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Home My WebLink About18954-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21091 Date OCTOBER 14, 1992 THIS CERTIFIES that the buildin~ Location of Property 975 ANDERSON ROAD House No. County Tax Map No. 1000 Section 50 Subdivision ACCESSORY SOUTHOLD~ N.Y. Street Hamlet Block 1 Lot 15 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 1990 pursuant to which Building Permit No. 18954-Z dated APRIL 16~ 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 SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JOHN & PHYLLIS MACK Rev. 1/81 5~ilding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18954 Z ..,~. .~.../.~..~..7... ............................................ ............... County Tox Mop No. 1000 Section ....... . .~...~.. ....... Bilk .......... ~ ....... Lot No ....... ../....~.... ......... pursuant to application dated ..... ~..~../~ ................................... , 19..?...~.., and approved by the Buildino In,pector. / ~ Fee $...,~.J....'~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ': APPLICATION FOR~CERTIFICATE OF OCCUPANCY A. 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 f~om Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder ~sed in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residenc6s an~ 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.' 3. 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 an~ '~ consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reas°ns~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. Cer.tificat6 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 5. T?mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...October:l, 1992 :w Construction 01d Or Pre · " .......... existing Building ................. .cat,on of Property,.. .~..A~..ERSON ROAD - SOU~OLD. NgW YORK Street ............ Hamlet wet or Owners of Property . JOHN & PHYLLIS MACK ]nty Tax Map No 1000, Section .... ~? ........ Block ..... ! ...... 15 " ' Filed Map 'mit No 18954-Z .Dat~ Of Permit. March 5, 1990 . ............... Appltcant. JO~N B. MACK, JR. lth Dept Approval · ' ......................... Underwriters Approval ........................ nning 8oard Approval ........................ ~est fo~: Temporary Certificate ....... Final Certicate ........... INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. WlECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD February 27, 1992 SECOND NOTIFICATION John B. & Phyllis Mack Box 1837 Southold, New York 11971 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is not on file. $25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT $ 18954-Z ACCY SHED * Please contact our office on this matter'. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. *NOTE: ACCORDING TO THE CODE OF THE TOW~N OF SOUTHOLD, IT IS UNLAWFUL TO OCCUPY OR USE SAID ACCESSORY WITHOUT A CERTIFICATE OF OCCUPANCY. PLEASE SUBMIT APPLICATION ~/qD CHECK IN THE AMOUNT OF $25.00 SO THAT CO CAN BE ISSUED. THE ABOVE BUILDING PERMIT HAS EXPIRED. INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD August 14, 1991 John B. & Phyllis Mack Box 1837 Southold, N.Y. 11971 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: XX An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT 9 18954-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWI~ BUILDING DEPT. FOUNDATION FOU:~DATIO:! ( 2nd ) EOUGH FRAME & .PLUMBING INSULATION PER N. STATE E~;ERGY CODE Fi:~AL ADDITIO~A'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. [ J FOUNDATION ZND [ ] INS~J~TION [ ] FRAMING [~]'FINAL FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTR ............ B SETS oF PLANs ............ SURVEY ..................... CI1ECK ................. $OUTHOLD, N.Y. 11971 NOTIFY / TEL.: 765-1802 CALL ................... Examined..~..~.', .-~. ........ 19.~-~ _--__/~??' MAIL ;0: ' ./~/ ~ ~ Y ;.~ ' ..................... NOTIFY ~UI[.DfN~ ~P~NT AT /mfild~InJpector) FO~ .OUteD CONCreTE ~/ .....: ......... 