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HomeMy WebLinkAbout13149-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte Of Occupnncy No. Z-I5667 Date April 21, .1987 THIS CERTIFIES that the building . .A.D.r..5 .c.u. 1. ~..u.r.a. 1.. ?.o.Z.e...b.u.i.~ .d .~.a.g. ............... Location of Property ...2.5.5.0...S.k.u.~.~.k. Lane Cutchogue, N.Y. Houso No. ' .............. 'S't;~i ....................... County Tax Map No. 1000 Section 097 .Block 08 ...... Lot 31 Subdivision ............................... Filed Map No ......... Lot No conforms substantially to the Application for Building Permit heretofore filed in this office dated i~. a. y...2.2. ,...1.9.8fi. ........ pursuant to which Building Permit No. 13149Z May 25, 1984 dated ............................ 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 BUILDING AS APPLIED FOR The certificate is issued to ALBERT J. KRUPSKI, JR. ..................... [o¥,,'o), '~¥ ~r~j~ X .................... of the aforesaid building. Suffolk County Department of Health Approval ... N/A UNDERWRITERS CERTIFICATE NO. N/A - N/A PLUFiBER$ CERTIFICATION DATED: ........ Building Inspector Rev. 1/81 FOuM bO. ~ TOWN OF .Sou'rHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13149 Z Permission is hereby granted to: ..~.~....~.....~..~.....~.,. .... ~~.....~..:.~..: ............................... ,o...~..~....~..~.~..2~.....~..~.~ -'-- "-'-- ~'-'~ ....... ~ ................ r) ~ ~),~'.~-' ~ -- ' ~. ~ ..... County Tax Map No. 1000 Section .....C~.~...~. ......... Block ....... .~.....~. ........ Lot No ..... ..~..]. ............. pursuant to application dated ........... ...~..~......)=...~:.. ................ , 19.~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTNOLD Building Department Town Hell $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCt Instructions This application must bo filled in typewriter OR ink, and submitted ~a ~ 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 unu~al natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage d{sposal-{S-9 form or equal). 3. Approval of etectr}cal installation from Board of Fire UndepNriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Arch{tact 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)0 Non*conforming uses, or buildings and "pro-existing" land uses; 1. Accurate survey of pzoperty 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 informs- tlon required to prepare a certificate. C. Fees: l. Certificate of occupancy New Dwellin~.$25.00. 'Acce.~.sory :$10.00 Buslnes:l $50.00 2. Certificate 0-f occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10,00 4.Vacant Land c.g. $ 20.00 ~... ~./..~. ?.... 5.U~dated C..O. $ 50.00 Date ......... 6. ~lteratlon $25.00 NewCon~ bruc t, ion ' .~". Old or Pre-existing Building Vacant Land . Location of Property ........................... House No. Street Hamle~ Owner or Owne ......... . ...... ........ ... ................ 3 County Ta,~ Ma, No. ,OOO Section ...9.. ~ ........ B,ock ..... 0.. ~ ...... ~.o, .... t ..... · ' ' Filed Map No Lot No Subd~vts~on .......................................................... Permit No...... . .. cant .................................. Heelth Dopt. 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 ag,d regulations. Applicant ..................... Ilev, 10,10 7a FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 nam ral or topographic featu res. 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 responsible 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 $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .~.//~.~/./.~./..~. 5.Updated C.O. $15.00 Date ................... New Building ....v~,. ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~-..~..¢~.. ............... House No. Street Ham/et Owner or Owners of Property . ~. [ .~..~.%?...~..,.. ~.~'..c..~. ~..~..~.i..~....¢~-.. ..................... County Tax Map No. 1000 Section ...(?.?. ~. ...... Block .. ,~...~.. ........ Lot .... .~.../ ........ Subdivision ................................. Filed Map'No ........... Lot No .............. Permit No. ~, .~..1..~/.~.. Date of Permit .~'"~ .~./.cF?.Applicant .~./.~>¢,~f..)~//,77¢.~..~. :'., .~.. ~ ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ....... . .;,>~<'. ....... Request for Temporary Certificate ....... ~: .... Fna Cert ficate .. ~ .............. Fee Submitted $...J.~'...~, ~. ................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ¢~;2.~, ./~ .Z~.'