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Home My WebLink About32838-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32667 Date: 10/12/07 THIS CERTIFIES that the building ADDITION Location of Property: 600 GAGENS (HOUSE NO.) County Tax Map No. 473889 Section 70 LANDING RD (STREET) Block 10 SOUTHOLD (HAMLET) Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 23, 2007 pursuant to whicb Building Permit No. 32838-Z dated MARCH 23, 2007 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 REPLACE EXISTING 2ND STORY DECK ON AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BLAISE X & KATHARINE J. MYSAK (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~~u<t:'i",=,"<. Rev. 1/81 . Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 [V\~ ,./ APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or if!k and submitted to the Building Department with the following A. 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 2/1 0 of 1 % 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. r'--~-'7';-;.' , '. '. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings anI! ~"pre-existing" land us'es: 1. Accurate survey of property showing all property lines, streets, building and unusual'natural~{olfographiC features. , (, I I I 7 2. A properly completed application and consent to inspect signed by the applicant. IqaCdfti.ficate of Occupimcy is denied; the Building Inspector shall state the reasons therefor in writing to the appl~:1:o . C~ ~ I. 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 - $.25 4. Updated Celiificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. /0/;//67 , )( New Construction: Old or Pre-existing Building: (check one) Location of Property ~06 C>l)~~ t,'4YJ~';:> I2.::Q S-~hott . ouse No. Street Hamlet Owner or Owners of Pro peril': I5/JlII~ X fr1,f1/k.. I-lllfAl/f"'vi_< r (Y)YSIl J<- Suffolk County Tax Map No 1000, Section 70 Block / D_ Lot 'L / Subdivision Permit No. S 1- 'if S 8 L Date of Permit. "3 lz-3/6) n~ Plalllling Board Approval: ~-r9 Filed Map.._ ___ Lot Applicant ft/iljis€ X' frllSlt}J~ Underwriters Approval: J114 -- Health Dept. Approval: Request for: Temporary Certificate Final Certificate: x ---.--- (check one) Fee Submitted $ 2,s; ~:ic~1f:c- O\..e-t 7):J.LiY co "t 3.2 (Pro 7 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) PERMIT NO. 32838 Z Date MARCH 23, 2007 permission is hereby granted to: BLAISE X MYSAK PO BOX 1094 SOUTHOLD,NY 11971 for : REPLACE EXISTING 2ND STORY DECK ON AN EXISTING ONE FAMILY DWELLING.THISPERMIT REPLACES BP # 30341 at premises located at 600 GAGENS LANDING RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0010 Lot No. 021 pursuant to application dated MARCH 23, 2007 and approved by the Building Inspector to expire on SEPTEMBER 23, 2008. Fee $ 300.00 f f /, -'" ORIGINAL Rev. 5/8/02 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) PERMIT NO. 30341 Z Date MAY 20, 2004 Permission is hereby granted to: BLAISE X MYSAK PO BOX 1094 SOUTHOLD,NY 11971 for : REPLACE EXISTING 2ND STORY DECK ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP#24920. (AS