HomeMy WebLinkAbout13555-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z17309
Date SEPTEMBER 15, i988
THIS CERTIFIES that the building
Location of Propert~
AGRICULTURAL
1645 PLATT ROAD
24670 MAIN ROAD ORIENT
County Tax Map No. 1000 Section 18 Block 6
House No. Street Hamlet
Lot 4.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 24, 1984 pursuant to which
Building Permit No. 13555Z dated NOVEMBER 20, 1984
was issued, and conforms to ail of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is AN AGRICULTURAL SHED.
The certificate is issued to
~. RITCHIE LATHA~ JR. & JAMES P. LATHAM
(owner, X~)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N595535
~B~ing Inspector
Rev. 1/81
FO]B,~r NO. Il
TOWN OF $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 13555 Z
Date
Permission is hereby granted to: , _ . /~
~.~::...~..?../...~.-.. .......................................
· ~.,..11~-
^ ,_ ~ ......... ~. ........... ~.......2 ................
.,..~.~: .T~.. ~ ' ~, '
at premises located at ...... __~..,~.. ......... .~..3,.~....~ .......... .,..~. ....... .~~ ....
County Tax Map No 1000 Sect on 0 ! .~. Bock /- .... 'a~-L~ /
................................ ~ ......... LOT INO ...... ,%'~R ~%..9..(. ....
pursuant to application dated ...~.~.....,~...~. ................ , 10~..~..., and approved by the
Building Inspector.
Fee $&......: ..............
Building Inspector
Rev. 6/30/80
'BLDG, b£PTi"
TOWN OF SOUTHO,LD ....
FORM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N,Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter O R ink, and submitted m ~ 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, e 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.
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.
Fees:
1. Certificate of occupancy $25.00 -- BUSINgS$ $50.00 ACCgSSOR¥ $10.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.'00, over 5 years $]0.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Date ..........................
NewC°ns t'ruct i°n.. .... Old or Pre-existing Building ............ Vacant Land ......
Location of Pro-ert' /~A' ][P~"~ /~P ~ ~.7.~. ~/~ ~O/~'~ ..~.~../.~..~..~'
House No. Street Ham/et
Owner or Owners of Property .............. ~... ! ............... ~ ..... ~-~ .
County Tax Map No. 1000 Section ....~./..~. ....... Block .... ~. .......... Lot ................
Subdivision ....................... ;~..,...Filed Map No... ;. ...... ..Lot No ..............
Permit No.[.~..~'.E"..(..'~.. Date of Permit ./.~.~..~..Applicant..~.".
Health Dept Approval Labor Dept Approval '
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .....................
l.¢ ---
Fee Submitted S ..................... -
Construction on above described building and~permit meets ~ll applic, cC)le codes and regulations.
.........................
1000773 THE NEW YORK BOARD OF FIRE UNDERWRITERS
~ BUREAU OF ELECTRICITY
~- 85 JOHN *STREET, NEW YORK, NEW YORK '10038
Oate March 10, 1983 ~.p.~.~o. ~o. on~ 205718-83
N 595
THIS CERTIFIES THAT
only the ~{ect~a3 e~uip~ne~ ~ ~rlbed kel~ and i~r~uc~ ~.~ appli~nt named on the able application number in the premises of
~. ~cne ~ ar.. ~r~aCe ~. oz~ ~ ~v~ ~,, Orl~c, N.Y.
in H, e followlng location; ~ Basement ~ 1st Fl. ~ 2nd Fl. ~ Section Block Lot '
was examit~d on ~1 7, ~.~3 and /ound to be in compliance with the requirements of this Board.
FIXTURE
OUTLETS
EECSPTACLES SWITCHES
6 2
DRYERS FURNACE
FIXTURES RANGES =OOKING DECKS OVENS DISH WASHERS
FLUORESCENT
FUTURE APPLIANCE FEEDER~
TIME CLOCKS MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT
OTHER APPARATUS=
S E R V I C E
NO OF CC, COND.
PER ,~'
1
A W, G, NO OF HI-LEG
OF CC. COND,
A.W G FNO OFNEUTRAI
OF HI-LEG O~- NEUTRAL
E-ectric Roan Heaters: 1- 2.5 K. W.
1-GAF.1.
Arthur Ruroede
Main Road
Orient, N.Y. ~ 11957
Lic. #2334
GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board if inco~'rect. Inspectors may be their credentials.
COPY F CERTIF ( MANNER.
FIELD INSFECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
FLUMBING
INSULATION PER N.
STATE ENERGY
~ODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF $OUTHOLD
OFFICE OF BUILDING INSPECI'OR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N,Y. 11971
TEI. 765-1802
This is to advise you that the job under building
permit no. 13555Z issued to G. RichieLatham
on 11/20/84 for Agricultural building is completed and
a final inspection Was ( ) has not ( X) been done.
In order to complete this file, it is necessary ~hat
a Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for $10.OOpayable to the Town of Southold. Please indicate
to Whom the Certificate of Occnpancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very trul
Victor Lessard
Executive Admln{strator
VL:gar
encl.
