HomeMy WebLinkAbout16030-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N Y.
Certificate Of Occupancy
No ..Z-15884. . Date June 25, 1987
THIS CERTIFIES that the bmldmg ACCE 8 SORY SHED
Location of Property 570 Pine Tree Road Cutchogue, New York
HDuso No ................ St/eot ..................
104 01 9. 1
County Tax Map No I000 Section ... Block ........ Lot .............
Subdivision
·.. Fried Map No ..... Lot No ..........
conforms substantially to the Apphcahon for Braiding Permit heretofore filed in this office dated
Ma y 1 I, 1987 pursuant to which Building Permit No t 6030 z
dated J u n e 5, 1987. .. was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which ttus certificate is msued ~s ...
ACCESSORY SHED AS APPLIED FOR
ARTHUR DRAKE
The certificate is issued to . . .
of the aforesaid building.
Suffolk County Department of Health Approval .
UNDERWRITERS CERTIFICATE NO..
H/A
N/A
PLUMBERS CERTIFICATION DATED:
Buri&ng Inspector
Rev, 1/81
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)
N9 16030 z
· ..~~ ........ ~. .......... .~ ...........
~ ...................... .~ ...... ~ .......... ~....p.
.................................... ~':~'"~j~;'"": ........ ~.': ..... ;:i ............. ~'-;'"~"'_~ ...... : ............
at premises located at ..~..../. ........... J..~..,~.,..~.: ........... ..'..k~f~.tv~~ ........
Budding Inspector.
Fee $.....~......: ...........
................. 19.. ., and approved by the
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 Wpewriter 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. Commercmi buildings, industrial buildings, Multiple Residences and mmilar buddings 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 apphcable
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-exmt~ng"
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 reqmred to prepare a cerbflcate.
C. Fees: Additions 825.00
1. Certificate of occupancy New Dwelling $25.00, Accessory '$t0.00 Business $50.00
2. Cerbhcate of occupancy on pre-ex~stmg dwelhng $ 50.00
3. Copy of cert~fmate of occupancy $ 5.00, over 5 years $10.00
4.vao nt o.o. 20.00
5.Updatect C.O. $ 50.00 Date ..................... 7
Newconstructzon ...... Old or Pre-exlstmg Budding .......... Vacant Land .............
Location of Property ...Z)..~'..~.~? ......... [../.Y).~' ~..lQ .~..~../~.~ .' ....... ~./J .~.z~.~..~. ~..'~
House No. Street Ham/et
Owner or Owners of Property .. ~..~..~.~.~(}T.. ~ ..~...~'..~..~..-~_ .....................
County Tax Map No. 1000Sectlon ..Z.~...~'..... Block. ~./ ......... Lot ...~.'./ ........
Subd,v,s,on ..................... F,led Map No./[..7. Z ...Lot No./.~./%, .7'-,~'..~ ./'..¢~ ~-/
Permit No/.6.~..'~. P.. Date of Permit .~/,~. ~. ZAppl,cant. ZJT,/~'~..~J~......~.,., .~..Z~.~...~..~..
Health Dept Approval .................. Labor Dept. Approval .......................
Underwriters Approval ................... P~annmg Board Approval ......................
Request for Temporary Certificate .................. Final Certificate ......................
Fee Submitted $ .......................
Construction on above descmbed budding and permit meets all apphcable codes and regulations.
App[,cant ~.~.~ .....................
Rev 10 10 78
OUNDATIO.~ ( ls t)
OUNDATIO)! (2nd)
OUGH FRAME &
PLUMBING
NSULAT!ON PER N. Y.
STATE ENERGY
CODE
ADDITIONAL CO.~MENTS:
8x12 Mini Barn (red)'
8x10 Mm~ Barn (blue)
MINI BARN SPECS
All wood Irammg, 4x4 pressure treated hinders lot
runners FIoorjo~s~are2x4'sspaced tO" on center
covered wldr s,~,' plywood 2x4 stud', used in all
buildings
Roof trusses are 2x4 and 2x6 cov(;red with
plywood and 240-1b shingles
Painted "/~ ' texture 1 11 rough sawn covers outside
Door openings are 4 in 8-ft barns, 5 in 104t barns
6' in 12 tt barns, 70" high with one j,d(JlSe window
10 ft and 12 ft barns have double wide jalolse
windows
SttlNGLE,~
Dark Brown, Black, Brown,
OPTIONS
W~der Doors, Ramps, Extra Doors, E,,'tra Windows
Cupolos Weather Vane',
8x8 Mini Barn (charcoal)
Buildings are assembled for easy
N~ne colors of paint to choose
6x8 Playhouse (chestnut)
!i
12x24 Quaker Natural Finish
766-1~O2 g AM TO · I
POLL OWING INSPECTION
FOMNDA'ttO'N TWO
FOR ~EU CONCRI
~UG~ CRAMING~
~, INSIJLATI~ '
~,TE CON~T~
~ c~ co~
TE'F"QU1RED
:q. UMBING
iN MUST
kLL MEET
~t4E N.Y
ILE FOR
('""':""¥') ,,
C~J~CHO~U~
DATE
FOR APPROVAL OF CONSTRUCTION ONLY
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [,~ F~AL
REMARKS:
DATE
Examined...~ ~l,*i,s,..~.