.,~,, ..................... Rev. 10-10-78 FOUIID ~ T I 071 ( ?nd ) FRAME & PLUI'{BING 3. ltlSU[,ATION PER N. ,STATE EI~EEGY C,ODE ADDITIO~IAL COMMENTS: ............. -~_-~_-~_-~==: = 7GS-'1802 BUILDING DEPT. INSPECTION [ ] FRAMING REMARKS: [ ] FOUNDATION 1ST []ROUGH PLBG. [ ] FOUNDATION 2ND [1INSULATION []FINAL June 1, 1984 Southold Town ~uilding Department Main Road Southold, ~Y l197t The 'trusses were designed and con- structed after viewing trusses in other build].ngs, notably the Shamrock Tree bu]ldin~ on the strip-zoned Route 25 [n Mattitucko I fe~l they w~ll adequately support the alumi.num roof an~ the 30 foot Rory Kl~.nge 'FORM'NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL,: 765-1802 Approved '~. ,~.., 19~.~. Permit No. J..~./.q. c~ .%. ~)isapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled'in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 Per, nit to the applicant. Such permit hall 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department tbr the issuance of a Building Permit pursuant to the luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ',egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on pre~nises and in building for necessary inspections. . ................ (Signatu~ of applicant, or name, if a corporation) (Mailing address of applicant) gtate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. qame of' owner of premises ................. :'... .t ........................ (a~on the tax roll or latest deed) if applicant is a corporation, signature of duly authorized of~%e-rl (Name and title of corporate officer) Builder's License No ..... -~.'..~. ! .~. .............. Plumber's Licenle No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done. ~ . . -.~. ~ ~,'.~...~..[.°?.~)..~r'. .... · .~...~ . .~. House Number Street Hamlet County Tax Map No. 1000 Section ~? ~ Block O~ Lot. 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 ..................................................................... · Intended use and occupancy ..... Y ................................................ 3. Nature of work (check which applicable): New Building ........ Addition .......... Alteration .......... Repair Removal Demolition Other Work ~ (Description) 4 Estimated Cost t/~ts/~ ;,-o Fee ~" (to be paid on filing this application) 5. If dwelling, number of dwelling units ............. Number of dwelling units oil each floor ............... If garage number of cars 6. If business, commercial or mixed occupancy specify nature and extent of each type of use . .~-a.r. ~,...S..~.o ¢-.a~... ..... if any: Front Rear Depth 7. Dunenslons of existing structures ............................................ Iteight ............... Number of Stories ...................... , ................................ Dimensions of same structure .... Front Rear w,th alterations or additions: .................................. Dei~th ................... i... Height .......... . ........... Number of Stories ............ > ........ 8. Dimensions of entire new consfmction: Front .... .3.0.'. ....... Rear . 3 ........... Depth . .~.,~. .... Height /.S. ~ Number of Stories 9. Size of lot: Front ...... , ............ Rear ...................... Depth ...................... 10. Oate of Purchase '~.l~...!. - - . . Name of Former Owner .~.,~,a~ C..09..~¢q.~. 11. Zone or use district in which premises are situated./~.,-.r.q~v!'}wr.~.l ...................................... 12. Does proposed construction vidlate any zoning law, ordinance or regulation: ................................ 14. Name of Owner of premises /~i!. Kc.-' p.~.~.;...-...W.c... Address ................... Phone No ........... Name of Architect ......... i .................. Address ................... Phone No ................ iNa,ne of Contractor ........ ~ .................. Address ................... Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and-blo¢l~ number or description according to deed, and show street names and indicate whether nterior or corner lot. TATE OF NEW YOI~K, i S.S 'OUNTY OF ................. .......... : .......... being duly sworn, deposes and says that he is the applicant u, rame of individua signing contract) Cove named. .~. {e is the ..................... ! ................................................................... i (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements con(ained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the mann?r set forth in the application filed therewith. ',worn to before me this L 0 ............. O- f