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Home My WebLink About17442-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17367 Date SEPT. 29, 1988 THIS CERTIFIES that the building ACCESSORY Location of Property 1895 MINNEHA/~A BLVD. House No. Street County Tax Map No. 1000 Section 87 Block 03 Subdivision LAUGHING WATER Filed Map No. SOUTHOLD Hamlet Lot 53 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPT. 14, 1988 pursuant to which Building Permit No. 17442Z dated SEPT. 16, 1988 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 RELOCATE EXISTING ACCESSORY SHED AS APPLIED FOR. The certificate is issued to OTTO AND ELIZABETH A. YARO (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FOB~ NO. ~ 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) N~ 017442 Z County Tox Map No. 1000 Section ................... Block ~' Lot No, pursuant to application dated .......... Z.~../.../~.... ............................ , 19~./~., and Building Inspector. ~ee $....,Z,.~ ,~ approved by the Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957)~ Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00, POOLS $25.OOALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ I00.00 3. Copy of cerdficate of occupancy $ 5.00, over 5 :fears $]0.00 4.VacanB Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ....~.(?,,,~.~ NewC°nstructi°n ...... Old or Pre-existing Building ~.~.s,~.,.~'¢~. Vacant Land . .1~ ........ Location of Property ../2 ,~, ,S,~'. .......... , ,~1.~, .~,~,H'.~ ,~.~,, J~ ,L_.~, .P ............. ,~,, ,G.O,'~o. ,~.,~ House No, Street Ham/et Owner or Owners of Property . . .O..T~..o. , .&....d~.~.~.C~.~ .~.~+. , . .~.. ~...~.~. (~.~. .................. County Tax Map No. 1000 Section ..... ~"~ ...... Block ..... Subdivision..LO. P..~'.~.t..tg.c~..c~...,$95..~..~. ........... Filed Map No ........... Lot No .............. Permit No ........ :~.. Date of Permit ;i~..Applicant .. ,0~.~/~...~..<L..~. ...................... Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~eOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ .., Approved..¢ ........ 19~7'~. Pe rmi~ No..~.7. ~..~/..~..~ Disapproved a/c ..................................... ~uildi~nspector) APPLICATION FOR BUILDING PERMIT NOTIFY CALL MAIL TO: Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 zets 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 detailed description of l~yout of properW must be drawn on the diagram which is part of th.is appli- 'cation. o. 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 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 any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department 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 Regulations, for the construction of buildings, a,d. ditions or alterations, or for l:emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regul~tions, and to admit authorized inspectors on premises and in building for necessary inspections. (S~nature or apphcant, or name',~ 'a'corporanon) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ----- ............................. ................................. Name or owner of pretties ,.?~::o),.,gr...~.5¢2. y.q~...D..~..~.T..~.,....~.,...~.~ (T..c? ............................ :tk*-~"~zia '~ ft litg, ,:,* :'~;., ,~ (as on the tax roll or latest deed) ' If appl cat~ ~o~r~.~n..smn~t,,qre, of duly authorized officer. mctmemn-s Li~nse.No. a,~:,;, ,...- ............. Other i~ad~/~L[~¢n~e No, . .................... 1, Location of land on which proposed work will be done... ~ ~.~4.t ~ .G.. ~ ~ ~. ¢~ ...................... House Number Street Hamlet County Tax MapNo. 1000Section ..... ~ .......... Block.........~ .... ..... Lot..~7~...... ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premiscs and intended use and occupancy of proposed construction: a. Existing use and occupancy ...I.~..<~., .~..~.%.t.~.c.~ . .~ 'f~ . .O~O.~.&~ ............ b. Intended use and occupancy ~ ~ ~ [ ~. J '~' %7o~ G ~ %~ ~ ~ .............. 3. Nature of work (check which applicable): New Building Addition .... AlteratiQn---... ................ Repair .... Removal ........ Demolition ............. ' Other ~, t. i. J' ' t"" Dcsc ' 4. Estimate'd Cost . . . ./020...', i .......................... Fee .......... . . ~ " (to be t am on uung [ms appli~atmn) 5 If dwelling numberofdwellin' units · ' ............... Number of dwelling units on each floor If garage number of cars ................ 6 If business commercial or mix'ed occupancy ........................................ · ' , specify nature and extent of each type of use ................. 7 Dimensions .... ~fany: Front Rear ............... · of cx~stmg strtctutes Height Nuinl~er of Stories ............................. Depth ............... Dimensions of same structure with alterations or additions: Front Rear Depth Height ................................... 8 ............................................ Number of Stories ...................... · Dimensions of entire new cons[ruction: Front Rear .............................. Depth ............... Height NuJnber of Stories 9 Size of lot: Front ......................................................... ' · ............. Rear ............. Depth I0 Date of Purchase ............................. · ' .......... · .... Name of Former Owner Zone or use district in which premises are situated. 12. Does proposed construction violate any zoning law,' .............................. ' ..... 13. Will lot be regraded ordinance or regulation: . ~.~. ' .............. ............................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. ................. Address ................... Phone No ..... ' ......... Name of Architect ......... I .................. Address .. Phone No .... Name of Contractor ...... I ................. · ........... · · .................. Address ................... Phone No ............ i... 15.Is this property located within 300 feet of a tidal wetland? *YES. · If yes, Southold Town Trustees ~P. ermit may be required. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block' number or description according to deed, and show street names and indicate whether interior or Comer lot. ' STATE OF NEW YORK, COUNTY OF ............ S.S (Name of ndividual signii~g contract) above named. FEE: FOtLOWINO INSPectIOns: 3. IN~ULA~ON 4, FINAL CONSTRUC~N MUST BE COMPLETE FOR C,O. ALL CONSTRUC~ON SHALL ME~ THE REQUIREMEN~ OF THE being duly s~p~ ~~~ apphcant lle is the ! ' (Con tractor, agen t, corporate o fi/ce r, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all stateznents contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner[set forth in the application filed therewith. Sworn to before me this Notary Public, ,, ' t County fiB.EH K, DE VOE NOTARY PUBLIC, State cf New y~ · .. NO, 4707878, Suffolk C~unty~ ~ lerm Expires March 30, l~ (Signature of applicant)