HomeMy WebLinkAbout18798-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18877 Date MARCH 12r 1990
THIS CERTIFIES that the building. ALTERATION
Location of Property 53345-6C MAIN ROAD SOUTHOLDr N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 61 Block 1 Lot 13.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 8~ 1990 pursuant to which
Building Permit No. 18798-Z dated FEBRUARY 15, 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 CHILDREN'S APPAREL STORE - FEATHER HILL BUILDING #6
The certificate is issued to pRECIOUS PACKAGES
(tenant)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N-082951 - 7/27/89
N/A
Building Inspector
Rev. 1/81
rO'UM' NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED]
N°- 18798 Z
Permission is hereby gronted to:
.....~..~.....:.~..~.~.............~ v ..................................
....... ,
,~, ~7~ ~ . ~ v. ~~Y_.../'.....~.......~.. ~. ~ c
· '"'rr~"'"~-~"' .................. ~' ................. , ............... ~-~'w:~' ..................................
at premises located at ~.....~.....~...~.~. ....... ~¥~.~....~.., ....... ..~.....~ .......................................
County Tox Map No. 1000 Section ...... .C).~.l ........ Block ...... .?...I ......... Lot No..I..~,:...~ ............
pursuant to application dated .....~..~~.....~.. ................. , 19.~'.(-.~., and approved by the
Building Inspector.
Rev. 6/30/80
765- 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANC~
Location of Property ................ .i ...............
HOUSE NO. STKEET~ IIAHLET
Subdivision ....................... Filed Map ........ Log ..........
Permit No ...... Date of Fermi= . ..Applicant ...................
· Underwriters Approval
Dept. Approval
Planning ~oard Approval
Do
FORH
TOUN OF soUTHOLO
BUILDING DE FARTheST
TOUR IIALL
765-
APPLIC~ION FO~ CErTIFiCATE OF OCCI~FAN~i" INST~UCTIOH$
This appllcation must be filed in type~rclter OK ink and submitted to the Buildlng
Iusp¢ctor with the following; for new buildings or new use:
i. Final survey of property vlth accurate location of all buildings, property lines,
streets, and unusuaI natural or to?ographie features.
2. Final upprovat of Health Dept. of eater supply and sewnrage-dlsposal(S-9 form)°
3. Approval of electrical installation from Board of Fire Onderwrlters.
4. Sworn statement from pl~ber curcifylug that solder used in system cancels= less'
than 2/]0 of II lead.
5. Co~ercial buildings, industrial buildings, mlcipl= rcsldeucus and slm~lar.'
or Engineer responsible for the buildln~.
For existing buildings (Prior to April 9, 1957~ uoo-confo~img uses, or huildlugs
amd "pr~cxi=ting" land uses: .'
~. A~curate sunny of property showing all property linem, streets, buildings amd
unusual naturnl or topographic featurem.
. If a Certificate of Occupancy is denied, the Building Inspector shall =taCo the
rea=oas therefor in ~itiug to the applicant.
3. Date of any housing code or safety in=pection of b~lildlugs or premises, or other
pectiucut info--tiaa required co prepare a certificate.
For Vacant Laud Certificate of Occupancy:
I. ~ appliaatiou for vacant land Certificate of Occupancy shall be submitted,
amd a certified abstract of title issued by = title company showing single amd'
se~arace o~ermhip of,the entire l~t prior to April 9, ]957 shall also accompany
the application. If a Certificate of Occupamcy is denied, the Buildimg Inspector
shall state the reasons therefor in ~itiug to the applicauC.
FEES:
I.
CERTIFICATE OF OCCUPANCY -- New Dwelling $25.00, Additions to Dwelling $25.00,
Alteratiom Co Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00
Addition tn Accessory buildings, $25.00 -'Businesses $50.00.
Certificate nf Occupancy on pre-existing dwelling -
Copy of Certificate of Occupancy - $~.00 - over ~ years - $~0.00
Vacant Land Certificate of Occupancy - $20.00
~pdaCed Certificate of Occupancy - $50.00
Temporary Certificate nf Occupancy -$15.0.0 Residential
Commercial
?OUNDATIO:! ( 1 st )
?OUNDATI0:; f 2nd )
EOUGH FRAME &
.PLUMBING
iNSULATION PER N. Y.
STATE ENERGY
CODE
FI:;AL
COMMENTS:
FORM NO. 1
'; TOWN OF SOUTHQLO
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL,: 765-1802
.,amincd ?.O.
,'tpprovee~~./ .~.., lOt.~. Permit No. 1.8.9.9..~..~
Disapproved a/c ..................
(Building Inspector)
BOARD ~L bTll
3 SETS OF PLANS ...........
SURVEY ....................
SEFTIC FORH ...............
NOTIFY
CALL .............
MAIL TO:
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with
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 premises or pubLic stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app
cation·
e. 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 perm
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part tor a~y purpose whhtever until a Certificate of Occupan~
shall have been granted by tlxc Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tl
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appIicable Laws, Ordinrmces,
Regulations. for the construction of buildings, additions or alterations, or for removal or demolition, as herein descr/be~
The applicant agrees to comply with all applicabqe laws, ordinances, buildin~ code, housing code, and regulations, and t
admit auth. orized inspectors on premises and in building for necessary inspections.,~
(Signature oi' applicant, or name, if a corporanon)
(Mailing at'dress of applicant') .......
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ouilde~
fp ,~
Name of owner o remises ...... ~ ........................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
....... (Name and title of corpora[e officer)
Builder's License No ...........................
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
I. Location of land on which proposed work will be done ................ '. ................................
House Number Street. Hamlet
County Tax Map No. 1000 Section ...~.O~.O ......... Block ...&/.O.~. ......... Lot...~ .....
Subdivision ..................................... Eiled Map No.
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed constn,ction:
a. Existing use and occupancy .......... 7 ..... ' ........
'ri,ended use . . ...... .".: ." ...S e. .... ' .". ..........
3. Nature of work (check which applicable1: New t qng ....... Addition .......... Alteration .....
Repair .............. R,~moval .......... Demolition .............. Other Work ..........
-- (Descripti
4. Estimated Cost ...................................... Fee .................................
(to be paid on filing this application;
5, If dwelling, number of dwelling units ............... Number of dwelling units on each floor ...........
If garage, number of cars ...................................................................
6. If business, commercial or mixed occupancy, specil'y natnre and extent of each type of use ................
7. Din';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 ............... Depth ...........
Hei~tt ....... .' ....... Number of Stories .............. ; .....................................
9. Siz.e of lot: Front ...................... Rear..' .................... Depth ..................
10. Date of Purchase ............................. Name of Former Owner .........................
11. Zone or use district in which premises are situated .....
12. Does proposed construction violate any zoning law, ordinance or regu!:~tion: ............................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes
14. Name of Owner of premises ................ ' ....Address ................... Pttone No ............
Name of Architect ........................... Address ................... Phone No ............
Name of Contractor ................. i ........ Address ................... Phone No ............
15.Is this property located with£n'-IOO feet of a tidal wetland? *YES .... NO...
~lf yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate cle:n'ly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions
property lines. Give street :md block number or description according to deed, and show street nmmes and indicate wh
interior or comer lot.
· 8.
STATE OF NEW YORK-;, £/~ o S
COUNTY OF ....... ~.j;... a.
(Name of individual signing contract) /
above named,
He is the ....................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is duly authorized to pe,rform or have perfo~ed the said work and to m~e and
application;' that all statements contained in this application are true to the best of his knowledge and belief; and
Work wal be perfommd in tlze re=ncr set forth in the application Olcd therewith.
Sworn to before me this
(Signature of appli