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Home My WebLink About23655-z f ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-24633 Date SEPTEMBER 19, 1996 THIS CERTIFIES that the building ACCESSORY Location of Property 1925 WEST CREEK AVE. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 110 Block 2 Lot 6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 16, 1996 pursuant to which Building Permit No. 23655-Z dated AUGUST 30, 1996 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 ACCESORY STORAGE SHED IN REAR YARD AS APPLIED FOR. The certificate is issued to WARREN SHEPARD (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A //Auil,ding Inspector Rev. 1/81 "UK NO. 9 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) N? 23655 Z Dote ...... a%, ..VAD7 ...................... 19 Permission is hereby grant to:. .. .. . .......... ......... . ... .... J ' ...... . .. ...... ..... ... ........... . .. ............... ...... ....... a51,00" to Aw-A. .. ....... ......... atpremises located at .............. . ....... . .... .......... .1......!`......................................... ..........o................................................. ..................................... .......................................0..............................................o............................... County Tax Map No. 1000 Section ....... V..... Block ....................... Lot No. ..... ............. pursuant to application dated ............. ............ ......I(W.........o...... 19Y(10, and approved by the Building Inspector. 4 Fee $..9-9..........K— .. /"'� .......... .......... .... . . ......... Building Inspector Rev. 6/30/80 �( Form No. 6 _OWN F SOUTH OLD H OF BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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 survev or- 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 to lead. D. 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. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-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 reasoris therefor in writing to the applicant. C.. Fees 1 . Certificate of Occupancy - New dwelling $25.00, Additions to dwelling 525.00, 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 Pre-existing Buildinc - $100.00 3. Copy of Certificate of Occupancy - .25c 4. Updated Certificate of Occupancy - 550.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .��M -C b)-11.110. . . . . . . . . . . . . . . New Construction. . . . . . . Old '+O-�r Pr-e}--exi/sptiing Building. . . . . . . . . . . . . . . . . Location of Property. . . I. 0-41;?. . . . . . . . . . . . House N1y�o'.. Street Ha et W . Onwer or Owners of Property. . n . .4�c� A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 1000, Section. .1.1P&D. . . . . .Block. .Q2!0 . . . . . . .Lot. U06.+t0 . . . . . . . . . . . . Subdivision. ..r�..-. . . . .t�..j. . . . . . . . . . . . . . . . . . . . . . . . .Filed ppMap. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . . . . . Permit No. g$.bw.9. .Date Of Permit��.�11.1.1�Applicant.LA19414g7lj. . . . . Health Dept. Approval. . . . . . . . . . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . .000. . . . . . . . . Planning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . - / Reauest for: Temporary Certificate. . . . . . . . . . . Final Carticate.Y . . . . . . . . Fee Submitted: 545:��b. . . . . . . . . . . . . . . . . . . . . . . . . . .�: !�. .ANT .� Z.4 . . . . . . . . . . . . . . 7 .T AP_-ICALr� suiLDiNa DE". INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 CATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: DATE INSPECTOR P 1I;1.D I NSIx I I ON itv110RT DATL: (;0Mrfi:N'1'i II 'd POIINI)A'I'ION I I _ - M FOUNDATION —(2ND) I x OQA ROUFRAME RAf11? 6 i II jl 1'I,IIMR r NC; - f 1145 II.AT I ON PER N. Y . TAl'R I,NI,It(:Y CODE. I I F1 NAT. I - ------------------ U ADDITIONAL COMMI3N'I';: 9 F _ BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . ;F a BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . AUG 161996 . . . . . . . . . . . . . . . . . . . f ✓ 1 C--�° TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 BLDG. DEPT. TEL: 765-1802 NOTIFY: TOWS!OF SOUTHOLD CALL "=D 4`1, . . . Examined.. . ., 19! / MAIL TO: JC�t-•-;C'�. Approved....... ., 191?. Permit No. CO ..... ,t6, !. Disapproved a/c .................................. .....� *.J.i..l�lw... (Building Inspector) KATION FOR BUILDING PERMIT ^^//� qq�� Date. . �lA,�.S�-lf? , 19l�. INSTRUCTIONS a. 'lhis application mist 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 application. 