HomeMy WebLinkAbout23818-zFOBM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-24854 Date JANUARY 13, 1997
THIS CERTIFIES that the building~
Location of Property 62S0 COX
House No.
County Tax Map No. 1000 Section 84
Subdivision Filed Hap No.
ACCESSORY
CUTCHOGUE, N. ¥.
Street Hamlet
Block 1 Lot 24
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 7, 1996 pursuant to which
Building Permit No. 23818-Z dated NOVEMBER 21, 1996
was issued, and conforms to all of the requirements of the applicable
provLsions of the law. The occupancy for which this certificate is
issued is ACCESSORY STORAGE BUILDING IN REAR yARD AS APPLIED FOR.
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
MATTITUCK GUN CLUB, INC.
N/A
N/A
N/A
Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DI;PARTMENT
TOV/N HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 23818 Z
~oun~, Tax Map No. ,000 Sec,,a~ ......... ~..K..... ~,=~ / La,,~o..~..Y...
pursuant to application dated ................ ~....2 .................. , 19..~.~., and approved by the
Building Inspector.
. / B~iiding Inspector
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTHENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPA~YCY
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:
i. 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).
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 1% lead.
5, Commercial building, industrial building, multiple residences amd similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'!pre-existing" land uses:
i. Accurate survey of property showing all property lines, streets, building anti
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.
C. Fees
1. 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 Pre-exis~ing Buildinm - $i00.00
3. Copy of Certificate of Occupancy - ~ .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15400, Commercial $15.00
ate ............................
New Construction....g.'~....-... 01d Or Pre-existing Building .................
Location of Property ........................ k ...................................
House No. Street Hamlet
Onwer or Owners of Property..~..~.~...}. !.~..d~...~.
County Tax Map No 1000, Section .......... Block ................ Lot ..................
Subdivision....................... ......... . ... Filed Map ............ Lot ......................
Pe~i~ Ho. ~.~. ~ J..¢.. ....~ate of Permit.. !!/. ~:.!?.¢. ...Applicant..~?. ~.~:tr[ ..........~ ~e.^~., ~ .. ...
Health Dept. Approval .... ~.. 6 ................ Underwriters Approval .... .~3....~. ..............
Planning Board Approval .... ..b~..~ ..............
Request for: Temporary Certificate ........... Final Certicata ...........
Fee Submitted:
FUUI,II)/VF I. 0 },l (~HI) )
Ir I I1^1,
Al)Il ITl ()riAl. COrltfl~,tl'l',~; t
' i
Custom Designed
....... ~:~ .. ~ ~..~. · ~:::: ~:~,:::::,~,~ ......
Reasonably Priced
Picnic Tables Gazebos Playhouses Arbors
Planter Boxes Swings Benches Cabanas
Delivered Fully Assembled or We Will Build on Your Site
We Will Meet or Beat Any Competitive Price
Everything in this Catalog is Built in Peconic, on the North Fork
All of our double doors are 5' wide with 12" hook and eyes
Extra Heavy Gauge Galvanized Hinges with Solid Brass Pin
The
Porch Barn
This unique shed offers many different and convenient uses such as using one side for storage area and the other
aide for a changing room for the pool, or one side for storage and the other as a play area for a child. The space in
this is incredible and with two entrances it is easy to get most anything in.'fide whatever your use. You can even finish
this unique shed with some hanging flower baskets over the porch. A Iookthat is sure to g'ain attention.
laqkdr . ........... I~al ............. I~ml ilion ............ OH~er
Esi i.u~ted 1~ , 1' ~.~.~ ...........
' ~ ~ ...... ~ee ..............................................
11' ik~llling, ~tmr ol:ik~lling unite ............ lk~d~r o1: &mi ling unite ~l each glfx~r ................
Diu~l:iitalti o1: existing atrtu:ttn'ca, il: /lily; I%iail ................ I~m- . .............. Ihpth
Size et hit I l"lfstl .................... I~ar . ................... Ikq)th ....................
regra~d ..... ~-0 ......... Hill esceaa till Im r~r~ed Pr(an InOnises.: YES
~11" YES, ~lIIl~l)'I~X~ 'll~}~ll~ [~l~l'l' ~Y I~
PI,OT |)IAGRAH
S'~Z~E CONST~UClqON ~ E~JERGY
COOES, NOT RESF'ONSIDLE FOR
D}~S~Gk~ OR CONSTRUCTIO~ ERRORS
· ,Is!lng (hdy ~,~.~)rn, (lelXme.,; ~il~l ltilyll (hat. h(a iS the aill)l loath
Ik~ is Ilia .................................................................................................,~
((xmt, rnctoc, corlx)rate officer, etc.)
nf said (x~t~r or (~tl!rft, nt~l ia (kdy ittll[lOlliZCql I0 [x~rfoillt off hHv(* iIH I'onl~(l lite uaid ~>tk m~l to imke alii fi le /his
.ppi icnt lo*H thilL all atatolenttl colll'ilil~tl in this nppt ication me t lt~ to the'trent o1: hi*; I.x~dcalge ill~l Imlief; nlm
Ihnt the ~)~1{ will I~ Imrl:onled in the II[llllKl[' set I:orth i. the appl lent. ion l i led Ihet-~ith.
,g~.n Io Ix!~',e ,:~t thin /t /
.. /. od ,,
C~tRE L. GL,~
Nota~ Public, Stete of New York
No. 4879505
Oualifiod h~ Suffolk Coun~ ~[~
~mmission Expires December
BUAIU) 01, III,:/~I,TII
FOIIH HO. I /3 oI,Io (Iff II,A~S ...............
BUILDIH(~ DEPMUI'HEHT ~ f. III,CK
TO~4H Ilhl,l. '~ICPTTC FORH ...................
~OU'I'IIOLI)~ N.~. 1197 ]
i CMA .....
E~,,it.,.~(...., 19~c
AI~PI,] ca'ri(IN FOr' I1~1} I,DT NO I~ERH] T
1 N,WI'RUC'I' I ON,$
n. 'IIH.~ nlqtl Jcat:~(~! m~.",t be (i~plel:ely Filled Tn by tyl~,~riler or h~ hd~ m,I ~xhnltled to the I~dhlin~ hml~et.or w~
3 Bets oF plnn~ n(x-urnLe plo~ pIm~ I.o ncole. F~ re:cording t.o nch~]ule, .
API,,I(~'U](~ IS l~l~l~ ~IE Lo jtl~ l~Hhlin~ l~[~rh~nt [or the ismmm'e or ~ l~itdhlg Pemit ~lrmlm~t to the
I~l~hhng 7x~ Ord~rme of Lhe I'~ of ~Lhold, ~l[ffolk (~m~y~ ~ Yorl% mgl other ~l~tlc~ble l~s, Ordmm~e~ or
(~s ~ the I.t~ ri)Il or lnl:esl: de~])
I~d hlers '