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Home My WebLink About11766-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-t8475 Date OCTOBER 17~ 1989 THIS CERTIFIES that the building Location of Property 3070 WELLS ROAD House No. County Tax Map No. 1000 Section 86 Subdivision HORSE BARN PECONICr NEW YORK Street Hamlet Block 1 Lot 10.4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 15~ 1982 pursuant to which Building Permit No. 11766-Z dated JULY ir 1982 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 HORSE BARN FOR PERSONAL USE BY OWNER OF PREMISES. The certificate is issued to MAUREEN RINGOLD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ding Inspector 11766 (*FILS PERMIT MUST BE KEPT 01~I";~H,E COMPL~ION OF THE WOKK AuTHORizED). ~ Z '~ote S, 0NTIL F~.U LL Pe:rmissior~ is hereby granted ~0 at ?emises located at Tax Mop No. 1000 Section ....L~. p~ffs~ant to~ apphcat,on dated .,./.~,r~..~'...~..,:~....,,.~,.~.... ,;..; ...... ~ t . ....., 19~ and approved by tho Inspecto~ TOWN OF SOUTHOLD BUILDINC DEPART)lENT TOWN HALL SOUTUOLD, NgW YORK 765 - 1802 1197 APPLICATION FOR CERTIFICATE OF OCCUPANCY County Tax Map No. DATE ./.0 . HOUSE NO. STREET HAMLET O~ner or Owners of Property... 1000 Section .. . BIock Lot' Subdivisiou ....................... Permit Health ,.~ Filed Map ........ Lot...~.j~.... : . ' NO. //.~b~-...Date of Permit ..... Applicant . .. ) '.~. Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request Fee Submitted: for Temporary Certificate Final Certificate APPLICANT. . .~.~...~..-. .~.. rev. lO/14/88 FOPJ4 NO. ~ TOWN OF SOUTtlOLD BUILDING DEPARTHENT TOl~ff tlALL 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS 'This application must be filed in typewriter OR ink and submitted to the Building Inspector with the folliowing; for new buildings or new use: ]. Final survey of prop{erty with accurate location of all buildings, property lines, Streets, and Unusual natural or topographic features. 2. Final approval of Nealth Dept. of water supply and Sewerage-dlsposal(S-9 form). 3. Approval of electrical installation from Board of Fire Under~rlters. 4. Sworn statement froml plumber certifying that solder used in system contains l~ss than 2/10 of ]Z lead~ 5. Commercial buildings~ industrial buildings, multiple residences and similar. buildings and installations, a certificate of code compliance from the Architect or Engineer responsible for the building. . 6. Submit Planning Board Approval of completed site plan requiremen'ts. For existing buildlngs.(Prior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land'!uses: l. Accurate survey of property showing all property lines, streets, buildings and unusual natural or t6pographlc features. 2. A properly completed*Mapplicatlon, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, I957. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing c'ode or safety inspection of buildings or premises, or other pertinent informationi required to prepare a certificate. For Vacant Land Certlflc~te of Occupancy: ]. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of'the entire lot prior to April 9, I957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall State the reasons therefor in writing to the applicant. FEES: I. CERTIFICATE OF OCCUPANcY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration to Dwelling $25.00, Swimming Pool, $25.00. Accessory building $]0.00 Addition to AccesSory buildings, $]0.00. - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $/00.00. 3. Copy of Certlflcage of Occupancy - $5.00 - over 5 years - $10.00 4. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificlte of Occupancy - $15.00 rev.: 10/ld/gg FIELD' INSPECTION 1. FOUNDATION ( 1 s t) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C DE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN 0:: SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~ TEL.: 765-1802 E.,a,nincd. ~'~./.t.'. ~ .. 192.~ ............... l~..¢~- Permit No./f~.~..~.~. Disapproved a/c ....... : .......... · .-' rs~,~ii~;,i~/t;;~ ' ' ' ' ''" '" APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ^.plicatio..o../¢..7~( ..... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Build/ Inspector, w/th 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or areas, and giving a detailed description of laybut of property must be drawn on the diagram which is part of this ap[ cation. c. The work covered by this application may not be commenced before issuance of Building Pea'mit. d. Upon apprc'.