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Home My WebLink About22446-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-25344 Date OCTOBER 30, 1997 THIS CERTIFIES that the buildin~ Location of Propert~ 3630 ORCHARD STREET House No. County Tax Map No. 1000 Section 27 Subdivision ACCESSORY ORIENT, N.Y. Street Hamlet Block 3 Lot 3.4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 27, 1994 pursuant to which Building Permit No. 22446-Z dated NOVEMBER 3, 1997 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 SHED 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 Rev. 1/81 THOMAS D. STEPHENS N/A N/~ ~0~ NO,$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HAIL SOUTHOLD, N.Y. N~ 22446 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) DaTe ............ /.~ ............................................ Permission is hereby granted to: ~.~.... ~/~ ...................... ...... ~.:,,~..± .......... ,~.;..~.~ ................... to.....~~,..~,.,. ...... .~...,,~~..~...¢......~..~,.~.~..s.,,,,~, ...~....~...~...,.,~...~ ........ ~/...¢...~ ....... ~:.~.y./...~....~. .~;./...~ .... ..... ~.~.~~ .......... ~......~...?.~.~:.~.~.~...?.....~....~.,..~.., ~ ......................................................... ~.~..~......,~. ........................... /, ......................................... CountyTax Map No. lO00 Section ......... ...~...Z. ..... Block '~- LotNo. '~. r~, ........... pursuant to application dated ................. ~....~.....~. ............. 19....~'....~...... and approved bythe Building Inspector, ~e~',...~... Rev. 6/30/80 Building Inspecto,.[/ TOWN OF SOUTHOLD [[~]r'~.~.~ U I¥/ ~ ~' BUILDING DEPARTMENT TOWN HALL 765-I802 APPLICATION FOR CERTIFICATE OF OCCUPANC] 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 I% 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. Submit Planning Board Approval of c6mpleted 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. ~. Certificate of Occupancy on Pre-existing Buildinm - $100.00 3. Copy of Certificate of Occupancy - ~ .25~ 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ..... ........................ New Construction ........... Old Or Pre-existing Building ........ Location of ..... ......... i.'"fdi House No. StreetHaklet Onwer or Owners of Property....~ .'~).~,J'~ · .~.. ~ .--w-~-~..~Y-...~). ~ .~. ~ ........................ county T~ ~p ~o 1000, Section ..... :Z.9 ..... ~loc~ .... .~ ......... Lot..~:~.. .............. Subdivision .................................... Filed Map ............ Lot ...................... Permit No ..... Date Permit ................ cant ..................... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval .......................... "" Request for: Temporary Certificate ........... Final Certicat .~...... .... Fee Submitted: $ ....... .~..~.~..' .......... APPLICA~NT r ~ IDATIOI! ' (2nd) ;H FRM.IE & .. ., }," :;.,-,,...:?LUHBZ~G ." · LAT"r ON PER'~, STATE EUERGy CODE The High side Barn High sides and double dutch doors make this shed great for storing light equipment and t°°ls °f all s°rts' ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] IN~JI.ATION [ ,~]" FINAL DATE INSPECT~~j~ -\pproved 19 7~ermit FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 9isapproved a/c ..................................... // . (B~tdin. Inspector) ,' INSTRUCTIONS BOARD OF HEALTH 3 SETS OF PLANS .......... SURVEY ................... ClIECK . _ CALL ..... ftAI~ TO: Date ...... ,19 a. This application must be completely filled in by typewriter or in ink and submitted to the'Bu'ilding Inspector, with 3 =ts 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 publ/c streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applJ- ation. c. The work covered by tkis 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 ~ail 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 mil 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 · uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agiecs to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary -- (Signature of apvlig, a.