BUILT) at premises located at 600 GAGENS LANDING RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0010 Lot No. 021 pursuant to application dated MAY 20, 2004 and approved by the Building Inspector to expire on NOVEMBER 20, 2005. Fee $ 300.00 ORIGINAL Rev. 5/8/02 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION.t TH.E WORK AUTHORIZED) \2e.N..A)~'-{'- '-i I 24920 Z O~ Date JUNE FULL PERMIT NO. 1, 1998 Permission is hereby granted to: WALTER A JOHANSON 600 GAGENS LANDING ROAD SOUTHOLD,NY 11971 \. ./ for : REPLACE AN EXISTING 2ND STORY DECK AND ALSO AN ACCESSORY STORAGE BUILDING "AS BUILT" AS APPLIED FOR. at premises located at 600 GAGENS LANDING RD SOUTHOLD County Tax Map No. 473889 Section 070 pursuant to application dated APRIL Block 0010 Lot No. 021 24 1998 and approved by the Building Inspector. Fee $ 110.00 4Q,~ ?)'!diY9 Ins ector ORIGINAL Rev. 2/19/98 3 2-J> 3 Pc- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONS11IUCTION REMARKS: [ ] ROUGH PLBG. [ ] I~LATION [ vrFlNAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENEmAnON DATE INSPECTOR :2 <I t ~ ~dAN-(t( 3D3V J 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] JNSULATION [ ] FRAMING [Pl FINAL [ ] FIREPLACE & CHIMNEY JlJtJ ~8~~ ~- ~ - t:C ;A./ --< .- ~ ;~~~ ~~. Z:::::::-~ az~d ~ DATE IIf (~ INSPECTOR ~ \2ef'-l v-s-t cL 3 O~lt \ J 11Je;.p 765-1802 BUilDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ [ [ ] FIREPLACE & CHIMNEY REMARKS: ~O!'Jt5.<~....N~ D [ ] ROUGH PLBG. [ ] INSULATION [~AL IlIb k~ -- DATE I ~// ;;;/1 ~ INSPECTOR ~v-ed 3D3Y I ).<-f9 }<0 ~ 765.1802 BUilDING DEPT. INSPECTION [ ] FOUNDATION 1ST [] ROUGH PlBG. [ ] FOUNDATION 2ND [] IN LATION [ ] FRAMING [ [ ] FIREP~E & CHIMNEY REMARK~~/~ ~ ~ ~ - , 1~ _ -_ ~ DATE c,f 17 { I v INSPECTOR . .~~~ -3 .~'i~ .Z .~ . ~b ., Q/? S- f .$ :'ELD . I:;S~;2C7::'u:; . 1. 1/1),,7::: II II II II I :;OMMEuT.o FOUNDATION (1st) FOUNDATION (2nd) 2. II I ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE 4. FINAL ADDITIONAL COMMENTS: 5'e/l/r ,..eer- ~ . ~ H I ..., N "" R~ ir ~ z o~ . <::> a f i ~f '" ...,l:- :f, ....... ~ """", ~ -0 ~rr" .. . ..., H -.<>. o~ z~' ,~ ~f '" .'" -0 ..., rn APR 2 H91 00 PORM NO. I TOWN OF SOUTIIOI.D IIUII.DING DEPARTMENT TOWN IIALL SOllTIIOI.O. N.Y. 11971 TEl.: 765- 1802 1I0ARD OF DEALTH ............... 3 SETS OF PLANS ............... SURVEy........................ CUECI( ......................... SEPTIC FORM ................... 'l, BLDG. DEPT . . N FS UTHOLD 9r I.xuntned................ 19.... ~O.-?Y: f ~I:::~. ~f~ ~:: :~. ~~~~.; .~~:I:~ .~:.::..........\.. !eA~~Yt' NOTUY: . M. -:? '718 - CALL . /. .. /. ...... HAll. TOe.Q fl?~(.L I f.'/.. . . . . . . .~~. 711..1/! 7)....... .................................... ....................................................... ...4~.J... 4..... (Iktl)4;{i~~~~) APPLICATION FOR BUILDING PERMIT .Oate.... .~l-. ],...:-;1.... .19~. INSTRlICTIONS a. 