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HomeMy WebLinkAbout16410-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-I6156 ' Date September 10, 1987 THIS CERTIFIES that the building ...A.q C..~.S.S.q ~. y..S.~.E, p ............................. -~ ~ 1305 Village Lane Mattituck, New York Location ot ~roper~y .......................................................... :...:. County Tax Map No, 1000 Section 107 .Block I 1 .Lot 06 .. Subdivision..M./9. y.i.l.l.a.g.e. ~.a.n.o.r ............. Filed Map No...3.6.6.9...Lot No .... .9 ....... ... conforms substantially to the Application for Btdlding Permit heretofore filed in this office dated August 31, 1987 pursuant to which Building Pennit No. 16/410 Z dated August 31, 1987 ............................ 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 SHED AS APPLIED FOR Th¢ certificate is issued to JOHN A. CUSHMAN II & EILEEN CUSHMAN ..................... ?oYn'e;, ..................... of the aforesaid building. Suffolk County Department of Health Approval ............. ~ ./.A .......................... UNDERWRITERS CERTIFICATE NO ................. N / A PLUMBERS CERTIFICATION DATED: N/A ~ ~Building Inspector Rev, 1/81 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) Na_ 1 6410 z ,)ate ..~.~....,~..I ............. , Permission is hereby granted to: · .~.~-~&..~.:~.....!.!.~.~.~ ..... .. ,'"'h ,o .~~.....~.....~.~....~....~...~~..~ ..... ~'"'::~;::';'"'~:::":'";'~;.'~ ....... 'L;'~";F~'~'"'~'~~ ......... County 'ra,~ Mop No. ~OOO Sect~o.~......l...O....'l ......... B~ock ......... l.J. ......... ~_ot No...... ,.(~,...J~ pursuant to application dated( '~'..~..~..~.......~l,.~ ........... , 19..~..~.,-- and approved by the Building Inspector, 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 OCCUP ~NCY 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 o~ 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 ~ines, 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. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.Q0, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.vaoant Land O.O. 20.0o 5.Upc~atect C.O. $ 50.00 Date ................. NewC°ns f~z~ucti°r~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property /~.%c~L/ p//Z-/~/~d,,~ /_.~,.,2~c... House No. Street Hamlet Owner or Owners of Property ...... % ..... ~ ..... ~ .............. County Tax Map No. 1000 Section ..... /.?. ~. ..... Block ?/. Lot .O.~ ' Subdivision ...... ~,1..L-.L~..G..~...../~. f%{~.)~)(~ ...... Filed Map No....~..~.~.c~..Lot No ....... ~ ..... Permit No. l~® ~-. Date of Permit 'bi ................ Applicant . .--~-?../~.~,,...~,..~.l.L~..~.,, Health Dept. Approval ........................ Labor Dept. Approval ....................... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ....... J~,~,©. . ............... Construction on above described building a~i~,~ meets all applicable codes and regulations. Rev. 10-10-78 DOOR FRAME ll~Al~ A~SEMIBLY STANDARD FRAFIE5 END FRAfflE RIBBON BOARD RIBBON BOARD > I II Ill Il I Il ill ill Il RIBBON BOARD FZCI-I ADDITIONAL PIECE ADDS APPROX, 16 SQ. FI' OF FIX)OR AREA HOW TO A~SEI~IBLE 8'x8' SHED 1. Cut 4-.ribbon boards 2x4x7Sll'' long. 2, Nail door flame to one end of bottom ribbon boards, 3. Nail the balance of "Porter Frames" at 24" on center with end frame at outside. 4. Nail the other two boards inside at top of wall for bracing. 5. Finish wails, roof, and floor with sheathing materials. 6. Apply shir~gles, trim and doors to complete Assembly. 10 x 1.2 SHED 2 pcs. 2 pcs, pcs. 2 pcs, 2 pcs. ROOF SIIEATlilN6 SiDE W/~LL SHEATHING 36"___ FRONT WALL SHEATIIING 4 Req. 6 Req. 1 pc, 18 V4" 1 pc, 18 V,~" FLOOR SHEATHING I pc. DO0~ SHEATHI~ DOOR TRiM 48" 48" REAR W/~LL SHEATiIiI~IG 28'4~/ 33 2 28.4" 28,4o ~ i~e ~l. ! x 4 DO0~ TRIM DOOR Fi{AlvlE/~ElVl~LY FOR J[O FT. ~-~111'~I 1. Cut 2 pcs. 2x4~6'-5" long (board D) ~ See"cutting instructions" page 7 2. Cut 2 pCS. 2x4 5'3% long (board E) 3, Place A and B boards into shed frame and attach with 3x5. Nail plates each side wit~t l~A'' roofing nails. (12 nail plates required) El~II} FRAI~/~ISEI~II;LY' FOR 10 FT~ i~A}ll~ 1. Sanae as Steps 1 through 3 above. 2. Cut 1 pc. 2x4, 6'~5" long (board F) see "cuttitlg instructions" page 7 3, Place F board into shed flame and attach with 3x5 nail plates, 20 nail plates required. 13¥~' 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FINAL DATE / INSPECTOR/~////~ . .~UFEOLK COUNTY ~EALTH DEPARY~v ~ ,.--t," ~.