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Home My WebLink About19012-zFOPJ'I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19121 Date JUNE 7, 1990 THIS CERTIFIES that the building Location of Property 2705 SIGSBEE ROAD House No. County Tax Map No. 1000 Section 126 Subdivision Filed Map No. ALTERATIQN LAUREL, N.Y. Street Hamlet Block 6 Lot 1~ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 1990 ~ursuant to which Building Permit No. 19012-Z dated MAY 14, 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 ENCLOSURE UNDER EXISTING DECK AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. S~FFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 CHARLES & JANE KIRBY B~il inq Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19122 Date JUNE 7~ 1990 THIS CERTIFIES that the buildin~ Location of Property 2705 SIGSBEE ROAD House No. County Tax Map No. 1000 Section 126 ACCESSORY Street Block 06 LAUREL ~ N.Y. Hamlet Lot 01 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 1990 pursuant to which Building Permit No. i9012-Z dated MAY 14, 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 STORAGE BUILDING IN REAR YARD 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 CHARLES & JANE KIRBY Rev. 1/81 '~~ J~ld~n~g I/~nSPect or TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ,o .~~...~..~.,. ,~....~.~...~.~.,....,....~.....~.~.....~ , ~u ' ~ ~ ~ , ~~ ............ .~.~ ............... ~ .......... ~ .................... ,,,,em,,e,'=.,,~ ~, .................... ~.~.~. ................. ~ ................................................. co..~ fox M.~ No. ~000 S,~,o. ..... Z.~.~ ...... ,~=~ ..... .D.G ...... ~o, No....~J .............. Building Inspector. Fee $ .......... ; ............. Building Insl~ector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION 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 state~emt 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 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 i. 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 ~. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 dl~ Date .9 ! .~...~ ~.O. New Construction..y..~/9~.'.~~Old Or Pre-existing Building ..... ~ ........ · i Location of Property ~.~.~ ~ ~ ~ House No. '0- ' ................. Street Hamlet Onwer or Owners of P ................. ' .......................... County Tax Map No. 1000, S¢ction..3..2f~:~.9..Block..D.~.~. ...... Lot.~.~.~.g.~ ........... Subdi~ision...'..~..r~....F_._..;.........-3m~. . ..... Filed Map..~.g.L ...... .............. re,, 0 Permit No I~ O ~ ~ ..Date Of Permit ................ Applicant . ~. .. ~ealth Dept Approval Underwriters Approval Planning Board Approval Request for: Temporary Certificate ......... Final Certicate..~/ Fee Submitted: .$..~.~ ~o co Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL w 765-1802 BLOG. OEPT APPLICAT[0N 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 fnrm). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn state~ent 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 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: 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. Planning Board Approval ....................... . Request for:.Temp°rary Certificate........... Final Certicate.../.. ...... Fee Submitted: ~ ~, O~ Fees I. 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 Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date J.....~:..~.~..~.O. ............... New Construction ....... 31d Or Pre-existing Building ................. Location of Property~.~.~...~.! .~..~...~.~.~.~ ..... . ..................... .~.~ ............. House No. Street Hantl e t County Tax M, ap No. 1000, Section..]..~..~:~.~. .... Block..O..~... ~. p ...... Lot..~..~. ~.: .~. ~P. ...... · ' ~,1.~,~ . .I · Sub d zv i s ion.. ~..~....?~J~. ~ ...... C:-. :: Pe,mi, .... Date Of ....... Applicant.¢t' ,*. ~{ealth Dept. Approval .......................... Underwriters Approval ........................ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST FOUNDATION 2ND [ ] FRAMING ROUGH PLBG. INSULATION [//~INAL FIELD I~S~,~ECTION~ FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL COMM£NT~ ADDITIONAL COMMENTS: BLDG. TOWN OF FORM NO. 1 TOWN OF sOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD. N;Y. 11971 · ' ; INSTRUCTIONS BOARD OF HEALTH ............ 3 SETS OF PLANs ............ SURVEY ................... CHECK . . . TEL.: 705-1802 ' Examined .... .., 19 ~?. Approved... ;. ~.J.O.., Disapproved ale ..... ' ~' ' ............... :..::::::: ..... APPLICATION FOR BUILDING PERMIT ~t..4:~ ......... NOTIFY FLAIL a. This application must be completely filled in by typewriter or in ink and submitted to the Buildimj InSPector, with ~ ,. sets of plans, accui'ate plot plan to scale, Fee according to schedule. ~ b. Plot plan showing location of lot and of buildings oz:t premises, relationship to adjoining prcmis~ or uuhlic streets Or areas, and giving a tiers/led description of layout of property must be drawn on the diagram whichi~pa~'of this appli- cadam , 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 Permit to the applieanL Such permit shall be kept on the premises available for inspection throuo_hout the work. e. No building shall be occupied or used in whole or in pert for a.ny purpose whatever until a Certiflm~te of Occupm4c~- shall have been granted by the Building Inspector. ' ~'~'~ APPLI,CATION IS HEREBY MAISE to the Building Department for the i~suance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County. New York, and other applicable La~. Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, a~ he~in described. The applicant agrees to comply ~th all app ~cahle laws, ordinances, building code',~ housing code, and regulations, and to admit author/zed impectorx on premises and in building for necessary inspections. . , , . lg t pplican n :,, . .'.e.~,. ~ox ~ .s.s.: ..: ~ta~ .~4.. g.. d~..'ti ~ ~3..'. (Mailin= address of apptic~t) State wh~ther applicant is owner, lessee; agent, ~chitect, engineer, glneral contractor, electrician, plumber or builder. X. Name of owner of premises ~ (as on the tax roll or latest deed) Itapplieant is a co~oration, signature orduly ;uthorized officer. (Name =nd title of coipoiaie officer) u' ' ' ~ ~ ~-a~ Plumber's License ~o ......................... EJcctrJcJ~'s ~cen~e ~o O/hcr Tr~de~ ~ccn~e No ...................... I. [oc=tion o~land o, which proposed wore will 5c do~e, ~~ House ~umbcr Strce[ ........ ~ ~J'~ ~ J'~ ~ Hamlet .... ' .. . moc~ ......~.~q~ ...... ot ......... Lo~..~.?~ State · ' " ex st ng nsc and occupancy of premises and ' ' · . intended usc and occnpa~cy otproposed coB$[tuci{o~ a. EX~mng use and occupancy ....................... ~ .............. ...'.. ~ ,~';' ~ Rep:ur .............. R~mov~l ..... ~',.%,,.,..,,,..~?"Dumolition '"- .-'~. .... -~ima~n,'l poo,...' ..... .Tennis Court ......... Accessory Building Fc~'~? ~ ~ · ....... . ..... Other [~ork ............ 4 Estimated Cost ~ ~ . (tO be paid on flHn~ this appllc~tion) S. If dwelling, number ~f dwclling units ..... ~ ~umbcr of dwelling units on cach floor./. ..... ~ · 6. If buiiness, commercinl or mixed occupancy, specify nature and ext~nt of e~ch ~ypo of nso ..................... 7. Dimensions ofcxistingstmctures fany' Fron~. 1~.~ ~.~ ~ ~.~, ~' . D.~,k~ t m,~ht ............... N.,n~rorSto.~s I L~i6~~l ..................... . . ,, · . :. ...... D~mens~ons of same structure ~v~th alterations or additions: Front . .~ Rca ' ---~ ....................... .:. r*eu~t ...................... Number of Stones .................... 8. Dimensions of entire new construction: Front .... ~ ....... Rear . .~ ...... Depth A~ ........ ......... ..... ...2..2Z .2222 .22 10. Date of Purchase ~ ~U~.~..1.~.~ ......... flame of Fomer O,vner . ~. ~... ~0.~ .... 11. Zone oruse district in whicliprcmises are situated..~ ~ ..................................... [~. 12. Does proposed construction violate any zoning law. ordinance or regulation: . .~ .................. ~ ....... 13..W~I lot be regraded .; ........ ~ .................. Will excess fill be removed from premises: Yes .... 14. N~e of Owner of premises ~&~.ff~. Ki.~ %... Address~.~.~j~.~. Phone No.~/.~.-.~Lg~ N~e of Architect ........... ~ ........... .~... Address .................. Phone No ................ N~e of Contractor .......... ....... ~ ........ Address ....... [ ........... Phone No ..... ~'...'...; ..... If.Is tkla property 1peaced within lO0 feet of a ,tidal wecland~ *YES ..... NO .... · If yes, Soucho~d Town,Trustees PermlC ~tay be required. .. .... . .......... ~L~T D~, ,~ ~,~ ........ "' Locate cle~ly ~d di'st~ctly ~1 ~u~d~gs, whether existing or proposed, ~d. indicate ~1 set-back d~ensions from prope~y ~nes. Give street ~d block ~umbcr or desc~ption accor~g to deed, ~d show street n~es and ~Jcate whether intefior or comer lot.., ~ ~l'~ ~ ~ ~ ~ . .......... being dtdy sworn, deposes and says that he is the applicant ', agent, corporate officer, etc.) -. ~a~u owner or t~wners', and is duly authorized to pe,rform or have performed the said ~vork and to make and file this application; that all statements contained in this application are true to the best of his kno~vlcdge and belief;and that the Work will be perlbmled in the manner set forth in the application filed therewith. £Wom to before me this ; .,', ' ' ....................... day off,..~lT..L~ ........... , 19~.O. No. 4707878, Su · ... , :~:., ' ' (Signature of applicant)