'n,ls application DUSt be COft>letely filled In by tn-riter or in Ink mil S\b'altted to tbe Building Inape<:tor wi 3 sets of plans. sccurate plot plan to scale. Fee according to scbedule. b. Plot plan showing location of lot and of buildings on prstlses. relationship to adjoining p......ises or 1".tllc streets or oreas. and giving a detailed description of loyout of property llU8t be dr... on tbe dlagr... ...\eh Is parr of this DPlJlication. c. 'nlE! ..on covered by tbla oppllcation ....y rot be comenced before Issuance of IUUdlng Penait. d. Upon approl1al of tbls application. tIlE! lullding Inspector wilt I.- a 1U1ldlng Penalt to tilE! applicant. Such permit shall be . kept on tilE! prenalsea available for lnapectlon throoallCAlt the ..on. . e. No building shall be occupied or used in "lOle or in part for any ptTJlOll8 1lhatever ...tll a Certificate of Occupancy shall have been granted by tilE! Building Inspector. IIP1'I.ICA'nrn IS lE\lEllY HIVE to tilE! Iluildlng Ilepartment for tilE! ia_nee of a liulldh\J Pendt ptrllUllflt to the llulldlng Zone Ordinance of tbe Town of SoutllOld. &Jffolk County. New Yon. and otlter applicable I...... Ordinances or 1legulations. for tbe construction of buildings. additions or alterations. or for nIlOVSI or deaolltion. 88 berein described. 11te applicant agreea to comply with all applicable 1..... ordlnsnces. buUdina coda. llCAlalng code. and regulations. land to sUnit wthorlzed lnapectora en prstise. and in bul~"'ry Inspections. . .(Si~~~;~.~f.;~ii~~:.if.~'!'~~i;,.~;. .....f:..~:.~~:e...~.~.~.....'?>.~l~. (Hall log eddreaa of applicant) N' ~ . , '",''},U '\ 1l.... State ~lE!t1lE!r applicant is owner. leasee. agent, ord.ltect. engineer.' general contractor. electrician, pl..mer;'~ bu\I.1e If OPl.liCWlt is a COl'JIOration. signature of duly wtlK,rized officer. ................................................................................,....... . ............:........................... ...oCCUPANCY OR (Nme and tItle of corporate officer) USE IS UNLAWFUL \ktilders J.icense lb. ................VlJIHOUT CERTIFICATE PIU1bers License 110. .................QF-'OCCUPANCY .. I. IIIU.. . I. ."__ LA 4. FINAL . CC <If.... MUlT . CCNU'I'I..c.o. ALL CONI'fIIUCI'IOfI IHALL MEET Electricians J.icense No. ..................... THE REQUlltlMENTI Of' THE N.Y. , STATE CONS1lIUCTION a ENERGY OtllE!r Trade s License No. .................... CODES. NOT RES~SI8LI FOR .' e:,.",& e"J' ~ lDloll>I.lh>'IOIllJ'Q.......... I. IDCllttOO of land on "nd. proposed won will be done........................ ..'1':':':'.. "'"" l'\fll'l't Qtl. maORS.... ................................................................. ~.~~~t?t ~....... .~.. .19.~:. h:-.l ~ .-.?:\ llouse Ib1lter Street l\Inlet Coonty Tux Msp lb. llXXl Section... ::r.Q...... Block .... \.Q........ I.ot .. :1-.\.......... &JlxJivision ....................................... viled, tfap lb. ........~"..... l.Dt ................ (time) 2. :~a::::::i: ': :=.~~.=~~~.~.~~~~~.~.:~.~~.~.=~:~~~~...... b. Intended use and occupancy ............~~~~..................................:......... I.. Esti"..ted east ....... ...;..;............ ""lIu," uf ~rk (dledtwildlappllceble)z Hew ~ndlng ../sl..... Addition .>.?.......AItU.tioh ..;-. .. fiil llel..ir ............ IlI!aovaI ............. llonolltlon ............. Other Work ..........I..t,1.:.0..ij..n.i1)..~ !l i (De~ Of... ;)'--- .., .1J i . -".;~I. P Ion 1" l'I ; I: . .. .,..,. 'II '+ !iil: .ee ............................... ........ ..'PQI. .'. .1. . \ (to be paid 'x, filing this .~if~~~~)_u " . ._.1 ..' If ,k",lI ina, .u.her of dwellln8 ..,iu ............ IlI.ber of 1k...1I1ng omits (x, esch floor........'....... ..,.,'f!" 1. 5. 6. 7. Jf garsget 'J..,IJe:r of car. a..................................... If Io,olueoo, cannerclal or DlI2d'oCClJl>BnCy, specify ns~rbnd extent of eaclbtype of use.~.................... IIlmenslono of existing .tructure., If any: Front.......!........ 'Re.r ..~........... Del'tlt ..!:-:~......... lluight ...~.50.~.~......'.. Illll...r of Stories .......'b.......~.. S- IIllIenoion. of...no .tnll:ture with .lteratlons or addition.. Front ...:.~... Re.r ....~ llepth .. .-:-... Sa...__..... llelght .................... 1l111...r of Stories ............... IlI"enslon. of entire .- construction. Front................ Rear............... Depth.............. l!eight ......................... 1l111...r of Storie. ..................... \. Size of lot. I'mor... ...LC?\?~.... Rear ....... \99......., Depth.. J.'i 0. ..(9:-~~\O ) 1~J1e nf PI.rd,ase .....1'\~~.::-:7::. Name of Fomer o...,.,r ... ~. ..:~..:.~.~. ~~ t~!-,.I!~..... Zoce or u... dl.trlct In ..told. preml.... sre .ituated ............ A.. ~ ~.Sk:............ ........... ..... . . .... . . .. No 1kJe. pmpnsed ""u.tructlon violate .ny zoning I.... ordlnsnce or regul.tlon: ........................ 11111 lot be regraded ,.........~R...... 11111 exce.. fill I... reroved fmll pr....l...s. YI!S 10 Nan.,s of o......r of preml...s .~.J:~:iI:.~':":-:-.. Mdre.. .............................. I'''''te No. ............. 8. 9. Ill. II. 12. n. 14. 15. Nme of Architect ......L~d.~................ Mdre.. NlIfe of C.ootrector ................... ~ .. . .. ... Addre.. T. Ihl. property within 300 feet. of a tldsl ""'tland? * YI!S *IF YI!S, InJnDD 1tHll1IJSmEII Pl!Jtfn' MoW IE RF.I~JJRl!I). .................:............ I'l101te No. .............................. ."lOOe No. 10 .......... nOT DIAGRAM~ 1.ocate clearly and dl.tlnctly all bulldl"ll8. .,bether exlatlng or proposed, and Indlcste all set-\>SCk dlnen.lon. rrm pro(..rty line.. Give .treet and block nunl>er or description according to deed, and show street oanes snd Indicate ,.'helher Interior or comer lot. llS'O ~, ? c:c c;,tc < 51 ~,~ \ fl- (:. ~ I V-.JtL \ 'iJ p..ka \!1 ~ I J )-.. ~c.. t L., r- 2.2 -\10 \ )1 100 i 8 lhe appl. i<:JUll of ....Id .....er or ownera, ond la duly authorized to I'erfonll or I",ve l>erformed the aaid work mkl to .nke and file II';" "Wi ic..til~,; thot 811 stat..."nta contained 10 thia oltpllcation ore true to U,e heat of bla knowledge 8lkl lxilief; ",.1 Ihat the work will he perf'Onned io the lllfIOlter net f'Orth io the appl.lcatl<x. filed tlterewith. ~.m 10 befure ne 1I.la ...... ...'f.:.j.. ...dny of ..~.......19.0-l... Notary PllltLic L.)