HomeMy WebLinkAbout18820-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
8outhold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z18970
Date APRIL 16r 1990
THIS CERTIFIES that the building
Location of Property 935 BAY AVE.
House No.
County Tax Map No. 1000 Section 143
ACCESSORY
MATTITUCK
Street Hamlet
Block004 Lot 027
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEB. 15, 1990 pursuant to which
Building Permit No. 18820Z dated FEB. 26r 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.
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
HARRY G. & BARBARA L. JACKSON
N/A
N/A
Building Inspector
TOWN OF $OUTHGLD
BUILDING DEPART/~ENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
No_ 18820 Z
County Tax Map No. 1000 Section ......... .~; ..~,..].'~.,. Block ............. ..~..... Lot No ...... ~'...,~.... ......
Building Inspector.
~ ~
Rev. 6~30/80
Bo
Form No. 6
TOWN OF SOUTHOLD 'itli. ~...:~
BUILDING DEPARTMENT .................
765-1802 APR t 6 I990
, B~D~3, (~2;'~ '
APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ ...... ]~O~?~N OF?.~'~'j;':;.
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 statement from plumber certifying that the solder used in system contains
less than 2/10 of i% 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:
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.
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. Certifiaate 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. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New Con ru ~/' Date . . . ~a;/~...././.. Z ~¢.f~~
st ction.../.v ..... Old Or Pre-existing Building ................. ~
Location of Property../'~gg~.~.F~" ............... ~4~.S~.ee~t.~..~. ........ /~H~e~-~---/~¢-~ .....
Onwer or Owners of Property ..... ...... ........
County Tax Map No tO00, Section.../.~..~. ..... Block... ~..~.go..o. ..... Lot...CP.~P~.V,~?.O..C? ......
Subdivision .................................... Filed Mat) ............ Lot ......................
Permit No ..... J~,~.,~,.~,..Date Of Perra±t...t~Q/~:~./~...Applicant./.~.'~,~7~-t~'~.~..~'~.~
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ............... .. .. .....
Request for: Temporary Certificate ........... Final Certicate..~.. .....
..............
[1st)
FOUNDATION
(2nd)
FOU~,~DATIO~
2.
ROUGH FRAME &
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
Fi:~AL
ADDITIO~A'L COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION ZND [ ] INSULATION
[ ] FRAMING
REMARKS:
~INAL
DATE
151 0
BLDG, DEPT.
FORM NO. t
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OU, THOLD, N.Y. '119'71
TEl...: 765-1802
Approved . ../ _ ...... 19... ermit No.
Disapproved a/c ................
' APPLICATION FOR BUILDING PERNIlT
BOARD OF HEALTH
3 SETS OF PLANS ............
SURVEY .....................
CHECK ......................
SEPTIC FORM ................
TO:
INSTRUCTIONS
a, Thh appHcu, tion must be completely filled in by ~p~wfiter or im ~ak and ~uhm~tted to th~ BuildMg ~ec~or, with
sets of plans, accurate plot plan to scai=. Feu according to schedul=.
b. Plot pl~ showing location of lot and of build~gs on premises, ~lationship to adjoining prem~ or public
or areas, and giv~g a det~led desc~ption of l~yout of property must be drawn on the diagram whi~ ~ p~ of t~s appH-
ca,on.
c. ~e work covered by t~s application may not be commenced b~fore i~uance of Building Peril
fl. Upon approval of this application, the Buildinf~Impe~to= ~vffi.i~ued a Building Pc~it to the appS~t Such pemit
sha~l be kept on the premmes available for ~nspectmn'thfou~Out the work. ~
e. No build~g shall be occupied or used in whole or in part.~ia~ purpose whatever u~il a Cer~ifi~ of Occup~cy
shall have be~n granted by ~a Buildup Inspector. "' "'
APPLICATION IS HEREBY' MADE to the BuHdMg Dep~ment for the i~uance of a B~Iding Pe~it
Building Zone Ordinance of the Town of Soqthold, Suffolk County, New York, ~d other a~Iicable ~w~, Ord~c~ or
Regulations. for thru const~e~on 0f buHd~g% a~di~i~ns or alt~rations, or for 3emoval or demolition, as he~ described.
~e applicant agrees'~o ~b~plM With alt appli~able'hws, ordinance, bufld~g code, housing code, and repletions, and to
~dmit autho~z~ ~s~ect~ ~n'~.z~premises .... and ~ build[nK~ f?r necessa~ inspec~ons. ~
. ..... ........
. ~ (Mailin~ addre~ of applic~t)
grate wh~ther applicant is owner, lessee, agent, ~chitect, engineer, general c~ntmct~r, electrician, p~umb=r or builden
·
q=me ef owner o f premises
(as on the tax roll or latest deed)
f appHcan~ [x a corporation, signature of duly authorized of Scer.
' ; r CERTIHCATE
ul~b CC~SC No ............... , ~,L
EIcctfichn% L~ccn~e No ................. .. ., ..
Other.Trade% License No ......................
Location of land on which proposed work will be done[ .. . . .
l[ous~: Number Street. ' ' Hamlet
/¢3 .... . ,' o
County Tax Map No~ lO00 Section ............ Block .~.'.~',...0. ........ Lot..(P.,~oT.,o(~.Q.~..
Subdivision ....... Kiled Map No. Lot
(Name) ,, ,.
remlses and intended %isa and Occupanc
State existing use and occupancy of P ·' ~_ z~.~../~...~.' ' . .~..er-?t..~ ~__~~, 'y of proposed construction:
a. Existing use and occupancy .... ~ __./" .
b.
Intended
use a.d occ,,pane ..... .... ......... ',. ........................