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HomeMy WebLinkAbout18836-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20470 Date JANUARY 13~ 1992 THIS CERTIFIES that the buildin~ ALTERATION Location of Property 6580 OREGON RD. ~ 9905 ALVAHS LANE CUTCHO~u~NY House No. Street Hamlet County Tax Map No. 1000 Section 95 Block 3 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Per, nit heretofore filed in this office dated MARCH 5~ 1990 pursuant to which Building Permit No. 18836-Z dated MARCH 5~ 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 CONVERT ATTACHED GARAGE INTO A FA~4ILY ROOM ASAPPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JAMES M. McBRIDE H-016957 - JULY 10g 1990 N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEI~'v'~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) 18836 Z Permission is hereby granted to: ' o, C~n~ ~ ~ ~o. ,000 ~,,o~ .... ~ ..... ~,=k ...... ~ ............ ~o,,o ...... Z ............. Buildin~ Insp~tor. Building Ins~tor ~- 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). 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 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: 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. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swi~q~ing pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing 5uilding - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $I0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .~/O.-/.~.~...... .................... . .... . · Xow Construction ........... Old Or Pre-existing~Building .... Location of PropertyHouse~'''~''~'No. ............. ~'~reet'f~4'/ ......... ~ Onwer or Owners of Property..~...~'f../~.~.~.../~.,..~.~/~.~.~..~. ........................... County Tax Map No i000, Section..~-.5~.. ....... Block ...... 3 ......... Lot ...... .~. .............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No../.~.~.f~,.~..Date Of Permit ................ Applicant.~.~.~.,.~.~....~. ?./~.".'.'.~.~.. .... ~equest for: Temporary Certificate ........... Final Certicate..~.. tee Submitted: ~PLICANT FOU2;DATIO:! (1st) FOUNDATIO:~ (2nd) ROUGH FRAME & .PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FI;~AL fl. ADDITIO}IA'L COM~E~TS: , TOwN OF sou'mow FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11071 TEL.: 765-1802 Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY CHECK ...................... SEPTIC FORM ................. NOTIFY~ CALL ..................... MAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 't a. T1ds application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wt h ,~ 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 streets or areas, and giving a det~filed description of layout of property must be drawn on the diagram which is par~ of tltis appli- cation. ¢. The work covered by tkis 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 occupied or used in whole or in part for soy purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the BuiIding Depm-tment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of'Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Re-~ulations, for the construction of buildings, ad~ditions or alterations, or for iemoval or demolition, as herein described. Th~ applicant agrees to comply with all applicable laws, ordinances, building code, housin~ code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature et ~pplicant, or name, if a corporanon) (Mailing address of appIicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. (Name and title of corporate officer) Plumbcr's License No ...... ' ............ Electrician's License No ....................... Other Trade's Mcense No I. Location of land on which proposed work will be done: tlouse Number .4 / ' ..~ ' Street. County Tax Map No. 10130 S,ction ....... .t~. ~,,~:....' Block ...~... Subdivision ..................................... Kiled Map No. (Name) Hamlet Lot . · · State existing usc and occupancy of premises and intended use and Occupancy ofproposed c~nstrnction: : ....... . .........