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Home My WebLink About11277-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z-16161 Date September 14, 1987 THIS CERTIFIES that the bmlding AGRICULTURAL POLE BARN Location of Pro err 4000 Main Road Laurel, New York P YHo.~o .......................................................... No. Street County Tax Map No. 1000 Section Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...J.u.l.y.. ! ?.,.. ! .9.8.1 .... pursuant to which Buildzng Permit No. 11277 z dated ......J u 1 ......... y 14, I .............98 I 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 ......... AGRICULTURAL POLE BARN The certificate m issued to JEANETTE HOMMEL ..................... ?oYn'~;,'~~XX'XX ................. of the aforesaid building. Suffolk County Department of Health Approval .......... .N./.A. ............................ UNDERWRITERS CERTIFICATE NO ............ .P.e.n d .~ .ng ........... PLUMBERS CERTIFICATION DATED: N/A ......... Building Inspector Rev. 1/81 TOWN O~ $OUTHOLD 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. 11277 Z Permission is hereby granted to: .... ~.~...~.......~..~.~.~.~..~ ....: £~.~ ......... /~.~z~.Q ............. : ................................ .......... L~..~:c-.r...~..:¥..: ......... u....? ,a ...... O~..~.~-~........~.?~z_,..cu~7~,/.~..~.. ...... ~a~.....~e.../.~..~... at premises located at .....~...(~.~.....~.. ......... ~.../.~........~.~....~.....~ ...... ..~......~..~.-/..../~....~.~../....-~....:;7,.' County Tax Map No. 1000 Section ..J..Z~.-... ........ Block ....... .?.~..~ ..... Lot No ..... ..~*...~..[. ......... pursuant to application dated ....... (./(.Z./...~....._/...~.. .................... . 19...~.../, and approved by the Building Inspector. Fee $...../....~.,~ ...... Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Depar~men,t Town Hall $outhold, N.Y. 11~71 APPLICATION FOR 0ERTIFIOATE OF OCCUPANCY BLDG. DEPT· TOWN OF SOUTHOLD Instructions A. Th~s apphcatlon must be filled in typewriter OR ink, and subr~tted in duplicate to the Building Inspec- tor w~tn 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 cerUflcate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of compteted site plan requirements where applicable. B. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of peoperty 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: 1, Certificate of occupancy $5.00 2. Certd~cate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1,00 Date.. New Budding , Old or Pre-existing Building(X) ......... ¢/Vacant Land - Locauon of Property .... ? ................... ~ .... .~. I -. House No. Street Ham/et Owner or Owners of Property ~.~ ~ County Tax Map No. 1000 Section .............. Block ............... Lot ................ Subdiws~on .... .Filed Map No ........... Lot No .............. ......... Health Dept. Approval ........................ Labor Dept. Approval ...................... Unde~riters Approval ........................ Planning Board Approval .................. Bequest for Temporary Certificate ..................... Final Certificate ........ Fee ~ubmltted S..I ~,.~ ................... e ' ' ets all appl~cable~codes and regulations. Construction on above d scribed building and permlt~m~ Applicant . _.~ , ~... ........... Rev. 10-10 78 TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR ' P.O. BOX ?28 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Permit No. ,, ---, . .~ - ~-=~ ~e 3oo und nspe~lon .as ~ na n~- ,~ ~ s .... ~ ueen done. In order to complete th!s fi!e, it is necessary that a Cerc!ficate of O ..... ~- -ssued. Please r4 e~c!osed ~ ' ~= -~y be ~ ,-11 out the · orm~s) , return same to the above off!ce wlch a check for $5.00 payable to the Town of Southold. Please indlcate to whom the Csrtificate of Occupancy !s to be mailed, and arrang~ w!th this ~' ~ o. zlce for an inspection date. Thank you for your prompt attention. Very truly y urs, Victor Lessard VL:ec , ~ Admanis~r~or Eric 1 os Ures . '~-~ -ho :. FORM NO. 6 TOWN OF SOUTHOLD Buiiding Depar~men,~ Town Hall 8outhold, N.Y. 11@71 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This applicauon must be filled in typewriter OR ink, and aubr~itted in duplicate 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 disposat-(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 build;ngs (prior [o April 1957), Nan-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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. Fees' 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ,, New Budding .~. ........... Old or Pre-existing Budding(:X) ........ ~ ZVacant Land -, .......... .............. ,.~3 ~..~.~..~.~t .......... · Ham/et Owner or Owners of Prope,ty ... ~.