The URL can be used to link to this page

Home My WebLink About20094-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21174 Date NOVEMBER 24, 1992 THIS CERTIFIES that the building Location of Property 485 OAK STREET House No. County Tax Map No. 1000 Section 136 Subdivision ACCESSORY Street Block 1 Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 28 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13r 1991 pursuant to which Building Permit No. 20094-Z dated AUGUST 16, 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 ACCESSORY CARPORT STRUCTURE AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A JOSEPH &MARIE KOZEL /~/ B~ilding Inspector Rev. 1/81 IvOB~ NO. ~1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT NIUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) 20094 Z Permission is hereby granted to: ~ ~_i.~......~.:.~.~ ................ ,o...~~.~ ....... :~~.....'~~.~~/ .~ ........ ~~ ...... ~...~.....~ ............ , ............. , ................................................. . / / ............................................. ........................................ ~~~ .................................................................... co..~ To~ ~ No. ~000 S.:,o. .... Z.~A ....... ,,~k ......... ~ ......... ~o, No ....... ~. ...... Building Inspector. Fee $..~.....~...,.~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION 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 s~rvey 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. Submit Planning Board Approval of completed site plan requirements. existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and ~pre-existing" 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 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 - $i00.00 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 ...... ~ .~.~. ~ Z ~ .~.. .................. New Construction..¥_. .... ~Old Or Pre-existing BUilding .............. Location of Propert ..¥.~ .~..~.,< ~,-~- ~6-~--- House No. Street Onwer or Owners of Property .... ~. ~..~..~.1.~....~ ~.~ ........................ County Tax Map No i000, Section...~.~.~ ...... Block ..... J .......... Lot .... ~.~ ............... Subdivision ..... ~.. ~ ........... Filed Map ........ Lot .............. Permit No..~ O .~...Date Of Pe~it. Y ~.~.~. .Applicant. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ . 765-1802 BUILDING DEPT. INSPECTION [y'~//FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: ~*~',~ ~..~ DATE I(~ /l~l~ / ,NSPECTOR,/~'~ TOWN 'OF SOUTIIOLD OFt::ICE OF BUILDING INSPECTOR P.O. BOX , 1179 TOWN I IALL SOUTtIOLD, N.Y. 11971 TEL. 765.1802 Mr. & Mrs. J. Kozel 485 Oak Street Cutchogue, N. Y. 11935 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the foil. owing reasons. ~ An application for Certificate of Occupancy i~ not on file. /~/ No Underwriters Certificate on file. ~X The check is(~v~tak~d/not on file.) $25.00 /Z/ No Ilealth Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit t~ ~ 0_0 9 ~__ ~ Z Building ( Dept. Plumber solder Certificate on file. all permits involving plumbing being .issued after April 1,1984 ) ?'1ELD ~,,S.~u~ON ttDATE ~O~W~£gT~ FOUNDATION ( ls t ) FOUNDATION 2. ROUGH FRAME & (2nd) .FLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION DATE INSPECTOR ..! ,I E×amincd.. . fi ,. ......... 19 Approved.. ~.//~./~ ......... 19~./Permit No...~..~..d~. ?.. 7 Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL " SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ./ SURVEY .., ................. CIIECK .................... SEPTIC FORH .............. (B'uildino 4b~'pector) APPLICATION FOR BUILDING PERMIT ~ate .~. /13, INSTRUCTIONS 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, i~ b. Plot plan showing location of lot and o¥ buildings on premises, relationship to adjoining premises or public streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. The work covered by this application may not be c~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Pennit 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 ~hole 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 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 neces~ ~ -- t/ \(Signat~ke of applicant, of-i~me, if a corporation) (Mailin~ address of ~,ppli'/~int) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the t,ax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... .~.Z.¢//~.~../-~ ......... Plumber's License No ' Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will Be done .................................................. .... .... ..................... House Numl~er Street Hamlet County Tax Map No. 1000 Section .... I .~. ~ Block J Lot....~ Subdivision...~. ?..G.c~.,M.e~.. }4¢.1.6, !'t 7T~ ............ Filed Map No...~ ~..~ ........ Lot .. ~.~.c~..~:~. (Name) 2. 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 ................. .. ..... . ,.o..~..1~..~.~/..~.. . , ........... 3. Nature of work (check which app icable): New Bui/ding ~ ...... Addition ........ ;. 'A1terctiOfl'/... ........ Repair .............. Remov al .............. Demolition .............. Other Work ............... .~./.~. ~ .~. ,,~ (Description) 4..Estimated Cost. · ....................... Fee ...................... : ............... (to be paid on filing this application) 5. If dwelling, number of dwelling ul?s ....... Number o f dwelli:g. 7hi. ts on each floor ........... . If garage, number of cars ...... ; .~.~4 ~-e. il ~15~ ........... ' ..... 6. If business, commercial or mixed ,',ccupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmctures,~if any: Front ............... Rear .............. Depth ............... Height Number of Stories ' ' .~ D~ensions of same structure with alterations or additions: Front ................. Rear .................. D?th ..................... ~ HeiSt ...................... Number of Stories ' ' '2 ........ 8. Dimensions of entire new constmation Front...(a .'.. R ' ~ ~iit~'; :i Height ./~. ~ ...... ~.. Number of Stories .... ff .................................... ~ ............ Date of Purchase ......... ~ ...... . ....... Name of Foyer Owner ............................. Does proposed construction violat~ any zoning law, ordinance or regulation: . WHI lot be regraded ~ ' . · ' .... ' ........... ~ .............. N~e of Contractor ~. Afldra~e ~- -' ' ' ' I0. 11. 12. 13. 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold To~n Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all b~ildings, whether existing', or proposed, and~ indicate all set-back dimensions from property lines. Give street and block nu, mber or descriptioi~ according to deed, and show street names and indicate whether interior or corner lot. , L STATE OF NEW YORK, S.l COUNTY OF... ~ ........... J o set I-{ ................. being duly sworn, deposes and says that he is the applicant (Name of individual sigmngicontract) tbove named. (Contractor, agent, corporate officer, etc.) )f said owner or. owners, and is duly I . . authorized to perform or have performed the said work and to make and file this 4pplication; that all statements contained in 'this application are true to the best of his knowledge and belief; and that the york will be performed in t ~e manner set forth in the application filed therewith. iwom to before me this NOtmy F)u.b. lio, State P! N~WiYmk , · .... Qualified in Suffo k County ~.-~ Corn.mission Expires May 22, 19 ~