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Home My WebLink About20114-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hali Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20565 Date MARCH 4, 1992 THIS CERTIFIES that the buildin~ Location of Property 1495 VILLAGE LANE House No. County Tax Map No. 1000 Section 25 Subdivision ACCESSORY Street Block Filed Map No. ORIENT, N.Y. , Hamlet 3 Lot 2.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 28~ 1991 pursuant to which Building Permit No. 20114-Z dated SEPTEMBER 3, 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 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 CLYDE & ROXANNA MELLINGER Rev. 1/81 Inspector · ORM NO. ~ YOWH OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, H. Y. No_ BUILDING PERMIT (THIS PEPJ~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2 011 4 Z Do,e ....... --i~ ..................................... , ~9..~./ Permission is hereby granted to;~ , .~..~..~~.......~..,...~¥, ......... ~....~. .............................................. ......... ~..~, ~, ...... ~z:;;::;;';':~'"'~:)::):~ ...... x~ ................................. ~ ~ ~ ................................................. ~ ................ .~ ........ f~.~ .................................... ....................................... : ........ ................ County Tox Mop No. 1000 Section........................~- ~ Block ........~ .........Lot No.....~...c ./.. .......... pursuant to application dated ..... ~..~..~..~..//~ .................................. , 19./7~....,~/ Building Inspector. and approved by the ull~g IKspector Rev. 6/30/80 TOW~ I~LL 765-[~02 ....... "~ BLDG. D~PT. TOWN~QOU~OL~j This application must be filled in by typewriter OR ~nk 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, 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. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. CO~ercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code C,~pliance from archiuect or engineer responsible for the building. 6.Submi~ Planning Board Approval of completed site plan requirements. ;. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and 1. Accurate Survey of property showing all property lines, streets, building and ,t 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, Alcerations 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 Updated Certificate of Occupancy _ $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Co~ercial $15.00 .. ..... '[[[[-[ ............... ~'~ ~ .... Old Or Pre-exiselng Build~ng ........... ' .... House No. S~reee Hamle~ ''' un~y Tsx Map No 1000, Section .... ~ ...... Block ...... ~ ........ Lo~ ..... '~d[v[s~on .................................. F~led Map ............ Lo~ ...................... ~Ith Depe Approval ....................... Underwriters Approval nning Board Approvol ........... ues~ for: Temporary Cer~[f~ca~2 .... Submitted. - ': -' ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~. [ 9 ~099 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date ~OV~]H~]~ /~9~9()~ ~pplirationNo, onfi~e 0378~19~/92 1~ 256~36 THIS CERTIFIE~ THAT o~y the electrical equipment ~ ~scrlbed below a~ int~duced by the applicant ~med on the able application number in the prem~es of Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS FANS OUTLETS SWITCHES FLUORESCENT OTHER 9 7 DRYERS OTHER APPARATUS: E R NO, O~ E RCC~,CON D. AWG OF CC. COND, C NO, OF HI*LEG OF HI-LEG NO, OF NEUTRAL OF NEUTRAL P.O,BOX 38 OI~E)ll)OI~'~ NY, 1194~ Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. [.UPT Fgl~ Buik~llfl~ DEI"AK I Ml"fl !. Il'liS t. UI"'T UI- C~l~ i'll'II,ATE MUST I~IDI BE ALTERED IN ANY MANNER. U~.6O REV. CLYDE L. NI~LLIN(~E~, ~1%. 1495 Village Lane Box3 Orient, New York 11957 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [] FRAMING ~FINAL REMARKS~ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING 3. INSULATION FER N. STATE ENERGY CODE FI;;AL ADDITIONA'L COMME~;TS: USE ~S UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 t TEL.: 765-1802 ~ D Examined ( ............. ,19 Disapproved a/c ..................................... INSTRUCTIONS BOARD OF ltEALTtt ..... T''' --~3 SETS OF PLANS .......... ~-~-,SIJ RV EY ................... '--~CIIECK .................... SEPTIC FORH .............. Date ......t~....*,~...., 19.~/. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s~ts 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 o,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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. Suc~ permit shall be 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 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 necessary ins, l~ctions. ~./'),~ ,/"-) -- ation) . y 7 ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~f'~[. ~, .w~....~.. Z~.,~./~.-../~./,1~'~--7..,/~/~..~'.~ ................ (as on the t~x roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....~..~d2.4./'~ ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. ...................................................... House Number Street Hamlet County Tax Map No. 1000 Section .... o~,1~. ......... Block .... ~. ........... Lot...c~.,./. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . ~.~. /*de /-- ................................................. b. Intended use and occupancy ...'T~:ii~I~/.~,~ a~.,~. A.~.~~.. ~./.-~.,~.~]~ ............... k ( p!pli ) ' · 3. Nature of wot check which a cable: New Building ...... Addition .......... Alteration ,~ ~ .i.;i ..... pair Re .............. Removal ........ Demolition Other Work ...;... '. ... 4. Estimated Cost ..... : ...... Fee ~ ~ (to lfe paid/on filing this ap;lication) ' 5. If dwelling, number of dwelling pnits ............... Number of dwelling units on each floor ................ · If garage, number of cars ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of ~'l~}in~ structa~*-~f an,,' Fro,,*- ~ ........... xtear .............. Depth .............. H ight._~ ~...X)-. ~ ~'~ o f St ;r~,~.~~'.' · Dimension~tu~t~k~th alt ratic/fis'or/affdiflo~fs: Front ............ e ................. Rear .................. ~D.epth .. ....:.... ........... i" Height ...................... Number of Stories ...................... 8. ulmenmons ct' e,ntlre new construction: Front .../~>. f, ..... Rear /t'.C;:? / Denth /~,Q. / Height . ./~.r. ..... _...N/umber of Stories f. . · "i ......... ' .................. 9. Size of lot Front ~.~ Rear ................ .L ..... 3'~'.&' ! .............. ......... , ........................... uepm . ,;. ~:~r/. ................ 10. Date of Purchase . . i~';~..q~'~..(~. .............. Name of Former Owner .~. j~~ ........ 11. Zone or use district in which premises are situated..~I~..~/_.. .................................. 12. Does proposed construction violMe any zoning law, ordinance or regulation' ~/.t? ...... 13. Will lot be regraded ef/.~. ! .. · ' ' ' ' ........ , ............ ...... : ................... Will excess fill be removed from nremmes: Yes 14. Name of Owner ofpremises~,e( ,e~r~at~Z~ddress/.~j:a~/~Z/_,4Et~ t~'a~one x~ a~-.,.~ Name of Architect ,~.: ~L. L . . . Arlrlra~ . ....................................... rnone iNo Name of Contractor . ,tfd'r ~J~... i ................ Address ................... PhoneANo ................ 15. Is this property within 3'00 feet of a tidal wetland? *Yes u ~" , ~If yes, Southold Tiown Trustees Permit may be required. ... PLOT DIAGRAM Locate deafly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block .umber or descriptioi! according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. ...... .......... (Name of individual signiffg contract) above named. 3, INSLILATIO~ 4. FINAL . COSSTRUOTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.g STATE CONSTRU~ON & ENERGY CODEs. N~ RESPONSIBLE FOR DESIGN OR CONSTRU~ON ERROR~ being duly sworn, deposes and says that he is the applicant He is the ....................... (Contractor, agent, corporate officer, etc.) ~r owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contai~ ed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. Sworn to before me this .......... ~..~$~'/;r~. ...... day of. i ~)~',~. ........ , ' v }lo~u~lic Stateofg. Y,MonrooC~..r~' ti gj ¢0~ssi0n ~plres Oct 31,