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HomeMy WebLinkAbout14656-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy zj~537 THIS CERTIFIES that the building Re-cons truct A.c.c.es .s.o.roY Ga.za.b.? 350 Br,iarwood Lane Cutchogue, New York Location of Property/f/~O$~ ~/o~ ........................................................ Street Hamle~ County Tax Map No 1000 Section 1.36 Block 0 l Lot 5. . . Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated >'.eh r u ~.r.y.. 9 .......... 19. ~ ~pursuant to which Building Permit No ..... 14. .6 .5.6 z. .......... dated .. gq~ ¢~.. [ ~, ............... 19 .~ ~, was issued, and con~rms to afl of the requirements of the applicable provisions of the law. The occupancy ~r w~ch this certificate is issued is ......... ~b a.s. ~??!~ ~ ~-. ~e-cpp. struc.t acc.eq~or~ ~a? o o Th rtifi i edt FRED & MARYANN CARCICH ......... ;, ~;rdexo~ :~? ..................... e ce cate s issu o ................ (owne of the aforesaid building. Suffolk County Department of Health Approval [q / A ........ UNDERWRITERS CERTIFICATE NO ................ ~./.A. .............................. Rev, 1/81 FOBM NO. ~ TOWN O~ $OUTROLD BUILDING DEI~ART/~I~I~IT TOWN HALL SOUTHOLD, H. Y. BUILDING PER. J~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14656 Z County Tax Mop No. ]000 Section ..... )...;~;:~.,~o ...... Block ..... .~.,..! ........... Lot No ........ .~;:~,-~,, ........... pursuant to application doted ,..,~.~.~....~. ................... , 19..~.~2-- ~nd approv~ by the Building Inspector. Building Inspector Rev. 5/30/80 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 ~a ~ 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 build ngs, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the bud ng. 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 p2*operty showing all property lines, streets, buildings and unusual natural or topograph ic features. 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- lion required to prepare a certificate. C. Fees: 1. Certificate of occupancy 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O, $5.00 5 .Updated C.O. $15.00 Date .. /~ ¢{~¢;~/~. , [¥,~..~, , , NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~,,~ .... ~:),~, dlx'/~,f4/~.~/~,,. , L~.. ~/. r~.~;~.~..., House No. ~. Street Ham/et Owner or Owners of Property , .~ .... ,/~:../~.//~//~.,, ~ .................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ...... Lot No f Permit No./.~.d. ~. ¢.-~ Date o Permit ~.(..~. ~pplicant .. (~,~.. ~... ~ ......... Health Dept. Approval ..... /Q'/./~ ............. Labor Dept. Approval .... ,/K~/~, .......... Underwriters Approval ...... ~.//¢- ............. Planning Board Approval ..... ,/~,~ ............ Request for Temporary Certificate Final Certificate Fee Submitted $. ~.~. ;~2~. ..................... Construction on above described building an~it meets al/app~ co,es and regulations. Rev. 10-10-78 co '1553 7 7GS-XS02 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION REMARKS: 76S-1802 BUILDING DEPT. INSPECTION ~ FRAMING FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL REMARKS: INSPECTOR F~IEI,~D .INSPECTION__ COMMENTS FOUNDATION {1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 350 BriaDwood Lane Cutchogue, NY 11935 3 March 1986 Town Hall - Southold P.O. Box 1179 Southold, NY 11971 Attn: Building Department Gentlemen: I have enclosed a notarized application and three sets of plans of an unenclosed outdoor shelter (gazebo) of approximately 154 s.f., proposed for my property. The structure replaces a like structure which was destroyed in the hurricane. I have enclosed $25 application fee. V~er~]t ruly yours, F'~Fr~d FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.~. ~, ] ~.9.~ .......... Date ..... .~ p?. J:. .1. .7 .................... 19 .8.3. THIS CERTIFIES that the building ................................................ Location of Property . .3.5. Q..B?.%a..p.~p. qd...L.a.n.e. ........................... C.u..~.c~h~u..e... House No. Street Hamlet County Tax Map No. 1000 Section . J .3.6. ....... Block ....Off .......... Lot .... 0.0.5. .......... Subdivision.. [ ............................ Filed Map No. X .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...A. p .p 5.1. . 6. .......... , 19 8..3. pursuant to which Building Permit No .... ~. 2. .2.3.~.Z. ....... ' .... dated .... g. p.e.5.1...7 ................ 19..