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Home My WebLink About20073-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20247 Date SEPTEMBER 26~ 1991 THIS CERTIFIES that the building ACCESSORY Location of Property 1825 BRIGANTINE DRIVE House No. Street County Tax Map No. 1000 Section 79 Block 4 subdivision Filed Map No. SOUTHOLD~ N.Y. Hamlet Lot 60 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 2~ 1991 pursuant to which Building Permit No. 20073-Z dated AUGUST 9, 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 EUGENE & JUNE WLOCK Rev. 1/81 Building Inspector · 0~,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 20073 Z Date ................................. , 19 ....... Permission is hereby granted to: ..... ' .x..;..: .......... j~L..~ .......... at p ' ~.. ..... .a~./....z~'~...~..~..~. ......... ~/..~//.X ............................................. County Tax Map No. 1000 Section ......... .~.~....' ....... Block ........ . .~.... ....... Lot No ......... ~.~... ...... / pursuant to application dated .....~../....x~.... ....................................... 19....~.., and approved by the / Building Inspector. Fee $..~.~...~ .~.. Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. Eiaal 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 i% 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 i. 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 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ate ....... 7!L! ........ " nstruction Old Or Pre existi g B ilding location of Property ~ o ~ House No. Street Hamlet Onwer or Owners of ~roperty ....... ~7 .......................................... .. . ... . .. ... . . County Tax Map No 1000, Section ......... Block .............. Lot ...................... ~* ............. ......Filed Hap ............ Lot ..................... . Permit No Date Of Permit Applicant !Iealth Dept. Approval ......................... · Underwriters Approval ................... . .... . '!arming Board Approval ~equest for: Temporary Certificate ........... Final Certicate ........... fiELD FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE (2nd) FINAL ADDITIONAL COMMENTS: TOWN OF SOUTI~OLD OP[:ICE OF BUILDING IN~PECFoR P.O. BOX 728 TOWN tlALL , SOUTIIOLp, N.Y. 11971 SEPTEI~BER 20, 1991 TE~.765-1802 EUGENE . & ~ V/LOCK 1825 BRIGANTINE DRIVE SOUI'HOLD, NY 111971 To Whom This May Co.ncern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /~/'_ An application for Certificate of Occupancy is not on file. '(ENCI.OSED) /--/ No Underwriters Certificate on file. /~ The check is (X~x~maxXd/not on file. ) $25.00 /_-/ No llealth Dept. Approval on file. /_--/ No final inspection has been made. Please co~tact our office on this Thank you for your cooperation. Building Permit # 2 0 0'7 3 Z Buildin~ Dept. ***/--/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 matter. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS/JJ~TION [ ] FRAMING [//]/FINAL REMARKS: DATE INSPECTOR , .[ BUILDING DEPARTMENT TOWk','~]'-': o7S-? ....... TOWN HALL - TEL.; 765.1802 ,;an,,.ed. . . ,,ppro,.,d ...,¢Z.¢ ......... . Pc= Disapprove ~a~ ~ ~ ~.~ ......................... ; cOUNDAT~ON ')X~O REQUIRED APPLICATION FOR BUILDING PERMIT ~GR POURED CONCRETE 2 ~OUGH , FRAMING'& PLUMBING ;3, 4. FINAL CONSTRUCTION MUST BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ................ ,,,,. CHECK ...................... SEPTIC FORH ................ NOTIFY CALL Date ~'-Z 9 (~ ............... 19 . ~. 8t~..'~.~ ,~,~i~d ~ e c m letely fi11=d in b e,vriter or' ' "':' -' :~ ....f~'~['~,,-'.',~c~P~.~:nt?'' P~m~l~ y typ in ink and submitted to the nuildi.= Inspector, with 3 seta'~t't~lkfi~'~dO~t{'~t~.t~bt~llcltoi~kEa~. Fee accordin~ to schedule. "g-~'T~PE_f~,J~,~)/~'~:n~iZYpt and of build~ings on premises, relationshin to ad;elaine -remisex . ' or ~ ' rM° ~i ' ~ on - , = ,- or p blio streets c:,;~-~e~D~, ~'~.~..' &~.~.,}' ~ of layout of property must be drawn on the diagram whicb, ispart of tllis appli- 'q~'--~Qvn°~l:5~~_;tion may not be commenced before issuance of Building Permit. - ' d.' O~o~i":i't315'~:6i)i[Bf'th~'~ ~lic~'~{~'~ the Building inspector will issued a Building Permit to the applicant. Such permit shall l~i':kept.on .the-~r~n{it~s-:v-;:- ~ ej,!q~:~uaL~tL{,)~N;.,,i.,F~:~t~:t~f~:-r~{-mspect~on throug]lout the work. ...... j,~um~ sn'q!l 'oe 'Cc _i d .used in wh le shall ~fV~:' b~ f{~{'~d ll~l, 'l~'kg~'~ T~ o or ~n part for spy purpose whatever until a Certificale of Occupancy I-O~ t. OW~[~; IN,qF~:f~f"~i~,%~unumg inspector. , A'PPE,f.