~j~)~. . CloY~~. WILKINS Notary Public. State of New York No. 4952246. Suffolk Co~ra.. Term Expires June 12, '''''''"'l'"j ..~\..~ (Slgnot:nre of API'I iconr) Cj \ _______" "_~~_._____~___'_ ~ __"__ ~.___'_,.._____~,________..u_,~___~.. _',_--____ '- -'-'--~~--~----- " IJ() {) ,_ 71) _ / /) ~ ~ / TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER V.AL7eIfJJ. LL4I11SP'/ FORMER OWNER :::'ARjS, e~r/(9)J'C.~ ..-",(2- c. A A . 11 -E7'4.h.c. '- , SEAS. VL. EWO LAND 5'~() C, " () 000 I. ~ bDo AGE NEW FARM illable 1 illable 2 illable 3 'aodland Namplond rush land louse Plot IMP. 2-~c> 'Ii'IJ() <: / 0" ..; 9' ro .!;DOO NORMAL Acre M a..d. Ii" LOT ' STREET boo ~ '~a.-r:...:. ~v ./ r,f,~&.-",t~ ~ VILLAGE DIST. SUB. ~a:;d-Ub; s'" ACR. ... . 3 IX TYPE OF BUILDING E, . ,L, ' F' , _,. '. ~.::..,.,., '-" j' ',~. W . .r tP",.d', c fr , 2-~ '. S~I'\-1I"'1 FARM COMM. CB. MISe. Mkt, Value TOTAL DATE REMARKS 7 ~ 0 j S/s/ /,!;./ ..;.. ',I t?~ 7 I- 1.- ~. -C~i": ..i ~~tJ 0 ./ 2./~/f.{,. .JI}..In/~ ,/ ~.' /7i7'-U-~ I j /,'-/ /11- I~ ' J.. - f.!"If-'J , --: ,-- .{"j (1 () /////t-,}( 77/7k'SIf/'It..J.J~nrA.l-/)1I/O.i'-.lLI.I1.17 p- ~p, C::/JJlr~JI/c.1.",,,,I2-7AtJIIJ(ihWJ~""(,Jp .7:;-0-'0 ,,/..... 7/J. 'I/t 8 ./ 'L _' I.... ...I",/.~~ ~d d.. ~4 S(,OD / J/I$/7t. BUILDING CONDITION .,., BELOW ABOVE Value Per Acre Value FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD ~, .----~_._-, 1 COLOR ~ . !"-Iuhf - - ~ l , l"ii _c ..~ /. - " ." TRIM <1 .J . I , (~J/.;'';J!' ,c.. s{^ 1 .- f< f- II' t- ~ " , IA - ':01 fl . ." " , LI . ,. . - I ~ .., , I. Bldg. -'1".3)- elJI. ,/ #,ff:! g47Z,. ~ndation /::..8 Bath It. Dinette -c- I rjJ. k. <tension ~)~r,.':;;. I/-vn ~. ~~ /3 ~ .,~ BJsement vI-I.- Floors 6191{ --- <tension Ext. Walls ,..u"va '.......f I Interior Finish 51-!r:r7/~"eI< lR. xtension Fire Place h...D . Heat HW 8/? , DR. I ') L::c..~ /, x II - l R "7 1.5' Jt'7 Type Roof /..h-'~ Rooms 1 st Floor BR. I arch . Recreotion Room Rooms 2nd Floor FIN. B. orch Dormer ~/Ml'I'" {. '''is''' /ilL" J'/~~' 3reezeway Drivewoy iarage -- Patio O. B. .{rf(;~ fH 'i e.. - I,' I II) I), S /f-ui. / I Total I 4'1 f4': r// / * ;(07E ,.: 3 II Sit'IfL t20I-li;l1N CEJ1IJlt/ Fi/.l.J=l> CEMeitlr 840C.-<' FILLED g# . -1- .L:);:c. K 6;(1 X '" I.5'x, 1/ .~ OCCUP/\NCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE Of OCCUPANCY ""D EC '" st;f,~s . . . W AJ.:rEfi .:JC'#.4N.5S,J CACJ!=/Vs MN))/A)6 Sou7/1vL) /'>>'1-- ,,'11/ NoTES ~ = '{'Ix. 1./ n - c.e./f r: XLIII VRe./OHG (7c>~ ?~ g4' Rt?o-R EF,4".t1-S ~ "x J z" f> J.A 7"E )/X 6:/ SI/Jc ~A/~S ~X t/ /0/ ;(A./L. ~ ~E~K 2.X l~ f),1J. "E ~ ~ '(:: ... -1 /I '/ { H k '" X bU C A SL I DING ::::::j:)t$>D~ ,~ /( i 81 -rof f{,4tL- Sl])~ 1fAIL~ ~ ~ . r';"p ! i I , I , " 0- 'J \~ vi c~ ... ~ , o <0 N ." /~ --_._.-.-._--~..........-.;.......~..~~,. Rau:h , 8T ~8' 10" E. '" 8 S. 87' 58'10" SCALE! 30'= I" (0) . Iron pIpe 137.70 " ;" N 1. rr .. t~l r'f I ), 'T ...: I) tJ I!I....~ ~-1 ,: E '. e It III '" 'I .;." ~j ; ~.,T] ).,. II CO! ]j 'Ct-- "1 ()..r n ~! : + t' :: ?..., V) :r" :,1 ~ ~ t! N I' ~ 21] g, 'I I' ....1 N ~ . 2..~a___~_~ 1 '. 391.' . 