The URL can be used to link to this page

Home My WebLink About21902-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22965 Date APRIL 26, 1994 THIS CERTIFIES that the building Location of Property 4960 HORTON LANE House No. County Tax Map No. 1000 Section 54 Subdivision ACCESSORY Street Block 3 Filed Map No. SOUTHOLD, NEW YORK Hamlet Lot 21.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 31, 1994 .pursuant to which Building Permit No. 21902-Z dated FEBRUARY 4, 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 STOHAGE SHED IN REAR 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 Rev. 1/81 CHRISTOS VERVENIOTI S N/A N/A N/A Building Iispec~or~ FOI~M NO.;3 TOWN OF SOUTHOLD BUILDING DEPARTMENt TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Oa, ................ ................................. 21902 Z Permission ts hereby granted to: ~./.x~..~..~:.....~~.b.~,(..~.. .................. ...... ~Z~. ~......,~.../..~....~ .................. ~......~,,z~.~.,,_) ......... ~./..., ....... ../../.~./.. ....... to .. ~..4.'Z~.~./. ............ ~.....'~... ......... ..~...E ~... ~..c-Z.. _~ ........ ..?..~,,...../.~ at rem ses located at Courtly Tax Map No. 1000 Sectlon......~.....'~..~... ....... Block,......~....-~... ............ Lot No....,,~.,.,./..:..~ .......... Building Inspector. Fee $,,,~,,~..~.. .......... and approved by the Rev, 6/30J80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 L~ 'row~"O~'~rPi'm~°LO .... ~ APPLICATION FOR CEIITIFICATE 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 Bcard Approval of completed sit~ pi~i 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, Addit~nrs--to dye!ling $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 Buildinz - $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 ~t5.00 .......... ................. / --I New Construction...~ ~.~ .... Old Or Pre-existing Building ................. Location of Property .... ~...~..~..O. ............. ~.~.~..~...~.~; ............. SO.~..~a.~~ ............. ~-, ~---_~ House M,-, Street Hamlet Onwer or Owners of Prope~"~ County Tax Map No i000, Section....~...~..~.'....Block ..... P.1 ...... Lot..~. J.'.i .............. Subdivision .................................... Filed Map ............ Lot ...................... I 0 z .X.../..fl ...... Applicant.. .... Permit No...~ ........... Date Of Permit. .. Health Dept. Approval .......................... Underwriters Approval ..... Planning Board Approval ........................ Request for: Temporary Certificate ............ Final/Certicate..~.~.~.... Fee Submitted: $ ......... '~ ~: ! ~ - ' ' ~ ~ , ~i,, APPLICAN'i~- FOUI{DATION { 2nd ) 2. ROUGH FRAME & ,PLUMBING e INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL C0M~ENTS: ? · ',,~oti~er ver~ l)opula~ model, wt~rc~ wJl/~urel~ ~,,mpiemcn* Ihe nafurai L~ndscap~ ot your prop- :¢" [ik¢~ other mo&ds the doubledoor~ are 5' ~ ,,',o~,, AvL, lublc max,'num 10' htgh 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH ,PLBG. FOUNDATION ZND [ ] INSULATION / FRAMING ~]/FINAL, REMARKS 100% BUILT BY Fork W ood Design BARN X'/~ Another very popular model whicF~ ~ complement the nalural landscape of your prop- erty Like other models, the double doors are 5' wide and 6' high which will ~ccomodate every- thru9 from your tools 1o the heavy lawn & garden tractors, Available maximum 10' high. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ...... , 19 Approved .... .o~/y ....... 19 ¢~)Permit No. o~./.~:.O..2~...'. Disapproved a/c ..................................... (/l~t~t'di n g Inspector) ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... ~EPTIC ¥ORH .............. ,C^LL CeT.3... :MAIL TO: Date . .O'~.~ i .3j .......... 19qq. 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 pi'emises or public streets or areas, and giving a detailed description of layout of properW 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 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 in~ti~ --' (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, .lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. & ... Name of owner of premises ...~.//.'~. ]..~:~.~.~.....~.rt~..( .~..~/./.'..~..'~./. ~. .................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) sE/ !/. Builder's License No.. J. ~.. '.- ...... .~. ./....e 7/0. ~5 P umber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed.work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ....... .O. ?.¢ ..... Block . .,fl.. ............. Lot. ffl/~ o~/. } Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constr.uetion: a. Existing use and occupancy ..................... : · bi dd ' · nten e use and occup,ancy ............ : .............. 10. 11. 12. 13. 14. 15. property lines. Give street and block interior or comer lot. Nature of work (check which apphcable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal ............ Demolition .............. Other Work ............... Estimated Cost ........ ~ ....................... Fee .................. I (to be paid on filing this application) If dwelling' number ° f dwellingiunits ............... Number of dwelling units on ea?h floor .............. If garage, number of cars .... i ............................................. .................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................... Dimensions ot emst~ng structures, ~f any: Front ............. '.. Rear ... ........... Depth ............. Dimensions of same structure wlth alterations or additions: F?ont Rear DD.epth ................... I" Height ........... 't .......... Number c~f Stories ............... ', ..... lmensions of.e, nqre new construction' Front . Height . .~.. 1~,..t ....... Nun~ber of Stories /. ' i" :' r 'v ...... Size of lot: Front , Rear ............................................ Depth ...................... Date of Purchase i ........... ~ .................. Name of Former Owner ............................. Zone or use district in which prqmises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ............................. Will lot be regraded ......... I ................... Will excess fill be removed from premises: Yes No Name of Owner of premises ...i ................. Address ................... Phone No ................ Name of Architect .......... ! ................. Address ................... Phone No ................ Name of Contractor I Address Phon6 No Is this property within ~00 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all !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 ST^TE oF NEW COUNTY OF ......~[<~\.Yw... (Name of individual signing contract) being duly sworn, deposes and says that he is the applicant above named. / i agent, corporate officer, etc.) of said owner or owners, and is duly lauth, orized to perform or have performed the said work and to make and file this application; that all statements contained m this application are true to the best of his knowledge and belief; and that the work will be performed in the m/anrre~ ~et forth in the application filed therewith. Sworn to before me this /. f i ....... ...... ......... p~otary Public .... ._~-c/.~/.':'~...'7~..~..',-~' .~~ County · ROBER~ , $C0~ . . . . // ........ [a~ ~xp;~E ~y ~1, 1g~ (Sxgnatur~ of app~cant)