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Home My WebLink About20079-zNo Z20157 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector' Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date AUGUST 21, 1991 THIS CERTIFIES that the buildin~ Location of Property 200 FIRST House No. County Tax Map No. 1000 Section 126 SEC. 1 ACCESSORY SHED STREET LAUREL Street Hamlet Block 10 Lot 7.2 Subdivision G.I. TUTHILL Filed Map No. 861 Lot No. 95 & 96 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 7, 1991 pursuant to which Building Permit No. 20079Z dated AUG. 9, 1991 was issued, and conforms to all of the requirements of the applic~bla provisions of the law. The occupancy for which this certificate is issued is CONSTRUCT AN ACCESSORY SHED AS BUILT. The certificate is issued to JOHN J. EBERT~ JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 B~i~ding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. NO_ BUILDING PERA41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 20079 Z ~te .....~.~... .......................................... , ,~.?~ County Tox Map No. 1000 Section ........ ./....~.....~,~... Block ........ ~..~.. ...... Lot No ....... .~.~... ...... pursuant to application dated ............................................ , 19. ond approved by the Building Inspector. Fee $.-~~ Rev. 6/30/80 Form No. 6 ICATION FOR T ATE 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. 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/I0 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 fer 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. 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 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 ......t% '~ '~'~ '~'-~' '~ '~ ....................... New Construction ........... Old Or Pre-existing Building..~.~ .... Location of Property ........ .~..~..~,...,~..~.~'~,, .~. House No. Street Hamlet Onwer or Owners of Property.~ '~'~....~.. ..... .~. ~.~...~.~?.~ .................... County Tax Map No 1000, Section .......... Block .............. Lot ....... ' .... subdivision ......... .~..../~.....~...~.% ~!t5 .~...~iledMap ...~.~. Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ....... .Final Certica~..~ FOUNDAT, ION ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~.ATION FRAMING [ ,-,]-'FINAL REMARKS: ~~, / DATE BI.DG TOWN OF Examined /.¢ ............ 197/ Disapproved a/c ..................................... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY ......... CHECK .......... SEPTIC FORM ............. CALL -. · MAIL TO: INSTRUCTIONS a. This 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 t~s 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. 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, addiQons or alterations, or for removal or demolition, as herein described. aShme i~papu~ti~itze~dg%es;:~t~cr~%pn~yprew/mtihse%~ana~pi~%%bi~ed.~ma~r~;dei~%%~acre~.~ncs.c~ .~...~ou~g.;coCe, an_~ regulations, and io /(Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is. owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde ........... ...................... Name of ow.ncr, of. premises ' . .................................... " .... ' ' (as on the tax roll or latest deed) If applicant isl~i~'dbrpOrat~n, signature of ,duly authorized officer· (Name and title of corporate officer) ALL CONTRACTOR'S }lUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ./'~ ..... ~.¢.~.,.. :.~..~.~.5.~ .............. ,../~ ....................................... House Number Street Hamlet County Tax Map No. 1000 Section . .~ .'~'~¢ ........... Block. ~ ~. .............. Lot..¢..'~.'..~ ....... · ' . ......... .... Subd,vision...e-r..~.4.Xh.k,,Z..~...--~-~,.(k..~C/~I FiledMapNo....~...~..~ ....... Lot ...:,.: · ~ (Nmne) 2. State existing use and occupancy of premises and intended use and occnpancy of proposed construction: < ¢ a. Existing use and occupancy .................................................................... b. Intended use and occupancy ......... ./-'3'XV%~ ............................................... 3. Nature of work (check which applicable): New Building . Addition ......... '..~l~.r~rrrrrrrrrrrrrrr~T?'hj .,., .. ........ Repair .............. Remo al .............. Demolition .............. Other Work... ..... . ........ 4 Estimated Cost .~..~..<~. Fee ] " (to be paid on filing this application) '5. If dwelling, number of dwelling qnits ............. Number of dwelling units on each floor ................ If garage, number of cars ..... I .................................................................. . . . dI · 6. If business, commercial or m~xe occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any Front ............... Rear .............. Depth... Iteight Number of Stories · Dtmenmons'of same structure with alterations or additions: Front ................. Rear ................. Depth .................... I · Height ...................... Number of Stories ..................... Dimensions of entire new const~ction: Front . Rear Depth Height ............... Number of Stories ....................................................... 9 Size of lot: Front ' Rear Depth 10. Date of Purchase ........... ~ .................. Name of Former Owner ............................ 11. Zone or use district in which pre~nises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............................. 13. Will lot be regraded ......... ~ .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ... ! ...... Address ............. Phone No. Name of Architect" Address Phone No Name of Contractor [ Address · Phone No 15. Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trustees Permit maybe required. i PLO*F DIAGRAM Locate clearly and distinctly all Ibuadings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. &Pq~pV£D AS NOTED ~ / N~rlFY BUILOI~G~ OEPARTM~ Al 755-1802 9 AM ~ 4 PM FOR THE FOLLOWING INSPfiCTIONS: 1. FOUNDATION - 'IWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.G. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.Y. STATE CONSTRU~ON & ENERGY CODES. N~ RESPONSlB~ FOR DESIGN OR C~RUC~ON ERRORS STATE OF NEW_.~.n.,.,, --Y°gJ~,x _ COUNTY OF...~. ~(.V ~ .~'x. ..... $.S ,, ....................-- -..x .: --~ - - - ---r-W- ~.-X~'O~Cih..<-).,.....~., .~4-'~..~. ,~ being duly sworn, deposes and says that he is the (Name of indi~dual signing contract) above named. ~ applicant He is the .............................................................................. (Contractor agent corporate officer etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make 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 performed in the manne~ set forth in the application filed therewith. Sworn to before me this ' i ...... ~RY F~NNER ~ Nom~ public, ~now york ~ (SJgnature of apphcant)