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Home My WebLink About13900-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCcuFANCY No Z-20477 Date JANUARY 15~ 1992 THIS CERTIFIES that the building. Location of Property 10625 OREGON ROAD House No. County Tax Map No. 1000 Section 83 Subdivision ACCESSORY CUTCHOGUE ~ N.Y. Street Hamlet Block 2 Lot 15 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 1~ 1985 pursuant to which Building Permit No. 13900-Z dated MAY It 1985 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 UTILITY 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 FRANK McBRIDE & SONS~ INC. Building Inspector Rev. 1/81 FOltM NO. ~ 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) N9 13900 Z Permission is hereby granted to: 0, .rem,sea,ace,ed a, ..../..~...~.~ .......... .~...~.../f..~.... ...................................... ............. .................................................................... County Tax Mop No, ]000 Section ................. Block ............... Lot No ............ pursuant to application dated ........ ../~...~ ...... / ............., 19~....~, and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN UALL 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). 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pFc-existing" land uses: 1.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. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions 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 Ftc-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. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 . ............. ~cy Tax Map No 1000, Section.. · · ..... Block ............ Lot .... . ... ivision ...................... ...... Filed ~ p Lot h Dept Approval Underwriters Approval ~ing ~oard Approval :st for: Temporary Certificate ........... F Certicate.....~f~...... F1ELD INS£~ECTION FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING {2nd) INSULATION PER N. STATE ENERGY ~ODE FINAL · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved .~-~,~ · Z ...... 19~..~.~ermit No. [.~,. Disapproved a/c ..................................... BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tlfis 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 area~, 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 ttds 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 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 granted by the Building I~spector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to premises and in building for necessar~inspections. , ~, , , 79 .. (Si~aature of applicant, or name, if a corporation) ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. of owner of premises . .~..<~.~L~.'. · .~QT. · ~ .... .~. · .~. ? .................................. (as on the tax roll or latest deed) nt 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 ..... ~ ................ ~ .................. ............... x.//.. ....... ............... House Number O~treet Hamlet County Tax Map No. 1000 Section ...~..~. ........... Block .. ~ ........... Lot .... [..~..'~.. ........ 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 ........ ; .vT~?~. ..................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alteration ....... epair ' 'i" ' ~¢~' ;,)/' Rem?al .............. Demolition ............. Other Work ............... 4. E~stimated Cost .......................... Fee ................ I ~' (to be paid on filing this application) 5. If dwelling, number of dvzelhng umts Number of dwelling units on each floor. If garage, number of cars · · .i ............................................ ' ................... 6. If business, commercial or mixed occupancy, specify nature 0nd extent of each type, of use ..................... 7. Dimensions of existing structures, if any: Front .... ~..~/.t...:, Rear . 0¢~-.~/. .(. ..... Depth ............. Height ............... Nur~ber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ! Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 10. Date of Purchase .......... ! .................. Name of Former Owner ............................. 1 1. Zone or use district in which pr~mises are situated ............ ,¢¢..~..~..~.-~. .......................... 12. Does proposed construction vio!ate~a_ny zoning law, ordinance or regulation: ................................ 13. Will lo5 be regraded ........ i .~. · .~. · · .......... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ................... Address ................... Phone No ................ Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ........................ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockI number or descrip tion according to deed, and show street names and indicate whether interior or ~orner lot. I APPROYEO AS NO, TED NOTIFY BUIL~NG D~PARTMENT AT 765-1802 9 AM TO 4 PM ~OR THE FOLLOWING INSPECTIONS: ~ 1. FOUNDATION - TWO R~QUIRED FOR POURED CONCRETE.~ ~. ROUGH - FRAMING & PI~U~BING 3. INSULATION 4. FINAL CON'..q RtJC r loN MUST BE COMPI.ETF FOR C. O. ALL CONSTRUCTION 5[~AI~I.. THE REOtHR~MENTS OF STATE CONSTRUCTION & CODES. NOT R~$PONSIB'I E FOR DESIGN OR CONS'rRuc'FION EILRORS, STATE OF NEW YORK, , S.S COUNTY OF ................. ............................ , ..................... being duly sworn, deposes and says that he is the applicant (Name of individual $igging contract) abow~ named. He is the ..................... l .................................................................... (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 will be performed in the manner set forth in the application filed therewith. Sworu to before me this .......'¢' .ff~/~..~j.. · ·/. .... daydf ...................... 19 .?.~ Notary Public, ' ~ ., ,/~ ................ ! ................ Count ~, ............................ .2: ' ~ ............ i NOTARY PUBt IS, State of Ne~q ¥of~ (Signature of applicant) N6. 410787g, Suit01~ C0uety ~ STURTEVANT MILLWORK CORP. '7§N~ INE)USTRY~CGU RT DE~ER P~RK, N,¥. 11729 PHONE 516-667-6700 , .,,., 0~':~ ANDERSEN PERMA-~HIELD® WINDOWS ~ GLIDING DOQR~ FO~ COMMERCIAL ~ INSTITUTIONAL USE