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Home My WebLink About19748-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22890 Date MARCH 7, 1994 THIS CERTIFIES that the building ACCESSORY Location of Property 1235 JOCKEy CREEK DRIVE SOUTHOLDt N.Y. House No. Street Hamlet County Tax Hap No. 1000 Section 70 Slock 2 Lot 19.13 Subdivision Filed Hap No. Lot NO. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 28~ 1991 pursuant to which Building Permit No. 19748-Z dated MARCH 28~ 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 STORAGE SHED AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED THOMAS A. & ROSEMARY E. KLOS N/A N/A N/A /uilding I~spector Rev. 1/81 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_ 19748 Z Permission is hereby granted to: ...~.~..:...~...,. ........ ~~ ............... ..... ~_..~......~..7...L ......................................... ,o... · :..:....,,..,, . '~:...;...:.....::-.-::: :..:..?_....: :.: ::'se, located at ................. ,....~..y.~ ..~...,...~.,j~.~........~ .....~~ County Tax Map No. 1000 Section ..... :.~....~... ........ Block ...... ~ ........ Lot No ................ ..../. ~.../. pursuant to application dated ...... ..~..~ ........ .~.....~... ......... , 19...~...(, and approved by the Building Inspector. Rev. 6~30~80 Form No. 6 ..e, APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinging 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 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ~;.'~./ l .~.~. New Construction .... ~ ..... OldO~.rPre-existing Building ............ Location of Property.. 1~.~,. ~ [.~ ~...~.~.~.~ i~.~.~. .... ii ~.~~ ........ House No. Street Hamlet Onwer Owners of Pro crt ~ ~ ~. ~ ~ ~ ~ cou, y ,ap 000, .... ......... ..... ......... Subdivision ... Filed Map ....... Lot ...................... Permit No. J.~..~.~..Z .Date Of Permit.. ~3l~.[ .~ ~...Applicant....-~...~..~.,...~..~.(..~.... Health Dept. Approval......~.!~.................Underwriters Approval...~.~ .................. Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ......... Fee Submitted: $.. ~ .................. I- 17. SPECTORS V~ctor Lessard Principal Building Inspector Curtis Hovton Senior Building lnspector Thomas Fisher Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD SCOTT L. HARRIS, Supe~vism Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 February 2, 1994 Mr. Thomas Klos Box 771 Cutchogue, N.Y. 11935 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XX The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (Ail permits involving plurabing being issued after April 1, 1984). BUILDING PERMIT % 19748-Z Please contact our office on this matte~. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 E×amincd ................ , 19... Disapproved a/c ..................................... BOARD OF HEALTH 3 SETS OF PLANS .......... SURVEY ' . CIIECK .................... SEPTIC FORH .............. NOTIFY: CALL ................... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tide 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. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or 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 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 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 La~s, Ordinances or Regulations, for the construction of buildings, additions or alterations, or, or removal or demolition, as t~erein described. _ The applicant agrees to comply with all applicable laws, ordinances, b~ jfdirlg code, housing, cgodq, an..d regulations, and to admit authorized inspectors on premises and in building for necessary in~ ~ons. {,./[/ [/ l .... ............. -- __~i] hature of app,~tica~t, or name, if a corporation) .. _ ?. .j. . . (Mailing address of'applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the t.a~'rolI or latest deed) ~ ......... If applicant is a corporation, signature of duly authorized officer. ~' (Name and title of corporate officer) 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 .~.~..~'c~' l~, D Block ............................. Lot .... ....................... . ................ Subdivision .... ~ (Name) Filed Map No ............. Lot :. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing occupancy ...~!.~,o" ............... ~ ' '~ ............... use and b. Intended use and occupancy ............. '~ ....... O 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] ~LATION [ ] FRAMING [~,,VFINAL .~ REMARKS: ~/~ ~ ./- DA~Z _:///?/ // INSPECTOR FOU~;DATIOH FOUNDATIO:~ 2. EOUGH FRAHE (1st) (2nd) & -?LUMBING 3. iNSULATION PER N. Y. STATE ENERGY CODE FI:~AL ADDITIOH~L COMHE~;TS 'l 3. Nature of work (cheek which applicable): New Building .... Addition .......... Al. temtion .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ,! ~.r~' (to be paid on filing this application) awellinglu, nits...!0..I.[:- .. Number of dwelling units on each floor 5. If dwelling, number of If garage number of cars .. i,~.[ffi . ' ......... ~6. ~ business, co,mm.e[.cial or mixed o!cupancy, specify,,,n~atu, re arid extent of each type of use lhS. I. ~. ...... t. lalmenslons~o, lexmtlngstructures i'fany Front '(~/. . Rear .~,O* I%nt~ .O/~ ' Height ...1~....~.h? f-~. Numbe[ of Stories .... ~ .................................................... ~Dim.e, nsions of same structure withjalterafions or additions: Front ...'~{'~l-~...~/~f Rear .................. ~ ~epm ...................... iHeight ...................... Number of Stories ....... ~. zJimensions of entire new construcqon, Front ~_'2~ I ,- ,--~, ...... i{t~ ...... ..... q t ? ...... ~r,, ...... ~cear .... ~cx,,..: .... Depth ,/1,~ .......... height ....13 .......... Numbe~, of Stories ..... I .............. 9 Sizeoflot Front [.~,C)~ Rear t~t~'9;,,' ........ ;,","'",q'&k;~'~ ......... ''' .'~ .ck..~2~.. ....... i ........... ~ ' ' ' ~"a ........... oep11¥.2 c~.~4 p.,...~ ............ 10. Date of Purchase . Name of l~orm~ O,-~ 11. Zone or use d~strlct ~n wi}ich premises are situated..~.~3i~'~'I ................. ~il ................ 12. Does proposed construction yiolat~ any zoning law, ordinance or regulation' ~ .... 13 Will lot be regraded [q~ I .. ' .................. ..... '~' .... i' ' ' ~ I,~ ...........Will excess fill be removed from premises: Yes 14. ,N, ame of~ .Ow,net of premises .[~hOfihmO ,¢l~.~kT~ldress~.'l.'lJ. ,Co..~%~. [I.q.3V~ Phone No..7~%~:~d. . marne ot Architect / AaHr,~- ,-~ ~, ' ............ r ..................... ~ ................... /Fuone iNO ................ Name of Contractor ........... 1 ............... Address ................... Pho~No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No,t~.~ .... *If yes, Southold ToTM Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ,e, xisting or proposed, and, indicate all set-back d/mensions from property lines. Give street and block nu nber or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW ¥ORr .... ..... -~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual signing' contract) above named. He is the ontractor, agent, corporate officer, etc.) f smd owner or owners, and is duly ~uthonzed to perform or have performed the said work and to make and file this lpplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner s~t forth in the application filed therewith. ~woru to before me this ....................... day .... , 19 ?../ ., I'I_ELENg O. HORNi~ I' :~..~. ,/~./ .................. '~.; ............ T .:. .... ,. Qualified In $uffol~, ~*** ~ommla~lon F...Xplree M~ lm~ .~ '5'c~°°/ O/b/ob//Po...~ / / / / ~ / / SURVEY FOR THOMAS A. KLOS 8~ ROSEMARY E. KLOS AT SOUTHOLD TOWN OFSOUTHOLD SUFFOLK COUNTY, NEW YORK FEB. 15~ 1994 FEB. 21tl985 DATE~ dUNE 18, 1980 SCALE: I"= 40' NO. 80-336 CERTIFIED TO: THOMAS A. KLOS ROSEMARY E. KLOS USLIFE TITLE INSURANCE COMPANY OF NEW YORK nOT lE COH$1OEI~D TO ~ A VALID THUg COPY L"~,~,' ~, y NORTH FORK HEAL~ DEPARTMENT-D TA F~ APPR~L TO C~STRUCT *no ~ NiS ~H&LF ~ TNE TITLE C~Y, O0~X- ~ ~F CO. T~ MAP ~ SECTI~ ~ ~K I LOT 19.13 H~E~, AHa TO ~g AISlON~5 OF THE LENDIN6 [/~ '- ' r~'~ ~ PR P RTY INSTITUTI~ GUARANTEES &RE ~T T~ER~BLE · mE~ A~ ~ ~E~I~I WITHIN I00 FEET OF T S 0 E · R HA TO &~ITIONAL INSTITUTI~S OR SUBSEQUENT ~ ~ R A~E ~ 1 ~ /I A I I HOWARO W. YOUNG, LAND SURVEYOR / I~~~Tie ce~(o) ~" ~n[~ l[ ~ IJ N Y S. LICENSE NO 4589~ I