~. ~. ~o ....... ~'-~-~,s~ ..... ~ ~ :, ,, ......._ THE SEWAGE DtSPOEAL AND.t~fAT~R 8{IPPLY FACILITIES FOR THIS ~'~'~ LOCATION HAVE Bt>SN INS, ...CTED ~f THIS.DEPARTMENT AND FOUND TO BE SATISF&C~ORI':. . ¢. Chief of ~,~tewater M~ag~ ~ --. ,, , / SURLY FOR JOHN A. CUSHMAN ~ & EILEEN DOHERTY LOT NO, 9~ "VILLAGE MANOR" AT MATTITUCK ~N ~ SOUTHOLD SUFFOLK COUNTY~ NEW ~RK ~UTH~IZ[D ALTERATION O~ ADDITION m ~1~ GUARANTEED su~vE~ ~ ~ VI~AT~O~ ~ SICk,ON 7~o~ ~ TH[* JOHN A. CUSE -~%~J ~G~AR~NTEES INDICTED HE,ION ~L RU~ ~LY ~ RIVERHE~ COMMENTS FIELD INSPECTION ~OUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1803 CALL ................ ~. MAIL TO: Disapproved a/c .................................... ~ ~'~ ~'" ~* ................................... ........... /.: . .0.~.~.~. ~.~. ~ (Building ~spectot) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This 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 tho 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 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 regulations, and to admit autho zed inspectors on premises and in building for ne e sa n z · ............ ' ~Si~nature of applic~nt,,or name, if a corporation) .~¥. :5%.,..~.~.r~q.L,..~. y... ! [~ .~. .............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ 0.~. ~o./~ ............. i ................................................................... Name of owner of premises ...... .~y.O.b}..~..../~......~.. {:.5. ~../t~.... 2~.....~yqQ...elL..~.... ~.~..5~.r(I..A..~ .............. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED 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 .................................................. I ~od V I L~4- ~-A4C_ ~X~.~. . ~..~.~.<. . . . : ............. House Number Street Hamlet County Tax Map No. I000 Section ....... [.~'.~. ....... Block ........ I. ] ........ Lot ..... .~...~. ......... Subdivision ........ y} .~..~.(.3..~....~.~.4.0.~. ........... Filed Map No..~. ~ ./o.~ ........ Lot....bT..~. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... [~,4~1D,$,127.4~ .............................. ._ .................. b. Intended use and occupancy ....... ~'~.gAC~ ~%.~..~. ........... ...................... 3, Nature ofwork (check which applicable): New Building .......... Addition .......... Alteration ............ Repair .............. Removal .............. Demolition ............ Other Work ............... I (Description) 4. Estimated Cost ......................................................................... " (to be paid on filing this application) 5. If dwelling, number of dwellin~ 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 ............... Nutnber of Stories .......... i... ................. 2 ....· .................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .......... ....~.. ~ .~.. Height ...................... Number o~f Stones ...................... .8. Dimensions of entire new construction: Front ...... I.~/... ..... Rear ..... I.o ......... Depth .... I.~.. ......... I . Height ............... Number of Stories ...... ~ ................................................... 9 Size of lot: Front" ~ Rear Depth '.. 10. Date of Purchase .......... i ................... Name of Former Owner .......................... ~ .. 1 1. Zone or use district in which premises are situated ..................................................... · " ' gl 1 2. Does proposed construction wolate any zonm aw, ordinance or regulation; ................................ 13. Will lot be regraded ...... Nfl. ................... Will excess fill be removed from premises: Yes I~o 14. Name of Owner of premises . 'i .................. Address ................... Phone No ................ Name of Architect .. ' ......................... Address ................... Phone No ................ Name of Contractor ........ i .................. Address .... : .............. Phone No ..... 15. Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No .i~i ....... *If yes, Southold Town Trustees Permit maybe required. ~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all sbt~back dimensions from property hnes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant [ (Name of individual signing contract) abbve named. Itc is the ..................... i .................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements con'~ained in this application are true to the best of his kn~)wledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............ 4.Z ......... day o~ ...... Notary Pubhc' .... ~.~.' ,~.f~. ~/o~ .......... County ~(~_~..~ [~l~'l~"t ~BL C, St~ d I~ Y~k /_/ . (Signature of applicant) No. 47078'18, Suffolk County Teh'n Expires MArch 30,