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Home My WebLink About19789-zFORM NO. 4 TOWN OF SOUTROLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25323 Date OCTOBER 21, 1997 THIS CERTIFIES that the building Location of Property 26850 MAIN ROAD House No. County Tax Map No. 1000 Section 109 Subdivision ACCESSORY CUTCHO~UE, N. Y · Block 5 Filed Map No. Street Hamlet Lot 3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1991 _pursuant to which Building Permit No. 19789-Z dated APRIL 18, 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 Rev. 1/81 MANFRED & ROEERTA LEE N-057391 - OCTOBER 16, 1997 uilding Ins~r~ i~OB~ NO. ~ TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ('I'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne- 19789 Z Permission is hereby granted to: .......... ............... /:/J ............. ~ ............................... ...~..~-~.....~...:.~.,......u..~...~.~... t ' ,o ....... ..... at. ~ ' at premises located .~...(g..~..~. ............~. ,~.....~..C~ ................. ~~.~ .............. /~, / County Tax Map No. I000 Section ~ ................... Block ......(~...~.. ........ Lot No.....~....~. ............ pursuant to application dated ...... ~ ......... ~ .............. , 19 .~.~.., and approved by the Building Inspector. Fee $ ........................ BulTdlng Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 PLICATION FOR CERTIFICATE OF OCCUPA~MCY 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 topograp6ic 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 c6mpleted site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: ~. Accurate survey of prqperty showing all property lines, streets, building and unusual natural or topographic features. 2. A properly complete'd application and a consent to inspect signed by the applicant. If a CertificateJof 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ate ..................... New Construction ........ 01d Or Pre-existing~ilding....~.. House No. Street HanD-et ....... .......... County Tax Map No i000. Section.. 7.~.~. ...... Block.. O ~ ...Lot.. :.~?..~. Subdivision .................................... Filed Map ........... ~L~t ...................... Permit No,.~,~. Z.~,.~. ..... Date Of Permit..Y~.~/.~,/ .... Applicant.~~,~ Health Dept. Approval .......................... Underwriters Approval ...... ~..~ .............. Planning Board Approval ........................ Request for: Fee Submitted: Temporary Certificate ........... Final Certicate~-~......... ....................... APPLICANT THE NEW YORK BOARD OF FIRE UNDERWRITERS (~;,~,~7 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NY 10038 THIS CERTIFIES THAT in the following location; n~sexaminedon ( )C![~!J f~/~J~ :L~, 1997 FIXTURE F ' r FIXTURES ~T~TS ~EPTACLES SWITCHES iNCANDE~ENT FLORESCENT DRYERS I mRNACE ~ORS FUTURE A~IANCE ~E~RS SERVIC~ DISCONNECT J NO. OI and found to be in compliance ~tih the National Electrical Code. RANGES iPECIA[ REC'I I I R. V I . C E NO OF HI-LEG OF HI*LEG Lot EXHAUST FANS DIMMERS P, O. ~30X ,1282 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. COPY FOR BUILDING DEPARTMEN~I'o THIS COPY OF CERTIFICATE HUST,NOT ~E ALTERED IN ANY MANNER 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. i i ~ORAUMNiDNA~ION 2ND i ,,, ] I~C.,]~ FiNA~ATION [ ] FIREPLACE~/~NEY /~ ~..~_~ FOUNDATION ( 1 st) FOUNDATION 2. (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: T ,¢ / / FORM NO. 1 TOWN OF SOU~NOLD BUILDING DEPARTMENT TOWN HALL ' ......... "' TEL.; 765-1802 Exanfincd · J..~..., 19 .~. / Approved · /.?. , 19c~./· Permit No..].?..'7..~.~. ~ Disapproved ale ............................. BOARD OF HEALTH 3 SETS OF PLANS SURVEY CHECK SEPTIC ...................... FORM (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewr/ter or in ink find submitted to the Building Ihxpe~tor,,gi. th 3 se~ of plm~, accurate plot plan to scale. Fee ,~ecorrting to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets dr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. o. The work covered by this application may not be commenced 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. ¢. 