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HomeMy WebLinkAbout15779-ZNo Z-17502 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date NOVEMBER 10g 1988 THIS CERTIFIES that the building Location of Property 2495 VARSTON ROAD House No. County Tax Map No. 1000 Section 111 SubdivisionSEC.D NASSAU FARMS ACCESSORY CUTCHOGUE~ NEW YORK Street Hamlet Block 06 Lot 86 Filed Map No. 806 Lot No. 357 conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16~ 1987 pursuant to which Building Permit No.15779-Z dated MARCH 19~ 1987 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 APPLIED FOR The certificate is issued to MARK & FRANCES SQUIRES (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Building In~ector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted l~ 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 features. 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 featu res. 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 $25.00 ALTERATiON $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory '$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ I00.00 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. . OId or Pre-existing Building Vacant Land Location of Property ' ~J ~%~,~--. ~-~. . .~.~. ~..~..~ . .~ .~ ~ ~' House No. Street Ham/et Owner or Owners of Property ¥~t~, .~_ ~ Co~. ~_ County Tax Map No. 1000 Section ...%.~.~ .......... Block .... .O.(~ ........ Lot ................ Subdivision.. ,~'¢, ,f~,,, .~,. ?...~. ...... ¥~, ~C. ..... Filed Map No..~,h ....... ,Lot No ........... Permit No.~.~.?.-I.~ 7-- Date of Permit .Applicant , .V'~. o---\.~ Health Dept. Approval ........................ Labor Dept. Approval .................... .. .. Underwriters Approval ........................ Planning Board Approval ................ .. . .. . Request for Temporary Certificate Final Certificate o,oO ....... Fee Submitted $ ......... Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... Rev. 10-10-78 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJVtlT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15779 Z Permission is hereby granted to: .~,~.2. ~~...~ · ....... ~L%...~.~......~..: ................... ....c.,.~.~.~....~:~.:...~.l..Z~ ....... ..~.,. ~,, .~ v 0 ~ ~,,.m,,.~. ...... ~....~ ....... ~~ ................................. ~ ............ County Tax Map No. 1000 Section ....... ~...~./. .......... Block ..... ..~..~. ....... Lot No....~..~.. ............. purSuQnt ,O opplJccltjon C~lted .... ..~...~....l..~. ............... , I9.~..~.., and opproved by the Building Inspector. Fee $..~...~./..:..~ Building Ins~ctor Rev. 6/30/80 /~777~' 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLBG. FOUNDATION ZND [ ]INSULATION FRAMING [ ~FINAL REMARKS= 765-1~0Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [/.~INAL REMARKS: OU:~DATIO.U ( 1 s t ) OUNDATION ( 2nd ) OUGH FRAME & ?LUMBING iNSULATION PER N. Y. STATE ENERGY CODE FI;:AL ADDITIONAL COMMENTS: TOWN OF SOUTIIOLD OFPlCF. OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL SOUTIIOLD, N.Y. 11971 To Whom This May Concern, TEL 765-1802 We are unable to complete your Certificate of Occupancy because .of the following reasons. _/'./~An application is ~lot on file. / / ?lo Underwriters /~ Thc check /~/ /]/ for Certificate of Occupancy Certificate on file. is(c~ed/not ou file.) ~/O,~_~ IIealth Dept. Approval on file. final inspection has been made. P]ease coDtact our Thank you for your Suilding Permit I~ Building Dept. ***/~/ I~o Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) office on this matter. cooperation. I J___7 7 _C z Z 0 P M,~,~ OF LANO ~_.. I C HAl2__ D ~-[ ,AT Tow,'-~ oF 5od-r~o~o , N.Y.' 14AR I 6 1987 ., 19~.~ ., 195.~. Permit No.]. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 (,.~M~A I ~ Disapproved a/c ..................................... (Building Inspector) APPLICATION 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 approvai 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 pumuant 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. ., ........ (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 .... .fl.~./~..,.~... ~..~.'('..~./'..~. :c7c.~...~.:...~.?c:'.{./.n~.'c~'c~' ............................ (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No.....t~....%~. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location oflandonwhichproposedworkwillbedone~ ~..~.t/~{5-~?y/~ 2~/~d/~ ) House Number Street Hamlet County Tax Map No. 1000 Section .... /./. ( .......... Block ...... .~o. .......... Lot .... ~x.~ ......... Subdivision ..................................... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing useandoccupancy ,~-Y Z .~.'~ ~ b. Intended use and occupancy ~o.,te~ /~ ~//.t~..~.~/.~./.. o 15. Is this property located within 300 feet of a tidal wetland? *Yes *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work. ,/'~.~"./.~. ~ .... ¢~ (Description) Estimated Cost ....... .x~5 .~a. Q .......................... Fee ...................................... ' (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................ ¥ ............... If business, commercial or mixed occupancy, specify nature and extent of each type of use .............. D~nens~ons of ex~tlng structures, ~f any: Front ..... Z'.~©. ....... Rear ... f.<7 ........ Depth .../~.. ......... Height .... /~..' ....... Number of Stories ........... D..A~..~. ........................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .......... · ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ...................... Rear ...................... Depth ...................... Date of Purchase ............................. Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 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. OCCUPANCY OR USE IS UNIgWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTE~ NOTIFY I/IUILD!NG OEPARTMENT AT ?ta5-1802 9 ~ TO · PM ~R THE FOLLOWING ~U~DA~!ON ~O ~Q~RED FOR P~URED ROUGH ~RAMING & ~UMBING 3, INSULA rlOr,~ gTATE OF NEW YORK, S.S ~O~ ~OT ~S~'s*~:t~' ~I SOUPY OF... ~N O~ ~t ,,-, ', ,,~ ,, .............. , '~F ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. {e is the ......................................................................................... (Contractor, agent, corporate officer, etc.) >f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application 'are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this ............ : ........... day of ... 4otary Public,.. ~.--~-:..... '.~.-.. ~.&. ~./.ae,.,_... County . . ~ 4~87~ ~ (Si~at~ of applicant) T~ ~r~ ~ch ~, 19 --~