The URL can be used to link to this page

Home My WebLink About20110-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20297 Date OCTOBER 22, 1991 THIS CERTIFIES that the building Location of Property 3735 VANSTON ROAD House No. County Tax Map No. 1000 Section 111 subdivision ACCESSORY Street Block 11 Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 1.6 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26, 1991 pursuant to which Building Permit No. 20110-Z dated AUGUST 30~ 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 PLATFORM (DECK) AS APPLIED FOR. The certificate is issued to MANUEL & BARBARA SIEGEL (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO; N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ~ /~ ~uilding Inspector FORM NO. 4 TOWN OF SOUTHO~D BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20298 Date OCTOBER 22, 1991. THIS CERTIFIES that the building Location of Property 3735 VANSTON ROAD House No. County Tax Map No. 1000 Section 111 ACCESSORY Street Block 11 CUTCHOGUE, N.Y. Hamlet Lot 1.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 26, 1991 pursuant to which Building Permit No. 20110-Z dated AUGUST 30, 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 SHED TO CODE 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 Rev. 1/81 MANUEL & BARBARA SIEGEL Building Inspector · 01~1 NO. 0 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALl. SOUTHOLDo N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 20110 Z Permission is hereby gr~nted to: ~, ..... ~.~ ........ · ....... · .~:~...~. .. . .... ......................... ~..~_~...~,.....~......~~...~ ........... ~....~.~..~... ...... at premises located at ....~....~....~..~...~..~...~ .............................................................. County Tax Map No. 1000 Section ....... ./../.../. ......... Block ...... .Z'../.. ......... Lot No ....... ./.'.....~.. ........ pursuant to application dated ......... ~./~....-~... .................................. , 197.l.., and approved by the Building Inspector.~/~/f Fee $ ........................ Rev. 6130/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF 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, 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. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00~ Alterations to dwelling $25.00, Swirmming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-exiisting 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 ................................ New Construction...~...~,{~. Old Or Pre-ex~sting B~ilding ....... Location of Property .............. .~...~. ~.~..~... f~.~.77 ...... i ....... ~.~.....~... ....... House No. Ramlet ~ ~treet Onwer or Owners of Property .... .~. ~.~. ~ ( ./~.-~-~'~/~ ~ / 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: $...~...~ ..... ~ ........ · .......... Form No. 6 BLDG. DEPT. TOV~I OF $OU'II'IOLD a. ~h~s application TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN t~LL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ust 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 fo~m). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contm~ns less than 2/10 of 1% lead. r 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" land uses: 1. Accurate survey of property showing ali 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 o£ 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 ~. Temporary Certificate of Occupancy - Residential $1~O0,/Commerclal $15.00 New Construction.-~'zr~'~Dm~- Old Or ~Pre-e~isting~Building .............. ..~. Locpt~on of Property ..................... . ................... · ...... ~ ........... House No. Street . Hamlet County Tax Map No 1000, Section ........... Block ................ Lot .................... Subdivision .................................... Filed Map ............ Lot ............. ~ ........ Permit No ................ Date Of Permit ................ Applicant ............................. ~{ealth Dept Approval Underwriters Approval Planning Board Approval ......................... Request for: .Temp°rary Certificate .......... Final Certica~ .......... .. Fee Submitted. $ .................... ~ ...... .. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] FRAMING [/~AL REMARKS: DATE INSPECTOR ~ BUILDING DEPT. r ~ INSPECTION ]' FOUNDATION 1ST [ ]' ROUGH PLBG.' ] FOUNDATION ZND [ ]INS~A. TIoN ]FRAMING,~ ~ FINAL --; .... ~ -L__ /. ~ ,~ FOUNDATION ( 1st) FOUNDATION (2nd) 2. ~OUGH FRAME & .PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FI~IAL ADDITIO~A'L COMMENTS ~RD OF HEALTlt ' ............ FORM I~O. 1 SETS , ............ '1]11 ,,. _ IIII TOWN OF SOUTHOLD CtlECE ..................... ~ [~ J~ TOWN HALL FOR}I . . · ..... ~ ' ~OUTItOLD NY 11971 NOTZFY~ -- ~0FSO~m TEL: 765-1802 CALL ;/~ .TZ,,: / ' ,,~,, ;~; .................. Ex,mined .... ...................... Approved .......... , . . Disapproved a/c .... / .................. ~ ..... '''" "(g [nspc APPLICATION FOR BUlLiNG PERi,lIT INSTRUCTIONS a. Tlds application must be completely Qll~d ia by ~pcwdte~ o~ i~ iak ~nd submitted to th~ Buildi~ lmspcctor, sets o[ phns, accurate plot plan to scale. Fee ~cco~ding to schedule. b. ~lot pl~ showin~ location of lot ~nd of build~s on p~emises, rehtionship to adjoinin~ pmmi~ ot pubUc streets or a~c~s, and giv~tg a det~led description of lsyout o[ property must be drawn on the diagram whic~ .c. The work covered by t~s applic~tio~ ma~ not be commcnced before ism~nce of Bu~di~ P~mit. 'd. Upon approval o[ this application, the B~ildin~ Inspector wgl issucd a guildi~ Pc~it to s~ll b: kept on th~ premises ~vaihbl~ for inspection tbrou~out the ~ork. e. No build~ shall b~ occupied or used in ~hole or i~ part for ~y purpose white,er until a Ce~iQczte o[ Occup~cy ~all h~t, b~ grmnted by the Bulldog l~spcctor. ' APPLICATION IS HEREBY MAD~ ~o thc Bulldog Dep~me~t for the issuance o~ ~ ' ' ' " Bmldm~ Zo~ O~dina~ce of the Town o[ SouthnM ~.,rr-,,. ~ ...... Bmldm: Pe~S ~u:u~t to the .... =. m z ,, -,, ,yp~c~me rows ommances, uuQd~g~od~, bousi code and ~e- ' aaml, aut~onzefl mspecto~ on premises and m braiding for .ecessa~ i~;ff;c~[~}~~ ' .elations. and to ~ . ~ ~t; or . .... ( (~ailin~ address of applic~t) St3te whether applica~, lessee, agent, ~chitcct, engineer, general contractor, electrician, plumbe~ o~ Name of owner or premises ..... U~ ~ (as on the tax roll or latest deed) If applicant is a co~poration, signature of duly authorized officer. Buildcr's License No ........................... .,. Plumber's License No ......................... Electrician's License No ................ ; ...... Other Trade's License No ...................... Location of land on which propost~d wolk will be done; ........ ~ .... ~0.3 p. .....: .... ,g Ilouse Number : Street. ...... Hamlet OCCUPANCY OR USE IS UNLAWFUL h!ffHOUT CERTIFICATE OF OCCUPANCY Coun,y Tax Mai, No. I000 Section ...... I.Ll.i ...... m~ck ti. /,¢ ,. ............... Lot Subdivlsio. , .............................. , ...... Eilcd Map No. '' Lot ~ (Name) '""~ ....................... i ' · ~ o~p~.~y ........ ~ .......... q .... :.~,l~ 3. ' ' e '"~' '' : q ' Nature of work (check which app lcab e) New Building .......... Addition .~.-~ .~. · ~'. d/'~teratlon .~..1.}.~ ....... .5. If dwelling, nUmber of dwelhng umts' '' ............... . Number of dwell ng units on~ffeh~ ~' floor ................ ]f garage, number of cars ...... . .............................................................. .. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... Dimensions of existing structures; 'fany: Front Rear Depth Hei._,ht Numb~er o ' Stories Dimensions of same structure with alterations or additions: Front....,............ Rear . . Depth tleight Number of Stories 8. Dimensions ofentire new construction: Front ............... Rear ............. .. Depth. .......... . . l-{ci~ht Nu nblcr of Stories 9 Size of lot: Front i Rea.,' Depth I0 Date of Purcixase ' Name of Former Owner 11. Zone or nsc district in which premises are situated .................................................... l'~~,,Does p~oposed Construction violaic any zoning law ordinance or regulation: 13. Will lot be regraded .; ........ : .................. Wiil excess fill be removed from premises: Yes .... No. 1,~. Name of Owner of premises : ' Address Plione No ' Name of Architect ........................ · · · Address ................... Phone No ................ Name of Contractor · Address Phone No ' ' 15.Is this property loeatled ~ithln I 00 feet of a tidal *tetland? eYES .... 1~0 .... ~f yes, Southo~d To~n l~ruatees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fr~m property lines. Give street and block number or description according to deed, and show street names and indicate whither interior or comer lot. t, IOT~FY B~IIL.~NG DEPART~AT 7($~1R02 9 AM TO 4 PM ~R THE FOLLOWING l, FOUNDATION - '~0 REQUIRED FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING 3. ~'NSULATION 4, FINAL CONSTRUC~ON MUST BE COMPLETE FOR C.O, ALL CONSTRU~ION $HA~ ME~ THE REQUIREMENTS OF THE N,Y. STATE CONSTRU~ON & ENERGY CODES, NOT RESPONSIBLE FOR STATE OF NEW Y~RI~,,~. o. o;S DESIGN OR CONSTRUCTION ERRORS ' ............................... : ................... being duly sworn, deposes ~d says that he is the applicant (Name of individual signin'g contract) ' of ~aid owner or owfiers, and is duly }authorized to pegform or have perfo~ed tile said work and to m~e and file this application: lhat all statements contait}ed in this application are tree to the best of his knowledg~ and b~!ief; and that the work will be perforated in the m~ner ~et forth in the application filed therewith. ~ (,~.. ~ ' ~/ ~ / ~ (Signature ofapplic~t)