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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22800 Date DECEMBER 17, 1993
THIS CERTIFIES that the building ACCESSORY
Location of Property 855 OAKWOOD COURT SOUTHOLD, NEW YORK
House No. Street Hamlet
County Tax Map No. 1000 Section 90 Block 4 Lot 17
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 22, 1993 pursuant to which
Building Permit No. 21830-Z dated DECEMBER 14, 1993
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 "AS BUILT" AS APPLIED FOR.
The certificate is issued to CHARLES & HELGA MICHEL
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
uil ing Inspector
Rev. 1/81
FORM NO.3
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)
Date xjl. C/ 19.....!..
N 9
° 21830 Z
Permission Is hereby granted to:
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at premises located at 5..... i~j~..... .l~S..
s~ I'.+?... ......././.~~7./...............................
County Tax Map No. 1000 Section Block 0 Lot No. ......1.7
pursuant to application dated 19..../Q .-J1..... and approved by the
Building Inspector.
Fee $
uilding Inspector
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OF, ink and submitted to the building
inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
9. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
4 "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date
New Construction............. Old Or Pre-existing Building....................
Location of Property ...U 1~' .Q :..............:f.~~r°?...... /.U/.1~.~
House No. Street Hamlet
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Onwer or Owners of Property
County Tax Map No 1000, Section......? .....Block.... ~ ..........Lot....1.7
Subdivision ....................................Filed Map............ Lot......................
Permit No ................Date Of Permit Applicant
Health Dept. Approval ..........................Underwriters Approval.........................
Planning Board Approval
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted:
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APPLICANT
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INSPECTORS OFFOLt
VICTOR LESSARD, Principal µ SCOTT L. HARRIS, Supervisor
CURTIS HORTON, Senior co Southold Town Hall
VINCENT R. WIECZOREK, Ordinance p • P.O. Box 1179, 53095 Main Road
ROBERT FISHER, Assistant Fire Southold, New York 11971
Building Inspectors Fax (516) 765-1823
THOMAS FISHER Telephone (516) 765-1800
GARY FISH
OFFICE OF BUILDING INSPECT
TOWN OF SOUTHOLD
S~'^ December 9, 1993
Charles & lga Michel
855 Oakwood urt
Box 105
Southold, N.Y. 11971
In order to iss a Buil ng Permit for your proposed
construction for buil gs cated on lots adjacent to tidal
water bodies, we will n d waiver of jurisdiction or a permit
from the New York State partment of Environmental
Conservation, and if wi 75 feet of tidal water bodies or
wetlands you will als nee action by the Board of Town Trustees
(waiver or permit).
Very truly yours,
OUTHOLD TOWN BUILDING DEPT.
Gar J. Fish,
Buil 'ng Inspector
Phone n ers:
DEC - 7 -7900
Town Tr stees - 765-1892
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Tfter investigation and inspection the Board finds that
applicant requests permission to erect accessory building
in front yard area located at Oakwood Drive, Southold,
New York. The findings of the Board are that the location
of the accessory building as shown on the survey is the only
feasible location. This location will also be compatible
with the surrounding properties.
The Board finds that strict application of the ordinance
would produce practical difficulties or unnecessary hardship;
the hardship created is unique and would not be shared by
all properties alike in the immediate vicinity of this
property and in the same use district; and the variance
will not change the character of the neighborhood, and will
observe the spirit of the Ordinance. The Board agrees with
the reasoning of the applicant.
THEREFORE IT WAS RESOLVED, Charles Michel, Oakwood Drive,
Southold, New York, be GRANTED permission to erect accessory
building in front yard area at Oakwood Drive, Southold, New
York, as applied for.
Vote of the Board: Ayes:- Ptessra: Gillispie, Bergen,
Grigonis, Hulse, Doyen.
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ FINAL
REMARKS: G
DATE INSPECTOR
BOARD OF HEALTH
FORM NO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY _ _ .
BUILDING DEPARTMENT CHECK . • - . _
f1;i 2 2 TOWN HALL SEPTIC FORM
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 NOT1FY's 7~J" 5 6 /
CALL
Examined /J_ 9 MAIL TO:
Approved ....Y 19/. . Permit No.0P~ _ .
Disapproved a/c
(Bu spe
APPLICATI N FOR BUILDING PERMIT
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 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 inspe 'on . n
(Signature of applicant, or name, if a corporation)
STo!ft~rso~.c7... scv7J~~iu;!lp7(
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Ocr>.v1--rC
~j/C'l¢EL
Name of owner of premises ...Cl~ ~ S. ,In,, ~ e;74
as . on . the tax roll . or.. . ItPP AS NOTED....... .
( latest deed)
DA~i BP./
If applicant is a corporation, signature of duly authorized officer. /4 %V
FEE 35ev B1F
NOTIFY BUILDING DEPARTMENT AT
(Name and title of corporate officer) 765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
Builder's License No. 1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
Plumber's License No. 2. ROUGH - FRAMING & PLUMBING
3. INSULATION
Electrician's License No. ' ' ' ' ' ' , , 4. FINAL - CONSTRUCTION MUST
~ BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
Other Trade's License No. ~v THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
I . Location of land on which proposed work will be done . ...................CODES: - NOf - RESPONSIBLE' ' FOR-
S T IGN OR CONSTRUCTION ERRORS
P17.
House Number Street Hamlet
//7........... Lot ~
County Tax Map No. 1000 Section Block ......./c
Subdivision C,- . ...B.. K............ Filed t,1a No. Lot ~ n .
p
(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
3. Nature of work (check which applicable): New Building Addition Alteratio
Repair Removal n
Demolition
Other Work .
/ (Description)
4. Estimated Cost
Fee.....................................
(to
5. If dwelling, number of dwelling units be paid on filing this application)
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 type of use .
7. Dimensions of existing structures, if any: Front ' ' • • ' ' ' ' . ' ' '
.......Rear Depth
Height Number of Stories .
Dimensions of same structure with alterations or additions: Front
Depth.... Height..........:... Rear.................
8. Dimensions of entire new construction: Front Number of Stories .
. .
Height . ~ Number of Stories Rear . . . . . . . Depth . . . . . . . . . .
~ .
9. Size of lot: Front St , r, 4~ZPi R ar . . . . . . . . . . "
_-.-r Depth epth. . . . . . . . . . . . .
10. Date of Purchase ' • ~ • ~ e
• • • • • • Name of Former Owner
11. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be regraded . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: es
No
14. Name of Owner of premises Address .
Name of Architect Phone No
Address Phone No.
Name of Contractor ' ' ' ' ' ' ' ' • • . • • • •
• • • • • • • • • . Address Phone No.
15. Is this property within 300 feet of a tidal wetland? * " " " " "
Yes.. No.........
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frost
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
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STATE OF NEW YORK,
COUNTY OF S'S
rtj.5o~~~' ' /1..~~ 4` being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the Ou>y~
(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 set forth in the application filed therewith.
Sworn to before me this
c
......day of. . e 19 3
Notary Public, County
JOYCE M. %MLKINS i .
Notary Public, State of New York
No. 4952246, Suffaft Con
(Signature of applicant)
Term Expires Jung 12,19Y~