2, ROUGH - FRAMING & PLUMBING INSTRUCTIONS / a. 4TJ~,~pplJcat[~l~y ~]]cd in by ~pewdter or Jn ink and submitted sets of pl~'~aJ~J~.to scale. Fee according to schedule. b-'A~JotC~[~o~l~o~E~nd of b~ild~gs on premises, relationship to ;djoining premiss *r public streets or arc~J~"~~e~e~t~.of layout of property must be drawn on the dia;,am whicR ~ pa~ of t~s appH- caUom:',~,',~ CONoTRUCTON & ENERGY c. C~'~~~ii~n may not be commenced before issuance of BuUding PermiL d. ;~'~O~)'~~t~e BuHdlng Inspector wQ] issued a Buiiding Pc~it to the appear. Such permit shall b~'o~~ ~v;~a~{; for i~spcction throu~out the work. .' ' c. F~ bui[~.s~b~:~~ed in whole or in part for any purpose whatever until a Cc~ifi~e o~ Occug~cy shall h~gn ~b~a~~ I~cctor. ' 76~-1802 9 AM TO ~ PM FOR THE STATE CONSTRUCTION & ENERGY ~'~'~'/''" CODES. N~ R~SPONSIBLE FOR (Mailing address ofapplic~t) gtate 9~$t~q~%~F~&9~9 agent, a.'cbitect, engineer, general contractor, electrician, plmber or builder. , ...... ~ame of owner of premises (as ~n the tax roll ~ ilt~t'~;idC ..... f applicant is a corporation, signature of duly authorized officer. Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... Other T. rade's License No ................ } ..... Location of land on which proposed work will be done; OCCUPANCY OR , USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY }louse Number Street Hmnlet ..... Z', County Tax Map No. 1000 Section .............. ~ Block ............... Lot /,5. /" Subdivision ..................................... Eiled Map No ............... Lot ....... ~.. (Name) ..... State existing use and occupancy of premises and in tend~.~4 t_U.se and occupanc,., of .,~i ..... , . .. Repair .............. R~movaii ..; ...... ;.. :. Dem~ olition .............. ' ~ Tennis Court ........ : Accessory, Bu~ldzng.~l~..Fence ....... Other Work ........... .. ................ Fee ...................................... 4. Estimated Cost ....... r.t..- '[ . (to he paid on filing this application) " .9, X : 5, If dwelling, number of dwelling uni:ts ............ Number of dwelling units on each floor ............ If garage, number of cars ........................................................"" "''' 6. If business, commercial or mixed occupancy, spec fy nature and extent of each type of use......--.'----. -.-' .. ... ' Depth if any: Front Rear ............... 7 Dimensions of existing structures · Number of Stories ............. Heieht ' Rear Dimensions of same structure with ialterations or additions: Front ' · · DimensionsDCpth ...................... oCentire new i"ciu t ....... ' ............... Nun*cF of ...... construction: Front '"' ',t ~n Rear > ..... ~:". Del~th .....: , . . 8. [ Height ......... ,i~:'.." -'~um~er, of Stories ..... ,-;'-~'~'"x'e~:, ,, ,, ............... , . , /,._, .................. -, .,, < , ,, - 9. Size of lot: Front ............. i ........ '. Rear . ... :... '; .............. D~.at.~.' .....'.~ . ..... <,., .... 10. DatcofPurchase .... .~.]/.~{.~ ~., ........... Name of Former Owner ~.];~c~c~[.4-",..6/z~*' "s-/~-°*~z'% . . . , ': . '. .~., · . · ~ , ' ,,~ *';; ~.. .; ........... 11. Zone or use d~stnct m whmh premlses are mtuated .... a.~.~.-9-qL ......... . ....... 12. Docs proposed construction violate any zoning law, ordinance or regulation: ................................. · ,. I . Will excess fill be removed' 'fr6m premises: Yes ..... 13. Will lot be reoraded ....... ~t4fh'"" ''''" '".',.h.3 'I~ c,~ " /~. 3' 7~ 5a,~t.q~,,/4 ~tfl~.c.~, ', 14. Name of Owner of premises ~ (._ .... Address .' .... Phone No. 260.%9- .... · ~./ i Add~ ......... ' · .' Name of Architect ........... ~ ............... '~'~ ... t. ~.~.Phone No ............. Addr:~ss Phone No .... Name of Contractor ' ' 15.Is this property located within 100 feet: of a tidal wetland.* *YES .... NO .... · If yes Southold Town Trustees Permit may be required. · PLOT DIAGRAM Locate clearly and distinctly all bhildings, whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and block m tuber or description accordhag to deed, and show street names and indicate whether interior or comer lot. H,e is the ' ' ' (Contractor, agent, 2orporat¢ officer, etc.) of said owner or o~vners, nnd is dui,. authorized to pe,rform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledg2 and b~li2f; and that the Work w~l be perfomed in the m~ne: set forth in the application filed therewith. ,, ,. Sworn to before me this ~ dayof Notary Public, HETEN IL DE ~g NOTARY PUBLIC, S~te ot New Ymk .14o, 470~878 Surf(fib Couoty~r ler~ EXp rl~ March :~0. 19 , (,,l ~o--- ..~/..,~. County (Signature of applicant;. nemg duly sworn, deposes and says that he is the applicant