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Home My WebLink About20485-zFOIl1 NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20582 Date MARCH l0w 1992 THIS CERTIFIES that the building ACCESSORY Location of Property 1955 HENRYS LANE PECONICr N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 74 Block 1 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 5, 1992 pursuant to which Building Permit No. 20485-Z dated MARCH 10, 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 IN REAR 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 RAYMOND ~ KATRLEEN LEONE Rev. 1/81 /~ui~ding Inspector FOBM NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? 2048~Z Permission is hereby granted to: ........... './~..~,~;..~ .............. ......... ./..~_/~.~./.:. .......................... ~',/?T~ ...... ~... . .~~w...~..~:....~..~~~ ....... ..................................... /..~ ...... ~..~.....~....£~ ......................... Co,,nty Tax ~ap No. Io0o S~ction ..... :.Z...~... ........ mock .... /. .............. Lot No ....... ~.. .............. pursuant tO application dated ...... ...~../...~.../..X.~... ................. . 19 ........ .and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TO~ OF SOUTI~LD BUILDING DEPARTMENT TOWN ~LL 765-1802 ~[PPLICATION FOR CERTIFICATE OF OCCUPANCY 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. For existing buildings (prior to April 9, i957) 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 - $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 $15.00 Date .... .l~,~c~. A,..I.97~ ...................... .. New Construction...~ ....... Old Or Pre-existing Building ................. Location of Property 1955 tlBNRY$ House No.' Street Hamlet RAYMOND & I~THL~ENLEOI~ 0nwer or Owners of Property ......................................................... .. ... .. . . County Tax Map No 1000, Section .... ~..f ..... Block ...... ~ ......... Lot .... ~.. . ................................... Filed Map .......... Lot .................. Subdivision . Permit No.~D.~.~.~.~....Date Of Permit ................ Applicant .......................... . .. Health Dept. Approval ..................... ..... Underwriters Approval .................... .. . . . Planning Board Approval ........................ Request for: Temporary Certificate ........ Final Certicate itt $ 25.O0~ ~ Fee Subm ed: ............ ~ ..... . ............ · P ICANT · Jl~ ..... ;~,! [,'i TOWN OF SOUTHOLD i J\l/ - TOWN.AL, ~ ....... [..]',:-:" SOUTHOLD, N.Y 11971 ~ ....... ~'?.f,'~' ,''-' ,~' ,' ,,, } TEL,: 765-1802 .... ...... Ex,mined ....... , Disapproved a/c ..................................... / (l~ilding Inspector) APPLICATION FOR BUILDING PERMIT BOARD OE HEAL'Ell SETS OF .PLANS .......... CIIECK .................... SEPTIC FORH .............. CALL ................... HA~L TO: INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2ts 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, ando,,iv'm~,o a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 nM1 ~,~ 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 tall 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 Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to drnit authorized inspectors on premises and in building for necessary inspecti~ (Signature of applicant, or name, if a corporation) /. .¢ Q'-- (IVlailing address of applicant) tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ameofownerorpremises ,1~../~. v'---~V9 ¢¢v /4,-qq/~/J¢C~) -. · ................................... ...... ....... ' applicant is a corporation, signature of du y author zed officer , · ............... ~; .... NOflF3f BUILDING DEPARTMENT Al' 765-1802 9 AM TO 4. PM FOR l`HE (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No Other Trade's License No ...................... FOLLOWING INSPECTIONS: I, FOUNDAI'iON TWO REQUIRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUM~ING 3. INSULatION 4. FINAl. CONSI`RUCTION MUST 8E COMPLETF~ FOR C,O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, St;qTE CONSTRUCTION & ENERGY Location of land on which proposed work will be done. COCAS. NOT RESPONSIBLE FOR llouse Number Street r Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... ..................................... Filed Map No. >.o ~82 rot .~.7 .... (Name) .................. Sta~e existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy · b. Intended use and occupancy filLeD Rennir -~ · ......... Addition .......... ?dteratFon ---,- ........ : - · · ~em0val , cmolition .............. Other Work. ' ......... , ............. D .51~,~ .... 4. Estimated Cost ...... e on ..... [ · · ............... Fee ....................... $. If dwelling, number of dwelling traits .... (to be paid on filing this application) · If garage, number of Cars ~ ........... Number ofdwelling units on each floor ................ d ify '": ........ i ......... j ........ 6. If business, commercml or m~xe occnpancy, spec nature and extent of each type of use .. 7. Dimensions structures, ................. of existing . if any: Front ............... Rear .............. Depth ..... Height ............... Number of Stories .......... Dimensions of same structure wffh alterations or additions: Front ............ pti ................. Rear .......... . ........ De ~ .... - ......... I Height ..... NtnnberofStor/ 8. Dimensions of entire new constnlmtion: Front ~'p ~ / ...... '~ .( , . ' ......... Depth ./.0 He,cbt ... l · '. Rear '7_-0 , N o.,<.q ............................ ........... um bet of Stones /..to:. ' ..... · .... .... I . ,- ..,, ........................... fy.. ......... 9. Size of lot: Front .......... ecear..~..~ F., 3-:~'.'~% ~ ~.3..v. 10.Date of Purchase ............ Depth . : ....... ...... ~' { ........ ......... Name of Eorme 11. Zone or use district in which premises are situated ..................... 12. Does proposed construction viola~te any zoning law, ordinance or regulation: <'~.o ' ' ' 13. Will lot beregraded . ~o ~ . xt.~_ ^,-~,._. .. ' . ' ' '~gO .... ,;..:.~. ........ W,II excessfill be removed from premi Yes . 14. ,,,m,u muwner mprem~ses ..r~.~.~-:.o.,-,v. g~o,,r~ --,, 1¢5--5 IfZvO!,t ,~ see: . ............ aaaress., ...... .=. ?~ ~.q'.... Phone No..7 Name of Architect ........... [ ........... ................ Address ................... Phone No ................ Name of Contractor .. 't~'i''' ib'f ............. Address ................... Phone/No ................ [5. Is this property wi n 3 eet of a tidal wetland? *Yes ........ No..Y'. ..... · If yes, Southold Tqwn Trustees Permit may be required. ., I PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frbm deed, and show street names and indicate whet?.~er property lines. Give street and block ngmber or descriptio/~ according to interior or comer lot. rATE OF NEgt4'ORK-}.p /] OUNTY OF .'~.'~.'~.'~.'~.'~M..~ .-~...c~./..~... (Name of individual signing Oontract) eve named. ! ontractor, agent, corporate officer, etc.) said owner or owners, and is duly au!thorized to perform or have performed the said work and to make and file this :>lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ,rk will be performed in the manner setiforth in the application filed therewith. om to before me [his ......... ..... · .... - County Notary Publlo, State of N~ Ye k No. 4879505 r'~ .. ~ ..... ' .................... Qualified in Suffolk Cou,ty ~/~ (Signature of applicant) Corem ss on Expires December 8. being duly sworn, deposes rind says that he is the applicant