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Home My WebLink About19521-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of 'the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20484 Date JANUARY 15, 1992 THIS CERTIFIES that the building Location of Property 21905 MAIN ROAD House No. County Tax Map No. 100Q Section 109 Subdivision' ACCESSORY CUTCHOGUE, NEW YORK Street Hamlet Block 1 Lot 8.9 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 13~ 1990 pursuant to which Building Permit No. 19521-Z dated NOVEMBER 16:1990 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 GARAGE STRUCTURE 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 JACK & PEGGY FOSTER N/A N[~ Rev. 1/81 lvO~ NO. ft 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) 9521 Z Permission is hereby granted to: ..........................................~o~ ~:~ O~ ...... ~ .~...~..~,~ ..~.~.-..~L~...~ ...... ~ ............ ...~.;~L~L....~..,H ........... ~..L~.~...I .... at premises located at ...~....I..~...°...~ ......... .~..~.......~......, ............. ~~..~-~-...~ ......... ....... ............................................ County Tox Map No, 1000 Section, ...... )..C).~ ......... Block ...... ..0..../. ......... Lot No ....... .~.:....~ ....... pursuant to application dated ...~..~~...../....~. ........... , 19.~...~..., ond approved by the Building Inspector. Fee $..L..~.....~.../..~ Rev. 6/30/80 Fo~m No. TOWN OF SOUT[[OLD BUILDING DEPARTMENT TOWN IIALL APPLICATION FOR CERTIFICATE OF OCCU 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, 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 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 I. Certificate of Occupancy - New dwelling $25.00, Addition~ 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.O0 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Coramercial $15.00 · ,ew Constructzon ........... Old Or Pre-existing Building ........... Hbuse No. Street ...... .... .......... .. .... ,.uunty Tax Map No 1000, Section~ ........ Block ....... %~.~. Lot .... ...., .;ubdivlston .................................... Filed Map ............ Lot ............. ~] ..... · .~ ........... Dare OE Porm~ ................ Applicant .... ~ealtb De~r. ApprovaI ......................... Underwriters · .. ntng Board Approval .......... , cquu~r for: Temporary Certificate Yee Sub,it red: S FOUNDATION (1st) FOUNDATION 2. 12nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieezorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 JAhqlARY 6, 1992 JACK FOSTRR 34 TOWNSEND AVENUE RII/ERHgAD, I~ 11901 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xxx An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. XXX The check is ~L~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 19521-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD JANIJARY 6, 1992 JACK FOSTER 34 TOI4NSEND AVENUE RIVERHgAI), NY I 190 1 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xz~ An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~u~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 plumbing being issued after April 1, 1984). BUILDING PERMIT $ 19521-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. 0CC[]PANC~' OR CE~'TIFICATE OF OCCUPA~,~C¥ ALL SHALL THE ~EQUIflE~ENT$ OF THE N V, ST,~FE CONSTRUCTION ~ ENE.~GY DESIGN O~ CoNSTRUCIlON ERRORS T v- -. ~ I '~u 7G5-~802 BUILDING DEPT. INSPECTION / [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION 2ND [ ] INSULATION [ ] FINAL 765-~80Z BUILDING DEPT. INSPECTION []FOUNDATION 1ST £]FOUNDATION ZND []FRAMING ..... [ ] ROUGH PLBG. [ ] INS..U~ION [ 4.'F1~AL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST l- ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS} ~__ '~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHQLD,. LNL'~ _ 1.!.9,7 1. TEL.: 765-1802 Approved ! k, 199 Per.it No. / Disapproved a/c ................ · .., ............................ .(Building Inspector) APPLICATION FOR BUILDING PERMIT ate ................ If,. INSTRUCTIONS a. TI, is application must be completely filled in by typewriter or in ink ind submitted to thc Building IkspcCtar, with sets of plans, aero,rate plot plan to scale. Fcc according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and -' ' - cation, otvm= a detailed description of layout of property must be drawn on the diagram which is part of tkis app 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 Per.it to the applicant. Such perm 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 a.ny purpose whatever until a Certificate of Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances c Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, as herein describec The applicant agrees to comply with all applicable laws, ordinances, b ' ding code, housing de, and regulations, and t f,81/~5iturc of ipplicant, or nar~'. [f'a c~-go.-;.lZ V'' · (Mailing address of applicant) State whether a~pplicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~ appucant is a corporation, signature of duly authorized officer, f~-' ' B ui,dcr's Lice nsc No... 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 ~, ~ .......... Subdivision ..................................... Riled Map No. (Name) ........... Lot ........... Slate existing use and occupancy o£ premises and intended use and occupancy of proposed construction: .... A. Existing use and occupancy .... ~ ..'. B Inte d d nd ' n e use a occuoancy ..... .... ' 3, Nature of work (check which applicable): New Building .. Addition ......... Alteration ......... Repair. R~n)oval Demolition Swlnll~[~p ~ol~ Tennis Court ' Accessory Building Fence O)th~r- '~'-her Work; 4. Estimated Cost ., ..~ ....... , .......................... Fee ..................................... J (tn ha paid on fi'ling this application} 5 Ifd Ill g : N iii bro. : 111~. · we ng, number of dweilin units ......... umberofdwe 0gunitsoneac or .......... erase·, number of cars ............................................. .. .. . .. 6· If business, commercial or mixed occupancy, specify nature and extent of each type of usc . · . 7, Dimensions of c,Sisting structures, if any: Front'..,; (o.~. ,".. ..... Rear ..:...6. q.f ...... D~[h' . Height .../4 ......... Number of Stories....~. ............................................ Dimensions of same structure with alterations or additions: Front Rear Depth ................... i... tleight ...................... Number of Stories ............ ;.. ? 8. Dimensions of entire new construction' Front ..... ~'7..~' ... Re~,' ~' o ~ . De-th . ~..6. He:ght ..../..~i ........ .Nu,mber of Stories . . .~.. .... ~.: ....................... ,,..' ....... 9, Sizeoflot:F?ont ....D,~.~ j ....... ' ~e~ ,~'c/r')' " r,~.~ .~,~'r~, " ? 1 1. Zone or use district in which p~emises are situated ........................................... · 12. Does proposed Constructi~o~vi61ate any zoning law, ordinance or regulation: ../?. d ....................... 13. Will lot be regraded . . .~/.~ .~ .............. Wll .... - ,'~....,~ ~ . ...... .. :,, .. ' ] excess fill be rcmpv, ed from pre. raises: /~'a Yea .... 14. Name of Owner of premises ~. IVy.. Address ~.o-~..O'ff..~ Phone No..7.T~/.'.~? f.6..... Name of Architect ...--rT~-.... Address Phone No Name of Contractor ~. ' Address Phone No " [~,L~ ~b. ia llrOperty loc;ated within'~0 feet of a tidal wetland? *YES .... m%f yes, Southold To~n Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimen=ior.~ :'r ' property lines. Give street and bloc number or description according to deed, and show street names and indicate w;::::. interior or comer lot. STATE OF NEW YORK, , S.S COUNTY OF .......... . ........ t .................................................. being dnty sworn, deposes and says that he is the applica: (Name of individual signiugcontract) ' above named. He is tile ' (Contractor agent corporate officer etc) ...... of said owner or owners, and is d'ulv authorized to pc;form or have performed tile said work and to make and file th application: that all statements contained, in this ,application are true, to the best of bis knowledge and belief; and that ti WOrk will be performed in tile mantlet set forth in tile application filed therewith. Sworn to before me this ....... day of .................... NOTARYPU~LIC,$~e No. 470787R Su~o' · Term ExpresMa~=h3 ~New Yerk . .... County (Signature