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Home My WebLink About17933-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19076 Date May 24, 1990 THIS CERTIFIES that the building ACCESSORY ADDITION Location of Property 905 PRIVATE ROAD #19 SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 50 Block 1 Lot 15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16, 1989 pursuant to which Building Permit No. 17933-Z dated MARCH 17, 1989 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy £or which this certificate is issued is ADDITION TO EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to SOHN & PHYLLIS MACK (owners) of the aforesaid building. SUFFOLK COUNTY DEFARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NQ J17933 Z Date .........C.y~.......1...7 19.~~ Permission is hereby granted to: ....1.~ ..~.l~~...~...1.. g.......7 . .~ti~....~,;~ r 14.74.. to ~ ....fin......... .......~..~T• . ct premises located at ...~.A.Si.......~.~Q..~.~....1......~~~."~.r~.4:!`fr.~ . . County Tox Map No 1000 Section Block ....0.1.... Lot No . pursuant to opphcarion dated ........7.Y ~,.Q~r!.:C.Y~ ~ ~ 19.~. and approved by the Budding Inspector. i Fee S Bu g Inspector Rev 6/30/80 Q ~ a_ , Form No. 6 ~r~.[ r TO4TN OF SOUTHOLD ii BUILDING DEPARTMENT APR ~ ~ ~ ~ I TOWN HALL 765-1802 BLCG Ctrvi. TOIR~v C'~'~~-:aiYO:.T? APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be f111ed 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 17 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate oc Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to Apral 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 applicaCion 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. GLrtlf it-d to :,f GCCUpancy ir'ew dwE Aliug $25.G0, Addtc.iuns Lo dwe ll.iug $~i.v0, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory Uuilding $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate 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 - $50.00 5. Temporary Certificate of Occupancy - Residential y$~15~.y00, Commercial $15.00 Date rl.(•~ New Construction...x Old Or P-rfe-exi;~sting Buildiqng...........^.g.~.... Location of Property.. Q$- . ~R~U~[ :e.. ISO~I~.~ 1. ,~A. /A~.4 House No. / Street J/ / Hamlet Onwer or Owners of Property. J~H'~!.g'~~i~~!?.. ~.P~f(1.~1.5.~~~ County Tax Map No 1000, Section..:~~........Block.....!..........Lot... ~ ~ Subdivision..~.1.p.q..h ............................Fci~led Map............Lot......././.............. Permit No. Q~ f J. %.....Date Of Permit ~~~7~$.(......Applicant~dt~f°~.~.~~~JJ.~ 5 rn~~ Health Dept. Approval ..........................Underwriters Approval......................... Planning Board Approval Request for: Temporary Certificate........... Final Certicate..~....... Fee Submitted: $ d T Q 0 APPLICANT TEL. 7G5-1802 ~~FFQLkC' o~p Opy TOWN OF SOUTIIOLD id ; ~ .`c OE'C ICE OP BUILDING INSPECTOR c=°n ,z P O. BOX 728 ~ TO1VN HALL ~c SOUTIiOLp, N.Y. 1 1971 ,~o~ ~ Sao May 23, 1990 SOHN S PHYLLIS MACK BO% 1837 SOUTHOLD, N.Y. 11971 To P7hom This May Concern, we are unable to complete your Certificate of Occupancy because of the following reasons. An application for Certificate of Occupancy is not on ftle. / No Underwriters Certificate on file. /4// T}ic: check is (~a~not on file. y $25.00 I_I No Ilcalth Dept. T:pproval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit 1 7 9 3 3 2 CACCY GARAGE ADD.) Butlding Dept. / No Plumber Solder Certificate on file. ( all pcrmit~ involving plumbing being tnsucd after April 1,198h ) r :1::LD EC:i~:~ ~~L',,:.. .:~KNCNT° H _ _ y FOUNDATIO"J ( 1st ) r C FOUIdDATIO;I (2nd) _ m_ 0 ROUGH FRAh1E & PLUMBI;JG N 3. ~ m m , IIJSULATIDII PER N. Y. STATE ENERGY CODE a ~ sa 4 . ~ / FI;IAL ~t o ADDITIOIIAL C0:"MEfITS x x ^o H 7] • 9 H - H O z z m a r _ H ~ T d m ro H ~ 79~ ~ f65-1802 BUILDING DENT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION (~FRAMtNG [ ]FINAL l n/ REMARKS: `T,,~~2_ U~- DATE ~ INSPECTOR 765-1802 ll! BUILDING DEPT. INSPECTION OUNDATION 1ST [ J ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ 7 FRAMING'~~ [ ]FINAL REMARKS: /~~t.~-~ ~=~~--~2,r, ~ r- _ E,~.~r~ a,t r l~ J" DATE ~ U INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( j ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~i / DATE /3 ~ INSPECTOIir/~ BOARD OF HEALTH 3 SETS OF PL.1N5 FORM NO.7 SURVEY . TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC PO[tP1 • TOWN HALL SOUTHOLD•N.V.11971 NOTIFY ~~~o TEL., 765 7802 ~ A~LL~ . r N7rLL ~T 0 E~camincd . q-l:e~rt. 1.2 I98~. - Approvcd !!.~.Q~.C.~..~~., 19~~.PennttNo ~ 79~~.~• D Disapproved a/c ~ ~ 6 1989 R.~'a.