~~.,.,,.,. ~,~..,~~ Ltt .................... County Tax Map No..1000 Section ............. Block ............... Lot ................ Subdiws~on .................................,J Filed Map No ........... Lot No .............. ,~.rm,t No..I ~*.~ .~.. Da,e of Perm,t. :7 ] ~./~ I..~pp,,oant. %~..Vt0~ ** ~.l ........... Health Dept. Approval ........................ Labor Dept. Approval ...................... ~., Underwriters Approval '. ....................... Planning Board Approval .................. ~ . . ~ Request for Temporary Certificate ..................... Final Certificate ........ - ......... . Fee ~ubm,tted $...¢, ~ .................... Construction on above described building and ~_ern~it~meets all appf~cable~co.des and regulations. Applicant., ... ,.~. ~~ ./~ .............. Re~, 10-10-78 FIELD ~NSPE~CTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ~',- o, 6u'C COMMENTS ~ , ~ . , ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 D]sappro/ed a/c ........................ k/~ ........... ........ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No././. ?.< .'~-- ."3.... a. This application must be completely filled'~in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl: cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this apphcation, the Building Inspector will issue a Building Permit to the applicant. Such pern 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 Buildh~g Department for the issuance of a Building Permit pursuant to t Bui/ding Zone Ordinance of the Town of Soutbold, Suffolk County, New York, and other appl5cable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or .for removal or demolition, as herein descfib¢ The applicant agrees to comply with all applicable" laws, ordinances, building code, housfng'code~.~d regulations, and admit authorized inspectors on premises and in buildings roi necessa~' inspections. ~ ,4 (Signature of applid'ant, or name, if a corporation) (M' o pp' ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Name of owner of premises ....... :. .~)'3.1TI ............................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... ~'. ? . ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............................................... House Number Street tlamlet County Tax Map No. 1000 Section .... ~..51~ ........ Block ...~ .............. Lot.. ~.5 ............ Subdivision .................................... '. Filed Map No ............... Lot .............. (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 ............................ ' ./,'ff.. Addition Alteration Nature of work (check which applicable): New Building .......................... Repair .............. Removal .............. Demolition .............. ' Other Work . ......... ., .... ~.~.:../Z..~..: e~,,/.~.Z~..~.~... (Description) _ Estimated Cost ........... Fe ............. ~ ......... ' (to be paid on filing this application) If dwelling, number of dwelling units ............... Nmnber o f dwelling units on each floor ................ If garage, number of cars. ................................................................. . . ... . If business, commercial or mLxedoceupancy specify natumand extent of each type of use .................... Dimensions of existing structures if any Front Rear Depth Height ............... Number of Stories ....................................................... 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 .......... ' Rear Depth Size of lot: Front ........... , ..................................................... 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 ........ Nmne of Architect Address Phone No Nane of Contractor ' Address Phone No PLOT DIAGRAM Locate clearly and distinctly ali Ibuildings, whether existing or proposed, and, indicate all set-back dimensions from :operty lines. Give street and block number or description according to deed, and show street names and indicate whether Aerior or corner lot. OUNT. X_OF .,~...o ~ (Name of individual slgmnE contract) ~ove named. is the ..................... ~ ................................................................... (Contractor, agent, corporate officer, etc.) said owner or owne~, ~d is duly authorized to perform or have performed th-e sgid work and to m~e a~d file ~is eplication; that ail statements conthined ~ this appliMtion are true to th~ best of his Bmwledge and belief; ~d that the 'ork will be performed in the m~n~r set forth in the application filed therewith. worn to before me t~s ~ ........ ............ .... ....... , ,otary Publ ~ . Count H0t~. Pubhe, S~ate of New,York ~. 52-0344963 Suffolk G~un~ · .~..........Z..~ ........................... i~V~ ~pires March $0~ ~ ' (Signature of applicant)