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Home My WebLink About17583-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17512 Date NOVEMBER 15~ 1988 THIS CERTIFIES that the buildin~ Location of Property. 37220 MAIN ROAD House No. County Tax Map No. 1000 Section 019 subdivision ACCESSORY ORIENT Street Hamlet Block 01 Lot, 11.2 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCT. 27, 1988 pursuant to which Building Permit No. 17583Z dated NOV. 2~ 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 ACCESSORY SHED. The certificate is issued to JOYCE A. BURTON (owner, XY~XY~) of the aforesaid building. SUFFOLK COUNTY DEPkRTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 FOIL~ NO. J TOWN OF Sou'r3.1OLD BUILDI14G DEPAgTME14T TOWN HALL SOUTHOLD, 14. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 017583 Z Date ................................................. , 19.. Permission is hereby granted to: .~.~ ........ ~ ........ ~~..~ ........... ............... ~,....~,....~...~ P ..... ~ ........... ~ ...... ;-r ...... ................................................... ~ ...... pursuent to application dated ...... ~,..~..~., ...................... , 'gZ~ and approved by the Building Inspector. 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 m~ 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 p~operty 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 $25.00 ALTERATION $25.00 1. Certificate of oceupancy New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 ZC_~..~. 5.Updated C.O. $ 50.00 Date ....... /~7..,~. .... NewC°ns t'z"uc tion ...... Old or Pre-existing Building ..... ~ ....... Vacant Land ............. Location of Property., .~ ~.~ ~. ~ ..... f~/."~J. . . '~ ....................... Z~.~./.~. .~.. House No. Street__ Ham/et Owner or Owners of Property .... tJ/z:~-.f.C-.¢., .,~; .~L~ ~ ~..~..~ / County Tax Map No. 1000 Section ... ~..~..~ ...... Block .... /. ......... Lot .... ~f.L~ :..?~..... Subdivision ................................. Filed M~p No ........... Lot No .............. ........... Date of Permit .......... Applicant.. j ~r~/~, ¢~...~z~... ,)~d,~../~.~'~ .... Permit No 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. Apphcant . . Rev. 10-10-78 yiELD FOUNDATIO~ FOUNDATION 2. ROUGH FRAME & (1st) ~PLUMBING ( 2nd ) INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: !i' .nj 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~N~ULATION // FRAMING [/,,]/FINAL ~ REMARKS: DATE 0~~ 2 ~ ~98S ;,i TOWN OF SOUTHOLD ~~L~J/ BUILDINGToWNDEPARTMHALL ENT · ~OUTHOLD, N,Y. 11971 ?, · .......... l t4 Approved . .//.'2~.. ........ 19~. Permit No..4 ....... Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS SURVEY ..................... c.~cK .;g~ .... ~ ............ SEPTIC ........... NOTIFY CALL ..................... MAIL TO: Date .................. , 19... INSTRUCTIONS a, T/ds application must be completely filled in by typewriter 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 buildings on premises, relationship to adjoining premises or public street: or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of tiffs appti cation. c. 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 permfl 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 Occupan% 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 Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, as herein described. The applicantl~ {~l~tS~ql~ith all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized ir~p~ecators on premis$§.~j3d in building p/~ons..~ ,/~ . ~ ..................... ~'*- :~Jl for necessary ins . ...,.......... ~'l'~l,']~ Ob~ ~'~O~i~O~O~ ~ -/ (Mailing address of applicant) , State ~lffiht~IM~lSli~~JCs~e~' agent, architect, engineer, general contractor, e~ectrician, plumber or builder. ..... ~.~r~.~:~ ~ ~ .................. ': ....................................... Name ~n~r~~.~:~ .... ~8 ~ ~ ~~ ~ll (as on the tax roll or latest deed) app~r ~~,~ar~tqt~quzy authorized officer. (Name and title of co,orate officer) Builder's License No. Plumber s License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done ...... t,~,... ~.6~q 'l/Q 0{..~¢~ .¢7.4g.~.~.~7./.~..qtT. C~j~.. ~... ~.7.~.e ............... ~.~; ~a ~ ' ~ouse Number ........ ' ........... ¢.1.~. [ ......................... Street Hamlet County Tax Map No. I000 Section ........ ~ ~.~ ..... Block ........ '~. { ........ Lot. [~t. ~ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrnction: a. Existing use and occupancy ~3.~.~.[~ ........ ~ ~, ~, . '~" ~s~ ?'~ .................... · ~ ~ .~ an~ oc~u~n~ ~-*~.~' ~....q. 3. Nature of work (check whichlapplicable): New Building v~' · Addition .... Alte:ration ... R pair Re~n I D ......... 4 E timatdd Co , fipti Fee - to be p$3.~ q~&fihng {hls application) 5. If dwelling, number of dwelling units ............... Number of dwelling umts on each floo~ If garage number of cars ' ,, ' · .. If business, commercial or mi~ed occupancy, specify nature and extent of each type of use 7 Dimensions of existing structures if any: Fr~ht : ............. ~ ....... Height N~mber of Stories ... ..... ' , ............ Rear ........... Depth ..... Dimension~ ........ ' ...... ' ...................................... of same structure with alterations or additions: Front Rear Depth Ilei~t ................. ' Number of Stores ' ' ' 8. Dimensions ofe~ti~ new con~t~ction: Front ..... [.~ ' .... Rear., .IO.t. Depth ..~ Height ........ x ..... N tuber of Stories ....... I ...................... . . 9. Size of lot: Front ......... [ . ; ....... Rear I0. Date of Purchase ......... ~. . · ..................... Depth ........... ~' '"; '~ ........ NameofFomerO~nyr ............ 222 2 2 ....... 11. Zone or use district in which Ore ises ar sit ated.. ~ ~k ~1 ............. ocs proposed Construction v~late any zoning law, ordinance or regulation: ... ~.O .......... Nme of Architect ........ ~ ............. ; · ./·. Address~ ......... ~ .... ~. · Phone No ............. 15. t of a tidal wetland? ~YES .... NO~.'' mIf yes, Southold Town Trustees Permit may be required PLOT DIAG~M Locate cle~ly ~d dis~ctly ~1 buildS?s, whether existing or proposed, ~d. indicate M1 set-back d~ensions fro~ prope~y Dnes. Give street ~d block number or deschpfion accord~g to deed, ~d show stree~ n~es and ~dicate whether intehor or comer lot. OCCUPANCY OR USE IS UNLAWFUl. WITHOUT CERTIFICATE OF OCCUPANCY 766-1802 ~ AM TO 4 PM FOLLOWING INSF'l[CllONS: I, FOUNDATION - 2. 3. INSULAlION 4. FINAL BE COMPIA'TI FOIl r.,.Oo STAT! (X]MWlIJ~tI~ It lllllY CODEL W)T ~ DESIGN OR ~ STATE OF NEW ¥ORK~,F~ cOUnTy is.s .... ..... qN m of individual signing contract) ......... above named. being duly sworn, deposes and says that he is the applicant ..................... I ...... iCon tractor ................................................ , , agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said wo~ a~nd to make and file this application; that all statements cont,~inea ;~ ~h; ..... r ........ appucatmn are true to the best of his knowledge and belief; and that the work will be perfomed in the m~n~r set forth in the application filed therewith. Sworn to befor~ me this