~(~r~' ' ' ,tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber Or builder. ........ C>..6o.~.('~. ....... 2 ......... . ; ..................... :amc of owner of premises .Xh(L~. / .~. (as on the tax roll or latest deed) :~ applicant !s a corporation, signature of duly authorized officer. · (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ........ : ................ Electrician's License No ....................... Ot er Trade s hcense No ...................... Location of land on which pro osed work wil be done ~1~23C> ~ ~.Q~ .~/g'-, . ...... ..... ' ................................................. ~ . .r~. . ~ t ~ ~/ . ,~,q,~. ~ House Number Street Hamlet County Tax Map No. 1000 Section ... '~..~. .......... Block .... .~. ........... Lot. ?..~.~. ............. Subdivision ...(~..~/~. g.~b..~.~t..~..~.~..~.. .......... Filed Map N~o. ~.5~.~..~. Lot .~. ......... (Name) ............... State existing use and occupancy of premises and intended use and occupancy of proposed construction' . . ' a. ~x,stin. use an, o,cupa,ey ...... .~ :.~. . .~.~.. : ~l~ ¢-~, 'm4,¢...,, s ',~L~ ....... ~. ~.~..~...m..~. l 3. Nature of work (check which iapplicable). New BuLldin~, · · Addition .......... Alteration ......... Repatr .............. Removal .............. Demolition ....... ;. ~thefWork .............. ~ ' (Description) 4. Estimated Cost o / ' ' ' Fee . 22? .' ...... i (to be paid on filing this application) 5. If dwelling, number of dwellinlg units ............... Nmnber of dwelling units on each floor.. If garage, number of cars .. [. · ............. 6. If business, commercial or mix:ed occupancy, specify nature and extent of each type of use .................. 7. Dimensions of existing stmctu es, if any: Front ............... Rear .............. Depth ............... Height Nura ber of Stories Dimensions of same structure with alterations or addit ons: ~r;~[ ...... ' ........ ,~ ..... i~i~i i ..... '" -' i ._ . ................... l~ear ..... ~epm Hmght Number of Stories " Dimensions of entire new construction: Front .............. · Rear Depth Height Number of Stories ............................................. 9. Size of lot: Front 10. Date of Purchase .......... i ............ Rear ...................... Depth ............... ...... ' ......... ' ........ Name of Former Owner ............. 11. Zone or use district in which p~emises are situated ......................... 12. Does proposed construction vidlate'any zoning, law ordin .... or ....~*:^- ' ....................... 13. Will lot be regraded ,/5,/.&g ...... · ................ · · ;.~'r~,~j .2~, ................ Will excess mi oe removed from remises- 14. Name of Owner of premises~.4~, ~.~ Aclrlr~..~O O~/q,~eg ~ ,. p ,, ' fi/~ :-Y.~..e[ O No Name of Archite"* · ". '- ct ............. _-"-.-'~ ~.7'..,l-u-'v/~ ~'~ .' .... rnone ~o.~.'~ 7.-CoJ. q'. .... ~" ........ Address ................ Pho Name of Contractor/!/.0. ¢Lr:/L -- ..... 15. ls this property w~th±n 1300 fe~' of a tidal ~etland? *Yes .... ~, ~ ~o ~q'.-~.~ ..... If yes, Southold lTown Trustees Permmt may be required. '". i PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing.or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. APPROVED AS OTED . ut&OwING INSPE~IONS: 1. FOUNDATION . ~O REQUIRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUMBING 3. iNSULATION 4, FINAL CONSTRUCTION MUST ~E COMPLETE FOR C,O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N,g STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ESIGN OR CONSTRUCTION ~ROR8 ;TATE OF NEW YORK, · ' '~' · _ .............. being duly sworn, deposes and says that he is the applicant (Name of in divid ual signiffg con tract) ~bove named· , Ie is the (Co ag po offic 't~ ') ......................... ntractor, ent, cor rate er, e . f said owner or owners, and is duly :authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the .'ork will be performed in the manner slet forth in the application filed therewith. woru to before me this No. 4951364 / (Signature of applicant) Quelified in Suffolk County Commission Fxpin~s ~,~?¥ '.>?. ~