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HomeMy WebLinkAbout17246-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20813 Date JUNE 19, 1992 THIS CERTIFIES that the building ACCESSORY Location of Property EAST END ROAD FISHER ISLAND N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 7 Block 3 Lot 3.18 Subdivision Filed Map Na. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17 1988 pursuant to which Building Permit No. 17246-Z dated JULY 20 1988 was issued, and conforms to all of the requirements of the agglicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY UTILITY BUILDING IN REAR YARD AS APPLIED FOR. The certificate is issued to BAGLEY REID (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A -alt/. Building Inspector Rev. 1/81 Fosas< xo. s 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) No 017~4~ Z Date Ci~~~'J!G!~ .04.1~~ 19.~~ Permission is hereby granted to: ./.J / ro . ~ r1........ 01............. . / ....~I ID~,~a~~ .....,~i:~.....,~....... ct premises located at ............~y~....,..~ ',,,,.I.1.,.•• . .........~..1. Gy~ County Tox Map No. 1000 Section Block Lot No..:~c..1.......... Q!1 pursuant to application dated .......N/..y~...........~..N~.........., 19~/.~, and opproved by the Build'i/ngg~ Insp~e+ctor. Fee $..~~+.,,'/.w.~~...ll. V ~...~~a~........ Building Inspector Rev. 6/30/80 E TOG1N OF SOUTIIOLD ~~vY~~y~=K~uL~'~L~~ `~'i - ~u~ i s is~2 IIUILDING DEPART:IE21T ~i~'g~~ TOIJN IIALL ~.~J L~;~~...n 3:~1..i%„~'e.°>'v~:a'~.e.._.~"~-.. SOUTIIOLD, NEN YOKIC 119`~"~.~~~~,..~~~~~.~~•~~"~~,~~~. , 765 - 1802 ,i APPLICATION FOR CERTIFICATE OF OCCIIPANCY NEN CONSTRUCTTOIY:_.,.,,OLD OR PRE-E%ISTIt7C BUILDING.._...VACA2tT LAND........ Location of Propcrty__~S~ `?~`:`?_~~..~~..__'~Q~ - ~~'.1',c~.,~_ NOUSE NO. ~ STP.EET UAMLET Ovner or Ovncrs of Property.~Qa~~1.~`' Covnty Tax Hap No. 1000 Section Block .,f Lot Subdivision Filed Map ........Lot_..._._, Pcrait No. ~,7!`;YI?~ate of Permit ~ ~ ~~A `Q~~~~~~/ _ G~ C~jC/_AppLicant~ Hea1Ch Dept. Approval Undcrvritcrs App roval..,'_',':',:~ PlaaninE Board Approval Request for Temporary Certificate Final Certificate Pce Submitted: $_.~,-~7~,/l.~,_.._... APPLICANT.. . _ _ ='ss'S rc~• 10/I4/88 C~~~ 4br3 7 Cow 2o~r13 ' FORM N0. 6 TOWN OF SOUTIIOLD BIIILDING DEPARTMENT ~I TOWN HALT. 765 - 1£102 ~ i APFLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. This application must be filed in typewriter OR ink and submitted to the Buildiog Inspector 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 De~lth Dept, of water supply and sewerage-disposalCS-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4.. Sworn statement from', plumber certifying that solder used in system contains less' than 2/10 of Iz leadL 5. Commercial buildings; industrial buildings, multiple residences and similar, buildings and installations, a certificate of code compliance from the Architect ar Engineer responsible for the building. 6. Submit Planning Boar Approval of completed site plan requirements. B. For eaisting buildings ~Prl.Or to April 9, 1957 non-conforming uses, or buildings ' and "pre-existing" land'~uses: I. Accurate survey of property showing all property lines, streeCS, buildiogs and • unusual natural or typographic features. 2. A properly completed', application, a consenC to inspect signed by the applicanC and a certified abstFact of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, 1957. ,1;f a Certificate of Qccupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informatiob required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: 1. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership olf~the entire lot prior to April 9, 1957 shall also accompany the application. Zfi a Certificate of Occupaocy is denied, the Building Inspector shall state the reaslons therefor in writing to the applicant. D. FEES: I. