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Home My WebLink About19282-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANC~ No Z19353 Date SEPT. 12~ 1990 THIS CERTIFIES that the building Location of Propert~ 260 House Ne. Street County Tax Map No. 1000 Section i04 Block subdivision Filed Map No. ACCESSORY HORTONRD CUTCHOGUE Hamlet Lot I3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 25, 1990 pursuant to which Building Permit No. I9282Z dated JULY 30~ 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 BUILT) IN REAR YARD I of 2 The certificate is issued to LOUIS $. BOURGUIGNON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NrA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~~/'u~i~d~i~gInspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19354 Date SEPT. 12, 1990 THIS CERTIFIES that the building. Location of Propert~ 260 House No. County Tax Map No. 1000 Section Subdivision ACCESSORY HORTONRD. Street Hamlet 104 Block 01 Lot 13 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 25, 1990 pursuant to which Building Permit No, 19282Z dated JULY 30~ 1990 was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is The certificate is issued to ACCESSORY SHED (AS BUILT) IN REAR YARD LOUIS S. BOURGUIGNON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 2of 2 ~uilding Inspector FOB~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL (COMPLETION OF THE WORK AUTHORIZED) No- ',928~ Z .Date ....~ ..................................... , 19.~ Permission is hereby granted to' ~ . .~~ ........... ~ ....... ................ ~..~~ .......... ~....~ ..... ~ .................. ....... .................. a[ ~ I~ated at ....... ~~~~......~ ....................................................... ~o~ To~ ~, ,o. ,o0o ,e~,,o....~..~... ,,~, ........ Z ......... ,o~,o ........... /~ .... pu~uant to application dat~ ........ ~.~ ................................ , 19~.., and approv~ ~ the Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTItOL[L N.Y. 11971 AUGUST 29, 1990 TEL. 765-1802 LOUIS-BOURGUINON 71 GRAND AVE. SHIRLEY, N.Y. 11967 To Whom This May C09cern, 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) /~/~ U~derwriters Certificate on file. /_~ The check is(o~avdy~D~WJ/not on file.) $25.00 /5/ No llealth Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on Thank you for your cooperation. Dui]ding Permit It 1 9 2 8 2 Z Building this matter. Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) , 765-1802 //~/?,/~/*"-- ~x~'q BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING DATE INSPECTOR Form No. 6 BUILDING DEPARTMEN~ I ~ I ti TOWN HALL SEP I 019cjo ~I [ BLDG. DEPT. [ TOWN OF $O~I.:~TiON 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. 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 less than 2/10 of 1% lead. $. 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. B. For existing buildings (prior to April 9, 1957) non-conforming use~, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. '.. 2. A properly completed appiicatlon and a consent to inspect signed by the applicant. If a Certificate o£ Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. ~ 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. Businesse~ $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 ~. Updatud Cernificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 .......................... :: Construction ' Old Or Pre existing B ilding ~ Loca:ion of . , .... ~.m$. ....... House No. Street Hamlet . Onwer or Owners of Property ..... County Ta~ ~p .o lO00, Section ..... ~e~/ .... Bloe~ ....... f. ....... ~ot .... Z~ ........ SubdiVision .................................... Piled Map ............ Lot ...................... ~lealth Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval " Request 'for: Temporary Certificate ........ Final Certicate..~ ....... ,,g.~ .~. " Fee Submitted: $. .. ...................... FOUNDATION (1st) FOUNDATIOn.! 2. ROUGH FRAME & -PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE FI;~AL ADDITIONA'L COMMENTS: BOARD OF HEALTIt ............ FOm~ r~O. 1 SURVEY ........ TOWN OF ..qOUTHOLD CII[:CK ...... TOWN HALL ~OUTHOLD, ~.y. l]97] NOTZ~ ~ , ~/~ ~-~ TEL.; 705-1802 CALL ............... Sxammcd..~./..~,~ ......... 19 ~ HA I L TO: o .... / ...... o .... ~ ~.d~ ~ ' ~..~. ~ .... .~/>/~ /~F~ ~ ......... ~..~ DA~. ~ B.R ~ / FOLLOWING ~Sp~CTIONS: (~din~ 1. FOUNDATION - ~O REQUIRED App LICAT~ FOR POUREDC~CR~E .... ~rr~AI~N FOR BUILDING PER~/HT 2. ROUGH - FRAMIN~ & PLUMBING · 3, INSU~TION Date ....... 4. FINAL CONS~U~ MUST . ~ COM~TE FOR C,O. ...... ~ '" n may not be commenced before issuance o~ BuUdlng Pc~i[ - ' d. F~:on approval of {~t~s application, the Buildin[Ins ect~r will l shall b~N~~~i~u~+~,~.