARD AS APPLIED FOR. 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 MICHAEL & MARIA CHECKLICK Rev. 1/81 ~ilding Inspector FORM NO. It 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) NO 20373 Z Date Permission is hereby granted to: ............... ...-b~×...t..~..~ .................................................. ..~..~.~.....~.~.....~....¥.......u.v.~..~ ...... ,o ...~~...~...~~...~~.,..~...~..~~.~.. ...~....¥~...~ ......................... : ............................ : ........................................... ~:. ........... at premises located at ...,/..,~,.~.,~. ....... .~...~...,~,J~z.et~, ........ ~.,..a~. ~....,~~ ....... County Tax Mop No. 1000 Section ..... .~....'~......?~.. .... Block ....... I~..~'~.. ...... Lot No.....~..~ .............. pursuant to application dated ..... ..~...~9~ ....... .~.. .............. , 19.~....~.., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTIiOLD BUILDING DEPARTMENT TOWN HALL 765-18Q2 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 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 si~plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-exzstzng" land usea: 1. Accurate survey of property showing all propcrty~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. Fees i. Certificate of Occupancy - New dwelling $2~$~, Addi%ions to dwelling Alterations to dwelling $25.00, Swimming poo~ $25.00,.~____R~y--5~k~r~i~-~ Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 ~.. 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 $15.00 Date ...... '''~' .~-~--./~J.J~.?..?-C .......... ~ew Construction .......... Old Or Pre-exi~5i~g Building ................. · House No. ''' ' ' ..... Street Hamlet Jnwer or Owners of roperty ....... p oun y Tax No 1000, ..... Bloc ... 0£ ...Lot ..... ...... "iiii ..... ~ermit No...~O.$~... Date Of mi ~ .,Applicant '' eal~h Dept. Approval .................... Underwriters Approval lanning Board Approw~l ........................ eqnc~t for: T'empo~ary Certificate ........... Final Ccrticate ........ Submitted: $ 6 ......... , FOUNDATION FOU~4DATIO)4 (2nd) 2. ROUGH FRAME & ~FLUMBING INSuLATIoN PER N. Y. STATE ENERGY CODE FINAL ADDITIO~A'L COMME~;TS: 765-1802 BUILDING DEPT. INSPECTION ] FOUNDATION IST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] IN/SULATION / ] FRAMING [-'~FINAL DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-]802 Examined .~ .~...~.~. ~ .... 19 · \pprovfd . .~.., 19q'.4. Permit No..-~.? ,~.'[ .~..~ Disapproved (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONs 80AF, D OF HEA. LTII ~ SUR V E'i' ...... SEPTIC FORZl ........... ~ CALL ................... HAIL TO: ~/s~ ................ ..... a. Tiffs application must be completely t~illed in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts 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 r areas, and giving a detailed description of layout of property must be drawn on tlie diagram which is part of this appli- ~tion. c. The work covered by this application may not be c~)mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector ~vill issued a Building Permit to the applicant. Such permit ~all 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 ~vhatever until a Certificate of Occupancy :all have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Buildin~ Department for the issuance o ' ' :ailding Zone Ordinance of the Town of Sou(hold ~',.%~' ......... f a Buddm~ Permit pursuant to the , ou.=~, county, r~ew :re(r, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ae applicant agrees to comply with all applicable laws, ordinancfis· building code, housing code, and regulations, and to !mit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or namel i~ .'; ~)~'t~(;;a'ti'o'n')',''' (Mailing address of applicant) ~ ' ' ' ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. i..o..~. ~ .¢. ,k.& .............. . . =me orownerorpremises .... ~.~.<¢¢ffLl.Cff ~./~['f-...~.~L ZI-7. ? }~..~9~ .~.... ..... , . (as on the t,.