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Home My WebLink About18913-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18925 Date MARCH 28, 1990 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 670 SMITH DRIVE NORTH House No. Street County Tax Map No. 1000 Section 76 Block 2 Subdivision M/O Goose Neck Filed Map No. i663 SOUTHOLD~ N.Y. Hamlet Lot 14 Lot No. 95 & 96 conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 22, i990 pursuant to which Building Permit No. 18913-Z dated MARCH 28, 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 EXISTING TWO CAR WOOD FRAME ACCESSORY GARAGE IN REAR YARD. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PENDING - 3/26/90 PLUMBERS CERTIFICATION DATED CHARLES GILLESPIE Rev. 1/81 Building Inspector l~OW~V NO. ~ TOWN Of: SOUTHOLD BUILDING Dz:PARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18913 N9 Z Permission is hereby granted to: .....~..~....~..:.~..:...!../...~.~.~ .......... ~o ..~.~......o~......~.~.....%.~.q.~...~'....~..~.....~ ....~...~. .... ~ ~.~~ ...... LI ~i'::' ';..' ~'~._ _. ;;.. ......... ~. ........ ..:.;: ...... ..;,. ........... at premises located at ..~...7..O.....~.....)~..a~r~....~....~ ........ ~,;~,d~/e~.d~,, .... County Tax Map No. I000 Section ....... ~;:)...~..~. ..... Block ....... .C7..~ ...... Lot No....I...~. ............... pursuant to application dated ...~.~~...~,~-m ........... , 19.~.~., and approved by the Building Inspector. Fee $~...~~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter~'R ink, and submitted mr-- __ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Muhiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of p~'Operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of an,/ housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 ~ BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $ 10.0Q 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Oate ............ ..... -~'~J - xisting Building ............ Vacant Land ............. Location of Property .. ~'~': .~.~k ~ ~..~ /~o.~ ~v;~ ...... ;" ~" ........ , .... '~ ................. ~?.~.~../.~.~... Owneror n ' ~,~ ~ ~ '~'treet~,l~ ~ ? Ham/et Ow ers of Property .... County Tax Map No. '000Sect,on ...... ..... B,ock ..... ........ Lot ................ Permit No. [~.~.J.~.~.. Oate of Permit .......... Applicant .................... Health Dept. Approval ........................ Labor Dept. Approval Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate , .~ .................. Fee Subm tted S .~' ~ Construction on above described buildin9 and permit meets all applicable codes and regulations. Appllcan~ . ~ / ....... [~'.' '~ .............. ~ Z FOUND^TION ( 1 s t) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITION[L COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ........................... ~ ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter erin ink and submitted,to the B~il4~ng Ip~p, ector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. · : ,~' ~, ,~ :, . ,~ ,,,,.~ .;. ~ b. ' Plot plan showing location of lot and of buildings on premises, relationship to adjoining~l~remises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. , ,, a,' - - 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 applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occu[~l[~~ or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the BIIII[~~.__'''~' APPLICATION IS HEREBY~~~III~I~ Department for the issuance of a Buildin§ Permit pursuant to the Building. .Zone Ordinance of th~[l~l~~folk~Connty,..New. York.'and.other applicahle~Laws, Ordinances or Regulations, for the construction of build~'gs,-~rddlh"'~s or alterations, or for removal o~ demolition, as herein described. The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to adm..i[authorized inspectors on premises and in building for necessary insl~'-lio~n~. ~ d .... ./..-o. _ ' ' ~ ' ' (Mailing address of applicanl0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '","" .......... ..... : ...... -'' ................................. Name of owner of premises .. :. ~~/~..,... ~ ................................. / las on the tax roll or latest deed) If applicagt is a corporation, signatgre of duly authorized officer. ," ,',, ' (Name and title of corporate officer) .Builder's License No .......................... ~lumber License No ,'iEl~ctrician s License No ....................... Other Trade's License No ...................... I.~: L~aiion of land on which proposed work will be done i ~??!~..'.'... .............. ~, ................ House Number ~ Street / Hamlet County Tax Map No. 1000 Section ....... .,. ,w...' .... Block ...... ..: ........... Lot .................. Subdivision .......... Filed Map No ......... Lot. -. (Name) 2. State existing use and occupancy Of premises and intended use and occupancy, of proposed construction: a. Existing use and occupancy ....... J..~')~..~ .... (~~ ............................ b. Intended use and occupancy ...... · .. - 0 .' ...... I ........... ....... r .......... Nat.ute of work (check which applicable): New Building .,tl~(M' ./~..~. Addition. Repair .............. Removal ..... ,, ....... Demohtionu'''- ......... ; ........ Alteration .......... ,., Other Work ............... · ' (Description) L Estimated Cost ...................................... Fee .... .f.~. ~., ~ ......................... '~ (to bei paid on filing this application) ; If'dwelling number of dwelling unit~ ~ Number of dwelling units on each floor Ifgarege number of cars ~ . If business ..... ' Specify nature alld, extent of each t.~yp,~e.p..f use '-" , commercial or mixed occupancy, .................... ' Di~. .ensions of existing structures if any: Front ~.~'. Rear ;~-~.. Depth Height Number of Stories ~ : ~ Dimensions of same structure with alterations or additions: Front ..'~. : Rear Depth ~' Height Number of Stories ' Dimensions of entire new construction: Front Rear i Depth Height ............... Number of Stories ............................ , .......... ,~'0 ............ '. Size of lot: Front ..... ].0.0 ............ Rear ..... /.0.~ ........... iDepth ... ~/ ................ ~. Date of Purchase ~me, o,f Fornler Owner , Zone district in which premises are situated 0(.Adl/~k.~L~d~ · cruse .... · ............................. Does proposed construction viola? any zoning law ordinance or re ulation Will lot be regradod ....... ' ..................... Will excess fill be removed from premises: Yes Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect Address Phone No Name of Contractor .......................... Address ............... I ....Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from operty lines. Give street and block number or description according to deed, and'shoW street names and indicate whether :erior or corner lot. - ~ APPROVED AS NOTED FEE: BY: g. ¢, NOTIFY 8L3!LDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH i- FRAMING & PLUMBING 3, INSULATION ~,. FINAL-~ CONSTRUCTION MUST BE coMpLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, STATE CONSTRUCTION 81, ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OFT CONSTRUCTION ERRORS .~,TE OF NEW YORK, .... ' ' UNTY OF.. ~q.'.~ I C ..... ........... ~. ~."f~."~ · · ~ :~.~'.',.w".~. L..' ......... being duly sworn, deposes and says that he is the applicant ..... .(Name of mdiv{dua, l signing contract) is the .................. :" ' ' - i ; ir'a;idr: .............................................. corporate officer etc ) said owner or owners, and is duly authorized to perform or have performed the said work and to make and fde this ,llcation, that all statements contained in this application are true to the best of his knowledge and behef; and that the rk will be performed in the manner set forth in the application filed therewith. , ~m to before me this '~ .day of ..... ~, 19 NOTARY PUBLIC, State of New York .............................. No. 4707878, Suffolk Count'/,o (Sign ppil t) Term Expires March 30, IS // ature of a can