¢~Fr~oN)~IS HEi~lirE~pJy/:)EC(o the Building Department for the issuance of a Building Permit pursuant ~o the Building~;2~{O.~d~:ha~bNO:tq}li~ Town of $outhold, Suffolk County, New York, and other applicable Laws, Ordinances or Regul~tiOt~¢~olr-tl~,~n~a~ilu&tiF~ldW~b~dings, additions' or alterations, or for removal or demolition, as herein described. Tim a~.p}~Kn)gt./z~a to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit~u$~ize°Lin~l~9~ll~O~l~4~J°~$!hd in building for necessary inspections. ' BEC~MPLEI'EFORC,O, · ....... & .~.... . ' All. CONSTRUCTION SHALL MEET .,,- -, : ..... : ............ TNE RFQiUREMENTS OF THE N.Y. ' (Si=~phcant, or name, :facorporal;~n) E[~4?$. NOT ~ESPONSIBLE FOR ................................ DEE;IGN OR CONgfRUCTION ERRORS (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... edger Tradc's License No ...................... I. Location of land on which proposed work will be done~ OCCU?ANO¥' OR USE IS UNUWFUL ' WJTHOUT CERTIHCATE OF OCCUPANCY - - .-5 Y [lous= Number Street Hamlet .................. tyT O,~ 9 ' ' Bio ~ Court ax M~p No. I000 S~ction .............. c~ .......... Lot .......... Sa vision ............ ,; ........ ~ited Map No. . (Nm.e) .............. Lot ........ ~ ...... State existing use and occupancy of premises and intended use'and occupancy of proposed constrt '1. Nature of ~vork (check which applicable): Ne~v BuildinB .......... Addition ....... ~tcr'tlOn -. . ~ ..... ............. .............. , mo,itioo ....... . Tennis Court ......... A~cessory Building .... ~ .... Fence'.'.' . . ~.~ G G ....................... Fee ,c~ (~o be p~d on ~ling this application) ~. ~r ~,v~.i.~...m~. or aw~.i~.~i~ ..... ~ ......... N.~r o~ U,~,,,,~ .~,~ o. ~=~ ~oo~. ~.~/ .......... If g f ~ ...................................................... nragC, number o cars ...... 6 Ifb i I d 9 ney ify d h tyv f ...... vD' ' t ' ' 'ir Y:~ ~ ~ - ~ ' ~a ..... ~' JA N b~ rst ' L~ ......................... " ............... ~ Dhnensions of same structure wit~ alterations or ntfdit[nn~' Frnnt ~ ~ ~n,, ~ ~ Depth . . Height /g Nu nber of Stones'. 8. Dimensions of entire new constmdtion: Front ...... 3.~ ...... Rear ..... ~.~ ....... Depth ..~ 3... ' ..... Height .. J..~ ......... Number of Stories ............ . ...... 9. Size oflot: Front .J.~q,D.... i .. Rea:..~).3.: ...................... ' .................... [0. DateofPurchase ..L~I~.8~ '~ ....... . ...... Name of Fa~er Owner ... ~%~ .. : 1. Zone or use district in which premises ar= situated ................................ 12. Does proposed construction violatc any zonine law. ardinance or re ulatian:i~'i] ' '": ...... 13. W~I lot be regraded .: ........ ~ ................. Will excess fill be removed from premises: Yes .... 14. N~eofOwnerofpremises ~ ~a ~U t~W~TtM 6~ . .. ' o~ .' .... Address C-~Phone No. ~ r ..... N~e of Architect .......................... Addres~ ................... Phone No ................ N~e of ConIractor .. ,,. · 15.Is thio property 1 i 100 feet t 1 wetland~ *YES .... NO.~. · If yes, Southold Town :Trumteem Permit may be required. PLOT DIAG ~M Locate cle~ly ~d d~stmctly ~1 ~uHdmgs, whether ex~stmg or proposed, ~d. indicate ~[ set-back d~cns~ons from prop~Ny Hnes. Give street ~d block number or descgption accord~g to deed, ~d show street n~es and ~dicat~ whethe~ interior or comer lot. · '-T. /// STATE OF NEW YORK, .3',.3 COUNTY OF ................. .................. being duly sworn, deposes and says that he is the applicant (I'lame uf individual signing contract) above nerved. , He is the ' ' (Contractor agent corporate officer etc) ............. ' ' o£ said Owner or o\vners, and is duly ::authorized to pe,rform or have performed the said work and to make and file this application; that all statements contaified in this application are true to tim best of his knoxvledge and belief; and that the work will be performed in the manner: ct fortll in the application filed therewith. Sworn to before me this .' ,.5 ............. ~..-5 ...... day of. i...X'e-X-~...' .......... ,19 ?.~. ~A~ ~C, State of t'.e'v York (Signature of applicant)