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $25.00 AddiCion to Acceissory buildings, $25.00 -'Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certific~iate of Occupancy - $5.00 - over 5 years - $10.00 • 4. Vacant Land Certificate of Occupancy - $20.00 S. IIpdated Certificate of Occupancy - $50.00 6. Temporary Ccrtifr~icate of Occupancy - $15.0,0 Residential • Commercial .P' ~ . i • J ev. 10/14/S8 r'IELD iGSPEC.I0;1 ~ ~~:)ATE ~ COMMENT° ~ v m 1 . 3~ H y FOUNDATION (1st) ° N FOUNDATION1 ( 2nd ) _ - m~ 2. z 0 P,OUGH FRAME & PLUMBING t', ti~ y 3. m m I1ISULATION PER N. Y. y STATE ENERGY CODE m a r ~ H 4, ,~m~ FIidAL W r o ADDITIOPIAL COMMENTS: x W ro ~ . x ro H y \ 9~ H O iA~ 2 V m a r y x c7 m ~v H D (t O ry~ PORN NO. 1 L5 V TOWN OF SOUTHOLD JUL 19 BUILDITOWNEHARLMENT EOUTHOLD, N.Y. 11971 BLDG. DEPL TEL.: 765-1802 TOWN F S T LD Examined ~j Received........... , 19.. . Approved . . R4~/...., 19r/~Permit No..~../.. ~ Disapproved a/c p~~y~y~, , (Building Inspector) APPLICATION rGft BUiLDIN%, REKNIT Date 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 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, additions or alterations, or removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buil code, hou 'ng code, and regulations,:and to admit authorized inspectors on premises and in building for necessary inspe ons. ' (Signature of pp icant, or name, if a corporation) ......~f...~.4. RX . hers /?eW Ypr,~ o~~`.°... (mailing aclclress~of~applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......Q.vt!~/~!e . Name of owner of premises ~~l.~°. y ~ /~f . / (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~ Builder's License No. ~ . ~ f~~/•/~ -L/~G Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. .~~I.. ~ o . 3 3 ~-.©j"" ,3 . House Number ~S/treet Hamlet County Tax Map No. 1000 Section Block ....tea............ Lot ~•S . Subdivision Filed Map No. Lot . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ' a. Existing use and occupancy . b. Intended use and occupancy ....~~~.i~.~rl.`'f'i~ct;~ i c. 3. Nature of work (check which 'applicable): New Building Addi~i~1 ~~~e tip Repair moval . . Demolition . , s rw pLh ~ 1'......... . Re ~ 7 ~ ~ ~ (~~cription) 4. Estimated Cost . ~..lfi,~U . Fe . ~.i.l. ~ i ...li It s, . t ' j (to be paid on,filingrthis,alppli4ation) 5, If dwelling, number of dwelling units Number of dwelling units on each floor:.".., ~ , , , . If garage, number of cars 6, If business, commercial or mi>ked occupancy, specify nature and extent of each type of use . . . 7 Heirhtsions of existing stru Nures, if any: Front : : ::Rear ; , Depth , , . g ~mber of Stories ' ' , . Dimensions of same structure'with alterations or additions: Front Rear . Depth L ...Height , .........Number of Stories , . Height D'~.~:k Nutruction: Front . t• Q. Rear ..1l7. • . • . • . • Depth... F} • ' • • . • 8, Dimensions of entire new con., tuber of Stories ..1 . . . . 9. Size of lot: Front ~ . Rear Depth . 10. Date of Purchase Name of Former Owner 11. Zone or use district in which 1Dtermises are situated . . 12. Does proposed construction v~olate any zoning law, ordinance or regulation : . . 13. Will lot be regraded :.....................Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . ......Address ...................Phone No. , . Name of Architect .................Address ...................Phone No. Name of Contractor .......'I• • • • . .....Address ...................Phone No........... , . 15. Is this ro ert locate' If es, Southold Town Td within 100 feet of a tidal wetlandY * Yes No ,`7~... * y ~ustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all 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 corner lot. I , , II STATE OF NEW YORK, i~ S.S CO'C7NTY'OF ~-~4!!~.... . • • • • • • • • 12v1 • • ~e ~ a • • I'• • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the.......~.~!ri.?.'r....~ (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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner sat forth in the application filed therewith. Sworn to before me this rd Y a 3 ............da of .....~4!'~........., 19$x. 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