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HomeMy WebLinkAbout22212-zFORM NO. 4 TOWN OF SOUTNOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF O~CUPANCY No Z-23133 Date AUGUST 2, 1994 THIS CERTIFIES that the buildin~ ACCESSORY Location of Propert~ 1485 MILL CREEK DRI~-E SOUTHOLD, NY House No. Street Hamlet County Tax Map No. 1000 Section 51 Block 6 Lot 29 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 6, 1994 pursuant to which Building Permit No. 22212-Z dated JULY 26, 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 FOR AN ACCESSORY STORAGE SHED AS APPLIED FOR. The certificate is issued to BETSEY B. DIu~ON (owner, lessee or tenant) 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 FOI~M NG.$ TOWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALl. SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22212 Z Permission Is hereby granted to: BETSEY B. DICI~RSON 1485 ~ilLL CREEK DR. SOUTHOLD, REI/ YORK 1197 ! CONSTRUCT BETSgY B. DICKERSON · at premises located at. .!.4...8..S....~.!~.L....C...t~.-.~,[.,~.~.!..V~.. ......................... .S. 9...l~.....O.~,.....l~...~...~.O...l~... ............ CounhtTax Mop No. 1000 Section ....... .5..! .............. Block ......... ~ ............... Lot No ..... ~.9. .................... pursuant to oppllcation dotod ..........J..u..1..y....6...,. .................................. 19....9..6. ......... and opprovod by ~he Building Inspector, Rev. 6/30/80 Albert A IQupski, President John Holzapfel, Vice President William G. Albertson Martin H. Garrell Peter Wenczel BOARD OF TOWN TRUSTEES TOWN OF SOUTFIOLD Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 June 27, 1994 Parker Dickerson 1485 Mill Creek Drive Southold, NY 11971 · RE: SCTM 951-6-29 Dear Mr. Dickerson: After a field inspection of the above referenced parcel, the proposed shed (8X12 or 10X16) is found to out of the Trustees jurisdiction. If you have any further questions, please do not hesitate to contact this office. Albert J. Krupski, Jr. President, Board of Trustees AJK:jmd Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOICN IIALL 765-1802 ~PLICATION FOIl CERTIFICATE OF OCCUPANCY 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: 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. B. 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 budding $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existin~ Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. ~emporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ Date ...Q..~...~. ~.~... New uonstruction ........... Old Or Pre-e~istin~ Building ........ 3'~.[... ' .............. e ~o. ~~ Street , Hamlet Onwer or Owners of Property ..... ' ....~...'~f.~.~ ................ County Tax Map No 1000, Section .............. Block ..... ~ ......... Lot..'~%.~ ............. Subdivisi°n ~'''~~''''Filed Map .... ............ Lot ...................... Permit No ................ Date Of Pe~it ................ Applicant..~~..~~ Health Dept. Approval ........ . Unde~riters ................. Approval ......................... Planning Board Approval ....................... Request for: Temporary Certificate ........... Final Certicate.. ~ Fee Submitted: $ ~.~ 7G5-'"802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION :~ND [ ] INSU~TION [] FRAMI~ ~3.~rINAL· , INSPECT~ ~f iELD~i:~S~ECTiON FOUNDATION 1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL Al 3ITION~L COMMENTS: Cb' £xamined .~/~..~ .......... 19 ~./~ A roy / --, 'Z .~.~2 pp ed.: ~//( .~. ........ 19z~./~7~ermi.t No...,~....~2../. / Disapproved' a/c ............. ................... i .... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD' OF }tEALTtt ......... ~--~3 SETS OF PLA,'q$ su wY ......... SEPTIC FORH .............. CALL .......... y..... ..... HAIL TO: (Building Inspector) , · APPLICATION FOR BUILDING'PERMIT Date ................... 19... BLDG. DEPT TOWN OF ~OUTHC)L:, 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 sti-eets 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 shall 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 South01d, 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 descr/b~d. 