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen: 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 Occupan shall have been granted .by the Building Inspector. APPLICATION IS HEREBY MADE to the Bvilding Department for th~ issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town ~f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construct/on of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspcctors on premises and in buildings for necessary it~p~c~ ,... '/) ,~gnature o f a@phcant, or ~3m~' '~~/4/ : ~ .~...~. ~ .... : ..... State/~_'.~.ti,~t is mvner, lessee, agent, architect, enginee}: ~eCralt~c'°ntC~ct°r'/~c~tn~'~/a~' ~m~°e~r~uild (as on the tax ~1~ or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No ...... ~"'.-~.,.~~/ Plumber's LJcens~ No ........... L/ ............ Elactrician's License No.' ................. Other Tradc's Liccn~e No ............. - ........., '. - I. Location of land on which proposed Work will be done .... · ............ '.' House Number Street Hamlet County Tax Map No. 1000 Section 0.~.~. Block 0.{ .... Lot. CIJO. r.O.~..c/r ~~ ~--- ............... ~> · ....... ~ ........ Subdivision .............................. ~ Map No. /. f .... (Name) ........... Lot .......... 2. State.existing use and occupancy of premises and intende~ use and ~ccupancy of proposed construction: · . ~,,sti.g u. and occupa~c~ ~ C~ C. a ~-Y ,.. ~- r~ o_ ' ~ .~.r,~'.:, :: :~" '" .................. .... b. Intended u. and OCCUpanCy .~"~.0...¢~...-~-.... · ': , '., ... ,-. ............. ..... Nature of work (chcck whicl, applicable): New Bt[i~ding ..... Addition .......... Alteration ......... Repair .............. Removal .............. Damolitian .~........ .... ~.. Other Work .............. ~ x~ ~ l Es,imated Cost . . ~ . ~ ~ .~. ~. ' ~ (to ~ paid on filing ~ application) 1~ dwelling, number o[ dwelling units ............... Number o ~ dwelling units on each floor .............. If garage, number otcars .............................................................. . If business, commercial or mixed occupancy, speedy ~ature and ~xtcnt of ~ach type of u~ .................. Dimensions of ~xisting structures, if any: Frov.t ............... Roar .............. Depth ............ H~i~lit ............... Number of Stories ..................................................... Dimensions ofsame st~ctur~ with alterations or additions: Front .................. Rear ............... Depth .... Hei~l~t - t ~.~. Dimensions of entire new construction: Front ~~.~ ~ ............. Depth ............. Height .............. Numar of Stories ..'. -- · ss onot: . .... ..................... D Zone or usa district in wht~ premises are situated...~..' ........................... '~j.. ................ Does proposed cons~ction violate any zoning law, ordinance or regulation: ...~.~ ...................... Wi~ lot bc regrad~d t ~'~..(~h?~?'J~. ~{~.~. Wi~ fill be Name of Owner of premises .~A~C~ ~..~q~a.[~ Add~,~. ~h~.. V~g~G. ~one No. Hame et Architect ......................... ... Address .................. · P~an No ............... N~e of Coutractor ........................... Address ................... Phone No ............... PLOT DIAGRAM Locate clearly and distinctly all buildiv.gs, whether existing or proposed, and, indicate all set-back dimensions frov. toperty lines. Give street and block number or description according to deed, and show street names and indicate whethe .tcrior or corner lot, rATE 0 F N FxWc~----YI~ R K~/~~ _ ....... 'r aC g cOh- i ......... t -ing duly ~worn, depo~ ~ad ~y, ~t h* i~ ~, ~ve named. ~ ~(Contrac ~' ' ' ' ~~r:'''~ .................... ; ................ els the a~nt, corpo~te o~cer, etc.) said owner or ownem, ~d is duly autho~ to perfoml or l=ve ~rformed the sa~ wo~ ~d to m~e and ilia ~plication; ~lat all statements contained in ~ application a~ true to the ~st of hia~Ow~dg= ~ ~li=f; and that the 'ork will b= performed in tho m~ner sot forth ~ thz application filed therewifii. worn to b~fore me ~is r"~JF~y~UiLDING D~'~ARI'MENT AT NO FOLLOWING INSPECTIONS: DE CGMPL~TE FOR C O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR FOONDAT?O~I PlaN, ,t% ~' F'KOD~ P~A AI