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Home My WebLink About20833-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21071 Date OCTOBER 8~ 1992 THIS CERTIFIES that the building ALTERATION & RENOVATION Location of Property 2260 PECONIC BAY BLVD. LAUREL~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section I45 Block · Lot 4. Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JLrLy 10g 1992 pursuant to which Building Permit No. 20833-Z dated JULY 16~ i992 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 ALTERATION & RENOVATION TO NON-HABITABLE ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to ANTHONY J. MERCORWI,LA (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A · - /BuiJn~ Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y* BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-~No. 208B~Z Permission is hereby granted to: ~..~..~../... ~~.~...~.. ............. .... ...... ~,~ ....... ~/~/ ...... ..................... ~ ............. ~ ................................ ~o ............. ~/~ ............. ~... .~ ....... ~ .......................... ~ ............................... ,~ ................................... ~ ................................................................................... .~ ............................ at prem,ses I~ated at .................. ~. ........ ~ .......... .~ ......................... ~ ......................................... ............................................... ~~ .......... ~/~ .................................................................... co,~ ~0~ ~,p ~o. ~0o0 ~,,t~o, ..... ~:~ ....... m~ .,.~ .......... ~o~ ~o ...... ~ ......... / pu~uant to application dat~ ...................... ~ ...................... 19..~ and approv~ by ~e Building Inspector. //Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD 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: I. 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 f~om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder Bsed in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences an~ 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 Vpre-existing" iand.qses: 1. .Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed applicJtion an~'~ 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 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. Cer.tificate 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. T~mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ........ ~ .............................. ew Construction ........... Old Or Pre-existing Buildin~ ......... · "0 ouse o. Street Hamlet ~er or Owners of Pro err /9~z~v~ ~ /~~ ' ' P Y ........... {. · . usty No 000, ..... ........ .... .... "~'"' .... ~ ................... > ........ Fil d ~ap ............Lot ...... i? ....... ~al~h Dept. Approval .................... Underwriters Approval... . ................. a.si g Board ^ppr0va .... .............. 'qoesc for: Temporary Certificate ........... Final Certicate ........... e Snbmi~ted; $ ........................... TOWN OF SOUT~OLD ' OFFICE OF BUILDING INSPECTOR ........ : -' P.O. BOX 728 TO~,¥N HALL SOUTHOLD, N.Y. 11971 ~ERTI FI CATION TEL. 765-1802 Building Permit No. (pleaffe print) tp±ease print) - I certify that the solder used in the water supply system contains less than,2/10 of 1% lead. Swo,r~ to before ,me this (plumber's signature} 76S-1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE /~/~///? ~ FOUNDA'TION (1st) FOU~DATIO~'~ 2. ROUGH FRAME & INSULATION I2nd) .PLUMBING PER N. Y. STATE ENERGY CODE .I FINAL ADDITIONA'L COMMENTS: Examined .... Approved .... ~...7/./~..:. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 'SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ,19,~,~'-, Disapproved a/c ..................................... . (/B~dino Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVCY ................... CIIECK .................... SEPTIC FORH .............. CALL ~: ............... HAIL TO: a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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- cat~,~n. 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 is.sued a Building Permit to the applicant. Such permit shall bd 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 eonstruction 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 to admit authorized inspectors on premises and in building for necessary inspl~tions. _ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · *~ ~ , "~ //~c~," APPROVED AS NOTED Name of owner of premises . ~.~P..~..Y...ff..../~... ?.0..~.L'7'.. ,/? .......... IlJG~: ' 'Z/?~'~'b~8.R #' (as on the tax roll or latest"d~b~ - / ............ FEE:'''''-'~C~ ~''~ BY:. If applicant is a corporation, mgnamre m Dray aum~onzeo omcer. N~ BUI~ING DE~E~ 'AT (Name and title of corporate offic4~0p~U t ,.~%A A~ghAf Builder's nicenseNo. ~JSE ~SUN WFUL Plumber's License No ......................... 765-1802 9 AM 10 4 PM FOR THE FOLLOWING INSPECTIONS: ~, FOUNDATION - lWO REQUIRED FOR POURED CONCRETE 2. ROUGH , FRAMING & PLUMBING 3, INSULATION 4, FINAL CONSTRUCTION MUST Electrician's License No .... V ZH.OUT t~rr;rl rIOITr.E,C, OMPL~T~ E0R C.O. , . ....... ~J[,~jj~[~[~l~l%J~! ~ttM. L CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. Other Trade's License No ........... [~;~..[.}~:~,;~ ~P~[;~ ~ $TAT~ C~NSTRU~TION & ENE'GY 1. Location of land on which proposed work will be'done...~.~ P... ~.~ ~~ ~. ......... - . ................................ ~o ~lg..~ .~.~V., .... ~ House Number Street Hamlet J ..... ....... ..... ........ ............ Subdivision ~ '~ P~C Filea Map No. 7¢ ~ .... Lot .... /7' ....... · . · .r. 'L' ...... &'~;~i) .......................... State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occunancu ~~ ' ~d~, ~'~'~..'.' '~'~ 3. Nature of work I ' (check which applicable): New Building .......... Addition .......... Alteratio~ .~..~.... Repair ...... Removal . . Demolition i .............. ; .................... './~. ~ .... 4. Estimated Cost ............................... ~ee . .~ .............. (to be paid on filing this application) 5. If dwelling, number of dwellingjunits .... ~ ..... Number o~dweI~ing its each ~oor~ .......... . If garage, number of c~s .... ~..~ ................. ~? If business, commercial or mixea occuuanc~ s~ecff- nature ~a ~,,~, ~ ,_. 7. Dimensions of existing structures if any Front ~. R ar~m Depth .............. ~Height ............... Nu~berofSto~es. l ~ ~ [ ..... . ..... ~.....e ~. . D~ensions of same st~cture w~th alterations or additions: Front ................. Rear ................. Depth ................... ~.. HeiSt .................. ' ....Number of Stohes .......... ,.. ...... 8. Dimensions of entire new const~ction: Front,..f~ ....... Rear. f~ ........ Depth . ~f~. ~ ....... Height ............... Number of Stohes ..... ~... 9 Size of lot: Front Rear Depth I0 Date of Purchase ' Name of Foyer Owner 11 Zone or use district in which premises'are situated 12. Does proposed construction violate.~ny zoning law ordinance or regulation: 13. Will lot be regraded ......... ~ ................... Will excess fill be removed from premises: Yes No 14. Nme of Owner of premises ...~ ................ '. Address ................... Phone No ................ Nme of Architect .......... ~ ................. Address ................... Phone No ................ N~e of Contractor ......... i ............... Address ................... Phone No ................ 15. Is ~h~s property w~th~n ~00 ~aat o~ a ~kdal wetland? ~Yas ........ No ~I~ yes, Sou~hold Town Trus~aea Permit may be required. PLOT DIAG~ Locate clearly and distinctly ~1[ build~gs, whether existing or proposed, ~d. indicate ~I set-back d~ensions fro~ prope~y ~nes. Give street ~d block humber or description accord~g to deed, and show street nines and indicate whether ~te~or or corner lot. S TATE OF NEW Y,,Ol~, -- S cou ¥ S. (Name of individual signihg contract) above named; , ..... being duly sworn, deposes and says that he is the applicant fie is the .............................................................. , .............. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyI authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed ~n the..meqner ?et forth in the application filed therewith. Sworn to before me this .. ............. //.//'..aay (h"'rh..lC:..-...'. .......... ,19 ... ' _[~6Tili~?i/[I~IU~.~'~N~ / / · (Signature of applicant)