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Home My WebLink About19328-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Zt9302 Date AUGUST 17~ 1990 THIS CERTIFIES that the building Location of Propert~ 1100 House No. County Tax Map No. 1000 Section Subdivision SOUTBWOOD ADDITION BEACHWOOD LANE SOUTHOLD Street Hamlet 70 Block 10 Lot 60 Filed Map No. 2141 Lot No. 53 conforms substantially to the Application for Building Permit heretofore filed in this office dated AUG. 1~, 1990 ~ursuant to which Building Permit No. 19328Z dated AUG. 17~ 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 CONSTRUCT A DECK "AS BUILT" 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 MATTHEW /JOSEPHINE MC KIERNAN B~uildi~g Insp'ec~or Rev. 1/81 BLDG. DEPT, ~ TOWN OF SOU%'HOLO ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 76§-180Z . APPLICATION FOR CERTIFICATE OF OCCUPANCY r~ This application' must be filled in by t'ypewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate locat, ion of ail 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 tatement from plumber certifying that the solder used in system contains , less than 2/10 of 1% lead. 5. Commercial building, indus, trial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from'architect or engineer responsible for the buil'ding. 6. Submit Planning Board Approval of completed site plan requirements. .B. For existing buildings (prior to April 9, 1957) men-conforming uses, or buildJmgs and pre-exlstzng 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 $~5.00, 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 - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. UpdaL~d Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .~.. ................................... ;;t.w Construction .... ~ ...... Old Or Pre-existing Building ................. House No. ~treet Hamlet ''' ')nwer or Owners of Property. ~ Z~.( ....... /-~-~/.C~./~-~. ................ ............. Underwriters Approval ................. arming Board Approval ................ .:" Request 'for: .%emporary Certificate ........... Final Certicate.. APPLZC..~T /'. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y, 11971 TEL.: 765-1802 Examined ................ , 19... ^ppro,ed . .L. ?., Pe mit No. l . Disapp~*oved a/~' ....................... ............. BOARD OF HEALTH ...... SURVEY ................ C .CK ......... ......... SEPTIC FORM ................ NOTIFY~ CALL MAIL : (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filIed in by typewriter or in ink and submitted to the Building Ihspeetor, with sets of plans, accurate plot plan to scale. Fee according to schedule. bo Plot plan showing location of lot and of buildhngs on premises, relationship to adjoining premises or public strcctr or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of ttQs apph- cation, o. 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. ¢. No building shall be occupied or used in whole or in part for m3y 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 construct/on ot~ bu//dings, additions or alterations, or for z:emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cod~, and regulations, and to admit authorized inspectors on premises and in building for necessary in~pectior~s. . . (Signature of hpplican~/Jor name, if'a c'o~o'r~ti~jn')' ' ' (MaiJing address of applicant) //g ?/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Namcofownerofpremises ../.~..~.~..~.?.x~J..~.~. k/..~/.~.,ro ~ (as on the tax roll or latesi deed) If~plicant is a corporation, signature of duly authorized officer. ........ i/df ................... Builder s License No ........ ~ ........ , . Plumber s L No. .. lccnse ................... Electrician's License No "'--'- Other Tradc's License No Location of land on which proposed work will be done; }louse Number Street, Hmnlet County Tax Map No. 1000 Section ... ~..7....~. ....... ' Block . . ~. ~. ............ Lot... ~ .~. Subd~v s on ......................... Eiled Map No. . . (Name) ........... Lot ............. State existing use and occupancy of premises and intended use and Occupancy of proposed construction: B. Intended use and occupancy ........ .q~ ....... 3. Nature of work (check which applicable): New Building .......... Addition ...~...., .. Alteration ......... ~. · Repair. ........ ~ ,., .[, .R~mov:~i .............. Demolition .............. S~i,'~ming 9ool .............. 4. Estimated Cost . a9..q9 .... ....................... ............................. ~ (to be paid on filing this application) 5 If dwelling number or dwelling u~its Number of dwelling units on each floor , If garage number of cars. . ~ ...................... ......, · 7. Dimensions of existing st~c~ures,~if any; Front . ~, . . ~.,. Rear . .,~(.~ ....... Hexght ...~ ......... Numb~rofStones...~ ............................ ......... Dimensions of same structure wit~ alterations or additions: Front ... ~.. ~; ....... Rear ........ ~ .... Depth ..................... , HeiSt ..................... um of StoNes ............. 8. Dimensions of entire new constn~dtion: Front ..., ........... Rear ............... Depth ............. Heiglxt ............... ~umber,of Stones ........ '..; ...................................... 10. Date of Purchase . ~ ~ ~i ................ Name of Foyer Owner .~ ~ ~ ~./T P~.O rP ......... 1 I. Zone or use district in which prem~ises are situated ................................................... 12. Does proposed construction violate, any zoning law, ordinance or regulation: ... ~.~ ........................ 13. W~I lot b~ regraded .. i... ~. ~ ................ Will excess fill be removed from premises: ~ Yes .... No.. i ~' Address Phone No 14 N~eofOwner of premises · - · N~e of Architect ~ Address . Phone No ................. N~e of Contractor ... I . ·. · ....... ~.. . Address ................... Phone No...~ ~ ......... · ~ yes, SouCho~d To~n ~rustees Permit may be requ~ed. ~ PLOT DIAG~M Locate cle~ly ~d-dist~ctly ~1 b',ufl ~gs, whether existing or proposed, ~d, indicate ~1 a~t-back d~ensions from propeay ~nes. Give street ~d block n~mber or descgption accord~g to deed, ~d show street n~es and ~dicate whether interior or comer lot. STATE OF NE~V YORK, above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ~uthorized to pc,florin or have performed the said work and to make and file this application; that all statements contaiz~ed in this application are true to thc best of his knowledge and belief; and that the work w~l be perforated in the m~ner s;ct forth in thc application filed therewith. Sworn to before me this Nota~ Public ......... ~ ...................... County ~ PU~I~ ~ of New Y~ ; c of applic~t) being duly sworn, deposes and says that he is the applicant