HomeMy WebLinkAbout15449-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z-15198
No ..................
January 13, 1987
Date
THIS CERTIFIES that the build~g Agricultural barn
44075 Main Road Peconic, New York
Location of Property h~s~ ~oi ....................... ~/e~i .......................
County Tax Map No. I000 Section 075 .Block 01 .Lot 0
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore Fried in this office dated
.0. c. t..o.b.e.r...2.3. ,.. ! .9.8.6. ..... pursuant to which Building Permit No. 15449.g
dated October 30, 1986
............................. , 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 .........
AGRICULTURAL BARN
The certificate is issued to BARR VINEYARD LTD.
..................... ...................
of the aforesaid building.
Suffolk County Department of Health Approval N / A
N/A
UNDERWRITERS CERTIFICATE NO ..................................................
N/A
PLUMBERS CERTIFICATIOI~ BATED:
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDinG PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
at premises located ~ .... .~ ...........~... .................................................................
County Tax Map No. 1000 Section O') ,,,~'-' Block ..... ...l~....J ......... Lot No.
pursuant to application doted .... ...C~.......~....~...~"~..~,c~ ........... , 19.~...~., and approved by the
Building Inspector.
Fee $.~.,:.~ ....
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
JAN I 2198I/
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted i re.iii 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
natura~ 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.
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 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:
1. Certificate of occupancy $25.00 -- BUSINESS $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50-. 00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
5.Updated C.O. $ 50.00 Date ..,t..
NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land ........
Location of PropertyHouse !~' ''~' No~'C' .~?.1;~. .~_~.2_~. . '~' ' '' -'if '¢' '~"~' ' '[~) ~j' 'I' ' '~ StreetI'/'~' '~' ' ? 'J[~' ~ .............
Owner or Owners of Property .¢..~ .... .~ ...... ~..~.f ...... ~' .~.. ........................
County Tax Map No. 1000 Section ............... Block ............... Lot ..............
Subdivision ................................. Filed Map No. ;T."; ...... Lot No.
Perrnit,o. !.~..~..?C.~.. Date ofPermit [.~.1~..6.(.~.~.Applicant, ,.(;~..~..~.~'C.~j.~?.~-
..... .......... Labor Dept. Approva, .........
Health Dept. Approval
Underwriters Approval ..... .~..t.,; .~.~.-:'./ ~ ........ Planning Board Approval /~', '' ''.. '
Request for Temporary Certificate .... .~. I. ~... ....... Final Certificate '.~
Fee Submitted $ .l .l.~. ........................
Construction on above described building and/Fe)rmit meets a~appli~ble codes and regulations.
Applicant ';/?/(¢'.. ~ ..................
~OUND;%TION ( 1 st)
'OUNDATION ( 2nd )
:OUGH FRAME &
PLUMBING
iNSULATION FER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS
· FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined. ~ .~..0.,
Approved .~...~. ·., 19~JP. Permit No..)..~-.?.~.(~ ..~.
OCi' 2 3 ~986 '
Received ........... ,19...
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
0. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
seis 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 building for necessary inspections·
..... , ml.a .....
(Signature~ap~icant, or n~rfle, if a corporation)
.'O,~ ........ .7. ...................... ,., ........
(raa£1±ng address of appl±cant)'
State whether applicant is owner, ~essee, agent, architect, engineer, geuera] contractor, electrician, pinmber or builder.
· ...... ..........................................................................
N~me o~ o,~ner orpremises .%.~. &¢~.. - ~'.~..~:I.0..~.~5... FT. 0.., .........................................
(as on the tax roll or latest deed)
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 .... .~.~. ! .vt....~..~..~t-.~... .... ~ .0A~...M...~?....~..~-.~/., .......
....... .¢..¢. ........................................................................... '
House Number Street Hamlet
County Tax Map No. 1000 Section ..... .(~..-~..~.'~. ...... Block ..... ~.! .......... Lot .... .~...27..~. · .......
Subdivision ............. ~>~ ..................... Filed Map No ............... Lot ...............
(Name)
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 .... ..'~.. [~-'~ ~. ~T~)~('t~'-?
3. Nature of work (cheek which applicable): New Building ....M..... Additionl .......... Alteration ..........
Repai Re al De oliti : Other Work
4. Estimated Cost . . r.~..~. .~. .................... Fee .....................
(to be paid on filing this application)
~ .
5. If dwelling, number of dwelling units ............... Number of dwelling tlnits on each floor ...............
If garage number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each ~ype of use ........ : ..........
7. Dimensions of existing structures, if any: Front ............... Rear ..... i ......... Depth .............
Height Number of Stories
Dimensions of same structure with alterations or additions: Front I Rear
Depth ...................... Height ...................... Numberl of Stories .......
8. Dimensions of entire new construction: Front ............ Rear .... ~f) ....... Depth ~ .......
Height Number of Stories
9. Size of lot: Front Rear ..... ' De
10. DateofPurchase ~ ~f.-~. NameofFormerOwne/ ..
12. Does proposed construction violate any zoning law, ordinance or regulation: ..!..t~d.C~. .....................
13. Will lot be regraded ......... ~ .O. .............. Will excess fill be removed f~om 9rem~ ises: Yes ('~)
Name of Architect Address ~ Phone No
Name of Contractor .......................... Address ............. i ...... Phone No .... .. ,/. ........
15. Is this property located withinl.00 feet of a tidal wetland? 1~ Yes ..... No ..x~..
* If yes, Southold Town Trustees Permitmay be required.
PLOT
DIAG RAM
Locate clearly and distinctly all buildings, whether existing or proposed, andi indicate all 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 corner lot. I
STATE OF NEW YORK,
COUNTY OF ................ S.S
......... .~.z...,~....z~. ~o/t ?&.(d__ being duly sworn, d{poses and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ........................................................... , ..............................
(Contractor, agent, corporate officer, e!c.)
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
.............. ~..~.....~...day of .... .Q .C_~..'. ............ 19 ?..~
............... County ~-n
_--~r~,,~ ~,,,,~ 1~ ~ (Signature of applicant)
¸IT --
lOB NAME & NO.