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Home My WebLink About16996-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17426 Date OCTOBER 19~ 1988 THIS CERTIFIES that the building Location of Property 50605 Nain Road House No. Street County Tax Map No. 1000 Section 70 Block 1 Subdivision Filed Map No. ACCESSORY Southold, New York Hamlet Lot 8 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 13~ 1988 pursuant to which Building Permit No. 16996-Z dated MAY 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 ACCESSORY STRUCTURE AS APPLIED FOR The certificate is issued to J. DOUGLAS PEIX of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building Inspector Rev. 1/81 · 0~ 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) No_ 1699~ z Permission is hereby grqnted to: / · .................. :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: co~.~ To~ M~. No. ~000 S.~t~o. ...... ~ ........... ~ ............ ~ ..... ~ot No ................. .~.. Building Inspector. Fee $.~~ 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 TOWN OF SOUTHOLD 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 featu res. 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 ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ lO0.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date NewC°nstruction ...... Old or Pre-existing Building ..~ ...... Vacant Land Location of Property ................ ~;~3 , . , o House No. Street Ham/et Owner or Owners of Property .... . County Tax Map No. 1000 Section ....... 7..(~, .... Block ...... ! ........ Lot....<~ .......... Subdivision ................................. Filed Map No ........... Lot No ....... Permit No.. . Date of Permit cant .................................. Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building an~,/~r/~, me~l~ble cod,,~ regulat~ions. App,,cant// . . Rev. 10-10-78 'OUNDATION ( 1 s t) 'OUNDATION ~OUGH FRAME & .?LUMBING iNSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. DATE OAI&PE.t.J Hous~ 5¢FPI1- 5TF. I? w~rH t ~2.." TH Ir_..v.. ?b,¥WOOP 5~'ATH/KI~ I~ lb PEbT OObl bb~ PI~GT APl'ROVED A~ NOTED 786-1802 9 AM TO 4 PM )OR FOLLOWING 1. FOUNDA;rlON FOIl 3. INS~ 4, FINAl. BE COM~ ALL CONS~ THE RE~IR~ STATE USE IS OR JNLAWFUL ]' CERTIFICATE IPANCY" [A6T ' ~L.~VATIoLI ~p 5H~P '~'A~.~; k4'~'"' FO~ I~' 0u 8 ^r r...t u. \ 31Tlff FLAIM 5¢_.AL¢¢ ¥~ ---I~0" SOFPIT '~TP. IP WITH t L~) z.¢4 ?bATe 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 \/ ~--,,,~ ~TEL.: 765-1803 E,amined ~/); ...... ,19).~ Disapproved ~c ..................................... APPLICATION FOR BUILDING PERM IT INSTRUCTIONS Received ..... a. Tkis 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 g 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 for removal or demolition, as herein described· The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ..... 25~..~....~ .,.7-......c~...~. p., .... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... .~.. ~i:l~ g.,D6d,.~Y~. ...... . .~1~O..'~. ...................................... (as on the tax roll or latest deed) If applicanJ~a~cor~ration,.signature of duly authorized officer. · ~(~Nam~r~r'a[~ '¢~'~'' ....... /.4;.'....~, .~.~t ' Builder's License No ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · ...5..o. ~ ................ /':¢~....~..,,~. .......... ' .... ~~..~ ..................... House Number Street Hamlet County Tax Map No. 1000 Section ........ '~..z? ...... Block ..... fl. ........... Lot.. Subdivision .............. ' ................ : ...... Filed Map No ............... Lot ............... . (Name) 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 ..... .~...~....~. ...... -- ~,,~h .................................... 3. Nature of work (check which applicable): New Building ......... , 'Addition ...... Alteration ...... ,. Repair .............. Removal .............. Demolition ........... Other Work ............... (Description) 4. Estimated Cost . ~ .~.t:Z::x~ .......... '~ (to be ~aid, on filing this application) 5. If dwelling, number of dwellifig units ............... Number of dwelling units on each floor ................ If garage, number of cars ............................................ ~ ........................... 6. If business, commercial Or mixed occupancy, specify nature and extent of each typ~ of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... i ...... Depth ............... Height ............... Number of Stories ............................ i ........................... Dimens~or/s of same structure with aiterationg Sr additiofis: Front ............ ~..'.. Re/~r .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ ~ ...... Depth ............... Height ............... Number of Stories ............................ i ........................... 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase .............. : .............. Name of Former Owner . ~ ............. : ............. 11. Zone or use district in whlc premises are s~tuated .............. ' ............ . ......................... 12. Does proposed construction viola~ any zoning law, ordinance or regulation: .. ~/~i ....................... 13. W/Il lot be regraded ....... ~ .~ ........ ;. ....... Will excess fill be removed; from premises: Yes 14. Name of Owner of premises ..-4.: .~..~.q~. ~'~ ~q. Address . ~.~.: ~'.~.q~. NP[(4 Phone No ~-t~. ~ ~,'..'~..'1 Name of Architect ~' ~ · .... .%~... Phone No....'1. ........... ............ · ~ ~-- .......... A:ddress ...... ;... Name of Contractor ~;e~--~g.t~4..~'o~.~. ..... Address . (~.e~.. ('~A .~..~r7... Phone No. ~/~.~.~1:~.. 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 sho~ street names and indicate whether interior or corner lot. ' - STATE OF NEW YORK, COUNTY OF ......... ........ S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) abuve named. fie is the .............................................................. ] ........................... (Contractor, agent, corporate officer, etc.): ~f said owner or owners, and is duly authorized to perform or have performed the s~!d 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 th~ ~ork will be performed in the manner set forth in the application filed therewith. ~worn to before me this ~otary Public, ................. County ~0¥~v ~'~uc, ~tate ~f r;~ Y~I~ (Signature of applicant) . No. 4707878, ,~uff.o, k Co~nty~a,