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. -- (S~~ant, or name, if a corporation) ' ' ' (Mailing address of applicant) 4~(.,~ [ [,~ 7/ State whether applicant is owner, lessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder. Name of owner of premises .~ . . .~.~ ~ / C ~ ~'D/~ ...... (as on the tax roll or latest deed) If applicant is a corporation, signature.of duly authoriied officer· (Name and title of corporate o}~cer) Builder's License No Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of l~d~n which proposed work will be dop~. ..... ~ .......... · ........................ ' ............... Subdivision...~ / ~ .... '4~ ......... Filed Map No ............... Lot . ......... (Name) State existing Use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use and occupancy ..... ? : - ;, ., .......... ;~. ..... .? , :,.~.~; .,.. ............ b. Intended use and occupancy ......... . ..... .~ . :.,,. . % · 3. Nature of work (check which applicable): New Building ......... Addition ...... Alteration .... ' . Repair .............. Removal .............. Demolition ..... : .......... Other Work ............... 4. Estimated Cost .. ..... escr on 5.. If dwelling, number of dwellingiunits ....... N mb f d (to be paid on filing this application) Ifg mb of ' · ....... u er o welling units on each floor ......... arage, nu er cars ... ~ ....................... . ...... 6 'Ifbusi ' " ' ........ i 1o i d ifyn and ' f ............................ ' .... ' P Y nt cl typ of · ness, commerca r m xe OCCH anc , spec ature exte o ,ca i e use ............... 7. ~imensions of existing structur{s, if any: Front ............... Rear .............. Depth ....... , ....... eight ............... Nmflber of Stories ................ ' Dime ion of shin ith It rio dditi :F ....................... j ' ns s estructure w a era ns or a ons ront ................ I~ear ~.. ' .......... Depth .... ] ................ : · · Height ............ ........ :.. Number of Stories ........... : ......... · · 8. ~ s~ons ofent~renewconst ction: Front. /..'Z-~... , Rear · ./ · .-'~:~.... De-th .. ,ne~gnt ............... Number of Stories ]. ' ........ ~' ,.~,,' --f' '-'.' ~t: ',,. · · 9. Sizeoflot Front . ' · ',~ .........' ........... ' ............. 10. Date of Purchase ,, ~_ · ......... Depth_ .... . t,t:~ ~ .. · ..' .' · '.' '~... ....... · ......... r~ame ot Former Owner .... ff..q .... t.~. .~.~p,..~ 11. Zone or use d!stnct ~n wtfich pr~m~ses are situated...~.'~4~' ~ . 0y~,~ ', 12. Does proposed construction,violate any zonin,, law ordin~d ....... ' ' ' ' %'-'f .................... ' ..... wm lot oe regraaea ~ ,, .. · ........................ ..... · ~ ': .... .,. · ~,. ,. · .~ ..... wnt excess fill be re,,mov~d,£rom premises: Yes ' 14. Name of Owner of premises/.~ /~ ~g..S-..~6f-..~. (-J~-~4~ .,2..~. ~..5 .~.. ~.~..-~.~.." · .' .~.--v~.q~ddress / ..... Phone No. Name of Architect ............................ Address ................... Phone No ................. Name of Contractor ........ :. . .... Address ........ . .. Phone No ............ ' .... 15. T.s this property ~ithin 300 feet of a tidal wetland? *Yes...25-~.. No ....... · If yes, Southold T~own Trustees Permit may be required. '' ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block gumber or description according to deed, and show street names and indicate whether interior or corner lot. COUNTY OF ........ O CK.. .? (Name of individual signingj contract) ~bove named. APPROVED AS NOTED * · NOTIFY BUII..D'"~ DEPARTME"T AT 785-'1802 ~ AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & pLUMBiNG S. ~NSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION Lil ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS .... being duly sworn, depose~ and says that he is the applicant {e is the ' i ' . i (Contractor agent corporate officer etc ) ............ ~f said owner or owners, and is duly agtt'mrized to perform or have performed the said work and to make and file this pplication; that all statements contained in thisupplication are true to the best of his knowledge and belief; and that the ,,ork will be performed in the manner se/forth in the application filed therewith. worn to before me this ....................... of...! ......... '{ ......... 19..q No. 01BO4842180 I ' · .... ~ · · · ·. Qualified in Suflolk Counli ~ r, (Signature of applicant).