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HomeMy WebLinkAbout13250-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z ]5566 Date April 1 , 1987 THIS CERTIFIES that tile building ., .A,c. c. e..s .s?. r..y ................................... 37800 MAIN ROAD ORIENT Location of Property ~/~t~s~ ~o: ....... Street Hamlet County Tax Map No. 1000 Section 020 .Block 03 .Lot 009. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 25, 1984 , gp 13250. Z ....................... .. pursuant to which Buildin ermit No ..................... dated J u n e 2 5, 1 9 8 4 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 sro'rage barn. The certificate is issued to s c o t t L. tt a r r 5_ s ..................... ?o¥.'o;, ..................... of the aforesaid building. Suffolk County Department of Health Approval ...... .N./.A. ................................ UNDERWRITERS CERTIFICATE NO. .N./,~ ..... PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 FOIB,~ NO. Il TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PEPu~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13250 Z Date ...................... 19 Permission is hereby granted to: ......... ..~T..¢~../.7:. ....... .~., ...... ~.....,~ ....... ........ ............. ...... .G2.~z,....~..,..~ ...... ,o ....... ~'~.,~...,,x../=~.~...~.~......~...~.~.,~;~z~.~....~ ...... ~z~.~:....~,,~x~ premises located at ................. : ........... .~ ........... ~ ~'~,.~.. .... 19 ~' and o roved b the pursuant to application doted ........ ~...,~,~Z'~ ......................... , ..... i:,~ pp y Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 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 OR ink, and submitted i~ 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approva~ of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and sYmilar 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~"operty 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 requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of bccupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ,~...(~.~, j..~. i ~ 5. Updated C.O. $15.00 Date ............... New Building .., ,)~ ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~. 7K~t~ .~....~ .~. ~.~. ! .l~t....~..O.~-~. ............... . .O. I~.~t ~.~..% ~. ~..~., House No. Street Hamlet Owner or Owners of Property ....... ?.~ .O. ~'~...~.~,...L-*J~,t.~'~-,~.f2i ......................... Cea nty Tax Map No, 1000 Section ,, ,O, ~ ..... Block ...~. ~ ........ Lot...~..O...~ .,..~... Subdivision ........................ , ........ Filed Map No ........... Lot No .............. Permit No. [~.~-,~..(~). Date of Permit~l~..~/8.~c'.Applicant ,~T~..~..~.~/.~...~-='~.[.~. ....... Health Dept. Approval ....... ~.~ .......... Labor Dept. Approval ... ~.~ ............ Unde~riters Approval ...... ~ .[~ ........... Planning Board Approval .. ~.~.~ ........... Request for Temporary Certificate .................. ... Final Certificate . . ...~............ ..... Fee Submitted $.. described build~n~ and~rmit meets al pp~icabl co e~ and regulations. A~plican .................. ~EL~ INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICI~ OF BUILDING INSPECTOR ILO. BOX 728 TOWN IIALL SOUTHOLD, N.Y. 11971 TEL. 765-18O2 This in Co advise you chat the job under building permiC no. t3250Z innued to Scott Harris on 6J.~4/84 for Accessory ia completed a final inspect[on hen ( ) has not ( X'")''been done. and fn order to complete this file, it ia necessary that a Certlflcate of Occupaocy be issued. Please fill out the enclosed form, return same to the above office with a check for$10.O0 payable to the Town of S0uthold. Please'indlcate to Whom the Certificate of Occnpaney is to be mailed, and arrange with this office for an inapection date Oceepancy or line in nnlawful without a Certificate of Occupancy. l'lenne. I, eIp us to clear up th~. matter so that legal action does not hav~ to be taken. Thank you for yonr pro,pt attention. Very truly _your~, Victor Leseard Executive Administrator VL:gar 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [,] II~LATION~ FRAMING ["] FINAL ~'~ .......... /, ~ ,, DATE INSPECTOR March 20, 1986 Please extend B.P. ~13250 for six months. With this extension the permit is good until June 25, 1986. Thank you. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................. 19 Received..- . Approved Disapproved a/c ...~...~ ......... .~......~ - // . . , 19~.Q/Z~ INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter 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 lnspector will issued a Building Permit to the applicant. Suchpermit 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· APPLICXTION 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 applichble 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, ordinancestTl~uildiffg code, hgdsing code, and regulations, and to admit authorized inspectors on premises and in building f°r nece~i'~-.~t....~.~ . ~'~'~ '" - (Signature ¢t¢~pplicant, or i~ame, if a corporation) · (Mailing address of applio~nt) State whether applicant is(~ lessee, agent, architect, engineer, general contractor, electri~i.an, plumber or builder. Name of owner of premises .',~l=l~:~.t~,,, ~ ~..~l.P.r/..~. (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 ~rade's License No ...................... ! 1. Location of land on which proposed work will be done.. ~ ~1~.. ~_~..~. ~. g.~..~.~.~.. ~..~.~.2 House Number Street Hamlet County Tax Map No. 1000 Section .... ~.~. ......... Block ..... ~ .......... Lot ..... ~./~ .......... 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../. .'~. ~..~. .... ~..t~..~. .................................... b. Intended use and occupancy ~ ~... ~*~~ ~ ' 3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... o'~ (Description) 4. Estimated Cost ............................ i Fee~,.~d~..[t ~, ................................ ~ · ~to be paid on filing this application) 5. If dwelling number of dwellingl units ............... 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 ..................... .... if any Front Rear Depth 7. Dtmenslons of existing structures, . ........................................... Height ............... Number of Stones ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear ...... Depth ................. i... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction Front ......... Rear .......... Depth ......... 10. DateofPurchase ..,~.~.~! ................... Nam,e of Former Owner .~0~',~t .............. 11. Zone or use district in rwhich p(emises are situated...~.~'-~t~e~ ~...6.. 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~..~. ....................... 13. Will lot be regraded ... ~.0.~! .................... Will excess fill be removed from premises:,.,Yes ......... , ................. Address ................... Phone No ................ Name'of Contractor ................... Address .................. Phone No ............... PLOT DIAGRAM Locate clearly and distinctly ali 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. ~ ' STAff OF' N : copy__.. s.s ............ / "(Name of individual sighing contract) .I .... being duly sworn, deposes and says that he is the applicant above named. He is th~ ..... (Contractor , agent , corporate officer , etc . ) of said Owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this application; that all statements cont!ained in this application are true to [he best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this|' ' ...... Notary'Public,/ .. County /ff ~,, ,,,,~ i,,,,, ¢.,,,, "'