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Home My WebLink About20447-zFORM HO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20576 Date NJ~RCH 9~ 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 1475 PECONIC BAY BLVD. House No. Street County Tax Map No. 1000 Section 145 Block 1 subdivision Filed Map No. LAUREL~ N.Y. Hamlet Lot 2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 20, 1992 pursuant to which Building Permit No. 20447-Z dated FEBRUARY 25, 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 SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNI~I DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 RICHARD P. & GRACE I. GRIFFITH /~il~ing Inspector ]~OB~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PRF-Jv~ISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 20447 Z Permission is hereby granted to:/2 ~ ~ ~ _ TM a I~ated at ..... ~.~Z~... ~.~ ...... .............. /~;;~/ ~, ~. ~". ~ ~ , ............ ...................................... ~"~'~'~t'""~ '"'~"~ ......... 7 ......................................................... Co..~ fox M~p ~o. ~000 s.~t~o. ...... ~.. m~ ............ ~ ...... Lo~ No. ~ pumuant to application dat~ ..... ~. ................................... , 19.~ and approv~ by ~e Building Inspector. Rev. 6/30/80 L&L,~?~ L TO w I',J OF' Form No. 6 TOWN OF SOUTHOLD BUILDING DEPA~RTMENT TOWN HALL 765-1802 ~-PPLICATION FOR CERTIFICATE OF OCCUPANC 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/I0 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" laud 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 - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction ........... Old Or Pre-existing Building ......... Location of Property .......................... ..~. ....... ~ .................. · ......... House No. Street Hamlet O~e~ o~ O~e~s o~ ~ope~t~ .................................................................. County Tax Map No I000, Section.. .; ..... Block ................ Lot ..... ' ............ Subdivision Filed Map Lot . . Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept Approval . Underwriters Approval Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $. A~P~ICA~ BLDG. DEPt. TOWN O~ SOUTHOLD . i Examin [~.: ....... , Approved...~..;~.. ........ 19~. Permit No. ~ .~..~..~. / Disapproved a/c ..................................... ~ .,(B'uildi~zl/n sP e ct or ) APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD -BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-180:3 INSTRUCTIONS ~PLA~ . /suRveY ......... :..::::::' ~c~IECK .................... s~rzc ro~ .............. M-AIL TO: Date ' .., 19 a. This 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 alterations, or for removal or demolition, as herein described. The apphcant agrees to comply with all applicable taws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaryj~pections. ........... -- (Signature of applicant, or dame, if a corporation) · (Mailing address o{ applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (as on the t,W.x roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber s L~cense No ......................... Electncmn s License No ....................... Other Trade s L~cense No ...................... Location of land on which proposed work will be done. it/'7,7' &r,/ / IIouse Number Street Hamlet County Tax Map No. 1000 Section /¢'~- Block O/~ ~b'~ ' Lot. 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 b. Intended use and occupancy .............................. ..... ......... ,~...;..,.,:~, .,.,.~ ........... Repair . .. ~ ' ' ......... ........ Removal~ .............. Demolition ........... Other Work ............ (Description) 4. Estimated Cost ............ Fee (to be paid on filing this appljcati.qn) 5.. IfIf gdWelling'arage, numbernUmberof°fcarsdWelling ..... flnits:. .............. ............... . .. Number. ....cf dwelling. . . units on each: ........... floor..; .,~,q~ :~.. ! ...... 6. If business, com]nercial or mixed occupancy, specify nature and extent of each type of use ........ 7. D~menmons o~ existing structureS, if any: Front ............... Rear .............. Depth .............. Height Number of Stories Dimensions of same structure wiith alterations or additions Front ............ Rear ........ Depth .................... :.. Height ...................... Nurfiber of Stories ...................... 8. Dimensions of enfire new constrUction: Front Rear Depth Height ............... Number of Stories ........................................................ 9 Size of lot: Front ~ Rear Depth I0 Date fP has ~ NmeofForme Ow · o urc e ........... I ......... ' ......... a r ncr ............................. 1 1. Zone or use district in which premises are situated ............. 12. Does proposed construction violMe any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded . ........ : ................... Will excess fili be removed from premises: Yes No 14. Name of Owner of premises ... ! ................. Address ................... Phone No ................ Name of Architect ......... ' · Address Phone No Name of Contractor . Address Phone No 15. Is this property within 3'00 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Tiown Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block humber or descriptioh according to deed, and show street names and indicate whether interior or corner lot. !iflI'HOUT CER'fh ST^TE OF .i S (Name of indMdual si~niq~ co~t~act) named. AP/PROVED AS NOTED .. NOTJ~/BUI~NG D~'PART~T ~ 765~1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPECTIONS: t. FOUNDATION ~0 REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. ~NSULATION 4. FINAL ~ONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.Z STATE CONSTRU~ION & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS being duly sworn, deposes and says that he is the applicant He is the . .. ................... . ............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulylauthorized to perform or have performed the said work and to make and file this application; that all statements contaified in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. Sworn to before me this Wotary CLAIRE I. GLEW i ' NO. 4879508 ~ .~ (Signature of applicant) GomffilSsIon I~X~Ii'e8 ueoemm~r ~. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I/I/~SULATION FRAMING [,/] FINAL DATE 'OUNDA'TI ON 'OUNDATION :OUGH FRAME & (1st) ADDYTIO~IA'L COMMEHTS: (2nd) -PLUMBING [NSULATION PER N. Y. STATE ENERGY CODE FINAL