HomeMy WebLinkAbout23009-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z--24003
Date NOVEMBER 2t 1995
THIS CERTIFIES that the building
Location of Property 350 K~TNNEYS RO~D
House No.
County Tax Map No. 1000 Section 59
Subdivision
ACCESSORY
SOUTHOLD{ NEW YORK
Street Hamlet
Block 3 Lot 33
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 5~ 1995 pursuant to which
Building Permit No. 23009-Z dated SEPTEMBER 12~ 1995
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 STORAGE EkU~U AS APPLIED FOR.
The certificate is issued to CORI & KAREN LANG
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
N/a
N/A
Rev. 1/81
FORM NO.$
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN ~
$OUTHOLD, N.Y.
N?
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED~.~
~oo~ z ~'~ ................. ~'~ ................ '~'~'"'"~'
.............................................................. ~~....~..~,_,_ ............................................
CountyTaxMapNo. 1(300 Section ........... ...~'...?., .,, Block .............. ~ .......LotNo ........'~.......'~.. .............
pursuant ,o application dated ........................... '/"~ .,,-~,......~'~...., 19....~..~and approved bythe
Building Inspector.
Fee $....,m"f..?(., ..............
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Cod ,md 9care,~ ~
P. O. Box 1083
Cutr..6.ogue, NY 11935
APPLICATION FOR CERTIFI~A~oo~C'~O~(~N~Y
This application must be filled in by typewri~'~ ~nk:an& ~ubmitted to the building
inspector with the following: for new buildirrg-.~o.r ne~ use:
1. Final survey of property with accurate ioc~t~oh of ail 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 tire 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 bnildings and
"pre-existing" land uses:
1. Accurate survey of property showing ali. 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.
C.
~I.jScertificate 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-existin~ Buildine - $100.00
3. Copy of Certificate of Occupancy - ~20.00
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
'-~P~ Date .... Z(? .[q~. ~. ] ]/~]~.~. ] ....................
New Construction..:~... Old Or Pre-existing Building .......
Location of Property... ~]
House No. Street Hamlet
Onwer or Owners of Property ..........
.... .... .ot .?.3....
County Tax Map No 1000, Section .... ~ ........ Block .....................
Subdivision .................................... Filed Map ............ Lot ......................
.G.o.p.',
Permit No.'~..~...~..?.~..Date Of Permit...~/. ............ Applicant .........................
Health Dept. Approval .......................... Underwriters Approval .........................
Planning Board Approval ........................
Request for: Temporary Certificate ........... Final Certicate ...........
Fee Submit ted: $..
.............' A LIOA T ............ ' '
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
October 12, 1995
Mr. Cori Lang
P.O. Box 1083
Cutchogue, NY
11935
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(Ail permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 23009-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, NewYork 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING iNSPECTOR
TOWN OF SOUTHOLD
October 12, 1995
Mr. Cori Lang
P.O. Box 1083
Southold, NY
11971
To Whom This May Concern:
We are unable to complete your Certificate of
because of the following reasons:
xx An application for Certificate of Occupancy
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT % 23009-Z
Please contact our office on this matter.
cooperation.
Occupancy
is
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
FII~I.D I"~PECTION R~PORT DATE COMMEIfl'S
~ C
FOllNDATION (IST)
r0UNnATION (2Nh)
z
ROUGII FRAME & '
PLUHBING
INSULATION PER N. Y.
STATE ENERGY
ADDITIONAL COMMENTS:
7~5-1802 g AM ~ ¢ ~ FOR
E ~OMPLETE FOR
ALL 60~STRUCTION SHALL
THE REQUIREMENTS OF THE N.
STATE CONSTRUCTION & ENERG
CODE N~ RESPONSIB~ F0
DFRI~ OR ~RU~ION ~RO
t"' E~V D
//
The The
Quaker
This is the roomiest shed going. It uses are anything
from sales office to pool house or even studio - the
possibilities are endless.
Gable, A-Frame
or Cottage
An excellent addition to your property, Great for
storage space and comes in a variety of sizes, Window
is included for that extra special look
The The
High Sic e Barn
High sides and double dutch doors make this shed
great for storing light equipment and tools of all sorts,
Dutch Barn
This Colonial looking barn has enough space for the
modern day homeowner, The usable space includes
room for shelves, a loft, and even a work station, You'll
enjoy the look and get the space, ~ ~
WE BUY THE BEST MATERIALS, TO BUILD THE BEST PRODUCTS, TO SELL TO THE BEST PEOPLE - OUR CUSTOMERS
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] FOUNDATION 2ND
[ ] FRAMING
[]FIREPLACE&CHIMNEY
REMARKS:
] ROUGH PLBG.
[[ ] INS~U~TION
[ ,/J' FINAL
DATE
INSPECTOR ~/~~ ~
FOI1M FI(). I
TOWN 0[: SOU IlIOLI)
BUII, DIN(; IDL:PAI] IMISNT
~- TOWN IIALL
/ / SOUIlIOLI),N,Y, 11971
I~xamiued 19~-- ' '
l)iSalqU eyed a/c ................................ ~ ....
............. .- .... ........................
; ' AI~;A'I'ION FOIl [tUILDIN(~ PEI1MI]'
3 SETS OF ['I.ANS .......
SIIllV£Y ................
CIIECK ......... ~ .......
SEPTIC F D [I. II ...........
