HomeMy WebLinkAbout23567-zNo Z-2~660
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANC~
Date SEPTEMBER 30, 1996
THIS CERTIFIES that the building ACCESSORY
Location of Propert~ 875 SO~'£~ ~a~RBOR LANE BOU'£~OLD, N.Y.
House No. Street Hamlet
County Tax Map ~. 1000 Section 75 Block 4 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JUNE 18~ 1996 pursuant to which
Building Permit No. 23567-Z dated JULY 9~ 1996
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 BUILDING IN REAR yAR~ AS APPLIED FOR.
The certificate lis issued to
B/~/~Y W. & BE~/ERLY L~HR
of the aforesaid building.
SUFFOLK COUNTY D~PARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED
Rev. 1/81
T(~VH OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
N?
BUILDIHG PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
2356T Z Do~e .............. ~/~... ............................... , ,~.~.
Permission is hereby gronted to:
~:~..?..~.~..~...~. .....................
.Z.~.L,~...////~,.~....Z:.~:~,~
~ ~~ ....... ~_~ .................... : ................
to.~.:~.~ ........ ~.....~.Z...~. ........ .~.,.2'.~.,..'<~ ....... ~...>... ........ ~......,~,~
...~..~,~ ......... ~. ......... ....~...~:7~ ./~_. J
o,p~m,,e,,oco,~ ~ .......... z'..y~ ....... ...~..~......../.~.....~.., .....................................
County Tax Map No. 1000 Section ................. Block ......... Lot No .............
pursuant to applicotion dated ....................................................... 19. and approved by the
Building Inspector.
Rev. 6130/80
s=reezs, and unusual ~acura! or rope§repair features.
2. Final Approval from 5eaLih De?c. of ~-acer supply and sewerg~e-dispcs&i(S-~
3. Approval of electrical tnsua!iacion fro~ Board of Fire Unde~Jri~ers.
less zhan l/t0 of !% lead.
5. Conunercia! ouiiding= t~dustrlal oui!ding, nuiniple r~sidances and si=ilar buildings
and-ins~aL!a~!ons, a certificate of Ccde Compliance frcm !rnhi%ac% or engineer
responsible for the ~ui!din~.
6. Submit Planning ~oard Approval cf comu.!eaad sloe plan requlramenus.
,3.
For exis:in~ buildings (prior to kpr±l 9~ ~95Y) non-confo~-n-in~ uses, or 5u!idings and
i. Accurane su~Tey of proper~y shew%n~ al! propers? line~, streess, bu!Liin~ and
unusual na~urai or =opo§raphic features.
I. k properly completed e~p!ica~icn and a consann ~o inspecn signed by 5ne applicant.
if a Certificate of Occupancy is denied, cae 3ui!d!n~ inspector shall scene the
reasons ~herefor in ~±uin§ to eke applicant.
C. Fees
~ Car~i~iaasa of 0ccuDanc]; - New c~¢a!lin~ '~ ' ,
~. . ~&~.O0, Add±:ions as aweL!ing $25.00
Additions co accesso~' ,~! '~-=. ou~_m_~= ~25.00. 3uelnesses
2. Care!ricers of Occupancy on ?re-exisc!n~ 3uiLdinz - $100.OO
3. Copy of Ceruificaua of Occupanc~r - -25c
~=. Updauad Carti£icate of Ocaupanc7 -
· ~_m~or=~r. , Carti£ica~a of 0c~uuancv. . - ~esident±al 5~3.00, ~o~me~~_a=" ~ ~ ~D.00
~a~e ..?r..~. ~g .............................
~ew Ccnsrruc:ion...~Q, ...... OLd Or ~re-~xi~r±ng guild±rig .................
~==ion o~ ~ro~er~...~-r ............. ~.~¢/.~.4 .............. ~...~..-~ ............
~ouse No. 5~ree~
eta= o~ o=.=. o~ ~:~=~.~,~..L,.~ ..............................................
Subdivision .................................... ~*i=~-i ~d '.".'aD. ..... . ...... Lo~ ......................
~e=it -~o.2-~ ........ ~a,e 0~ ~e=~....q.:~.;. .... ~.~_i~-n: .............................
?tanning ~oar/ Approval ........................
{rlF. L]) INSPECTION REPORT DATE COIVRqEN']'S
FOUNDATION (IST)
FOUNDATION (2ND)
ROUGH FRAI'tE &
PLUI,,iB[NG
{I
INSULATION PER N. Y.
ST~T~ ~R~
CODE
ADDITIONAL COHI'.fENTS:
765-~.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
[ ]~ULATION
[,~] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS::
DATE
I NSPECT~
0
Z
~ 3 ~qET,q OF PI,^N~ ..............
~ CIIRCK ........................
BF. PTI C FORM ..................
HAll, TO: .................
APPI.I CAT I ()iq FQR BU I I.D I H(| I'i~,RH I T
I H~'I'RIICT IOH.q
Dnle ................ ,19~.
h. Plot plm~
~mit nh~ll tm kept ~ the ~mi~ ~ailable for hm~cti~ li~m~i~t I1~ ~rk.
I~lilder,~ l,lcen.qe Ho ..........................
PJ~l~rn l,~cel~r~ No
..... :...?~.~. ...... .~...~k.~~ ...... .~ ............... ~...~.~[~.~ .....................
~ ~.,~,.~. ,~ ~,~,., ......~. .... ,,,~.~ ....... ~ ....... ,~,: ......... .~....
~,lxlivi~ia~ ...................................... FiI~I ~qp ~ ................ lot: ...............
~-)
a. Fgisl:J~ ~]~ m~l ~tq~:y .............................................................................
/~l~J [tiotl ............ O/he[
............ t~/er of i[~,lli~g lu~ils (il ea(]l [It~r ................
......................................
APPROVED AS MO~D
NOTI~ ~OlLDIN~ DEPARTMENT AT
765-1802 9 AM TO 4 PM FOR ~E
FOL~W;NG INSPE~ONS:
1. FOUNDATION - ~0 flEQUtRED
FOR ~URED CONCR~E
2. RO~H - ~MING & PLUMBING
3. INSU~ON
4. FINAL - CONSTRUCTION MUST
BE COMP~ FOR C.O.
ALL CONSTRU~ION SHALL MEET
THE REQUIREMENTS OF THE
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSI6LE FOR
DESIGN OR ~NSTRUCTtON ERRORS
,58
~; of i~Mividt~d si~.nilq~ collt tat'l)
~: ~,, ,I,~ ...... Q.~.~ ..................................... : .......................................
tull Ihe ~[k .ill I~ l~rl:otll~l iii Ibc n[i.lssr ~k I'o~lh hs the iippl ic~; ion file~l flare. Jib.