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HomeMy WebLinkAbout12852-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16186 Date September 18, 1987 THIS CERTIFIES that the building .... A.q .R.I.G.U.L..T.U.R.A.L...sT.qR..ag.~' .S...S.H.?. ?.Z.~.q. pv..z.n.n.n~c Location of Property 39395 Main Road Peconic, New York House No. Street Hamlet County Tax Map No. 1000 Section 085 . .Block 02 .Lot 007 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Boilding Permit heretofore filed in this office dated January 30, 1984 pursuant to which Building Permit No. 12852Z dated.....February. ...... 1, 1..........98/4 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 ......... AGRICULTURAL STORAGE & SHIPPING BUILDING The certificate is issued to ... c. J. VANBOURGONDIEN, INC. .................. ?o¥,,'o;, .................... of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO ................. N 8309/45 ~/A PLUMBERS CERTIFICATION DATED: / ..... ~¢:7 ..... )v.. ~..,--r...a~ ........... B~lding Inspector Rev, 1/81 FOIL~ NO. ~ 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) 12852 Z Permission is hereby granted to: .... ~..~.~.....~.~..~o~.~...~_. ...,?.0....,...~.~..~.....~..~ ............................. _ ._::.....d~.~....~..~ .Y.: ........... ./../..7.~Z... - ,o ' ' ......... ~/7 · ..-..~,.~.~.',~'.......~ ......................................................... ~ ..................... ../9 ............................. Tax Mop No. 1000 Section ...~.] .-4~...~2..~. ..... Block ....~.....~'.. ........ Lot No. "~)~)"7" County / pursuant to application dated .... ~..~..~'..~.. ............................ , 19~...~., and approved by the Building Inspector. Fee $.Z~., '.~,,.~ ...... Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE O Instructions A. This application must be filled in typewriter OR 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, a certificate of Code compliance from the Architect or Engineer respons b e 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 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 required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of'occupancy on pre-existing dwelling $ 50.00 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 ...................... New Cons truct ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~. ~, ~ ~..O..~. .......... ~,/~ (.A,r., ,/c~? ............... House No. Street Ham/et Owner or Owners of Property 47 ~ .~.~,'~L~ ,~. ......... ~.,~;G ~,~ l.~,t~,q . /.~. .~ ...................... County Tax Map No. 1000 Section ... ,~'. ~?~, ' ...... Block .... .~..~,~ ....... Lot....~) ~(f,). ~ ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/~"4~ ~ Date of Permit . licant ....... ~.% ~.', ........... . Health Dept. Approval ........................ Labor Dept Approval ....... , ................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~Septe[~ber 9th 1987 es JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT C,J.V~ Bourgondien T~c,~'~'/S Route 25 E/0 Bridge Lene.Pecort. fc New York in the followlng location; [~ B~sement [~lst FI. [] 2nd *~7. Section Block Lot was exatnlned on ~U~LI~t ~0 ~.9~7 aad found to be in co.~pliance u, lth the requiro.*e~ts ~f thls Board. FIXTURE OUTLETS EWITCHES DRYERS ~XTURES RANGES OVENS INCANDESCENT FLUORESCENT 4 MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: Panel~ ]-17 C:tr 200 a~pS MOtors 5-F HP S E R V C NO OF CC COND ~ A W O. J E Cheshire & Son Inc. PO Box 243 Calverton ,New York 11933 This certificate must not be altered in any manner; return to the office of the Board if rinCorrect. COP~Y EOR ~BUILDING,DE~AETM£NT. THIS CO~, 0C GENERAL MANAGER may be ideptifled by their credentials. IN ANyMANNER, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because,of the following reasons. /Z/ An application for Certificate of Occupancy _~s not on file. /_~. o Underwrite___rs Certificate on file.-~ /Z/ The check is(outdated/not on file.) /5/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. ~uilding Permit # 2~/ ~ ~ ~ ~ Z / Building Dept. / ~ d3 O / ~ ***/5/ No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) FIELD INSPE~TIO~ FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR I'.O. BOX 728 TOWN IIALL SOUTtIOLD, N.Y. 11971 TEL. 765.1802 This ia to advise you that the job under building perraJ r: no. 12B52Z issued tn CJ Van Bourgondien o,, _2~1/8!_~-_['i~]-~-o7 Agrioultur~_--~ui!ding _ is completed ;J firlal 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 $10.00 payable to tile 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 ia un]awful without a Certificate of Occupancy. Please help u~ to clear tip thi8, matter so that le;~al action does not have to be taken. Thank you for yo,r prompt attention. Very truly Victor Lessard Executive Administrator VI,: ga r enc! . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . .~.~./ ....... 19& ~ ^pproved ....... pe it No../.Z. Disapproved a/c ...... ~ ............. ..... "'(l~uilding Inspector) APPLICATION FOR BUILDING PEFIMIT INSTRUCTIONS Received. ,~, ~./. ~f .... 1 9 ~ a. TbJs 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 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 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 code, housing code, and regulation_s, and to admit authorized inspectom on premises and in building for necessary insp._~e.ctj,ons. (Signature of applicant, or name, if a corporation) .... .... A'..Z (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If apgli;canJ; is a corpo, r.~ftion, signature of duly authorized officer. ,~ (Name and title~ff corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Locationofland on which proposed work will be done ......................... ;.,.-%. ..................... House Number Street Hamlet County Tax Map No. 1000 Section ..... ~ ....... Block ...a.~ .......... Lot..(d~.Z ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building .~/. ........ Addition .......... Alteration .......... Repair .............. Rem'oval .............. Demolition .............. Other Work ............... : (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling 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 ..................... 7. 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 8. Dimensions of entire new construction: Front ......... , ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ....................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ." .... ~ ...... .o ............. Will excess fill b~e removed from premises: Yes _ No 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~ indicate all set-back dimensions from property lines. Give street and bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF N~) RJ~aZ. /~, C/OId~TY OF r"~' ' ~ .... · ~ ~me of~dividual s:' above named. ining contract) being duly sworn, deposes and says that he is the applicant He is the ................ ~2-.¢.4.x~,~-q..~_~... .......................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dhly authorized to perform or liave performed.the said work and to make and file this application; that all statements cogtained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manrler set forth in the application fiIed therewith. Sworn to beforgme this ....... ~--.'~'...day ;f ......... 19~J~. Notam Pu~lic ............ ............. ~/ ....... / ~~~"-:'~ ...... ' ~// ....(Signature of applicant) '1 ~ c~LI" L L_ r tF i I¢'-c~'x 14L¢'" I iL ¢' I. '~ I 2, ~OUGH - FRAMING & PLUMBING I¥ CP~TA ~ U "~' 3. INSULAT!ON 4. FINAL - CrqNSTRUCTION MUST BE COH~PLETF FOR C O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. ArZTW U [2-.. C, J oi.-4 M¢-'.,¢ o"' ~'-4'