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)..