Approved ~ ~ .~
Dmapproved a/c
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.. 765-1802
BOARD OF HEALTH --~,,,~.
3 SETS OP~ANS --...-.
SURVEY
SEPTIC FORM ............. :
NOT PY ' v -
CALL ~-~-%-~---
MAIL TO:
........ *owILcg cp J
(Budding Inspector)
APPLICATION FOR BUILDING PERMIT
Date ........ , 19~
INSTRUCTIONS
a. Tins apphcation must be completely filled m by typewriter or in mk and submitted to the Bufldmg Inspector, w~t
sets of plans, accurate plot plan to scale Fee according to schedule.
b. Plot plan showmg locatmn of lot and of buddings on premmes, relationship to adjoining premises or pubhc str.
or areas, and g~vmg a detailed descnptmn of layout of properW must be drawn on the dmgmm which ~s part of this ap
catmn.
c. The work covered by this apphcation may not be commenced before msuance of Bmldmg Permit
tl. Upon approval of this apphcat~on, the Buff&nd Inspector will ~ssued a Building Permit to the apphcant. Such pe~
shall be kept on the premises available for inspection throughout the work
e. No building shall be occupmd or used m whole or m part for any purpose whatever until a Cerhficate of Occupa,
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Bmld~ng Permit pursuant to
Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordmance
Regulations, for the construction of buddings, addmons or alterahons, or for removal or demohtion, as hereto descnb
The apphcant agrees to comply w~th all apphcable laws, or&nances, building code, housing code, and regulations, and
admit authorized inspectors on premises and m budding for necessary ~nspection~~..,. d~:.~
(Signature of appl,cant, or name, ff a corporation)
State whether applicant m~owner, lessee, agent, architect, eh;neet, general contractor, electrician, plumber or build
Name of owner of premises Ar ~7-~.ZY~... ff.-..~.~. ? J~-.-~. ...........
(as on the tax roll or latest deed)
If applicant is a corporanon, mgnature of duly authorized officer
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY
Builder's License No ........
LICENSED
Plumber's L~cense No . .
Electnclan's License No
Other Trade's L~cense No
Location of land on winch proposed work will be done
House Number Street
County Tax Map No 1000 Sectton
Subdtvision
(Name)
Hamlet
Block / .. Lot h /
Filed MapNo // 7 ~ Lot ~f~&/~.
State existing use and occupancy of premmes and intended use and occupancy of proposed construchon
a. Existing use and occupancy . ~ 5).4.-C.H .C.'t? ..........
b. Intended use and occupancy '~YO/--- ~'~-~ (2~ .............
3. Nature of work (check which applicable) New Budding ./.'~ Addition ...... Alteration .......
Repmr ..... Removal ..... Demolition .......... Other Work.
(DescnpIlon)
4 Estimated Cost. ! ~ ~..J~.5]'.e.'.'..x .......... Fee
~ (to be paid on filing this apphcation)
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. Dtmenmons of exlstmg structures, ff any Front .... Rear ........ Depth .......
Height ...... Number of Stones ..
Dimensions of same structure with alterations or additions Front ......... Rear ............
Depth ............ Height ............ Number of Stones ...............
Dunenslons of entire new construction Front .......... Rear ............ Depth ........
Height ....... Number of Stones ..........................................
9 Size of lot Front ...... Rear ................. Depth ..........
10. Date of Purchase ......... Name of Former Owner ..........
I 1 Zone or use district in which premises are situated
12 Does proposed construction violate any zoning law, ordinance or regulatmn ...................
13 Will lot be regraded ................. Will excess fill be removed from premmes. Yes N
14 Name of Owner of premises ........... Address ............. Phone No.
Name of Architect ................ Address .............. Phone No ............
Name of Contractor ................. Address ........... Phone No ...........
15. Is this property located wzthin 300 feet of a tidal wetland~ *Yes ..... No .....
*If yes, Southold Town Trustees Permit maybe required.
PLOW DIAGRAM
Locate clearly and distinctly ~dl bu,ldmgs, whether existing or proposed, and indicate ~dl set-back dnmenslons fro~
proper~y hnes GlYe street and block number or descnptlon according to deed, and show street names and indicate whethL
mtenor or corner lot. }
STATE OF NEW YORK, S S
COUNTY OF ......
(Name of individual signing contract)
above named.
being duly sworn, deposes and says that he is the apphcm
He ~s the .................
(Contractor, agent, corporate ofhcer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th
application, that ail statements contmned m this apphcatlon are true to the best ofh~s knowledge and belief; and that t?
work w~ll be performed in the manner set forth m the apphcation filed therewith.
Sworn to before me this
........ /.( day of . '!
.......... County
~t ~ltl.le. stm ~ ~*~ (Signature of apphcan
Ne. 4707878,
T~'~ ~ l~ch 30,