TOWN OF SOUTItOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. i 1971
TEl,. 765q 802
This is to advise you that the job under building
permit no, 13555Z issued to G~ Richie Latham
on 11/20/84 for Agricultural buildinq is completed
a final inspection has ( ) has not ( x) been done.
and
In order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for $10.00payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupanc~y. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very truly ~,
Victor Lessard
Executive Administrator
YL:gar
encl.
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ]
FOUNDATION 2ND [ ]
FRAMING
REMARKS:
ROUGH PLBG.
INSULATION
[ ~FINAL
DATE
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved ~....~J~'~.. ~..~.o.., 19 ~. !. Permit No. J. ~.~.~.~.-.ff..~.
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 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 throu~out 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 co, de, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary in~l~ectio~a~., .~ ( .,~ [/
.......
(Signature of applicant, or name, if a corporation)
i?Z. ....
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ..~-.'~..~. !' .0~.. ~. [.~....~../c./.~.~,.~... ~..-..../~..~.....~.....ff~.... ?.:. ~
(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... · .~.~..~?... ?./?.~....~.L../~...~....?..~... ~ ........
....................... O.
House Num bet Stree~ ..................... I~I&~n'l;i) ........
County Tax Map No. 1000 Section .... /..~. ........... Block ..... ~.. ........... Lot...~....~.Z/( .........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... ~..~..l..~.td .&..~'~...~-. ..............................................
b, Intended use and occupancy ....................................................................
Repair .............. Removal ...
Estimated Cost ..
5. If dwelling, number of dwelling units..
of k ( ppli ) ' ' ' ' :
Nature wor check which a cable: New .Building ..... Addlhon .......... Alteration . ~ .... ~ ....
......... Demolition ........... ... Other Work ...............
~ (DesCription)
............... Fee ......... ,, ................... ; ........
'" (to be ipaid 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 i Depth
Height ............... Number of Stories .................... :
Dimensions of same structure with' al~erh~ons or additions,: .Front ........ ... Rear ......... : ......
Depth ...................... Height ....... ~' · 't ........... Number 95 Stories ............. r. ........
8. Dimensions of entire new construction Front ~ o . ~-r F~o : r~,,,h
Height ...Uo .......... Nur~ber of Stories ............. t .............. .............. ~ ..............
9. Size of lot: Front ..... 2.~ Rear . ..~.~.2....' !Depth /ff2,~ .. /. .
10. Date of Purchase ...~/~-~.... l .~.~. ........... Name of Fo'r~e'r 6~v~;;' i--~' ~..~]. ~2~'~o/~/
I 1. Zone or use distriqt in which premises are situated ~t~r~t. 1~O 6~.TiJ..~.. '~ .......................
12. Does proposed coii~trucQon violate any zoning law, ordinance or reoulation' 7~/0
13. Will lot be regraded .... ~.,...~.q..,; .... ..: ..... _. ~ill excess ill! be removeld from premises: Y~s
14. Name of Owner of premises ~....~.l.~..~./. q'~ 3~.~.. 3~'dress .. tg~ l~.. .... ' ....Phone No. ,-~ 2~..-'..~.~ [.~.
Name of Architect ~-' Address Phone No
Name of Contractor ~ · .............. Address .................. Phone No ....... ; ........
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. ir dieate 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. '~, ' --
5
STATE OF NEW YORK,
COUNTY OF .......... ....... S.S
................................................. being duly sworn, dep6ses and says that he is the applicant
(Name of individual signing contrac
above named.
He is the
(Ct tractor, agent, corporate officer, etc.i
of said owner or owners, and is duly authoriz{d to perform or have performed the shid work and to make and file this
application;that all statements contained in th!~ application are true to the best of hii knowledge and belief; sad that the
work will be performed in the manner set forth i~ the application filed therewith.
Sworn to before me this [
........................ day of ..................... 19 .~.
... '.~ ...... ~ , ~ ~ ~-
Notary Public, . ....... ~.c. g-. ~/~ County ,, !i~/,:"
HEI.['N K bE ¥OE '" ...... '~
PUBL,¢, Stat~ of Ne',', ','ink ,~ ,'~llllt''ll~l~'a;ure
NOIARY
of'
applicant)
No. 4707878, ~flot~ Count~j~ ' '
lerm Expires M~,rch 30, 19~- , i ,:
N.37o2~',
Iq 57~6'20"E.
~° 5z' 4°" v/
-DC. ALE
,~' lr2o'4 PIPE
AFZ E'A I
?
NOTED
~, ~,. ~.. ~_
FEE:_~. ' '""' BY:
NOTIFY, BUILDING E~EPARTMENT A1z
765-18~2 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR pQURFD CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULAJION
4. FINAL - CONETF?.?'FION MUST
BE CmMPI.FTE rz~R C. O
ALL CONSTRUCTION SI{ALL MEET
THE REOLJIRnMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.