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 tb.¢ Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, as herein described. T!~e .~ppli.can.t a~r. ees to comply with all applicable laws, ordinances, building cod housin- c z ' aamlr autbomzea mspectors on premtses and m bmldmg for neces:~r~, mspection~e'~lat.°ns' and to . ' - . (Signature oi' a~plicant, or n~r~e~, if 'a~'or~o'riridn')' ' ' (Mailing address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. amean tie o o officer) Broider s L No .... Plumber's License No .................... Electrician's License No ................. Other Trade's License No .................. I. Locatmti of land on which proposedj~ 7ill be done; ' .. -.-, c", ..... .................................... ~--.w. ~..'v&'~D~ ~.~.. HOuse Num bet Street, Ha:n'l~t' ........................ County Tax Map No. 1000 Section ..... {. O..'~ ........ Block .. ~. .... Lot... ~..~. .... ,' Subdivision ..................................... Eiled Map No. (Name) .............. Lot ............ ' State .-' . ~- ex sting use and occupancy of premises and intended use and OCcupancy of proposed construction: A. Existing use and occupancy...~ ~,~;,r,~.~, 'tt~ 0~;-;~'3 ~l~!.~t) W~ ~' .............. B. Intended use and occupancy ......... r ',o~.q:,~.* *; .;..i,;'ifil~,~d; ................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ......... '.. pair. R~ ¥ , · .Swimmin~ oool ......... Re .............. mo al .............. Demolition ............... ,. , Tennxs Court ......... Accessory Building .......... Fence ....... Othe~.~¥~. ~p~...~ . 4. Estimated Cos .............................. ee ..................................... ' · ! ~he, paid on filing this application~ 5 Ifd veil' b fd t ' g un' Nt mb f d Iii its each . x rog. nun crc we n ~ts ............... ~ crc we ngun on floor ................. If garaee number of cars 6. If bus ness, commercml or m~xedloccupancy, specify nature and extent of each type of use ........ ' ............ 7. Dimensions of existing structures, if any: Front ..,I .... i..~... Rear .... i ........ ~i Depth '~ii~i ...... Height ............... Number of Stories ..................................... · .... Dimensions of same structure wi(h alterations or additions: Front ................. Rear .....,......... Depth .................... 'i. Height ...................... Number of Stories ........ ' ' '''"'"' 8 Dimensions of entire new constn~ction: Front Rear . Depth .. Height Number of Stories ' 9 Size of lot: Front ~ Rear ' Depth l0 Date of Purchase ,' Name of Former Owner I 1 Zone or use district in which premises are situated ' · ................. · ' ' ' ordinance or regulation: 12. Does proposedconstrucnonwolateanyzomnglaw, . .. ............. ..... · ....-.-.- ... 13, Will lot be regraded ......... i ................... Will excess fill be removed from premise, a:, . Yes .... N~a.. 14 Nmme of Owner of premises Name of Architect ' Address Phone No - · · Name of Contractor [5.1~ ~ki-~ property located within 300 feet of a tidal wetland? eyES... · If yes, Southold TownI Trustees Permit may be required. . PLOT DIAGILAM ' Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property Hnes. Give street and block umber or descr/ption according to deed, and show streei names and indicate whethsr interior or comer lot. STATE OF NEW Y(~K,, COU~Y OF .... a ....... (: ' I ... ) ~ .......................................... being duly swo~, deposes ~d says that he is the applicant (Name of individual sigqing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners. ~d is dqly authorized to pc?ors or bare perfo~ed the said work and to m~e and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perforated in the manner set forth in the application filed therewith. Sworn to before me this #/ Notary Public,~,~lSl!_t,, ~. ,~,,~. , County . · .... (Signature of applicmat)