~ TOWN OF SOU. HOLD uu (Buildm; Inspector) APPLICATION FOR BUILDING PERMIT Date d'!Y'~•" . . 15 . INSTRUCTIONS a. This application must be completely filled in by typewnter 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 bwldmgs on premises, relatronship to adloinmg premtses or public stree or areas, and giving a detailed descnptron of layout of property must be drawn on the diagram which is part of this appl cataon. c. The work covered by this application may not be commenced before issuance of Buildmg Permit. d. Upon approval of this application, the Building Inspector will issued a Buildmg 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 to part for any purpose whatever until a Certificate of Occupant shall have been granted by the Buildmg Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, adddions or alterations, or for removal or demolition, as herein descnbe~ The applicant a;rees to comply with all applicable laws, ordinances, buildma code, housing code, and regulations, and t. admit authonzed mspectois on premises and u7 building for necessary utsp qua ~ ~ ignature of applicant, or name, if a corporation) • (Mailing address of applican~ State whether appl/i/c~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name oC owner of premises ~J•C{f n/. . ~•.`ZI/-)c,(~• . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authonzed officer (Name and title of corporate officer) Builder's License No ~.kil~C~. • • Plumber's License No . . Electrician's License No . . Outer Trade's License No . 1. Location of land on which proposed work will be done . . House Number Street Hamlet ~ / k County Tat hiap No 1000 Section • • • • • • . • • • • Block ( Lot ..~.J• . Subdivision . Filed Plap No Lot . (Name) State e~istmg use and occup.ncy of premyi^ses and mtendcS ulse/and occupancy oC proposed construcUOn a. Existing use and occupancy ~.:+`.~,t~~~InL'Y .~..,Q!7.U, y1~ S L . b. Intended use and occupancy • • • • C•'•/ !'S • • • ~j~!7 • • • . 3. Nature of work (check whuh applicable). New Building Addttton Alierauon,~ . Repatr .Removal Demohuon .Other iVork~!r}.Knt^~... . (Descnpuon 4 Esttmatcd Cost ~ D U r~ Fee . ~ (to be patd on filing thts appttcauon) 5. If dwelling, number of dwelling units Number of dwelling units on each t7oor . , , , , , . If gara;e, number of cars • • . • • • . . 6. If business. cotnmerctal or mt~ed occupancy, specify nature and extent of each type of use . 7. Dimenstons of existing structures, tf any Front Rear Depth , . Hcr_ht ...............NumberofStones.................................... Dimenstons of same structure with alterations or additions Front Rear . Depth ~ Iletght ..Number of Stones . Dimenstons of entire new construction: Front ~ Rear ~ Depth a. , , , , . , Hetgltt ..............Number of Stones . 9. Stzeoflot Front Rear........... Depth 10. Date of Purchase Name of Former Owner . . 1 1. Zone or use district m ~rhtch premses are situated . . 12. Does proposed construction violate any zoning law, ordinance or regulatton• . 13. will lot be regraded • X.1 will excess fill be removed from premtses: Yes 14. Name of Owner of premtses ^.f ~k^l .1~!t'tfk•+~', J.'~.... Address!?4 ~c.F!&?,7, , , , . • , , ,phone No.-7.'~.S ~d, , Name of Architect .Address ..............Phony. No . Name of Contractor ..........................Address ...................Phone No............. . IS.Is this property located with in 300 feet of a tidal wetland? *YES....NO~C.. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth interior or comer lot. APPROVED AS NOT~E~Dq?,g FEE .~.s_=-------BY NOTIFY Bl11LDiNG DEPARTMENT AT 765•t802 9 AM TO 4 PM FOR THE Fttttpualivj, iNSPECTITQ~NO REQUIRED , i FOUNDATION FOR POURED CONCRETE 2 ROUGH -FRAMING & PLUMBING 3 INSULATION 4 FINAL - CONSTRUCTION MUST RE COMt'LETE FOR C O ALL CDNSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N Y. CODES CONS R R S ONSIBtE E FOR DESIGN OR CONSTRUCTION ERRORS QCC114aNCY QR • usE ~s uNtaw~u~ W1~H~ pCCUPANQ~ jE 0 STATE OF \EIV YORK, S S COUNTY OF • • • • • • • • • • being duly sworn, deposes and says that fie is the applica; (Name of individual signing contract) above named. fletst}to (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Gle tl: apphcaGOn, that all statements contained m tats apphcauon are true to the best of tits knowledge and belief; and [hat tl work wdl be perforned to the manner set forth m the apphcahon Glcd therewith. Sworn to before me this ..............r ` ...day ofy. ~//R!! 19 g.~ \otary Public, ...~'?`e'`~"'...rl t~'Q: County ~ • • NEIEN K DE YOE ~ ' L' ~Na47 78/&SUN Ik~Co~uwYork ~ (Si//g""n~~ature of applicar. 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