The URL can be used to link to this page

Home My WebLink About14593-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARtmENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22195 Date MARCH 17~ 1993 THIS CERTIFIES that the building Location of Property 3615 ACCESSORY BUILDING VANSTON ROAD, CUTCHOGUE, NY House No. Street Hamlet 111 Block 11 Lot~ 1.7 County Tax Map No. 1000 Section Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 4, 1986 pursuant to which Building Permit No. 14593-Z dated MARCH 2, 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 ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to JOAN R. SMITH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N(.' Z County Tax Map No. 1000 Section .......... .~,,.~.~ ....... Block ........ .~.l .......... Lot No. ,.,.J..:.,..'~.. .......... 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 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.~rom architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swin~ning 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 - $i0.00 4. Updated Certificate of Occupancy - $50.00 5, Temporar% Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .......... .. New Construction ........... Old Or Pre-existing Building ........... Location of Property ................. '.. ........ House No. Street Hamlet Onwer or Owners of Property.~.~..g~.. County Tax Map No 1000, Section......... ~ i ~ .... . Block...~.l ........ . .. LotJ..!~.]l .............. . Subdivision Filed Map Lot .. dP-, Permit . ate Of Permit ........ , ....... Applicant. . '.. . Health Dept. Approval .......................... Underwriters Approval ........................ . Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate .... ~ .... Fee Submitted: $..'.~..-..-~. ..................... - . ' ' ............. ~ -~ APPLICANT f ' ~IN S?ECT ION 1. ,'OUNDATION (1st) COMMENTS 'OUNDATION (2nd) ~OUGH FRAME & PLUMBING ~NSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTfIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 January 29,1986 Joan R. Smith Rt. 1, 3615 Vanston Rd. Cutchogue, N.Y. 11935 Dear Mrs. Smith, Please submit actual construction plans with your application, we need 3 sets. These plans can be hand drawn. Please give us as much detail as possible. Thank you so much for your cooperation in this matter. Please call us if you have any questions re- garding this matter. Sincerely yours, ~ Building Dept. Sec. Approved . .~...~.~ ;~' 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 19 ~.~ Permit No.l.~..~.'''~. .~ .~... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT FEB - a 1986" Received ........... ,19... 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 tlie 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 heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit ~uthorized inspectors on premises and in building for necessary insp~tions. ~ (x'''''x aD ' ....... /~.~,,,...~ .4,,..~3. ,t :...wOx~ .......... (Sigf[atOre of applicant, or name, if a corporation) h. (Mailing address of applic, ant) (J I l ~ ,g,~' State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises...3. O..~.~....~..'...~ .~t.[..~.~ ................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 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 .................................................. · ................ .............' House Number Street Hamlet 0 County Tax Map NO. i000 Section ....... .~.~./ .......Block ..... [ .~ ........... Lot ...... /.,.7 .... ~ Snbdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises ahd intended use and occupancy of proposed construction: o .C. 1,,t: .... . ................... a. Existing use and occupancy-. .... ~.. B.~v~. .... ~ ~ ........ ' ......................... b. Intended use and occupancy. ]~1 .~. ~..~.~. g. O.'t.'-[.. ~) .~ ~ ~ ~ .,.,,4(~ .... (,~.~. . 3. Nature of work (check which applicable): .New Building .......... Addition .. 'i ...... Alteration ...I...;... Repair .............. Removal .............. Demolition ........... '... other Work ............. L ~o~ £~-.'1- ~ ~?Oo ~. ' (Description) 4. Estimated C0st~.% .ID.~2.~. ................ ' a,oo.'i. ' Fee. .................. (to be p.a~d on' filin~ this application) 5. If dwelling, number of dwelling units ............... Number of dwelling unitsl on each floor ................ If garage number of cars i ' 6. If business, commercial or mixed occupancy specify nature and extent of each typ6 of u~e ................. ' 7. Dimensmns of existing structures, if any: Front .... ~"{' ' ' · il .... Rear .. g.0....~ ...... Depth . ,.3.0 .......... Height ............... Number of Stories ......... 2. ~ ............... ! ........................... Dimensions of same structure with alterations or additions: Front ............. ~ .... Rear .................. Depth .......... Height Number of Stories .......... D'm ' ' ' ~ * ~ ...... i' · "' 8. a enstonsofent~renewconstruct~on: Front...~ .1~ .... d'" Rear . ~[..8 . Depth I.~ ~ .... Height .............. Number of Stories . J ~.~ ! ~ ._, 9. Size of lot: Front . ~...~ ~. ............. Rear ...... ~ .~. ~ ........... Dep,th . .~.~L~ ........ i ....... 10. Date of Purchase . D {[~,.. L~/..-/.'/ .... : Name of Eo~.r~, j~r, Owner ~.~t..[~,~.~,. ~{~t~.a~ } .... I1. Zone or use district in which premises are situated ~ {~,~t.~.,.Ol . i . .'" ~J . '" i' ' 12. Does proposed constructioll violate any zoning law, ordinance or regulation':' i i~.' i~. iiiii,"" .~.' iiiiilii ii" 13. Willlot be regraded ...~/.O ............. Will excess fill be rerrmvet["from oremi~e's: ' "Yes '~o) 14. Name of Owner of pr,erc~ses .~J ~.~vX. R, ~,,. ~'h.. Address~.l~ .~-1[ .~.,~ .~ ~ .FC.%k. bj[ll~Phone No..J'.5 .~.". ~.~. $ $ .... Name of Architect . .l~. q.~.~ ..................... Address ................ .0. Phone No ................ Name of Contractor . .~.~..~. ................... Address ................ i. · · Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, 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 coiner lot. , STATE OF NEW YORK_, / zou ¥ OF..°. ... " ........ ~ ~.~.. ~i ~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) tbove named. fie is the 0~{~ (Contractor, agent, corporate officer, etc.) )f said owner or owners, ~d is duly authorized to perfom or have perfomed ~e said work and to m~e and file this ~pplication; that all statements conta~ed ~ this application are true to the best of his ]:nowledge and belief; and that the ~ork will be perfomed in the m~ner set forth ~ the application filed therewith. gwom to before me this ............ ~h ..... day of.. .¢~ ...... 19 ......... i' '' ~ ' k ~AN 7~v~ / [ ~ ~ ~ :,(Signature o.fapplicant)Jh No~Y p~. s~5~ Now Yor~ [ ] .... Cornmi~io~ r:::~ires March 30, 190~ , IVIAp' r_,~' L,"a4D ! This ~.~ 'Lding was constructed in 1970. It is to be moved approximately 200' ,to the proposed location. %'be Aast elevation has one center door. The l~orth elevation has one wJ. nd{o%,~ in gable inst,~ad of door. Foundation piers to be enclosed with lattice, 765,1~0~ ~ A~4 TO 4 P~V~ ,~ THE l:~~ COf~Fi ~'~ .... ~1 .. ~, . ~N~Gy II West Elevation First Floor Floor