HomeMy WebLinkAbout23160-zFOPuM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO Z-25096 Date JUNE 20, 1997
THIS CERTIFIES that the buildin~ ACCESSORY
Location of Propert~ 215 PIERCE DRIVE ~e'rCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 136 Block 1 Lot 11.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 22, 1995 .pursuant to which
Building Permit No. 23160-Z dated DECEMBER 5, 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 S~ED IN THE PEAR YARD AS APPLIED FOR.
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
CHARLES & SUSAN BRIGHAM
N/A
N/A
Rev. 1/81
//ui~ing ~nspector
FORM
*TOY.~I OF SOU'THOLD
BUILDING DEPARTMENT
TOWN HAIl
SOUTHOLD, N.Y.
23160 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date
?
Permission Is hereby granted to:
.......................................
.~ ........ ../..:~ ...... ~m.~ ..........................
to ............................. ~ ....................................... ~.. . ..'::...~-~ ..............................................................
...... ...~...~ .................. ~ ............ ~ ......... x~. ......... ~ .....................................................
~t premises located at ......... ...~...d..O~.........~../..~.".~.....~.........~..~f/.~..-'~... ...........................................................
CounlyTax Map No. 1000 Sectlon...Z.~...,~.. ............ Block / [otNo. /'A ../. ...........
pursuant to application dated .......... ~ .......... ~ .......................................... :and approved bythe
Building Inspector,
Fee o.,,~ .......
Building Inspector
Rev. 6~30~80
Form No. 6
TOWI~ OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
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 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/I0 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 r~qu~reme~ts.
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
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-existinR Buildinm - $100.00
3. Copy of Certificate of Occupancy - ~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.......~....~. ~ ................. ..
New Construction .... .~. ..... Old Or Pre-existing Building .... ~ .............
Location of Progerty ......... .~.. ~ .... ~ .... ~. .......... % ...................
House No. Street Ha~et
County Z~ ~ap No 1000, S~o~...-..,.< .................... .........
Subdivision.. ~ ~ ~ ~.. ~.~.~. (~ ....... F~led ~ap..~57~ .... Lot.. ~9.:~ ..........
Pe~it ~ (~ D~Pe Of Pe~it.~vz k~.~. .Applicant
......... ........... .... ................
Planning Board Approval ....... ~/~ ............
Request for: Temporary Certificate ........... Final Certicate..~. .....
Fee Submitted: $ .............................
-
~PLIC~
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
May 29, 1997
Charles Brigham
215 Pierce Dr.
Cutchogue,N.Y. 11935
To Whom This May Concern:
We are unable to complete your Certificate
because of the following reasons:
of Occupancy
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file.)$25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 23160-Z
Please contact our office on this matter.
cooperation.
Thank you for
SOUTHOLD TOWN BUILDING DEPT.
FINAl,
AI)I)J. TIOI'/AI. COHHEHT$:
The
Quaker
This is the roomiest shed going. It uses are anything
from sales office to pool house or even studio - the
endless.
The
Gable, A~Frarne
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 Side 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
Approved ..... ./¢ .....
FORM NO. 1
TOWN OF SOUTHOLD
BUILD1NG DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y, 11971
TEL.: 765-1803
., ig? rm,t No.
Disapproved a/c .....................................
3 SETS~'4
SURVEY
CHECK ....................
~FT !~ORH ..............
ing Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tlds 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 buildiugs on premises, relationship to adjoining premises or public streets
or areas, and giving a det~led description of layout of property must be drawn on the diagm~n wbich is part of this appli-
cation.
c. The work covered by this application ~nay not be cmmnenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Buildiug 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 pa~t for any purpose whatever until a Certificate of Occupancy
shall have beeu 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 Cotmty, New York, m~d other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolitiou, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and r~tions, and to
adh,it authorized inspectors ou premises and in building for necessa,7 in ns.
''' ~ignature o, app,icaut, o5 namTi, a co p '~)''
'; (Mailing addres~ of.~plicant)
State whether applicant is owner, lessee, agent, architect, engineer, geueral contr~ct6r, electriciah, plumber or builder.
........ OW.l~.~.~ ................................................... l~p~0~[~.g$.~0I[~ .........
~,ne of ow.~r of p~e~nis~s . .~.~hffS .~ ...... ~.~ ~v.I ......~.a~...~....~. ~..:.~ .....