~ .3, 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 ......... a gazebo accessory structure. The certificate is issued to ........ .E.D.N. 5..~.-.. ~9.B.g. .................................... (owner, fear, e-or of the aforesaid building. Suffolk County Department of Health Approval ... B./.~ ................................... UNDERWRITERS CERTIFICATE NO ........... r~/.O ................................... Rev. 1/81 om~ ~ I I I I × ~AP FR. R, cOt~~ OF FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Examined. ~'~.o~x~.l.q..., 19 .~.~. Approved . .'."~....O_/~..../.qT..., 19~(~. Permit No..} .~./.f .~."~...~.. Disapproved a/c .................. . ................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tltis 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 whate¢er 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 i,,spectors on premises and in buildh~g for necessary~ns~ (Signature of applicant, or name, if a corporation) ..... .ow.. q.v. .............. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... ~:O.~(-~.. ~C~.. / .~M/W~'. ~ ....................... (as'--on the tax roll or latest deed) If applicant isa corporation, signature of duly authorized officer. (~~ (Name and title of corporate officer) Builder's License No .......................... CAMILLE PRELLI Notary P~lblic, Stale of New York No. 31-47~,2.327 Qual. in Now York Coltnt~/ Commmoion Expiro$ March 30, 19~..~' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ..................... ¢rrx . ......................... 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 ..... f~,~././~/~.~ ................................................. b. Intended use and OCCUpancy ... ~,/dL/. '~/.~..~t,~.~z~d,,.,..~t'.~---Z~ ................. 3. Natme of work (check which app!icable): New B tiding .......... Addition .. i~- Repai,r .............. Remov¢l ............ Demolition ........... · Other (Description) property lines. Give street and block number or interior or corner lot. 4. Estimated Cost .... .n'.Z'(d~,~'z~.O,, ................... Fee .................................... ' ' (to be paid on filing this application) If dwelhng, number of dwelhng routs .............. Number_of dwelhng umts on each floor ................ If garage, number of cars ...... ,:... I'~I'~['I II'DA[~[~..¥. (~. ....................................... 6, If. business, commercial or m~xed 9cctlt~l~i~/~&if~t~l~re an~'exten, t.o,f each type of use ..................... 7. Dimensions of exist, ins stmctures,lif alYttti _lgntiC..~',lil~ll. A~l~[~li .....~.~..: ..... Depth .~t4~ ............ Depth .... ' . S]...Fl: ........... i. Hel~[.[ lli~tli~l..Ul~,.% I} .~.l. ~%~r~f Stories Hexght .. '..t~..d~./(....'. N,umbeJ' ofl0~ O~l;~l~fil~l~ .'[[ i.e .......................... 1, ........... 9. Size of lot: Front ..... ff-~, .l.e~/. ....... .'l'I~ . .· · .(~ : . ~ ........... Depth .... '[~.(t~ ............ 10. Date of urchase ....... I ........... Name of Former Owner ................ 11. Zone or use district in which premises are situated .... ~3t/2~,,.t~'14q.,. ..................................' 12. Does proposed construction viola~e any zoning law, ordinance or regulation: .~O ............................ 13. Will lot be regraded ....... ~ .N.~. ................ Will excess fill be removed from premises: Yes 14. Name of Owner of premises i~,~l¢i~6~Cz.~ ...... Address $'$'O~.~.~../~.. Phone No. ff.3['{-..7~'.~ .... Name of Architect .......... .. !;'T .............. Address ......... .'F. ........ Phone No ................ Name of Contractor .......... i.-7. .............. Address ........ .-'7 ......... Phone No.. ~ ............ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ation according to deed, and show street names and indicate whether APPROVi~'D AS NOTED c, '-- C. 785-~802 ~ A~ 1'O ~ PM FOR THE ALL COO;O ~UC'~ON SHALL MEET HE REOth, ~..:, ,~{:NrS OF THE N.Y STATE CO{~)~ rRUC'rION & ENERGY CODES. NOI RESPONSIBLE FOR ~E8I~N OR CONSTRU~ION ~8RORS. TATE OF NEW YORK,o ~'_ .., ,., ... ~. ~1~..~. '.~'.~'. '. .................... being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) above named. (Contractor, agent, corporate officer, etc.) *f said owner or owners, and is duly iauthorized to perform or have performed the said work and to make and file this ~pplication; that all statements contaified in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et forth in the application filed therewith. ~worn to before me this ,' ~~4..~_~.~.~ { ., CAMILLE PRELLI ! / ~ ] Commission Expires March 30, 19,0~.?'