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Home My WebLink About14001-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16188 Date September 18, 1987 THIS CERTIFIES that the building. ADDITIONS TO EXSITING AGRICULTURAL BUILDING Location of Property 39395 Maix~ Road Peconic, New York House No. Street Hamlet County Tax Map No. 1000 Section 085 ..... Block 02 .Lot 007 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Play 28, 1985 pursuant to wh/ch Building Permit No. 14001 Z dated Jun e 3 ~ 1985 was issued, and conforms to all of the requirements of tlle applicable provisions of the law. The occupancy for which this certificate is issued is ......... AD'DITIONS TO EXISTING AGRa[CULTURAL BUILDING AS APPLIED FOR The certificate is issued to C. J. VAN BOURGOND IEN, INC. ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval .... N /A N830945 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A , / Rev. 1/81 ~Olt3g NO. ~ TOWN OF $OIJTHOLD 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-~ 14001' Z Dote ..,. .................................. Permission is hereby granted to: . __ C x:'. ~ ~ ? ~.. .... ~,c ................................. :~..,.z.~.~../..~, ..... ~..../..~.....~...~.~.,,~..,,~ ............. ...... ~z~.~.~....~..,..~. ............ x/.~.~.. ,o ...~...~zd~..F....~.~.~.~..o.~zs..~...~.~..zx~Z?~.~..~-/~.~..~ ....... ...z~,.z~.~.C...-~ ........................................................................... ~/.... ................................. ..... ~'I,~9~; 4~-- /.u. ~., ...... ~ z~-,,,.....,G~.-... ,,prem.seslocoreao, ........... ,...~....~-... .......... ~4~. .~....,. ~ y ....~...... Courtly Tax Map No. 1000 Section ..~...~.'..'~....~...,.. Block ..~... .......... Lot No../~-..0....7. ....... purs,an, to application dated ...~-~'~...~.....(~..4~... .................... , 19..~...,"~nd approvuNJ/''by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6. TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 TOW "6F'Sb 0LO APPLIDATION FOR CF:RTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and submitted I ~ 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 disposel-(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 property 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: 1. Certificate of occupancy $25.00 -- BUSTNES~ $50.00 ACCESSORY $I0.00 2. Certificate of-occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.'00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C OhS t ~ uc ~ i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............................. House No, Street Ham/et Owner or Owners of Property ~ q.. . G(~. ~¢'¢~ ~.~..A ,~'.~ ....................... County Tax Map No. 1000 Section .. ~ Bock .... ~ .. Lot ~ .... Subdivision ................................... ~d. Ma~o ...... Lot~o .............. Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ' . ................ Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 Co% IG I" I hLI) [ I~ S lq,:c'r I{~N COMMI,N l ~.~ FOUNDATION (1st/ FOUNDATION (2nd) 2 o ~{OUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE 4 o FINAL ADDiT'iONAL COMMENTS: lO001, . THE NEW YORK BOARD OF FIRE-UNDERWRITERS BUREAU OF: ELECTRICITY ~- J~ 85 JOHN STREET, NEW YORK, NEW YORK IO03B THIS CERTIFIES THAT N only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of C.J. V~m Bcurgoudten, Ibc., n/s Rte. 25, E/O Bridge Ia., Pecoaic~ N.Yo in the following locqtion; [] Basentent ~.%l " ' FIXTURE FIXTURES RANGES OUTLETS $WITCNES FLUORESCENT 10 15 1 10 DRYERS FURNACE MOTORS ~ Ist Fl. [] 2nd $~. Section Block andfound to bein compliance with the requirementsofthls Board. APPLIANCE FEEDERS Lot EXHAUST MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE OTHER APPARATUS: E NO OF NEUTRAL~l T. Ii. Cheshir~ & Son, Calverton, ~.¥o 11933 This certificate mvst not be altered n any manner; return to the office of the 8oard if i0cor~ect. In~sp~ctor~, COpY FOR BUILDING DEPARTMENT. MANAGER by their credentlafs. ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined ~.~?. '. ~. ..... , 1 .r~..' Approved~.O.~'~..~...~. ....... 1 .~.. Permit No..~..~..~..~..~. Disapproved a/c ...... ~ ...... ~ ............. .y/-~ ..... (BuSlding Inspector) APPLICATION FOR BUILDING PERMIT Date/.. WX.. ,g.. ..... 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 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 necessar,>' ',pectio~. /' ~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) / State whether applicant is .ow.r.~ner., lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. C..~... V~.i .l~.~..4/..t~..~..O.,fl~...~.l'~g'/K../.lll~.~, .......................... (as on the tax roll or latest deed) If applicant is & corpoj,'a~ion, signature of duly authorized officer. /(Name and title of c/~'rporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done.../.7, r~././.r./.../.~V...~.../7../,-7.~'. -.~'..~/,: .~:'. ............. House Number Street Hamlet County Tax Map No. 1000 Section O~ -~-' Block . O ~ Lot .4~5. cO r~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing a. use and occupancy ........... ~.~ ........................... /.....~, .... ~ ....... b. Intended use and occupancy .................................... .~.! ......... . .i~.~./~. t.././.~..~t'.~... 10. Il. 12. 13. 14. property lines. Give street and blocl interior or corner lot. Nature of work (check which applicable): New Building. .........f Addition ..........~ Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... Estimated Cost ' ~ Fee .................. ~' (to be paid on filing this application) If dwelling, number of dwellin: units ............... Number of dwelling units on each floor ................ If garage, number of cars ......................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use .. ~A~. ~'.tf././.r'.~..~.--P'~'~. . Dimensions of existing structures, 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 ..... Rear Depth Height ............... Nuiuber of Stories ......................................... , ............. Size of lot: Front .......... : ........... Rear ...................... Depth ...................... Date of Purchase ! Name of Former Owner one:or ' ' Z use district in which p em~ses are situated ................................................ Does proposed construction violate any zoning law, ordinance or regulation: ... t"//f.~ ..................... ;.. Will lot be regraded ....... d~'..re. .............. Will excess fill be removed from premises: Yes /'~ Name of Owner of premises... ~:'.'~J~ i.. i... i.. Address ................... Phone No..~'.,~.~.'..~.-o7. ~'.~.~.. Noane of Architect ......... .................. Address ................... Phone No Name of Contractor ........ i .................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from : number or description according to deed, and show street names and indicate whether STATE OF NF, W/YQII, K,. · ~/ (Na~e o f individual sig~/ng contract) ......... being duly sworn, deposes and says that he is the applicant He is theab°ve named. . , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly 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 mann,~er set forth in the application filed therewith. Sworn to before me this AI:'~mO~'~D AS NOTED ~ ~ NOThFY ¢~ ;U_~tNG DEPARTMEMT AT 765-1872 9 AM TO 4 PM FOR THE FOLL~'"~,'¢ '~'c~C~ONS, -. , , . FQU TWO REQUIRED F.; . CONCRETE 2. RCLJ¢~Z~-~RAMIN~ & PLUMBIN6 3. INcl.'-A *. .... . .~N MUST 4. F?>L - C~ ....... ~'~-~ ~. ~,..N SHALL ME~ ALL CmN?''?' '~'"~ ~ THE R~P .... :~:TS OF THE N.Y. c~ ~o, ~ ENERGY STA~ ..... UC,ION & CO~ES. N'*T RESPONSIBLE FOR' DESIGN Oq CONSTRUCTION ERRORS,