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Home My WebLink About20527-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20836 Date JULY 2, 1992 THIS CERTIFIES that the building Location of Property 4205 House No. County Tax Map No. 1000 Section ACCESSORY GARAGE MAIN ROAD LAUREL~ NY Street Hamlet 125 Block 1 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 7~ 1992 pursuant to which Buildinq Permit No. 20527-Z dated APRIL 8, 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 GARAGEAS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIPICATION DATED WARREN & SUZANNE WIELT Rev. 1/81 l~Olt,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAiL SOUTHOLD, N. ¥, BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No-N? 205~?Z ~te ...... .~..~,... ........ ~. ............... , ~9..c/...~ Permission is hereby granted to: ..... ....... ................. at premises located at ...?..~...?...~/,. ...... ...~..0~......Zd.u .......~ ......................................... County Tax Map No. 1000 Sectio,~,../...c~....~.. ......... Block ......~....J ........... Lot No....~...~ pursuant to application doted .~......7.f '/ -- ......................... , 19.~....,2~., and approved by the Building Inspector. Fee *.Z~.."3.:~A ..... Building Inspector Rev. 6/30/80 Form No. 6 TO~N OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 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 1% lead. 5. Commercial building, industrial building, m ultmple 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. B. 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. ' 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 - $i0.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ' · Date . ~ ........ ew Construction .... O1!Or Pre-existing Building..~ ........ ocation of Property....~.~.~.? ..... ~ llouse No. Street Hamlet ~wer or Owners of Property .... . ..... )unty Tax Map No 1000, Section ........ Block ............. Lot...~. ................ .bdivision .................................... Filed Map ............ Lot ..... rmit No.~.~$f~.'Z.? .... Date Of Permit~.~..Z~ cant ...... ..... Appli .~?~ alth Dept. Approval ......... ................. Underwriters Approw~l ......................... anning Board Approval ........................ quest for: Temporary Certificate ........... Final Certicate ..... e Submitted; $....~.. ........... .................. ......................... APPLICANT FIELD FOUNDATION ( ls t) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING I~SULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS FORM NO, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 ~ , TEL.; 765-1802 E× aminedX.~/~J~ Approve~.. Disapproved a/~ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF KEALTII ......... 3 SETS OF PLA:IS .......... SURVEY ................... CIIECK ..... CALL ................... MAIL TO: INSTRUCTIONS a. Tlfis application must be completely filled in by typcwriter or in ink and submitted to the Building Inspector, with 3 2ts o£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 areas, and giving a detailed description o£ layout o£ property must be drawn on tlie diagram which is part o£ this appLi- ation. ¢. The work covered by fl-tis 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 aaJ1 be kept on th~ 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 o£ Occupancy roll 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 uilding Zone .¢l'tg!~gf~egg§f~g;~t~L~. of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or -t~ulations for the c~g~io~ o( buildings, add tions or alterations, or for removal or demolition, as herein described. applicant agrees to cohnply with all applicable laws, ordinances, building code, housing code, and regulations, and to flmit authorized inspectom on premises and in building for necessary ir3s, pe/etions. _ ............. (Signature of applicant, or native, if a corporation) (M'aiLing address of applicant)' ' ' fate whether applicant is o~vner, lessee, agent, architect, engineer, general contractor, electrician, plumber ~r builder2 ame of ownerofpremises . ' '~ . . ' (as on the t~ roil'or latest deed) 'applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... g'~¥~/.' .......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land off which proposed work will be d't}ne ................... IIouse Number Street Hamlet County Tax Ivlap No. 1000 Section / a~.~.'"- g/ .............. Block ................. Lot ................ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing Use and occupancy of premises and intended use and occupancy of proposed construction: 3. Natureofwork c , · .i ' ~ ' ( beck whJch apphlable): New Building ...... Addition .......... ?alteration .......... Repair .............. Remora .............. Demolition ............. Other Work ......... 4. Estimated Cost ......... x. ? (to be pa d on filing this application) 5. If dwelling, number'~C, dwelling un!ts ............... Number of dwelling un ts on each floor . If garage number of car~'~ ,' - ............ 7 r,: ............ ,~.y,-. 7, ,,~u oecupancy, specuy nature and extent of each type of use ... ' ' n~ u Js oi existing stmctu/,qs If any Front ,- ' ................. ~ . .............. Prom O"e,,r ol Stories .... ' ........ Dm~enslons of same structure with ~ ....... ',J ............................................ ,, _ e structure with ~rauons or aaoltlons: Pront ....... Rear ... 8. Dnnensions of entire new constructit};'~'~-~ ......... Height ....... ~r ~'i~ir~fi~ ........... 'Rear ........... Depth ....... · mze otmt Front ......... .. X,~ ....................................... I0. DateorPurchase .~iZZiL\ ........ ., · ......... Depth ...................... · ~ urn,ct m wmcn premilges are situated ..~X ........... . . ' i . 12. Does proposed construction violate any zonin~ law. nr~' ' ' ' ; ........................ ,~ ...... ~ ............... ~i~l excess nu t~e removed ~rom premises: Yes No t'*. rqame oluwner mpremises .................... Addr~ ................... Phone No ................ Name of Architect ~~ 2{222 ~t~t;es~5 ......... Phone No ....... Name of Contracto~~;;~ '.'~,' ' ................ Phone No ...... i.. Z ...... Locate clearly and ~sting or proposed,~d, indicate all set-back dimensions from property lines. Give street and block nu nber or descriptioh acco~d~g~'o-c~;;~"and'~ ow street names and in ~ntenor or comer lot. d~cate whether I EqUIR · (Name of individual signing Icontract) ore named, r I~OTIFY GU}t. OING DEPARTMENT AT 765-1802 9 AM lO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOtJND~FIO~ ~0 REQUIRED FOR POURED CONC¢iETE 2. ROUGH ~ FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSIRUC~ION MUST 8E COMPL~I'E FOR C.O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, SLATE CONSTRUCTION & ENERGY CO0~S, NO~ RESPONSIBLE FOR DESiGN O~ CONSTRUCTION ERRORS being duly sworn, deposes and says that he is the applicant ~ (Contractor agent corporate officer crc ) said owner or owners, and is duly a{~thorized to perform or have performed the said workhnd to make and file this '~lication; that all statements containe'd in this application are true to the best of his kno~vledge and belief; and that the ck will be perfomed in the manner se~ forth in the application filed therewith. om to before me~ N~ Publle, ~ate of N~i~ ........ N~ 4879505 ............ ~ Qual~lnSuff~kCou~ ( (Signature of applicant)