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Home My WebLink About19560-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19660 Date JANUARY 15, 1991 THIS CERTIFIES that the buildinQ Location of Propert~ 1710 House No. County Tax Map No. 1000 Section subdivision ACCESSORY SHED TUCKERS LANE SOUTHOLD Street Hamlet 59 Block 04 Lot 5.1 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOV. 28, 1990 pursuant to which Building Permit No. I956OZ dated DEC. 3, 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 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 LINDA J. & LEE D. COOPER Rev. 1/81 Building Inspector FORB~ NO, ~ TO~VN 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) NO- 19560 Z / Date ..~' ./....~.' ................... 19..2-~ ...... ../.~..~ ............. Permission is hereby granted to: __ , / ~, ~ ..................... ~ ...... ~.. .......... :~.~ .......... ./...~.~...... ~/~.....~.a~.~ ........ :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: County Tax Map No. 1000 Section ........ .~...~'..~.. ..... Block .............. ...~.... Lot No ..... ~.~./.. ....... 19..~..~, and approved by the pursuant to application dated ..,/././,~....~... ................................. , / Building Inspector. Fee Rev, 6/30/80 Form No. 6 /" '~ ....~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-I802 APPLICATION FOR CERTIFICATE OF OCCUPANCY ,A. 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, maltiple 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. 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, Commercial $15.00 Date ..J~D.~K~.~Q~.%~% ...................... New Construction ...... ..... Old Or Pre-existing Building ........ ...... . .. Location of Property. JTJD.~U~gF~.~e~.~gq~91~,..~gW.~9~ ............................... . House No. Street Hamlet Onwer or Owners of Property ..... ~e.e..~.~O~.~iO~.~J.-.~qqpg[ ................................. County Tax Map No I000, Section .... ~ ........ Block...~ ............ Lot ...... ~,) ............. Subdivision ................................... . Filed Map ............ Lot ...................... Permit No~5~ ......... Date Of Permit...~/.9.0 ....... Applicant..~99.~.~[~.~P.o~ ........ Health Dept Approval Underwriters Approval .... Planning Board Approval ............ Request for: Temporary Certificate ........... Final Certicate..~ ....... Fee Submitted: $... ~...0.0 ..................... ' ............ z I OUNDATION (1st) OU~.;DATIO:! (2nd) OUGH FRAME & -PLUMBING NSULATIO~! FERN. Y. STATE E~;ERGY CODE t! Fi:;AL ADDITION A'L COMMENTS ~'c~F~m.-,J ' /0 F' //~'7 / 'L ~;F O~CUPANCY ; & FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL TEL.: 765-1802 Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARO OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. NOTIFY; CALL ................... MAIL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter or {~ ink find submitted to the Buildin~ sets of plnn~, a~'~',,rate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre, or areas, and giving a deta/led description of layout of property must be drawn on the diagram which is par~ of tki$ apt: cation. ¢, The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, thc Building Inspector will issued a Building Permit to the apphcant. Such porn shall be kept on the premises available for inspection througJqout the work. e. No building shall be occupied or used in whole or in part for arly purpose whatever until a Certificate of Occupant 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 Building Zone Ordinance of tb.e Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance: Re-ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describer Thg applicant aerees to comply with all applicable laws, ordinances, building code, housing code, and regu!~tions, and admit authonzec~ inspectom on premises and irt building for necezsary insp~4~ons~ ~, ,~.~, , (Signature ot applicint, or name, ff a corporauon) IRt0. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder O N/=aR- ........................................... Name of owner of premise~ .. .-~ ...................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Electrician's License No Other Tradc's License No. ....... ............. . 1. Location of land on which proposed work will be done[ 1'7 1.0. 'Tuc~_~.Rs LA,Jr. .,..... .. ,%OOTHOLI) llouse Number Street Hamlet 059 o.o. · 05/.O.O t 005. ool · County Tax Map No. 1000 Section .... Block ,' Lo ' Subdivision ..................................... F. ilcd Map No. . ............. Lot ............... (Name) 2. State exisling use and occupancy of premises and intcndcd use and occupancy of proposed construction: A. Lx£$ting usc and occupancy ........................................................ ............. ' V./ · 3. Nature of work (check which applicable). New Building .......... Addition .......... /alteration .... ~ ~,~ ~,~' · ............. ~m?vn, .............. Demolition .............. S~,~... '. , . Tennis Court: .~ ....... {ACcessory ~uildlng.~ ....... Fence ~ -- ~ ~ ...... ... Work; ......... 4. Extimated Cost .~ fA ~ ..... [ .......................... Fe~ ................. ~ ............... [ {l~ hc paid on ~li~ thi~a~plication} S. Ir dwelling, number of dwcllin~ units ............... Number of dwelling unit~ on each floor .............. Ir garage, number of cars 6. lfbumncss, commercial or mixdd occupnncy, specify nature and extent o~h type of use ..... . ..... 7. Dimension~ofexistingst~ctur~s, law Front ........ Rear " Depth Hei-ht Nud, ber of Sto~cs ~ ~ .......... ~'~ ................ D' i f ~itl It ti dditi F R :mensonso samestmcture s x a era onsora oas: rent ................. ear .............. Depth ................... ~... tI~i~t .............. Number of Sto~es ...... 8. Dimensions of entire new const:nmtion: Front Depth ..............· Rear ............... · - ........ Heinht Number of Stories 9'Size of lot: F?ont ' ....................... Rea.,' ..................... · Depth .............. · .. 10. Date of Purchase .......... 1 1. Zone or use district in which p~emises are situated 12. Does proposed Construction violate agy zoning law, ordinance or regulation: ......................... WIll I d ' ' ' ' ' y 1~. otberegrade -------..-................... 14. N~e of Owner of prem~a ..~ .................. Addre=. ......... ...... . . . PhoneNo ............... N~e of Architect ......... i~ .................. Address ................. . . Phone No ............... N~e of Contractor , ' ' Address Phone No ...... 15-La tkla ~roperty ~oe~ted ulthln'lflO feet of a tidal uetland? *~gS .... NO .... ~I~ yes~ Southold Yow~n ~rustees Permit may be required. PLOT DIAG~M Locate cle~ly =d dist~ctly property ~nes. Give street =d b~oc~ number or desc~ption accordMg to deed, =d show street nines and ~dicate wac::. interior or comer lot. RPPROVE~O AS NOTED FEE .~ Y: ---- 7C,~-1802 9 AM TO 4 PM FOR THE FO[.LOWING INSPECTIONS: t, FOUNDATION. - ~0 REQUIRED FOR POURED CONCRETE 2, ROtJGH ~ FRAMING b PLUMBING 3, ~NSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.~ STATE CONSTRO~ION & ENERGY CODES. N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW, YORK, : COUNTY OF .~ ..... i S. ' ........ ............. .... bei, - du,y swo n, deposes =d says that he is the app,ica, · (Name o~ndwldual stgping contract) above nam'ed. He is tile . ~ , (Contractor, agent, corporate officer, etc.) of ~ald owner or owners, and is duly authorized to pe.rform or have performed the said work and to make and file Il: application: that alt statements coniamed in this application are true to the best of his knowledge and belief;and that work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ day of.. · .....19 Notary Pu~. 5~'c .............. County (Signature of applic=-n'