{[o.,~ .... ::.: P,. ' 'ssucd a Building Pc~it to the appH~ Such pe~it e. ~-~A~l~o~ ~Bsed in whole oran part for any purpose whatever until a Ce~i~ of Occup~cy shall h~L~~iid~g Inspector. AP~L~[~~Fg 'h~ BulldOg Dep~ment for the issunncc of a B~ld~n - -" Su~di~ ~~~ ne Southold Su ....... g re.it pu~uant to thc Rc_ul ~J~: ol DUH~gS, aoOitlOns Or alteration~ ~- ~-- ' , - pp .Ordm~ces or The aI ~,~{~jg~pphcable la~vs, ordinances bu-~:-. - - , described. ~~rem~sesana m uUuamg for necessa~ inspects. ~ ns, and to ALL CONSTRUCTION SHALL ME~ ~.. ~ /~ STATE co.smu~m. ~ ~ERO; - . ~,~:~.=~ o, ~p~{~, o; ~;~. DESIGN OR CONSTRU~ON ERRORS '(~uilin~ address oF applic~i) St=~c whether applicunt is owner, Jessce, ~gcn~, ~chi~cct, engineer, gcncr=l con[~uctor, electrician, plumber or builder. · ........ ; .... . . ....... ..... .... (as on thc tax roll or latest deed) .... ' ' ' ' I[appl/cant is a co~oration, signature o~duly authorized Buildcr's Liccme No .... ~ ....... Plumber's License No Electrician's ~ccnsc No ....................... O/her T/adc's ~censc No ...................... Location oFland on which proposed work will b~ done: Joust Number Street ...... · COUnty T~s Map No ~000 Section ............ Block .... ~ ... ......... ~o, .... Z.~ Subdivjsion ...... · ...... ~ ~'; . ............................... FHcd Map No. ,,: S. (Nm.c) .............. Lo~ .......... ' o ~ and occupancy o~ premises and m~cnd~d usc and occupancy o~ proposed cons ~ sc ~nd occupnncy .... ~4~.~..O/l~ ........ ~... . ...... ': .~...~ .............. .. ' ................ , ............... 3. Nature of work (cheek which applicable]: New BuiLding .......... Addition .......... ,kit,ration . ~ .~. ...... Repair ........ ' ~ , ...... R$~moyal .............. DemolilJm'n .., ......... ~Swl,'~alrn~; mmldm ...... -. .... ' :: ...... 4. Estimated Cost ............ ~ ..................... . .,~ ~ .~..% ,,, .. . /~' ... ttee ............... ~ ..... .... ~ ............. -- (to be pai~l'6~ :~lin,g th'iL ~blication} $. If dwelling, number of dwelling Units .......... .. .... Number of dwelling units on each floor ................ If garage, number of cars ..... i .............................................. .... 6. If business, commercial or mixed[occupancy, specify nature and extent of each type ofuse.iiiii~ ,7. Dimensions of existing structure!, if any': Front ............... Rear ............... Depth .............. Height ............... Number of Stories ......... . ..................... ';,¢: d.* · · .'.,c; .............. Dimensions of same structure with alterations or additioni: Front · ge~r .' Depth il Height '''''Numbe" ................... ''"rofStdnes' " ~'~ ~''' .,8. Dimensions of entire new constrtiction: Front ..... Rear ........ t ........ D'epth; "~ Hci'ht ....... · ...... .. ,, , , · - ........ ,Number of Stones ..... . ...........:i :: ...... ,,:9. S~ze of lot: Front .... I ~ ' .... ~ ~... 10. Date of Purchase .................. l~ear ............... ~ p .~, ........... 4 ................. Name of Former Own¢:~ ,,,. ~, .......,.' 'r '"- · ',~ ....... 11. Zone or use district in whic ~ premises are situated ' . ' ' ' , , 12. Does proposed constructl ' - ....... : ........... : ........... ~; · ',',)i40 · ' '-=' ' · ','- ·" ........ on violate any zoning law, 13. Will lot be regraded .; ..... i ordinance or regulatmn: , ~. (l,0.,.. $.~,~..,¢] .... ~ .............. Will excezs fill be remove.d/from premises. ~, ,Yes ;-... No'. 14. Name of Owner of premises ~. O~O~.~,o.,i,t... Address "tl. (~'r'~.'14~'~, ~.J/,g.~,~ig~Phone No, :~.q. AY M~ ! ..... Name'of Architect ' .......... 4 ................ Address ................... Rhone No. a .... -.:.~ ......... Name of Contractor . ! · If.Is this proper't'y ...... ' ................ Address ........ ~.;$~..D?Phon~aNo.?'..;.)~'~/;.~; .... located within {00 feet ~'a tidal.~.~e~lU~l:? · If yes, Southold To~n; Trustees Permit may be requi~'ed-~'~'~ r~ :~O:' PLOT DIAGRAM "~ ' ,,~ '~",*':_ ¢,~,' , Locate clearly and distinctly all buildings, whether existing or proposed, =d.'d, ai[li4 fli'i-ggek: property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. ' ,5 h di STATE OF NEW YORK, S.S · . (Na~ne of individual signing contract) ..... being duly sworn, deposes and says that he is the applicant above named· . ~ is the . . (Contractor, agent , corporate officer, etc. ) ....... of said oxvner or owners, and is dulyI authorized to perform or [lave performed tile said work and to make and file this aPplicat on: that all statements contained in this application are true to the best ofhis knowledge and belief;and that thc Work wilt be perfomled in tile manner!set, forth in tile application filed therewith .... S~Vom lo before nle this ~ . , ............ /~ ..... day of .'. ' ................. lIKE# It ~E , NOTARY PUBLIC, State d New Ymdt .............. ' ~. 4707878, Suffollt Cm.mt¥o, ' (Signature o f applicant) Term b~te$