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Home My WebLink About20353-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20430 Date DECEMBER 30, 1991 THIS CERTIFIES that the buildin~ Location of Property 54005 NORTH ROAD House No. County Tax Map No. 1000 Section 52 Subdivision ADDITION SOUTHOLD, NEW YORK Street Block 1 Lot Filed Map No. Lot No. Hamlet 1 conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 27~ 1991 pursuant to which Building Permit No. 20353-Z dated DECEMBER 27~ 1991 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 REPLACE FLAGSTONE WITH WOOD AS BUILT FOR PATIO WITH FENCE ENCLOSURE. The certificate is issued to WILLIAM & JOANNE TURNBULL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~ i l~di~ g Inspector~ Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOI.D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 20353 Z ~t, Z. ....... .'2. ......................... , ~9.?/.. . .._/ ,~ ..... ~~...~.~.~,.....~, .......... .,...,..~./ ~ ,o Coun~ Tax Mop No, 1000 Section ......... ~.~... Bilk ........ .~ ......... Lot No ...... ~ ............... pumuant to a~llcatlon dat~ ..... ~~ ....... ~ .............. , 19.~, and approv~ by the Building Inspector. Rev. 6/30/80 2 ? 199{ Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN IIALL 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: 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 preTexzstlng" 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 Inspector shall state the reasons therefor in writing to the applicant. C. Fees l. 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 B ' uzldlng - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ................... ..ew Construction ........... Old Or Pre-existing Building .......... Location of Property.~..~?.?..~. ~O~P-/~ ~f4d5 .~.~o. .L..~ .~.~.~ ................... · .. {/.2.fl .............. House No. Street Hamlet ''' Onwer or Owners of Property.. . .. Couaty Tax Map No 100~, Section ....... .~..~...Block ...... ./ ......... Lot.../ ............ '.;ub division ..................... Filed Nap Lot Permit No ................ Date Of Permit ................ Applicant .................... !{ealth Dept. Approval .......................... Underwriters Approval ....................... "!.1ling Board Approv]l 'request for: TemTorary Certificate ........... Final Certicate ....... ~... ee Submitted: $ ............................ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTIIOLD, N.Y. 11971 Examined ...... 19. Disapproved a/c . ' ................... : ~; ~ .~ ~ ' ~ ~' ' APPklGATIO~ FOR BUIkDI~G ~ ~ .L,, INSTRUCTIONS SURVEY ................... CllECI~ SEPTIC POR:I .............. CALL ................... HA I L TO: Date " ., 19... a.' Tlu~':apphcation rn'usi:be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts or' p]:~i, ad~urate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bulldogs on premises, relationship to adjoining premises or public streets r areas, and giv~g a detaled descriptioKof layout of property must be drawn on the diagram which is paa of this appli- ation. c. The work covered by t~s application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Pe~it to the app~cant. Such pe~it ~Mi be kept on the premises ava~able for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose xvhatever until a Certificate of Occup~cy mil have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the'BuildNg Dep~ment for the issuance of a Building Pe~it pursuant to the uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable ~ws, OrdN~ces or egulations, for the const~cfion of bu¢dNgs, additions or alterations, Or for removal or demolition, as hereN described. he applicant agrees to comply ~vith a~ appl cab e axvs, ordinances, bu~din¢tcode, housing cod , and regulations, and to Jmit authonzed mspecto~ on premises and ~ build~g for neces~inspect~s. ~ ~ ~ c~d ~ . (Signature of applicant~ or n~le,T a cor3~ra~[~n) ''' tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the t~ roll or latest deed) applicant is a corporafion, signature of duly audmrized officer. (Name and title of corporate officer) · . Bu Ider s L cense No ................. Plumber% License No ........ E ectr c an s Dcense No ....................... Other Trade's License No. ~ ' '-. ........ ' ' Location of land on which proposed work will be done.~..~.° I Street Hamlqt Cmmty Tax Map No. 1000 Section Block ot.. ... Subdivision ...................................... Filed Map No. (Name) Lot · State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: ' ..... Z ............. *:9 '4..* v..'.,5 ......... b. Intended use and occupancy ..... ~ Repair . "' ! ' g .......... Addition .. ....... ixe?°'v~l -' '° ....... z~'~'....]~emolition · .. ~ i 4e..~o'rr.m..~ . ' ............. let Work ..... ~ .... 4. Estimated Cost ~ ~.... ~.... ~r'~ff'~a'~e._ (Descripfio,) ...................... ....................... (to be paid on filing this application) $. If dwelling, number of dwelh g umts ............... Num her of dwelling units on each floor · If garage, number of cars ;. 6. If business. COmmercial or in ed occupancy, specify nature . ' ................. 7. Dunensmnsolex,stin~,struc ' ~ r ..... ,~ ~ andcxtentofeachty eof use ........ · ,~:,~.nt .... , er of Stor'es ~ ' · ~ .......... Kcar ......... Depth ...... ,-,. . ,. ....... Numb ........ tructur,, with altcratmns or additions: Front ' ' ' ' ' ........ 8 Dimensions of entire new consimction: Front ................................. Depth .................. ~, ·. IIeight ......... Rear .......... Number of Stories Height Number of Stories Rear ~ ..................... · ' · · · ' ......... Depth Size of lot: Fi'oat . ........ · .......... Rear .................. Death I0. Date of Purchase .I~/..20 I 1. Zone or use distri t i,;'~l,~', ..'_i ' '. ...... : ......... Name of Former O ...... ~""' .................. c .......~.u premises are situated.. . . .. ~'""' ............................ 12. Does proposed Construction v elate any zoning law o ' ' ' ' ' ' ................... 13. Will lot be regraded ..... I , rdmance or regulation: ....... ............... Wall excess fill be removed from premi~ ~ ............. 14. Name of Owner of premises .. !. es Yes No ................. Address ................... PLione No ................ Name of Architect ......... ~ ................. Address ................... Phone No ................ Name of Contractor ........ ; ................. Address ................... Phone No ......... . ....... 15. Is this property within ~00 feet of a tidal wetland? *Yes ........ No ....... · If yes, Southoid ~own Trustees Permit may be required. '' ... [ PLOT DIAGRAM Locate clearly and distinctly all buildings, wLiether property Lines. Give street and block ~umber or existing or proposed, and. indicate all set-back dimensions from description according to deed, and show street names and indicate whether interior or comer lot. 'rATE OF NEW, YORK. ..... (Name of individual signing ~contract) ore Ha/ned. being duly sworn, deposes and says tLiat he is the applicant said owner or owners, and is duly I (Coutrnctor, ngant,corporate office/, c~.) ........................... authorized to perform or Liave performed the saki work ~nd to make and file tLiis :)l/cation: that all siatemants contained in this application are true to tLie best of Liis knowledge and belief; and that tLie rk w/Il be performed in the re=ncr set'forth in the application filed therewitLi. om to before me tbi~ i , ~ll{l~dlo Ou~k[~ou~ ~ ~ (Signature of applicant)