~x roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) DATE: ~_B.R Builder's License No. · .FEE: ~ ......... ~ ....... NOTIFY gU~Lt3ING DEPAgrMENT AT 785-1802 9 A~ TO 4 PM FOR ~'HE Plum ber's License No. ,. ~ FOL[OWt¢ G ~NSPE:t. dO. ~S. I~ FOtJND/~rlON TWO ~:IE(~tJiF!ED Electrician's License No ................ FOR POURED CONCRETE Other T~ade's License No ...................... 3. INSULATION 4.FINAL CONSTRUCTION I~US7 8E COMPLETE FOR C.O t q 5 . . ¥ ........ Location of land on which proposed work will be (lone. .' ......... ' ' ALLT~E'~IR~,,~F~T.,,S_, {~rr,_ T,N/E: NY, CONS~RU6TIO~ .SHALL. M.E[.".r.. llouse Number Street I~{~B[!~. NOT vRESPONSIBLE FOR' ~' DEStGN.ORCONSTRUCTIO" ERRORS Con,ny Ta× ,rap No. 1000 Section 0 a 2, mock ' O ....... Lot ...... .O. Subd ,. ion ,' ......... ....... ~ ........................... Filed Map No. (Name) .............. Lot ..... ' ........... ~la[e exJsling use.and occupancy of premises and in ~ended use and occupancy of proposed construction: Existing use and occupancy ................................. . ............................... 'ntended .se and occupancy ;=/¢ property lines. Give street and bock l~tenor or comer lot. ,,~,~cnpuon according to deed, and show ~treet names and ~.Nature of work (check which applicable): New Budding . · · Addition .......... ,'dtcration ... Repair .............. RemovaI .............. Demolition ..... ~.~..0'-.~.. ' · ............. Other Work ............. ~. . ~4/.~, ~ (Description) 4. Estimated Cost ............ . ................... Fee _c~ ~,% 0'-?3 5. If dwelling number ofdw,"' o . (to be paid onfiingt isa licati ~' , elllne, unl[$ ..... ,., _ PP , on) · --garage, number of cars ......... mUmDer ofdwclli~ , t nits o~ eec fl 6. , , , . .. ~ ................... o oor .... ' ......... 7. ~)fi~u~'~ieos~'sco~!~setri~t~al ,or mlx:ed occupancy, speclf)~ natur;'and cxtc;t o'f',,'~'; ','' ',' '~''" .......... : ......... tlcight , mo structures if any' Front. · c,,cn t)~pe ol use ...... . . ............ '.. Rear .............. Depth .............. ............... Number of Stories .................... . .................. Dimensions of same structure with alterations or additions: Front ............ · · · · ep,h ........... ................. ear .......... .......... ' ' ' .................... Number of Stories .......... ' .... 8. Dimensions of entire newc;nstruct out ..... /a'(..: · Rear .... /&: ....... Depth ..ij?.'.'t'j~j Height .../.0 t . 9. Size of lot: Fi'ont'i J ..... Number of Stories /.. .2 ..... ": ......................... r> eofPureb se ' ....... J4;'27" I1. Zone or use district in ,vhich premises are situated ........ )~.¢','q. !~.~eL .-U.I.O-..C-;-.. j jj ........ j jjjjjjjjjjjjj .............. ~ame Otl'omler Owner ' t.~pr,~./_, '/' ...... 12. ~,.o. es proposed construct on violate any zonin,, law o ' . 13. '¢,ilI lot be regraded , . Mr, o , rdmance or regulat on: 14. ,N, ame o,f .Ow.ner of prem,ses fDj~a,.el J.lTlar;.~ ~e&/;;3~,'~.Vlll ex.~e?,fi!! be_,removed from premises: Yes' '/"~' r~ame ot ^rcnitect ...... ' ......... *maress ~#;~:~/.,l, llo~t .Y.r,.,.~...~,~. Phone No ~.Q')- o.¢.a, I. ~ Name of Contractor ~'' ~,~, ~,' f.~--, .............. Address .. · g~-' eh "' ........ · ' .... .'-~- % ...... ' .......... one INO ..... · · 15. Is thz~rP~ropert~y within 300 feet o'f' ~' 't'i'd'a~dwder~s~tb'~ ................ Phone No ....... .. ''' ~ yes, ~outhold Town T ........ ~&mm. *Yes ....... (7 Ma-'~3 ........ · -~ues ~erra~t may be required. ~ ....... PLOT DIAG RA2,! ~ATEOF NEW YORK, "~- ...... " ' DUN~Y OF ...... ~ ...... S~S ,~caCo~ '"~'~C"~'~C'~[C]¢" ''" beingdulysworn, dcposesandsaysthatheistheappli o amc of individual signing contract) ...... from is the ......................... : (Contractor, agent, corporate officer, etc.) · said owner or Owners, and is duly authorized to perform or have performed the sakt Xvork ,~nd to make and fl,e qication: that all statements contained iu this application :Ire true to tim best ~, x~dl be performed in the manner set forth iu the application filed therewith, of his knowledge and belief; and that the )m to before me this .... · · 7{' ....... day of .... i .~J~)-,(1/.. ~.,~,~f. ..... 19~'~- ' l~rm'ExPi~s ~ptember 30, 19~-- ' ',J .............. (Signature ofapp/cant)