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Home My WebLink About20924-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20987 Date AUGUST 28t 1992 THIS CERTIFIES that the building Location of Property 555 VILLAGE LANE House No. County Tax Map No. 1000 Section 25 Subdivision ADDITION ORIENT, N.Y. Street Hamlet Block 2 Lot 5.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26r 1992 pursuant to which Building Permit ~). 20924-Z dated AUGUST 27~ 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 ADDITIONS TO AN EXISTING ACCESSORY BARN IN REAR YARD AS BUILT The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTYDEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 DOUGLAS & KARIN CONSTANT FOI~ NO. II TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PER'AlT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~To, 2092~Z Permission is hereby gra~ed to: ~..~...~.~/.~....~..-...~. ................ .... .,z...~ ...... ~.~.~.~.....~ ...................... ....0..~,~.~......~.: ............ /..c?.~. ............ ..... ~ ....... ~ .................................... ..~.. ........................................ ~ .................................... .............................. ~J.~ ....... ~..,f../..~.~ ....... ~.~.:. ........... c~....~ ........................... ct ~remises Dcoted ............................... '././ .................................................................................. _ O~e/5.~z- ........ .............................................. '.~.~...~....~......~~ ....................................... County Tox Mop No. 1000 Section ....,,o~.,,O'~ ........... Block ....... ,,~/,,~,, ........ Lot No ...... ~../. ......... ~u~uon, ,o o~,"~o, ion do,,~ .................. ~./..4~ ....................... , I,.f~, ond o~ro~,~ ~, ~e Building Inspector. ,Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FORCERTIFICATE 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 site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '~pre-existing" land uses: i. .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, 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 - $1OO.O0 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $t0.00 , 4. .Updated Certificate ,of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.O0 / / '~lew Construction ...... ./..~O~ Or Pre-exis~ing Building ....... Location of Property;..~"~."-/ ............ ~.'~'~- ......... ,,. House No. ~' Street Hamlet )nwer or Owners of Property. . . ~ ............................ ,~ounty Tax Map No 1000, Section. '=~ ~ ...Block. ~ .Lot.., ~.~ I ;ubdivision ' Filed Map . ... Lot 'ermit No~.~.~ .... ~ '~ .... ~/~ /~ A~licant.~.~10~ ,uatq o~ermig..,~ .... ~ ....... ~ .... ,.~ .................... 'lanning[ealth Dept.BoardApp r oval....~../~.~Approval ......... Underwriters Ap p rove ~.. ~. ~.yJ~ ~.~ l~.../ , %equest for: Temporary Certificate ........... Final Certicate ........... ~PLIC~T FOU~;DATIO:$ 2. ¢2nd) HOUGH FRAME & ·PLUMBING INSULATION PER N. Y.' STATE ENERGY CODE FI;;AL ~DDITIOH~L COMMENTS: Examined .... .~/~..Y ...... 19 ~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved ....... ~. ...... 19/... Permit No ........... Disapproved a/c ..................................... " spe;t~;~ ........ BOARD OF HEALTH ........ 3 gETg OF PLAIIS ........ SURVEY ................. CIIECK .................. SEPTIC FORt! ............ / MT~I L T O: INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with se'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 street or. areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl 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 permi 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 Occupant 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, 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 t, admit authorized inspectors on premises and in building for necessary ins~/~ctinns .... .... /.~ c~ 1~ ~&~. ..............· -- (Signatufe'of applicant, or name, if a corporation) · (Mailing address o f applica~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............................. :f ...... . ........ ~ ..... . ....................... APP. Rv, VED-A$ NOTED ...... Name of owner of premises .... ............. ~ (as on the tax roll or latest ~¢) ~ :~ ~y:~ ~ NOTI~ BUILDING DEPARTMENT AT If applicant is a corporation, signature o f du~~OR ,o, .............................................. 1, FOUNDATION ~O REQUIRED . (Name and title ofco~orateof~E ISUN WFUL FOR POUREDCONCRETE Builder's License No. ~.i~ 2. ROUGH - FRAMING & PLUMBING 'WiTR'0UT CERTIFICATe: FINAL CONSTRUCTION MUST Plumber's License No ......................... 8E COMPLETE FOR C.O. Electd~hn's License No ............ THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Other Tr~de's L~cense No ...................... CODES, N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS I. Loc~ on ofhnd on which proposed wore will b~'done ................................................ Hous~ Number Street Hamlet ~o,m,~ ~ M~ ~o. ,000 ~,'on ....... ~.~ ..... ,,o~ ....... ~ ........ ~o,.. ~C 1 .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~ .... Oz'tq4~..~. ~&. ~. ,~-~: ..... : ........ b. Intended