INSTI~,IICTIONS
Il. 'l'his aPlflicalion musl. be Conlplelely [illed ill by lypewrller m' hi ink ami sUlmlitled to Ihe lll]ihli,g lnspech~t, wi
sdsofplaus,~ccmaleldol plm~loscalm Fee nccmding lo schedule.
or aleaS, and givin~ n dehlJled descdlflion oF Jayotll gl pmpedy musl be dlaWii Oll Ihe cliaguml which is pall el this
C[llJOll.
c. The wink cove~ed by lifts aplfligalion may riel be oommenced befm~ issuance el lluildin[ Pemlil.
d. Iipon apl~mwJol'llftsaplJlicaiJm~,lhe lluildinBlnspeclorwillissued alhfildin[Pemlillolh~applicanl. ~uch pe
shall be kepi on the inemises nvnilable fin inspection flu'ouglmul Ihe wink.
e. NO btlJldilq~ shall I)e occupied m ilSed ill whole or in pail I'or lilly pUlI)OSB whalever unlJl a Celti~cale of ()cc~lp
shall have been g~anled by the lluilding h~sl~eCtOl'.
API'I.ICATION IS III]RIHIY MAI)Ii lo the l}uiJding l)~palinlOIIJ [01 [Jl~ issuance O( a JluiJding P~lmJJ J)lllSilalll
JhfiJding Zmm Oldinanca or Ihe 'J'OWII (1[ Soulhold, Suffolk Colllliy, New Yolk, ami [)Jh~l' npplicM)le l.aws, ()ldJlIilIlC
lielptJatJmls, [ol (he OOllSlltlClJoll el I)uiJciingL ri(billions or nllmnlions, or for lemoval ~ ~' (IclIIOIiIJoII, ns helein descd
'lhe aplflic;m agrees Io comply wilh all ,plfliuable laws, o~dinanc~s, building code, housing code, and ~elpflal,)ns,
lldlllJJ nulholJzed illSl)eC{OIS 011 plOIIliSOs alii( ill buildi,g fm tlecos~aly JllSlleClJOll~, · ~
(Signalme el applicant, or name, i[ a COl polalJoll)
(khuue and lille elf COlllmnl¢ oil(ceO
lluihh!l's I il:cnse No .... ~~Z'~ ~'~
[ Im,bel s I.icense No .........................
l:Jet h'ci i s Lice.se Ho .......................
()lher 'll,de's l.ice,se No ......................
I ot:aliml el hltJ(J Oil which ploposed ,,vmk will bc done ..............................................
.... s.o .................. i..: ........... ...........
I louse Number Sit(el Ih. nlet
Subdivishnl Filell M;q) N,~) ............... Lot ........... (Name)
~ - .. (I)cscliption)
.................................... Fec ......................................
. II gaiag~, immt)~r o[c[t~s ................... , ....................................................
?. I)inicllSiollS ol'exJsJill~ ~JlIIC(III~S, il JJJJ~: l~lonl ............... l(0ar .............. i)uplll ...............
IleiBhl ............... Nunlb~l o[ SIo~ics .......................................................
J)illlCllSJOllS o[ SJ[lll~ sJl'Jlc~Ll(e wilh llJlelllliolls ur midi(ions: i;lOll( ................. Nc[if . ................
DcpJh ....................... lJeJ~hl .................... ..,J'hlmbcl o[SlOlJeS .....................
Ileighl ............... NJllllbel o[ Slolios ....................... ~ ...............................
g. Size ()J' J~)J: J JL]JJ[ ......... ............. IL~a~ ...................... J)~l)lh .....................
I(], I)Mu u[ Pillchns~ ............................. JqilJli~ O[ ~;Ollii~l OWiI~r .......................... ~ ,
I 1. Zm~o o~ usC dislHcl in whJ~Jl JIIOIllJSCS [lI~ siJ~lill~[J ................................................... ..
ii. Will Iol b0 le~lilti~tl ....... ~ .................. Wilt uxeuss [~ll be iBiiIOVUii [[()JJJ Jlft]lllJSos: YeS (~
J4. ~Jitlil~ of ()WtI~I' O[ J)lelllJS~S ........... t ........ Add[~ss ................... lqlone NO ...............
Jqillli~ iii' Architect ........................... AthJiess ................... PIItiIiI~ J~(I ................
IIilIIIC O[ ' ' . Ad~Jlgss ................... l JlOll~ Nil,
15. I~i lilJs j~l:opel'L~ i~JiiJill '~()0 [eel o[ il LJdili I~eLilmd?. ~Ye8 ........ I'h~...~ ....
PI.OT I)IA(iRAM
] (iclll~ [;JcnlJy [llliJ dJslill[:lJy nil I)uiJdill~s, wJlelhef exislin~ or ploposed, illlil, iudJcal~ all s~t-back dilllellsiollS Il(il
plUlU.'.lly lines. Giw slrccl ami bk)ck i,,tlmlmt or dcs,.:liplion accol(.l)ng !il (Iced,
S'I'A'I F. C) F HI:,W YO f,K, S.S
~. '()lJ N I'Y OF .................
.......... ~.~. ! . . ~ ........................ bciitg duly swo~n, deposes nnd s~tys Ihal he is the applit'
(N;unc of individunl siglling c<mtrnct)
.. .... ........................................................... ' ...........
(Conhneh)i, nB~nl, cofpo~n[~ ol'[i~l, cia.)
<)1 snid owne~ or own~ls, ~nd is duly nulJioli~ml ~) i)~t[o~nl or hnv~ p~l[Omiml Ih~ snid work and Io m~k~ ~md lil~
api)liualion; Ihal nil shH~m~nls conlnim:d Jn Ihis npl~licalion
5WOIII I0 J)eJolo II1~ this
~o ~B~2248, Suffolk