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Home My WebLink About19204-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z~19447 Date OCTOBER 16, 1990 THIS CERTIFIES that the buildin~ Location of Property 36225 MAIN ROAD House No. County Tax Map No. 1000 Section 97 Subdivision ADDITION CUTCHOGUE, NEW YORK Street Hamlet Block 1 Lot 25.! Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 17~ 1990 pursuant to which Building Permit No. 19204-Z dated JULY I8, 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 BAY WINDOW ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 JOHN& SUSAN BEDELL B~ld~ng ]fnspector FO~I~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPAI~TMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT {THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~ :Y 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 l~nes, 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 %lectrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system conta~s ~ 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 building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 19~) non-conforming uses 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 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. 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. Businesses $50.00. 2.CertifiqAte of Occupancy on Pre-existing Building - $i00.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4.UpdaL~d CArcificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.,~0, Commercial $15.00 ~' Date .... · ............................ ' ....~.... New Construction ........... Old Or Pre-existing Building .... . .... Locatio. of Property...~.6~ House No. Street Hamlet Onwer or Owners of Property ........ Couety Tax No ooo. Section ...... .... .... ......... .... ............. SubdiVision ' .................................... Filed ~ap ............ Lot ...................... / ~..~ Permit No../.?7.d~.~.~....Date Of Permit ............. Applicant.~ .................. [{ealth Dept. Approval .......................... Underwriters Approval App ' ""' P~anning Board rovai ....................... Request for: Temporary C rtifmcate ........... Final Certtcate .... Fee Submitted: $...~.~.:t~o .. ~K~c. qo~.t ........ ~ ..... . .............. TOWN, OF SOUTI~OLD OFFICE OF BUILDING IN~'PECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 August 21, 1990 TEL. 765-1802 TOW/ DIAZ, BDILDER ~2580 HAIN RD. R.R. # I EAST HARION, N.Y. 11939 RE: J. & S. BEDELL To Whom This:.May Co,ncern, We are unable Eo complete your Certificate of Occupancy because .of the following reasons. /--// An application for Certificate of Occupancy is not on file. (ENCLOSED) /_--/,~o U.n. derwriters Certificate on.file. /_~// Tile check is(~X~/not on flle.) $25.00 /-_/ No llea..l~h Dept. Approval on file. /--/ No final ' ,~ ' _ ln~p¢:ctlon has been made. Please contact our office on this matter. Thank you for your cooperation'.. Building Permit ti I 9 2 0 4 Z Duildinq Dept. No Plumber Solder Certificate on file. { all permits involving plumbing beinq 1,~ued after April 1,1984 ) FOU~DATIO.U ( ls t) FOU~$DATIO:~ (2nd) 2. ROUGH FRAME & .PLUMBING iNSULATION PER. N. Y. STATE ENERGY CODE FI;tAL ADDITIONA'L COMME~;TS FORM NO. 1 TOWN QF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................. 19... Disapproved a/c ..................................... BOARD OF HEALTH ............ suRvEY ...... ..... : :: ...................... .............. NOTIFY~ CALL MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Thi.s application must be completely filled in by typewriter or in ink and submitted to the Building l~pector, with 3 sets of plans, accurate plot plan t~cale. 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 dra~vn on the diagram which is par~ of th_is appli- cation. ,.~ ¢. The work covered by tkis applieatinn 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 pen'nit shall be kept on the premises available for inspection throu~out the work. e. No building shall b~ 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 a Building Permit pursuant to the Building Zone Ordinance of the Town of S6uthold, Suffolk County, New York. and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, as herein described. The .applican.t agr. ees to comply with all applicable laws, ordinances, building code housing, ~-~t ,, o ' admit anthonzed inspectors on premises and in building for necessary inspe~ reouiatmns, and to (Mailin= address of applicant) grate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) ? applicant is a corporation, signature of duiy authorized officer. Plum her's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done: '" N;n,t;er ................................. {~0r~,~.~.~... llouse ............. .~' Strc?t, Countyrax Map No. 1000 Section ~.. I Hal~nlet ~;~6~7/ ....... BlOck ..... ~ Lot ~. ".l Subdivision ..................................... Eiled Map No. (Name) ............. Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed construction: A. o cupa, y.. P Rep.~,r .............. R~emoval! .............. Demolition ........... ~[SJ['it~lliil,~o.ool~.~. · ~;J{ ..... T~nnis Court ......... Acdessory Buildin~ .......... F~n~e .{~t~11.~.,~ ! ~. ~ i o '5,~" .y~.~.& '~,~,~g ~ ,,,,. ,~..~..p~.~ ..... ;. E~timatedCost ......... /.~ .{~..I ...................... Fee ./r~/..~...~.~--/,..4,;~ ............ i...~.-..' ' i ' (to be ~aid o~ 0Jing th s app ~ation} ~ If!dwelling number 6f dwelling uni{;s Number of dwelling . **o.~ · , , · .............. units on each i~oor ................. L IClbusin~ss, commercial or mixed oqcupancy, specify nature and extent of each type of use ...... 7. Dm~ensions of existing structures, il' any: Front ............... Rear ............... Depth ......... H61eht' . Num beti of Stories ' Djmenslons of same structure with alterations or additlons: Front ................. Rear ...... D0pth. ................... .. · Height ................... . .. Number of Stories ............... S. Dimensions of entire new construct!on: Front ............... Rear ............... Depth ........ H~i°-ht Number of Stories ' ....... ~. Size of lot: Front ...................... Rea .............. .. Depth ....... . ...... 3 ............................ D/~te of Purchase I.. Name of Former Owner ............................. I. Zgne or use district in which premises are situated .................................................... . 2. Dees proposed construction violatelany zoning law, ordinance or regulation:. ............................. . . 3. Will lot be regraded .... ' .. Will excess fill be removed from premises: . ' .... i ....... i ......... Yes .... No.. 4. Name~ of Owner of premises '' "i''" ........." Address ................... Phone No ................. N~mc of Architect ............ ~ .............. Address-. ................ Phono No ................. N0me of. Contractor :5.I~ thxs property loqte~ within 300 feeto~ a tidal wetland? *YES .... NO.:,.. · Iii yes, Southold Town T;rustees Permit may be require;d. i PLOT DIAGRAM Lo,ate clearly and distinctly.~ll bu!fldings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or comer lot. / ;TATE OF NEW YORK., OUNTY OF ' · J (Name of individual signing! contract) bore ~amed. ' .i being dnly sworn, deposes and says that he is the applicant . .1 , . ~,, '. , (Contra.~,tor, agent, corporate offi~dr, otc;) · .t sa,d"owner or owners,'an~Pis dully fiuthorized to eegform or rove performed the ~a d work and to m~e and file this ephc~tmn, that al!, statements ,contained m ttu~: apphfatmn are trne to the besLqf.lHs knowledge and behef; and that the fork ~ill be perforated in the m~ner s~t forth in tile a~p cation filed therewith. ~'~ ' .... J ........... ~.,. ....day Of..?.~ ............ 197.O