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Home My WebLink About19902-zNo Z20131 FORM NO. 4 TOWN OF 8OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N~Y. CERTIFICATE OF OCCUPANCY Date AUGUST THIS CERTIFIES that the building. Location of Property. 73355 MAIN ROAD House No. County Tax Map No. 1000 Section 45 Subdivision Filed Map No. cHIMNEy AND WOOD STOVE GREENPORT Street Hamlet Block 03 Lot 03 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 23, 1991 pursuant to which Building Permit No. I9902Z dated MAY 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 CONSTRUCT cHIMNEY AND INSTALL WOOD STOVE. The certificate is issued to MARY & KEVIN TERRY & BARBARA MC ELROY (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 !~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 19902 Z / Date ........ -~'-~2.~"~.'~.~: .................................. . , 19o.~/ ................ ..................................................... m,$es I ~ ..... ~.".~'~'~ .................... ~ ................ ~.' ...................................................... County Tax Map No. 1000 Section ..........~..~ ..... Block .....~ ........... Lot No...~ ................. pursuant to application dated ............4~.~...~... .............................. , ig....~.Z and approved by the Building Inspector. F,e $...~:.:/...~.. Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN 1L~LL APPLICATION FOR CERTIFICATE OF~occUPANCY \. This apPlication must be filled in by tYpe~¢riter 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 instal.%ation 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 C~pliance from archiuect or engineer responsible for the building. 6. Submid 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 Uuilding Inspector shall state the reasons therefor in writing to the applicant. i. Certificate of Occupancy - New dwelling $25.00, Additions ~o dwelling/$W~5.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessorv building $25.00, Additions to accessory building $25.00. Businesses $50.00. ' 2. Certificate of Occupancy on Pre-existing Build~ng _ $I00.00 3. Copy of Certificate of Occupancy _ $5.00 OVer 5 years - $10.O0 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 e~ Construction .......... Old Ot Pre-existing Building ocation of Property. 7S~-'O~- .~.~.~....~..~:. ~.?~...~.~.~...~.. House No. S t ree t ~,l/~.w Hamlet ~wer or Owners of Propert~ ........... ............... Lot ..... ~. ............ ,bdivision ........... ......... Filed Map ...... Lot ....... ............ alth Dept. Approval .................. ; ...... Underwriters Approval..l ................ !ues~ for: Temporary Certificate ...... Final Certicat9 ........... . · fm/- ' .... fiELD i::S'~:ES?iO:i I{DATE II COM~46NTS _ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 "- t,~;-~(-~ ~ '" TEL.: 765-1802 -,:,:., 9f./. )is~pprovcd a/c ..................................... ltO^I~D OF HEAl_TIt ......... SETS OF ?L,~.~IS .......... SUI~VEY ................... CII[CK .................... SEFTIC F 0 R,~I .............. C^LL !&¢.S ........ HAIL TO: APPLICATION FOR BUILDING PERI'AlT Date . . "~ 19 INSTRUCTIONS a. Tlfis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~s of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relfftionship to adjoining premises or public streets areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ion. c. The work covered by tkis application may not be c~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant, Such permit ~11 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 ill 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 ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ,gula[ions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ,~ applicant agrees, to comply with all applicable laws, ordinances, building code, housin~ codei~and regulations, and to nit author/zed inspectors on premises and in buildin~g for necessary inspec~pns. ......... :~'~ ....... (Signa[ure of app' i~ca[l't, or name, if a corporal:ion) ::~,~¥ ~ , ~,:~ ~ ' :,', ~ (Mailing address of applicant) :te whether applicant is owner,,le~se~, agent;,;architect engineer, general contractor, electrician, plumber or builder. - own,r o premises .:.. ' 't 'e ;eli ilt; t d id) ' .pplicant is a corporation, sight,re 0~'duls/'auth'brized officer. ,' (Name and title o£ ocfr~or~'t~ Plu bet s Lmense No ......................... Electrician's License No ....................... Olber T~ad¢'s License No ........ ~" ' ',x" ....... Location o£1and on which proposed ~ork will lie done. ................ :ou~ty Tax M~p Ro, I~00 Section . ..~ ....... Block .... ~D .~ Lot .~.._~, ubdMsion ..................................... Filed Map No ............... Lot ............... (Name) ~e exislin~ use and occupancy o£premises and in~ended use and occupancy o£proposed construction: ...... ~ ...... ,.~ .......... Intended use and occupancy ........ ..~.... 3. Nature of work (check which appilicable). Ne~v Building .......... Add t on .......... Alteration ....... Repair .............. Removal .............. Demolition .......... Other Wp rk .~.~, ~,.~. ;~:~ . 4. Estimated Cost. ............ I ...................... ... Fcc .................... :.'77.. ..-Z'.'.'.'.'.'.-~...... 5. If dwelling, number of dwellin, .~;,~ (to be paid on filing this application) Ifgarage, numberofcars . . i ... Numberofdwellingunitsoneachfloor... 6. Ifbusness, commercialor--:.. '," ............... ~ture':~nd~xte ise .......... ooc,,pancy, spec y n 'ofeach typeof, i i i i .... 7. Dimensions of existing structures,lifan . Front ......... , Y ...... R~ar .............. Depth ...... Height ............... Number of Stories ................ · ........ Dimensions of same structure wit alterations or additions: Front ....................... Dimensions of entire new construition: Front ............ ' ............... Rear ............ Depth ..................... Height ........... ~ ...... 8. · .......... Nnm bar of Stories .................. Height ............. u i . .,. Rear ............... Depth .... ' 9. Size of lot: Front ...... .N mb~r of Stones ................................................... ....... ......... Rear ' 10. Date of Purchase , · ................. Depth ...................... ............. 1 ....... ' ......... NameofFormer Owner . I I. Zone or use district in which premises are situated ........ ' ........................... Does proposed construction viol.,* : 3. ' ........................ Will excess/'ill ...... ~,~ ,egraueu : ............. .. [4. Name of Owner of premises ..... i be removed from premises: Yes , ............... Address ................... Phone No ................ Name of Architect . ...... ~ ..... ~ .............. Address . . , . Name of Contractor 4f~.~y..~ ~/~z ,.. >'~3 ',2 · '~' ........... Phone No ............ 5. ' ' ' v' : ............... a. aaress w.~. o.. ,~.qo...{/?..~.,~.7.~.<"-p lone NO .?.~' 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 mldmgs, whether existing or proposed, and. indicate all set-back dimensions from ~roperW lines. Give street and block number or descriptioh according to deed, and show street names and indicate whether aterior or coruer lot. ye named, i ., A RO)IED AS NOTED S.p. NOTIFY ~ D~'p~ 7854802 ~ AM ~ 4 PM FOR 1, FOUNDATION . ~ REQUIRED FOR POURED CONCRETE 2. ROUGH. FRAMING & 'PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MU~T ~ COMPLETE FOR C.O, ALL' CONSTRUCTION SHALL ME~ THE'RgQuIREMEN~ OF THE N.~ STATE CONSTRU~ON & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRU~oN ERRORS being dnly s~voru, deposes and says that he is the applicant is tbs ................ aid OWner or owners, and is duly autiiorized to perform or have performed'the ;aid xvork and to make and file this 'ication; that all statements contained i:n this application are trne to the best of his knowledge and belief; and that tile ~< will be performed in tile manner set forth in t,!m application filed therewith. m to before me this ...... of ..... ,o r ~ , [~lgnamrc o ~mml~lo~ ~ ~ ' f applicant)