Loading...
HomeMy WebLinkAbout13699-zFORM NO. 4 TOWN OF SOUTHOLD ~UILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-17380 Date OCTOBER 5, 1988 THIS CERTIFIES that the building Location of Property 3500 BEEBE DRIVE House No. County Tax Map No. 1000 Section 103 Subdivision ACCESSORY UTILITY BUIDING CUTCHOGUE~ N.Y. Street Hamle% Block 9 Lot 3 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 5~ 1984 pursuant to which Building Permit No. 13699-Z dated FEBRUARY 8~ 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 14' x 14' WOOD FRAME UTILITY BUILDING The certificate is issued to STANLEY CHASE (owner, -- of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF2~LTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N671286 - DECEMBER 14, 1984 Building Inspector Rev. 1/81 FOBS[ NO. ~ TOt/~N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT frillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~3699 Z Permission is hereby granted to: ...~..~.~....~..~..~~i .... ,o ......... ............................... ot premises located at ............................................................................................................................ ................... .~.~.~....~~...~~ .................. :: ........................................ ................. .~.~. :.~~....,~,..~. ...... /.../...~.~ ............................................. ~,n~ Ta~ Ma~ No. I~ ~,,,,~/..~...~ .......... B,~ ...... .~. .......... Lot ~o. ...~.. ............. purs,ant to appUccltlon doted .~.,~,. ........... . .~,... .................. , 19.~,..,~, ,nd approved by tBe Building Inspector. Fee $..~..~.,..~.. ..... Building Inspector Rev, 6/30/80 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O{ Occupancy 35Q0. Beebe Drt ....... Cutchogue Location of Property i.~ ~/'d .............. Street Ham/et County Tax Map No. 1000 Section .. j1.0.3. ...... Block ... ~ ........... Lot .. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... D.~9....~ .......... ,19~.4.. pursuant to which Building Perlnit No. 1369.9~ dated ..... F..e.~....~. ................ 19 .~..5, was issued, and conforms to all of the requirelnents of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... 114'X ~4' wood frame utilSty building The certificate is issued to ..... /~UGUST & RUTH BOHbl ............. of the aforesaid building. Suffolk County Department of Health Approval .,..N./.4 ................................... IJNDERWRITERS CERTIFICATE NO ......... # N~5.7. ] ~ 8.6. ............................. Building Inspector Rev. 1/81 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 ~ ~ 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 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 comp{eted 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 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- tion required to prepare a certificate. C. Fees: Additions $25 .00 POOLS $25.00 ALTERATION $25 .00 1. Certificate of occupancy New Dwelling $25.00, Accessory ~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ ID0.00 3. Copy of certificate of occupancy $ 5.00, over 5 ),ears $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .................. NewConstruc lion .... Old or Pre-existing Building ............ Vacant Land ........ Location of Property 35.00 Beebe Dr. Cutchogue, N.Y. House No. Street Ham/et Owner or Owners of Property ...... S. TANLE .~ CHASE County Tax Map No. 1000 Section 103 9 3 ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. ]46.99Z 218/85 AUGUST & RUTH BOHN ......... Date of Permit .......... Applicant .................................. Health Dept Approval NA Labor Dept Approval NA Underwriters Approval #N67 ! 286 . NA ........................ Planning Board Approval ..................... UPDATED Request for ~'~Certificate ..................... Fina~ Certificate ....................... Fee Submitted $ .... .5.0...0.0. / ~ Construction on above described building and perrr~3ff'~P_plicabl~,codes and regulations. Applicant . ...r'~~.... ............ Rev. 10-10-78 / FORM NO. 6 TOWN OF $OUTHOI,D ~uilding Department Town Hall ,~;outhold, N.Y. 11971 APPDCATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitte~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 Depto 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 p~an requirements where applicable. B. For existing buildings (prior to April 1957), Nomconforming uses, or buildings and "pre.existing" land uses: 1. Accurate survey of peoperty 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 bu!ldings, 3, Date of any housing code or safety inspection of buildings or premises, or other pertinent in~orma* tion required to prepare a certificate. C, Fees: 1. Certificate of occupancy $5.00 Certificate of occupancy on pre-existing dwelling/ land use --?re-.~;×ie f,£[~g; C. 0. $15 ~ 00 '~ Cop¥ of certificate of occupancy $1.00 Vacant land C.O. $ 5.00 New Building ~./; b/~',/~:**,/:.'/,,h. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ~. ~'~.~(?¢? .... ~.~ ~'b,-~. .... D£; ................ ~L~ ,~-.Q~ ~..~ t.'/~,-.. ~/~. :~.~ .... Hou,~e No, Street Hamlet Owner or Owners of Property /),K,~ ¥~.~'. · .Q' ~,~'J .... ~, q/./.~ ....,~,.t-/I,[/,, ....................... County Tax Map No. 1000 Section ,. 1, ¢~, ~, ........ Block ,..~ .......... Lot,, .,'~¢-~ ........... Subdivision ................................. Filed Map No .......... ,Lot No .............. H Permit No./,-~,, ~, ~.~.-Oate of Permi~"~,,~ ~ ,~Appticant, ~.~ ~,;,., ~ .......... Health Dept, Approval ........................ Labor Dept, Approval ........................ Underwriters ApprovalN. ,~,'.~L ~,. ~,, '~' ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ,~, · ·. ............. Fee Submitted $. ~.~ .~.~. C .................... Construction on above described building, and permit rpeets /'all appl~laL.~ codes and regulations. . Apphcant ...... //~...-./~,! .: ............................ Rev. 10-10-78 STRUCTURAL ANALYSIS MODEL ANALYST SUBJECT I CHECKER ANALYSIS DATE INDEX PAGE NO. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 Approved .~ .~...~7. ..... , 19t~ff~ermit No.../~..6. ~.~..Z- Received ........... ,19... Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis application must be completely filled in by Wpewriter 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 l~o~t and of buil~l_~g.s~ 9n_ p_r~_rnisgs relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagiarfi 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. /0 ~ / / ...................... ....... (Signature of applicant,~-~"~or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ·,..~...®..~. ~.e f-. ........................................................................... ~' .... Name of owner of premises ~ ~& ~t4~... ~.~..~J.... ~u.:[-.~... ~O,~-J ~3... 7..~ ~l~I~©~.~ ~. t~l~12~': l[~'~' ...... "J (as on the tax roll~j~l~~ .... fficer ' ~'~/-d:y-t~r~l_ts, v. ~ ~ If applicant is a corporation signature of duly authorized o ' . ~E~"~F/~- R~ /'~C-) - N .~__B~: _~L~_~ OT FY BUILDING D~-~RTM~ ......................... 765~1802 9 AM TO 4 PM FOR THE .....................~/ TIONS: (Name and title of corporate officer) FOLLOWING INSPEC Builder's License No. ~/..~. ............. 1. FOUNDATION . TWO RE~I · .,, FOR POURED CONCRETE 2. ROUGH - FRAMING ~x Plumber's License No ......................... 3. INSULATION 4. FINAL CONLSTRLI'-j !~5, T Electrician's License No ....................... BE COMPLFTE FOR C. O ALL CONSTRUCTION Other Trade's License No ...................... THE REQUIREMFNTS Off ~ STATE CONSTRUCTiOn,r 1. Location of land on which proposed work will be done ............ COD~. · · · NOT ' 'F~S'p'c~.G~::.' ..... ~ ....... ..... .... ........................' .... House Number Street._ c¢_. ~t~1~ ............... County Tax Map No. 1000 Section .... I.(9 .~.'~ ..........Block ....cE ............. 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 ... ~ ................................................................. b. Intended use and occupancy . .~tj./i ~.~t ./~.~..r~.ff.% ................................................. 3. Nature of work (check ' ' ' ~'/" ' which apphcable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... i (Description) 4. Estimated Cost ............ ~ .......................... Fee ...................................... ~' (to bo paid on filing this application) 5. If dwelling, number of dwelling units .w ............. Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy specify nature and extent of each type of use ..................... 7. Dimensions of existing structur:es, if any: Front .-: ............. Rear . . . Depth Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front .-: ............... Rear .................. Depth ................... ~'... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ... l .~.' Rear . l~ Depth . ~.~/ ..... Height I.~~ Number of Stories 9. Size of lot: Front ........... i ............ Rear ...................... Depth ...................... 10. Date of Purchase . i. Name of Former Owner ' hp~ I I. Zone or use district in whic emises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. '.,q.q ........................... 13. Will lot be regraded . ..~? .... ~ .................... Will excess fill be removed from premises: Yes No Name of Architect - Address Phone No Name of Contractor . :. ....................... Address ................... Phone No ................ .. i PLOT DIAGRAM Locate clearly and distinctly al! 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 Corner lot. TA'IE OF NE~ :S S .... 4-~,44/L~ ?..".-~..~'.... i .................... being duly sworn, deposes and says that he is the applicant , (Name of individual sig~ing contract) above named. He is the ..................... ~ ................................................................... (Contractor, agent, corporate officer, etc.) 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 mann6r set forth in the application filed therewith. Sworu to before me this Notary Public, .~~ .......... County No. ~ao* - ~""°~, ~, ~0c°""'Yl, gd (Signature of applicant)