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HomeMy WebLinkAbout16178-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19706 February 4~ i991 THIS CERTIFIES that the building_ Location of Property 8305 COX LANE House No. County Tax Map No. 1000 Section 84 Subdivision ADDITION Street Block 3 Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 1.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 25, 1987 pursuant to which Building Permit No. 16178-Z dated JULY 7~ 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 STORAGE ADDITION TO EXISTING BUILDING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A PRIME PURVEYORS, INC. Building 'In~p~ct°r ' ' J Rev. 1/81 · OBI~ NO. o TOWN OF SOUTHOLD BUILDIHG DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 16178 z Permission is hereby granted to: ...~,~...x.....~..o,..,~ ............. : ........... .~ .................. ................................ ~ ........ ~ ........... ..fl..~ .............. ,o at premises I~ated at ..~.~....~......~..~ ........ ~~.~ .............................. County Tax Map No. 1000 Section ....C~..'~....~ .......... Block ...... ..~t..~.. ...... 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 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form), 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. S. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additiohs to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 APPLICANT ~ Date ..~.~....~. f[..~. ................ ~:ew Construction .......... Old Or Pre-existing Building ........... ] ' ' ' Location of Proper y ........................... , ~ ~ House No. Street Hamlet County Tax Map No 1000, Section...~.~ ...... Block .... ......... Lot .... Zf..z ........... Subdivision ............................... · ·- · · Filed Map ............ Lot ..... Health Dept. Approval ........................ · · Underwriters Approval. , ........ Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate...~... INSPECTORS (516) 765-1802 VICTOR LESSARD, Principal CURTIS HORTON, Senior VINCENT R. VqlECZOREK, Ordinance ROBERT FISHER, Assistant Fire Building Inspectors THOMAS FISHER GARY FISH OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD January 17, 1991 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-18Z3 Telephone (516) 765-1800 To Whom It May Concern: Please be advised that according to the present Zoning Code in the Town of Southold, a Building Permit and Certificate of Occupancy are not required for over the road commercial trailers. Therefore, no Building Permit or Certificate of Occupancy can be issued for the above until the Town legislature addresses this problem and changes the present condition. Very truly yours SOUTHOLDTO~ BUILDING DEPT. Vi.ctor Lessard, Principal Building Inspector VL:gar THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000771 BUREAU OF ELECTRICITY ~-- ~J[ B5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT was exami~ o~ and found to be in compliance a'ith the requ rements qf th s Board, fiXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS OUTLETS SWITCHES FLUORESCENT DRYERS SYSTEMS OTHER APPARATUS: S E R NO OF CC COND ~ PER ~' 1 C NO, OF HI.LEG AWG, Ruland Electric Coo P.O. ~ 143 ~ttituck, /~.Y0 11952 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be COPY FOR~BUiLDING DEPARTMENT. THIS COPY OF CERTIF CATE MUST NOT BE ~LTERED iN ANY MANNER. U~DATION (1st) UNDATION [ 2nd ) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL . ADDITIONAL COMMENTS: Examined .. ~.~ Approved 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 TEL.: 765-1802 .'] ...... 19~..'~ .~ .... , 19'~.'~. Permit No. ~.~./..~. ?..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .....~/~] 3 SETS OP,PL~j/ ...... SURVEY .... / ...... CHECK .. ~....-~.[~O] SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: J~Date June · 2.5., .......... 18878 INSTRUCTIONS a. This 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 regulations, and to admit authorized inspecto~ on premises and in building for necessa-w inspections. (Signature of applicant, or name, if a corporation) Post Office Box 201 Peconic. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises -prime Purveyors (as on the tax roll or latest deed) If applicant is a corggration, 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 ...................... Location of land on which proposed work will be done· . .~..~.~... ( ~.~...' .............................. ''' ..................... · ................ 5:..,e.%. ............ House Number Street ,,. Hamlet County Tax Map No. 1000 Section g -I i io' k . 3 ........Lot /., / Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... :l;o.w.~ge: ............ ~¥~g~.~acatl.,~te.~.~ ................. b. Intended use and occupancy ............................ : .., ..., ~ ~..~o~ ~:~o~,~,~,~,o,~~. .............. 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration .......... ~ Repair :: .,.,~ ... .... Re 0 1 De olition __ OtherWork , . :, . ,~' (DescfipIion) 4, Estimated Cost . ~25,000! --3~.~,~ .~.?/. ............ ; ......................... Fee .. o. ......................... i ~ (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 nat~[e a[¢~ .extent of each type of use .... :.. i'.- .............. 7, Dimensions ~o~ex~s.[ing structur~f any: Front ..... b~'~ ...... Rear ...5.4~.. ...... Depth...1..0.0. P. ~ ....... Height . .............. Number of Stones .............. ~ ....................... . · ._~: .'._.. .......... Dimensions'~rn~j~t.n~cture with alterations or additions: Front ..... ~.4..t~..~: ..... Rear . ~4. 2..-[~'~.. .......... .... 8. Dimensions of entire new construction: Front .... Rear .... 5.4..~..~.~...... Depth .. }][eight .1.5 P~;. .. Number of Stories o~e 11. Zone ~r use district in whirh pr~mises are situated ......... ~'~.~..6 ....................................... 12. Does proposed construction vioiat.e any zoning law, ordinance 6r regulation: .... ~. ?. ................... 13. Will lot be regraded ........ i~/~. ................ Will excess fill be removed from premises: Yes N( N( N~' 14 Name of Owner of premises ' Address Phone No Name bf Architect .......... ! ................. Address ................... Phone No ................ Name of Contractor . .~.~. ~ .~. ............... Address .. '..: .............. Phon,*.~h ............... 15. Is this property locatediwithin 300 f, ee,t of a tidal wetland? *Yes ......... ~o~ · If yes, Southold Town Trustees Perm%~ '~mBy be required. : '~' ,PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property li~es. Give street and block, number or description according to deed, and show street names and ~ndicate whether interior or corner lot. STATE OF NEW Y.,~,I.(/f~.~[_ ! S S ...... /q~. ~ F...~. ~ ./~....~./4q't 7. [.~../X.. ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is drily 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 wilt be performed in the manger set forth in the application filed therewith. Sworn to before meq/~ :this . ~A. -,~?~. ,~.,~.~ ~ ~x/~~m,~in Coumy (Signature of applicant)..