(as ou the tax roll or lat
If applicant is o corporaUou, siBnature of duly authorized officer. 765-1802 9 AM TO 4 PM FOR
FOLLOWING
1, FOUNDATION - TWO REQUIRED
Builder's License No. USE IS UNLAWFUL
Plumber's License No. .......... WITHOUT CERTIFICATE ,.,,.,, ,..:,
OF
OCCUPANCY
Elech'Jcian's License No ...................... STATE CONS',',,),)q' ,, 't , '
Other Trade's Liceuse No .................. D~GIGN O~ Cul~sl~,ut.~;. ;(
I. gocation of hud on which proposed work will be done ..................................................
.... kg. .......... ..............
lloose Number Street ~ Ilamlet
cou,,~y T,~ U,p ~o. ~000 s,~,o,, .... )~,OP .....mo~k ...QhQO. ....... ~o~...Q~I ..OPt ......
Subdivision...~.~.~....~-~ ...... Filed Map No...~. ...... Lot5
(Name)
2. State existiag use and occupancy of premises and intended use and occupancy of proposed construction:
~. 2~ti,,~ ~s, ~,d o~,p~,,~y .... ~ ~. ~. ~.'.[.~. r~ > ~>.~[ ...........................
3. Nature of work (check which applicable): New Buildin .. Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
~;' ~'Off-~ I · ' (Description)
4. Estimated Cost~.. .... ~.~ ...... , Fee ~ 6~
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............... Nmnber of dwelling units on each floor ................
If garage number of cars '
6. If bnsiuess, cmnmercial or mtxed o¢¢upancy, specify natm'e and extent of each type of nsc .....................
7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ...............
1 leight Numbei of Stories
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth .~Height Number of Stories
8. Dimensions of entire new constrnciion: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ......................................... ~- .............
9. Size of lot: Front ....... ! .'.'.L~'.. i ......... Rear ....... [ ~ ~.. .......... Depth ..... I.I. ~, ..............
10. Date of Purchase .'~Pl~.e.~..I. qg~ ............. Name of Former Owner ~,~n.~.~.
11. Zone or rise ...... . ................................
dlstrtct in wluch p~e n ~es are situated
12. Does proposed construction ' '
wolatei any zoning law, ordinance or regulation: ......... I,,~O. ...................
13. Will lot be regraded .... '..~. ....[...1~¢_. ,~...~ ........ Will excess fill be removed from premises: Yes
lq.o[ Address Phone
.......... , .......................................... Phone No ................
Name of Contractor , Address Phone No
15. /~s ch~a property utth:Ln 300 feat of a t:t_da2 weclaad? ~Yes ........ No .........
~If yes, Southold To~4n Truaeees Parm±t may he requ:Lred.
PLOT DIAGRAM
Locate clearly and distinctly all bdildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block nu] aber or description according to deed, and show street names and indicate whether
interior or corner lot.
ST^TE OF
"'~... ~-- "~.~[ ~. ~.~. Y. ~~' ........ being duly sworn, deposes and says that he is the applicant
(Name of individual signing ~ontract)
~bove named.
lie is the .............
I (Contractor, ageut, corporate officer, etc.)
~l' said owner or owners, and is duly afithorized to perform or have performed the ~aid work and to m~e and file this
application; that all statements containetl in this application are trna to the best of his knowledge and belief; and that the
work will be performed in the manner se~ forth in the
application
filed
therewith.
Sworn to before mo this
~ Couu .
~~orkN°l~rY Public, Stat "' ' ark ....
~o. 5~--812~8!~0, Suffolk Courgy Z ~gnatnre et apphcan t)
N 16038'50'' W
16038'50'' E
GARAGE
115.00'
0
N 16°38'50'' W
FRAME
GARAGE
22.28'
~o
S 16°38'50'' E
115.00'
115.00'
The The
Quaker
,is is the roomiest shed going. It uses are anything
office to pool house or even studio - the
e 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 Side Barn
High aides 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
: FOI/M N(.L 1
TOWN OF SOUTHOLD
BUILD1NG DEPARTMENT
TOWN HALL
?- I!'!:,!~ SOUTttOLD, N.Y. 11971
TEL.: 765-1803
Approved ......... , 19Z~, I ermit i~o .......... ', ,
Disapproved a/c .....................................
CIIECK ....................
rS,c` ~ ~' I-g--'F 0 R H
l'2iug luspector) '
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tiffs applicalion mnst be completely filled iu by typewriter or in ink and submitted to the Boilding Inspector, with 3
sets of plans, accurate plot l)lan to scale. Fee according to schedule.
b. PIct plan showing location of lot and of buildiugs 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 uot be commenced before issuance of Building Permit.
d. Upon approval of Ibis application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout Ihe work.
e. No building sbalt be occupied or used in whole or iu part for any purpose whalever until a Certificate of Occupancy
shall bare been granted by the Buikling Inspector.
