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Home My WebLink About19633-zNo Z20023 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date. JUNE 21{ 1991 THIS CERTIFIES that the building. Location of Property_ 10850 House No. County Tax Map No. 1000 Section ACCESSORY MAIN ROAD EAST MARION Street Hamlet 31 Block 11 Lot i2 Subdivision_ . Filed Map No. __Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 24~ 1991 pursuant to which Building Permit No. 19633Z dated JAN. 25{ 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 BETTY BILLMAN (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 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 19633 Z County Tax Map No. 1000 Section ...... .%~....K/.. ......... Block ....... ././.. ......... Lot No ........ .~...~... ....... pursuant to application dated ' ~/.. ................ , 19.?Z., and approved by the Building Inspector. '~ ~'~-~; ................... Feo $....~..~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTDOLD BUILDING DEPARTMENT TOWN gALL 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 archiuect or engineer rssponsible for the bu.'.lding. 6. Submi{ 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. ~. 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 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, Connnercial $15.00 ate .................. ew Construction ....... Old Or Pre-existing Building ................ ocation of Property ......... -- Nouse No. Street Hamlet ewer or Owners of Property ~ ~, )unty Tax Map No I000, Section..~! ....... Block..{~ ............ Lot lbdivision ........................ · - · Filed bfap Lot ~ it.~.. ~ / ~ Appli :rmit No .............. Date Of Perm .-~ ..... ~. cant ............... .alth Dept Approval · ' ...................... Underwriters Approval .................... anning Board Approval ........................ quest for: Temporary Certificate ........... Final Certicate ........... e Submitted: $ ......................... " fflg .... ' C o '~ ~0~._~ ~ APPLICANT · .~ i~LD I,,S, ~ ~ON , FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING INSULATION ?ER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: 7G5-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS: FOUNDATION ZND [ ] INSULATION FRAMING DATE INSPECTOR TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTItOLD, N.Y. 11971 Hay 31, 1991 TEL. ,765-I 802 JOlt~ H. BILLHAN 10850 MAIN ROAD EAST HAIl. ION, H.Y. 11938 To Whom This May Cogcern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /--//An application for Certificate of Occupancy is not on file. ' (ENCLOSED) /~//%Io Underwriters Certificate on file. /~ The check is(~k~dt~_~x_'~d/not on file.) $25.00 /--_/ No llcalth Dept. Approval on file. /--/ No final J.ns.pcction has been made. Please contact our office on this matter. Tllank you for your cooperation. Building Permit tJ I 9 6 3 3 Z Buildinq Dept. ***/5/ No Plumber Sol. der Certificate on file. ( all permits involving plumbing being issued after April 1,1984 BOARD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY ......... TOWN OF SOUTHOID CHECK .......... BUILDING DEPARTMENT SEPTIC FORM TOWN HALL $OUTHOLD, N.Y. 11971 NOTIFY CALL ? 7. ...... 19,4/ MAIL TO: Examined Approved. 1-9~/Pe rmit NO.. Disapproved a/c ..................................... (B~,fdin~/sp~ctor] APPLICATION FO]R BUILDING PERMIT Date . .~.'.~../. .... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building IJspector, with~3 se.ts of~ 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 tiffs appli- cation. c. 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. 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 e~?l~fl[difig 'l%/fi~]C/Si~rsuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other agph~%able Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal o?'derfiolifi6n/'fis herein described. The applicant agrees to comply with all applicable laws, ordinances building code, housing code'; and re,,uiations and to admit authorized inspectors on premises and in building for necessary in§pections. ..... ........ (Stgnatnre of applican~ or-name, if a corporation) / (Mailing address of applicant),', State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plum'l~et'"oi,~builder. .................................................................. ~. Ifil'..~O..;!','.~M~Rlt~O.~. ?.~.r.... .(~.~ d4~.-..~..,7,~.' Name of owner of premises . .. .~./:.. ~..2~. ................. ;L. 32~.~t~'.~..tO.l~... ~9'?'.':') .... (as on the tax roll or If applicant is a corporation, signature of duly authorized officer. (Name and title of co.orate officer) ALL CO~TRACTOR*S ~UST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrici~n's License No. ,r~ou~,x..~qve ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ' H N ~ ......................................................... ; ..... : ....... ouse um er Street Hamlet County Tax Map No. 1000 Section ) /. Block } t ................................. Lot...aq~. .......... ,... Subd v si .......... Filed Map No ...... (Name) ......... Lot ...... 2. State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......................... . ........................................... . b. Intended use and bccupancy .............................................................. .... . . 3. Nat re of work (check which aplphcable): New Building , ' ..... Addition. Repair .............. Removal ..... . · · · ~ . · ........ Alteration .......... (~?.4~2e.~ ~ ~ · · · ..... Demolmon .......... i'" Other Work ............... · ' '~ ! ~¢~ / (Descfiplion) 4. EsUmated Cost ~ .- 2,4 i · (to be paid on filing this application) g9 5. lfdwelling, number of dwellin nits ............... Numberofdwclling units on each floor, If garage, number of cars . . . . .'~..: ......... ' iT' ' i i ....... ~' IDfibusiness'c°mmerciat°rmixe~°ccupancy'specifynatureandextent°feachtype°fuse 'l~t'h' .... -- . mensions of existing structure~, if any: Front ............... Rear ............. ' ......... Hight Nu aberofSt ri ' ' ' e ............... S O es ..... ' ........... Dim ' cfa iih alt ration dditior~sl ........................................ Front R .... ens]ons amc structure w e s or a ................. ear ...... Depth Height Number of Stories ........... · Dimensions of entire~ew construction: Front ' Rear ............................. Depth ... ............... Name of Former Owner .. (.~..~..~/~, ........ Zone or use district in which premises are situated..~..c~.. ............................... 12 Do d ucti i lutes ni gla ~din .Ada ............... · es propose constr on v o ny zo n w, r ance or regulation: ........................... 13. Will lot be regraded ]J~.o ] .... · · ~, · :.'.~ .... ~ .:...... -.~ ..... wm excess m~ ce removed from premises: Yea No 14. Name of Owner of, premises (..m~..,.L:/. ,(~p~,. Address,~%-~ .c~ dc:-.f?. Js~t. Phone No Nm-ne of Architect . .. " ~-- ' ' ~'" c~ ................. a' ..... ;. .............. ^auress ....... phr.~e lq'.. 15. ~ u~u property ~ocate~ wxthin 300 feet of a tidal wetland? *Yes'~. .... No ~.r~....c · If yes, Southold Town Trustees Permit may_ be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nhmber or descri~p, tio,n accord'.mg to deed, and show street names and indicate whether ,-9. ~10. I1, APJ~'ov_m~D,AS NOTED . , // 76S-1802 ~ AM ~ 4 ~OR'T~E FOLLOW NG INSPECTIONS: ! 1. FOUNDATION ~0 REQUIRED FOR POURED CONCR~ 2. ROUGH. FRAMING · [UMBIN6 3. INSU~TION .I ~ FINAL CONSTRU~N MUST BE COMP~'~ FOR C.O. ' A~ ~NSTRUC~ON THE REQUIR~E~ STATE CONS~ON CODES. N~ RES~NSIB~ FOR UES~GN STATE OF NEW YORK, 70U NrI'Y OF ................. T Id' ' ............... . .............................. being duly sworn, depose~s and says .,.~, ne JS the ~p!~ix~'ant (Name o individual s~nm~ contract) ibove named. ' is the (Contractor, agent, corporate officer, etc.) said owner or owners, ~d is duly ~uthofized to perform or have perfo~ed the said work and to m~e and file pplication: that all statements contained M this application are true to the best of his knowledge and belief; and that the york w~l be perfo~ed in the m~ner s~t forth in the application filed therewith. ,worn to before me this : ..... day or. ] ..... ota~, Public : County NOTA~ PUBLIC, ~ate 0f New T~ (Signature of applicant) . ~ 47o78~8, Su~lkC0un~o/