14382 c. Gagen MAP OF LAND SURVEYED FOR CARL BUTkOViCH AT SOUTHOLD TOWN OF SOUTHOLD) N. 'f: Q o o o "1 o N "1 1\i > '0 <{ ... io- ~ UJ.- ,:> 0... NO ~l~ o <{ o DL \!.'l 2 a z ~ ..J ({) L III (!) <{ 19 ,-i.""'~ '~-;?: ~-'''':':''....~...:.:.~ l~0 'CG~ " N o \) '"1(- ~ ~ . I I I , ! , ". . L :": ",:'~:.;~J.~::-- " S,~,:,,'l i,':' .:' "_~, - ',-,' ~ ;-_,... f,..;,,"CqL..l:r.l"- i , i , , i I ! i i I I ! , I , t ", >,' 1]' ~hfssurve~'~a:l nl;t ~J.:, J ".. .-'1:ull'tl)'Or'sl1ksdse;:lor ...-..,~pdM81"'r.oIbIlCQn$i;::.; ',; l....:<a~.,...ClCp'f. (~ .:>:-:,ntcleslndlcGtedtMtf'8orH:N.~~.' .~ >':':'apersonfo(wtlcmtl'lv':""r :..'Ud, and on hIs h<'~l!;i", ~ -1 . '1'::;, [l~"3'rU:,'r,:~~ :'.. c.",.: ,(.' h.. ...- ....,. ~ ...~.;.,.._1.L Guaranteed TO -the Home Title Division - Chicaqo Title Insurance Co. and +~ Soutnold Sovinqs Bank., os survey~d Auqust 12. i~\)5 VAN "rUYL ft SON ~h-.7~. j I.Ic.ensed Land Sur '{on Greenport, New Yor l< ..--~-_.._. .-~-.----_..- ------ -.--.----.-- FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25813 Date: 07/09/98 THIS CERTIFIES that the building ACCESSORY Location of Property: 600 GAGENS (HOUSE NO.) County Tax Map No. 473889 Section 70 LANDING RD (STREET) Block 10 SOUTHOLD (HAMLET) Lot 21 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 24, 1998 pursuant to which Building Permit No. 24920-Z dated JUNE 1, 1998 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 STORAGE SHED IN REAR YARD AS APPLIED FOR "AS BUILT" The certificate is issued to WALTER A JOHANSON (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Form No. 6 TOWN 0 F SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR 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 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Comp.liance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "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. 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 - , .25~. 4. Updated Ce~tificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Da te .... ;r\l\l~. J . . ! ~~l} .. . . . . . . . .. . . . . .. . . . . .. . . ,w Construction........... Old Or Pre-existing Building................. >cation of Property.... ..~<?<? .<?~&o;~,: .I:~~~~Il.~d........... .~?~~~~!<!l. .l!:1:..................... House No. Street Hamlet WALTER A. JOHANSON lWer or Owners of Property........................................... ........................ ,unty Tax Map No 1000, Section.. .~l!........ .Block... 19.......... .Lot. .~l.................. .bdivision....... .~:..:v".{(f.3oSL.jY.ZiD;... .~~lzt.)MaP""""'" .Lot...................... ,rmit No.. ?~?~Q~....... .Date Of Permit. .6J.IJ'f>........ .Applicant. .~,,:m'l. J(qq4'&' J.)..tt).l'jp\1..... .~tty .alth Dept. ApprovaL........................ .Underwriters ApprovaL........................ Lanning Board Approval........................ .quest for: Temporary Certificate............ Final Certicate...xx:...... Ie Submitted: $ . . .~5...QQ . . . . . . . . . . . . . . . . . . . . . C3-...z. SI.{7J...CJ CO.cJ5813 . . . Th~>;~"1J .Qqigl.<:Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . APPLICANT