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 issue 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 MATE 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 Leas, 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. .... .4...... '�.. ............... (Signature of a licantr`fname, if a corporation) 112 :- fi .. ... .. . (Mailing address of applicant) - State whether applic�aan�t�is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................tll_P.c7°",-�QQ.,,,......................................................................................... Name of owner of premises !1. .l�S t.'"t'`��."�'' � ..f 1. � r t-U�&�-.. as on the Erol or latest If applicant is a corporation, signature of duly authorized officer. (Nam.and•title•of•corporate.officer) .-.•.•-.----••-.-.- r. Builders Ltetidle,No. ......................... Plumbers License Ido. ...................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will nue done. .....1 ...........`:'. .. 1AA ........ ................................. House Number Street Hamlet Conrnty Tax Map No. 1000 Section .t lOo&Q....... Block Ali.......... Lot QQ b�4...... 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 .. Mi ..i tno. �11e11u? XI aA Oc 4 .... t .1 E vfik',88104 c3 M191 3. Plature of work (check wi6cli applicable): New Building I ....... AMition .......... Alteration ..... Repair ............ Removal ............. i)emolition . Other Work ............ .'t ................ (Descri pl"ioh) 4. Estihrrtted Cost tbe�h>;ed�............ fee ! ................................... (to be paid on filing this application) 5. If owel 1 ing, rxotiter of dwell ing units .=......... iJL.ni)er of (dwell ing emits on each floor ................ If garage, umber of cars-:................................... G. If Ixtsiness, commercial or mixed occupancy, specify nature and extent of each type of use.=................. 4 7. Dimensiohs of existing stnhctures, if any: Front..-.J........... Rear lklt Depth height .....................• Nmber of Stories .�.................. Dimensions of sane stncctthre with alterations or additions: front �:............ Rear ............... Depth .................... 11eigltt .................... Mnber of Stories ............... 1 I l tl. Diutensions of. entire new constructiay�h: Front CCII Rear cl............. Depth 1 11eig1it .T..................... Nxiber of Stories ................... 9. Size of lot: Prvn-1 J• fpy;z...'......... Rear 101c�+....... Depth 10. Mite of Purchase SIW1 ...L 1.�.�... NM•me of Former Owner � 11. Zone or use district in which premises are situated ..1.� 5}Q( ..h� l........................................ 12. Does proposed construction violate any zahing law, ordinance or regulation: .-No.................. 13. Will lot be regraded .,.�.N. ..�.+.._n...,,Will e xcess fill be removed from premises: n (YEAS �t�/� ,t� Ill. Names of Owner of premises i�W14 c7hl�l,l� II�. d Address ��"akor—Mb fAlpFhone No.!'r!?310.E..... 71 Name of Architect r--- ..... ...... ..... ...... Arklress ..�....... Picone No. Nave of C(mtractor NA.For'kV1oA lkC�c 1 _. Address .fi%A- ,+2r...1'hone No.71&2070... 15. 15 * cl Wy,, this property within 300 feet of a tidal wetland YfS ........ .,,•,,,, *i.F YES, S(lUlil(11n IMN 7falSII:GS MIT MAY BE RE(A)1RED. PLOT DIAGRAM i,ocate clearly and distinctly all lxhildings, whether existing or proposed, and indicate all set-Ihack dimensions frim property lines. Give street and block mober or description according to deed, and show street names and indicate whether interior or corner lot. AP RAP ED AS NOTED _ DATE: B.P. FEE• By NOTIFY BUILDING DEPA 765-1802 9 AM TO 4 PM FOR THE LLOWINGOCCUPANCY OR 1. OUND TIONP-ECTION REQUIRED USE IS UNLAWFUL ROUGH - FRAMING ING & P 2. ROUGH - FRAMING d� PLUMBING 3. INSULATION WITHOUT CERTIFICATE 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR CO. ALL CONSTRUCTION SHALL MEET OF OCCUPANCY THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY srnlr (w raw Y(>(ut, CODES. NOT RESPONSIBLE FOR G� ((w ss DESiGKOR MNSTRUCTI)N L� ��... •. &X&-.....................being (July sworn, deposes aril says that he is Lite appi.icaut (Kane of individual. signing ontract) alxyve nattied, 4ile is lite ................... (CwiLractor, , nt, corporate officer, etc.) of: said owner or owners, atxl is (July authorized to perform or have performed Lite said work and to rmke and file this all)]ication; that all. staLAmnts contained in this appticati(m are true to (fie I)Pst of: his krxxal.edge nix] bp--Hef; mx1 that Lite work will be per.font"I in Lite manner set forth in Lite application filed therewith. Sworn to before me Lhis �.b ...day I9 .... Notary public .............� .. ..��.. .��!"`ft,�! v ROBERTL$ ,.R• (Sil;tk-ht:(tre of -hpl avant) NOTARY PUB State of N.Y No.472 .Suffolk County Terni May 31 19 HOLZM AM P-xlTkxs&*N it 10 9 �'�,beo�3ec,llD�(ocica�. owners by l ua lf,— _ 1-5+ 1 < < v �gel' ar as' 1 0 acc�t+e y ' .� OwAAJ by shepar d lb MeA -From VaL�,�rc_ r �ce- $'The No ?W.m lnffi Quaker