APPLICATION IS HEREBY MADE to the Bnilding Department for the issuance of a Building Pernfit pursuant to the
Building Zone Ordinance of the Town of Sonthold, Suffolk County, New York, and other applicable Laws, Ordiuances or
Regulations, for the construction of bnildings, additions or alterations, or for removal or demolition, as herein described.
The apl)licant agrees to comply with all applicable laws, ordinances, buildiug code, housing code,_ and r~tions,, aud to
admit aullmrized inspectors on premises and in building for necessa,~ in~f~ns.~ ~ ~ ~_
..... ~[(~. ~:./2~7 ~ ~ ~ ......
' (Signature of applicant, or nam~if a corporation)
(~iiing add[ess of ~pplJcmH)
State whether applicant is owuer, lessee, agent, arclfitect, engineer, general contractor, electrician,'plumber or builder.
..................................... , .............................. APPR0~E~'~$ ~0T~ ........
-, ~ , , · ./~
N~,,,~ or owner or p~,~,,~..~.~A'~S .~..~S~.. ~A~...~'.~":~*..,~:... ......
(as on Ihe tax loll or lat~E~e~ ~ ~_BY: ~
NOTIFY BUILDING DEPARTMENT AT
l[ aPl)licanl is a corporation, signatureo[(luly aulborized officer. 785-1802 9 AM TO 4 PM FOB THE
(Na,.e aud .t,e of eurpo,'ale ofriorl~CUPANCY OR
B ,,,er s,: e se No .............. USE' IS UNLAWFUL
P,,u,be,"sL censeNo ..... U/t .... WITHOUT CERTIFICATE
: "' .OF. OCCUPANCY
l.lech c a i s License No ....
Other Trade's License No...~./.~. ...............
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
.2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MLIST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCT!ON & ENERGY
CODES. NOT RESPON~SIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
I. Locali(m of land ()il which proposed work will I)e (loire .................................................. '
I louse Number Street ~ llamlet
Couuly Tax Map No. 1000 Section .... I~¢~OO ..... Block ...~O. 9 ........ Lot...~1 ~.O~ ......
Subdivision...~%~.¢ ....
(Name)
2. Stale existing use all(I occupancy of lnemises and inteuded nsc and occupancy o[ proposed construction:
u. ....'[e' .............. . .............
3. Nature of work (check wbich app[icable): New Building .......... Addition .......... Alteration ..........
P, epair .............. Remox al .............. DemoHtloa .............. Other Work ...............
4. Estimated Cos~ ............................. Fee ......................................
(to be paid on filing ii,Is application)
5. If dwelling, number of dwelling ui~ ts ............... Number of dwelling units on each floor ................
If garage, number of cars ...~ ..................................................................
6. If business, commercial or mixed Occupancy, specify nahu'e and extent of each type of use ................. ,..
Dm~e ~slo Is o existing st ~ ctures~ if any' Front
................ Rear .............. Depth ...............
1 leigbt Numb~or of Stol'
Dimensions of same sh~cture with alterations or additions: Front ................. Rear ..................
I)eptb ..................... ~. lleigbt ...................... Number of Stories ......................
8. Dimensions of entire new consm~bhon: Front ............... Rear . .............. I)eptb ...............
Height ............... Numb~er of Stories .......................................... ~ .............
9. Size of lot: Front ....... ~.~ .......... Rear ....... l ~. ~ .......... D?tb ..... 1.[. ~ ..............
10. Date of Purchase . . . ~v~ ~cqq3 .... ......... Name of Former Owner . .~
I I. Zone or use district in which pren~ises are situated
12. Does proposed construcfim~ violate any zoning law, ordinance or regulation: ...... ,.. ~ ...................
13. Wilt lot be regradad
.......... ~ .................. Will excess fill.be ren~oved from premises: Yes
Name of Architect ........... . ....... ~ ....... Address ...... ~~ Phono No~ ~. ~'.. ~..
Name of Contractor
.......... , ................ Address ................... Phone No ................
15, ts this prop~r~y wtd~n 300~ fe~C of a ~tdal wee[and? ~Yes ........ No.,,, .....
~If yes, Sou~ho.ld [qwr 2rcs~ees Perm:to may be required.
PLOT DIAGRAM
Locale clearly and distinctly al bt tngs, w tether existing or proposed, and indicat0 all set back dimensions from
property bnes, Gwe slreet and block n~ nber or description according to deed, and show street names and indicate wbelher
interior or corner lot.
~. .......~ ~,. ...' . , ~ .... .,.. being duly sworn, deposes and says that be is the applicant
(Name or individual signing contract)
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and Is duly ~uthorized to perform or bare performed the said work and to make and file this
application; that all statements contained in this application are true to the best of bis knowledge and belief; and that the
work will be performed in the manner s~et forlb In the application filed therewith.
Sworn to before me this