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Home My WebLink About20587-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22710 Date NOVEMBER 9~ 1993 THIS CERTIFIES that the buildin~ Location of Property 150 MASON DRIVE House No. County Tax Map No. 1000 Section 104 Subdivision ACCESSORY CUTCHOGUE~ NEW YORK Street Block 7 Lot Filed Map No. Lot No. H~let 1.3 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 23, 1992 pursuant to which Building Permit No. 20587-Z dated APRIL 28, 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 The certificate is issued to JANE SWEENEY (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A l~ing Inspector Rev. 1/81 I~OR~ NO. 0 TOWN OF SOUTHOLD BUILDIHG DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING P£R~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_N°. 20587Z Permission is hereby granted to: ...... ..,..?~..,../..~... ,o at premises located at ..... ./....~....~......~.~..~...~...~.. ............................................................... County Tox Mop No. 1000 Section ...... ./..~...,..~...... Block ......Z ........... Lot No ......... ./.~.....'~.. ...... pursuant to application dated ........ . .~....'..~....~.. ................................ , 19...~....:~., and approved by the Building Inspector. ,p(g Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 365-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. ~hi$ 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. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form) Approval of electrical installation from Board of Fire Underwriters. ~. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. ~. 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 requirement,~. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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 Inspect'or shall state the reasons therefor in writing to the applicant. C. Fees i. 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.O0 Ne~ Construction...~........ Old Or Pre-existing Building..~. ........ · Location'of P r op er ty...~.~ .. ~..~ ~C ................... House No. ' '''itrg~t --' ' Hamlet Onwer or Owners of Property ..... ~...~~ ......... County Tax Map No 1000, Section...~.~ ..... Block ................ Lot .................. .............................. Map ..... Lot .................... Subdivision ...... Filed ........ Permit No~.~. ....... Date Of Permit..~/~.J~.~.. cant ....... .. Appli ................ .. .. . . Health Dept. Approval.~...-....~.,.......Underwriters Approval ........... ~/~ ~.. ...... Planning Board. Approval .......... . ..i ....... ... Request ~or: Temporary Certificate ........... F~nal Cort~cate .... ?OU~;DA~TION { 1st) ?OUNDATION (2nd) qOUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI;;AL ADDITIONA'L COMMENTS: .C 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~'~NA .~.,~/~ DATE INSPECTOR BOARD OF BEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOVV'~ OF $OUTHOLD CHECK .......... ~ "~ BUIL'D, INGDEPARTMENT SEPTIC FORH $OUTHOLD, N.Y. 11971 .. .- ;Oo,i!<~ ,? ...... , TEL.: 765-1802 CALL ,' /9__ MAIL TO: Examined ....... 19. Disapproved a~c ..................................... APPLICATION FOR BUILDING PERMIT .. , ate ...... i z.z._ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Iff'specter, with 3 set~ 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 commenced 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. ~ B APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the uilding 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 alterations, or for removal, or demolition, as herein described. The applicant aerees to comply with all applicable laws, ordinances, building code, housirjg j~}:ie, and.regulations, and to admit authorizec~ inspectors on premises and in building for necessary inspe~/~ (Signature of applicant, or name, if a corporation) ......... (Mailin; address of a;plican;) State whether apiglicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .,. , . Name of owner of premises : ,,~,.~ ~ ~., ~ (as on the tax roll or latest deed) If applicant is a cerporation,'~igfi~tu~e of duly authorized officer. (Name and title of co.orate officer) , ALL CONTRACTOR'S HUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber s License No Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done~ ' ..... , House Number Street Hamle Coun,yTa., lap, o. 000See,on ................ mock .....7. .... .......... Lot... SubdMsion Filed Map No Lot (Name) ' 2. State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy . .~;.,'~..~.. b. Intended use and occupancy '"~-' 3 N eof ork (ch ck hich applicable) N Buildi ' ' -...(/ tiq-~in . atur w e w : ew ng .......... Addition.. .... Alters ... epair ........... Rem6vall .............. Demolition Other ' ' ...... Work 4. Estimated Cost ........................... Fee > · ' (to be paid on filing this application) $. If dwelling, numberofdwellinggnits .... ~,.... Number of dwelling units on each floor. . .--T7~. . If garage number of cars ~ ~ .......... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . .'~"~ .... ' .......... 7. Dimensions of existing stmcture~, if any Front.. ,~ / ~.. ~-~ x r~ .~ t~r~ / ' [tci-ht .~_~' J x~.._.L ..o. . · '~ ................ -~ ........... . .~epm . . . $4,7 ........ D' ' '!l dditi .~.' .C~. '. <.dy miens:OhS of same structure w: 1 alterations or a ons: Front ,.. Rear.. Depth ...".. '. Height .... ' ......... ~ ............ 8 Dim si so~ ............... ..............NumberofStories ............. · en on entire new construction: Front . /a-, R /..~ ' D pth ¢.~'.' ....... ......... ' ..... ear ............ e ............ H 'ght . .,~ff' N b f st el ............ unl er o ories ..... 9 si fi r '"".-'...... · zoo Bt: font .. : ............ Rear "' 0 D of P /~.a ....-.~.'..-...-- .. tJcpm ... . · ate urchase ,o · · · ....... .. ............ ~ ................. Name ~f Former Owner ............................. 1. Zone or use district in which premises are situated ....................... 3. Will otberegraded /3~'..,¢.. I. ,,. .... ' ..... Name of Owner ' ""' ' [~7:~;' '&c.~.;'; ....... w,,, excess rill be removed from premises: , ........... ; ....... one ,,o ..... Name of Architect ........................... Address ................... Phone No ............. :.. Name of Contractor ...................... Address .... : .............. Phone No ......... 5. Is this property located w, ithin 300 feet of a tidal wetland? *Yes .~.. No ..... .i~ ....... · If yes, Southold Town Trustees Permit may be required. .. ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from S roperty lines. Give treet and block ri,umber or description according to deed, and show street names and indicate whether ~terior or comer lot. ~P/PR0~E.0 AS NOTED 7~5-~802 9 AM TO 4 PM ~R THE FOLLOWING INSPECTIONS: I, FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRA~ING & PLUMBING 3. INSU~TION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. AL~ CONSTRUCTION SHALL ME~ THE REQUIREMEN~ OF THE STATE CONSTRU~ON & ~ERGY CODES. N~ RESPON$ffi~ FOR DESIGN OR CONS~U~ON ERROR~ ?ATE OF NEW YORK, S.JS 3uN-rY OF ...... ~ · '/ ..... ............. ~?....-~..L~. ~. · .~. · .~. .......... being duly sworn, deposes and says that he is the applicant . (Name of individual signing contract) Bye named., ,; (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly huthorized to perform or have performed the said work and to make and file ,this plicat on: that a l statements contain!ed in this application are true to the best ofhis knowledge and belief; and that the ~rk will be performed in the manner s~t forth in the application filed therewith. ,om to before me this ........ ...... day Of. 'l' ("~'~ ........... 19 tar), Public ...... ' County ...... ~.. ..... . .'c~.. a/..%..,~.-.... ~.~ ....... UNDAJ. COOPER (Signature of applicant) Nola~ Publio, fi~te of New'Ymt~ -- No. Term E~lr~