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Home My WebLink About16553-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16884 Date May 18, 1988 THIS CERTIFIES that the building UNDERGROUND PROPANE TANKS Location of Property 46520 County Road #48 Southold, N.Y. hgSs'o hio~ ..... '~'t/e~{ ..... Hamlet County Tax Map No. 1000 Section 55 .Block 5 .Lot 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 2, 1987 pursuant to which Bnilding Pennit No. 16553 Z dated. ............0 c r o b e r' 2 .... 1, .I ..... 987 ..... 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 ......... THREE UNDERGROUND 1000 GALLON PROPANE TANKS The certificate is issued to ANDREW MICHAEL PROPERT IES, LTD. ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-16553 Z . · .......... ./~.~~...~...~.../~¢~ / .~.a~..~z......~ .......... ~ ......................................... st premises ~'°eatecl at '"'~"~7'J'~"~'~'~'7 ....... ~'"~'""~'"~" ................................ i'i ............. cou.~ Tox Mop ,o. ,ooo sect,o......OT..~ ...... B,~k ..... ~ .......... Lot No ...... ~ ......... pursuant to application dated ..... ..~.....~ ......... ~. ..............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 OCCUPANCY 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 responsible for the building. R.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: I. Accurate survey of p~t)perty showing all property lines, 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.(10, Accessory,,,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 S. dat d c.o. 50. oo .... .NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land .......... Location of Property. ~ .o.~ .~.~; .~...~...'.. ~. ~ ~.'~..¥~.. .~...~.. ~ House No. ' ........................ treat . Hamlet Owner or Owners of Property .~. ~ ~r~.~ . .~. ~ '~f County Tax Map No. 1000Section.... ......... . . Block · .... ~.. ...... ... Lot.. ......... . . Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ....... Date of Permit · .Applicant .~... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Cer)ificate ..................... Final Certificate . ~..... ............... Fee Submitted $ ............................. Construction on above described building and permi),.Knee~ts all applicable ~Jes and regulations. App,,cant ....... I/:.:. Rev. lO.lO.7a BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1803 CALL .... '"~..,,~' 7 Examined. t~rf~. · ·A./.., 19 .fi-7 Approved. t~e~J~- - ~..[ ..... 1C7_~ermit No./.~...~.,.~...~.~ Disapproved a/c ..................................... (Building Insp BLDG. DEFT. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ......... J. ........ 19 . 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 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 regulations, and to admit authorized inspectors on premises and in buildhng for necessary inspections~ ....... . ............ (Signature of applicant, or name, if a corporation) F. ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ........ ~.,~,. . . .~ pF. _ . .. .................. ~. ............................... Name or owner of premises ...6~. ~C~..~.,.e.b~./?....?.~.o..p.~C;~ ?. ~....((~.. ................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ALL CON, TRACTOR'S MUST BE SUFFOLK COUNTY LICENS~/~%r ~ Builder s License No .......................... ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ...... ./~/.q.~...7~....~.(. 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 ....................................................................... b. Intended use and occupancy //.. ~..?./~ -- ~..'~'~'~/~"~G .~-'.~.~/,~. 3. Nature of work (check which aPplicable): New Building ..... · ..... Addition .......... Alteration .. Repair .............. RemOval .............. Demolition .............. Other Work. '~/-,t c~'.~/~. (Ddsc'ripIion) 4. Estimated Cost .~.~..~. ~ ii F ce/ Ut /'~ tto be paid on filing this application) 5. If dwelling, number ofdwellinglunits ~ ............ Number of dwelling units on each floor ................ If garage, number of cars .... !.. ~ ............................................. : ...., ............. 6. If business, commercial or mixe,d occ,upancy~ specify nature and extent of each type of use ...................... 7. Dimensions of existing stractur~s, if any: Frbnt...,. ,..,:: ...... Rear .............. Depth ............... fSt ...:...~ , x Height ............... Number o cries,.: ...... ., ......................... ... ............. Dimensions of same structure ~ith alte~rations or additions: Front ..... ' ............ Rear .................. Depth. ................ ..... Height .......................Number of Stories ...................... .... 8.Dimensions of entire new construction: Front i~o Rear ...~..'~P. ........ Depth . .~..O ........... Height .... .~[ ......... Number of Stories i ii iii i[i i i i i i i i ......................................... 9. Size of lot: Front ~ i ' ;,,.'"Rear ; Depth 10 Date of Purchase ' Name of Former Owner 11. Zone or use district in which premises are sit ated ............................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ! .................... Will excess fill be removed from premises: Yes 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 within 300 feet of a tidal wetland? *Yes ..... No w:... *If yes, Southold Town TrUstees Permit maybe required. ' PLO"r DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate ail 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 cornerlot. 5 STATE OF NEW YORK, COUNTY OF ................. i S.S ..... t . . · i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. lie is the ....................................... (C,ontractor, 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 contained in this application are true to the 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 : ?" 5.7 .................. ~...day o.f .............. 19 Note, Public ..... ~..~r. ..... .~ ....... County I Term Expires March 30,19...~ / F LI&HTIN6 FIXTURE SCI-IF. PULE HARK HAN[IF. cAT~ DE_cJ(I~ION LArlP QUANT, /'Tk _HAbCo .....v-~ 15___ ~?P H_~_D~.~ _I_5_O~I_H?-~ 25 . HADcO PIq8 16' LAMP po51- q01,IH.R.~ Z5 j~bPG, H OH IClC-D KE~NE SAN-oq5 A~AHAIS b~Hp dON ~,R~ 2.5 ASPHALT PAVING C~lfl Ll~ FEtE 4~ L.F, ~m~ ~ ~heet D of ARCHITECTS PLANNERS SMITHTOWN (516) 724-7191 / PORT JEFFERSON STA (516) 331-8555