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Home My WebLink About22426-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23449 Date JANUARY 12, 1995 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 1685 LANDS END ROAD House No. Street County Tax Map No. 1000 Section 15 Block 9 Subdivision Filed Map No. ORIENT, N.Y. Hamlet Lot 1.21 Lot No. conforms substantially to the Application for Building Permit heretofore filed.in this office dated OCTOBER 17, 1994 ~ursuant to which Building Permit No. 22426-Z dated NOVEMBER 1, 1994 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 S~ED IN REAR YARD AS APPLIED FOR. The certificate is issued to DANIEL & IVANKA PUHALOVIC (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A N/A ~-~ _~ I " Building Insp~ FO~M TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 22426 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ............. . ,/./. .................................. 19.. a, pre~,,e, ,o~ot~ a, .................. ./~ .::. .:. . . . ........ . .~. . . . .~. : .:. . . . . . ~ ......... ~ ....... ................ Coun~TaxMap No. 1000 Section ...... Z,~ ........ Block .......... ~ ....... LotNo ......... /:..~:... pursuant to application dated .......... ~C~....~ ..................... 19...~.., and approved bythe Bui{dlng Insp~toh "~ ~.,,.,~ .... 6/30/80 BLDG. DEPT. TOWN OF Form No. 6 TOWN 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 2/10 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 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-existing Buildin~ - $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 Date ......................................... New Construction ........... Old Or Pre-existing Building ................. Location of Property.. Z~,q~.,~. ,..¥,.~..~..~.~., ...~-,.,~.~, ~--~.~, ~/~'--/t//- ~'/~/ /~ - House No. '' Jtre;~ ................. ~a~{;~'[ .......... Onwer or Owners of Property...~.~..~.~.~.~. .... ~ ...................................... County Tax Map No i000, Section .... ./.i. ..... Block .... f .......... Lot../f.~Z ............ Subdivision .................... · · ..............Filed Map....... .... . Lot .................. . ... Health Dept. Approval ....................... · .. Underwriters Approval ..................... .... Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $...~ ......................... ULAT~ON PE~'~. STATE ENERGY CODE ADDITIO~IA'L CO,~.h~IENTS: The Special attention to quality Our Gazebo is not only beautiful, but each wood is used in Construction. Fragrant Cedar natural beauty for generations. Precise attention is given to every detail......right gazebo will maintain its structural integrity and~ the rest. - craftsmen. Only the fl are long-lasting and ~crews. These scre~ ~est, most ~lurable will maintain their J~/insure your . .The /~ * . The, Vllnl Barn / 'Carriage Another very popular model, which will surely complement the natural landscape of your property. Like other models, the double doors are 5' wide and 6' high which will accommodate everything from tools to heavy lawn & garden tractors. Our most popular model. An excellent "on location sales office", pool house, or general storage are for your home. A beautiful way to meet your storage needs. Single or double doors are available on ALL MODELS. 76S-Z802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] tN~TION FRAMING ~ FINAL REMARKS: BLDG. DEP'r. TOWN OF SOUTHO! 9 Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTM,ENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ......... SETS OF PLANS CHECK .................... SEPTIC FORM .............. CALL ................ MAlL TO: 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 shaft 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 necessary inspections. ,~ ~ ' -, (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrici~fi',' plumber or builder. .... ./. ................................................. : ....... AS.nOTEo ....... Name of owner of premises..~..~. ?.]..~.g....~....,~..~ .,~,.~......, .~..~./~., .,:..~; .~, ./'...~..', ,~,.ao... ~!~... ...~, .,~,/. tad on the tax rou or lares~[~fi~lt BUILDING DEPARTMENT AT If appl cant is a corporation, signature of duly authorized officer . ~ 766-1~2 9 AM TO 4 PM FOR THE · ·. ," .~- FOLLOWING INSPECTIONS: (Name and title of corporate of iceOCC[~PANCY OR Licens ~*l.,g .~1~., ElSUNLAWFUL ~u~to OERTI TE Humber's Lice~o[ ~o~x~ ~, . ............. OF 1, FOUNDATION - TWO REQUIRED FOR POURED CONCRB18 2. ROUGH - FRAMING & PLUMBING $. INSULATION 4, FINAL - CONSTRUCTION MUST BE COMPLETEFOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREVMENTS OF THE N,.Y, STATE CONST, I~UCTION & E,NERGY CODES. NOT 'RESPONSIBLE FOR DESIGN OR CONSTRUCTION'ERROB$ Other Trade's License No ...................... 1. Location of land on wliich proposed work will be done ............................ , ....... ............... /. . . . ................... ..................................... House Number Street Harfilet County Tax Map No. 1000 Section .. ~..].~.'..~..O. ..... Block ...~. fi; .~.0. ........ Lot.. ~..~/*, .~?. f. ..... (Name) ' ' ' 2. State existing use and occupancy of premises and intended use and occupancy of prooo~e'd cdhstl~tlotj~oB: - - '. :l. a. Existing use.and occupancy .......................................... '~ ..... , :F:..! ......... ..... b. Intended use and occupancy ·. · /~. ................ i.' '. ............. Nature of work (check which at~plicable) New Building . Repair .............. Rem?al .......... Estimated Cost .../. 7~ / q'; ~ 5. If dwelling, number of dwelling iunits .. ......... Addition .......... Alteration .......... Demolition ............ Other Work ............... - (Description) ...... Fee (to be paid on filing this application) Number of dwelling units on each floor ................ 15. If garage number of cars 6 If bus' cialo mix ~toccupa y ........................................................ . mess, commer r e nc , specify nature and extent of each type of use ............. 7 Dimensions of existi gst ctur~s if any: Fro R Depth ....... · n ru , nt ............... ear .. ..................... Height Number of Stories Dimensions of same structure with alterations or additions: Front ............... Rear Depth .................... I.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth . Height Numiber of Stones' ............. Size of lot: Front ........... i ........... Rear ...................... Depth ..................... Date of Purchase ........... i ......... ' ......... Name of Former Owner ............................ Zone or use district in which pre'~mises are situated .................................................... Does proposed construction violate'any zoning law ordinance or regulation: Will lot be regraded . Will excess fill be removed from premises: Yes No Name of Owner of premises ... ! ................. Address ................... Phone No ................ Name of Architect" Address Phone No Name of Contractor ........................... Address ................... Phone No .............. Is this property within 3;00 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold T'~own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail property lines. Give street and block interior or corner lot. buildings, whether existing.or proposed, and. indicate all set-back dimensions from umber or description according to deed, and show street names and indicate whether STATE OF NEWlYWed,,,],,/ 7, .... ' S;f YOHAqU330 ~ · , ................. ~,~ .................. boin~ ~ (Name of individual signifig cofitract) above named· · , He is the ....... ~ ............................................................. . Contractor , agent , corporate officer , etc. of said owner or owners, ~d is duly ~uth~ized to perform or have perfo~ed the said work and to m~e and file this application; that all'statements contain{d ~ this app~iCationare tru~ to the best of his knowledge and belief; and that the work will be perfomed in the m~ner s~t forth in the application filed therewith. Sworn to before me,th'is" 'x .... County ........ . (Signature of applicant)