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Home My WebLink About22048-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. No Z-22987 Date PL%Y 10, 1994 ACCESSORY THIS CERTIFIES that the building Location of Property 840 LITTLE NECK ROAD ~uTCHO~UE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 97 Block 7 Lot 26.6 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 24, 1994 pursuant to which Building Permit No. 22048-Z dated MAY 9, 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY SHED "AS BUILT" The certificate is issued to PETAR BOGOVIC (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A -' / ~ild~ng Inspector Rev. 1/81 FOI~M NO.$ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, N-° 22048 Z BUILDING PERMIT ITHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) CounlyTaxMap No. 1000 Section ...... .~....~.. .......... BIock.,,,.Z ................. Lot No....~..~...~..~. ......... pursuant to application dated ...., .~'., .Z.,¢~. ,~., ...................................... 1 g,...~.....4~...., and approved bythe Building Inspector Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL APPLICATION FOR CERTIFICATE OF OCCUPANC~ =.~,~y.~ This application must be filled in by typewriter'OR ink and submitted to the build~n~ inspector with the following: for new building or new use: 1. Final survey of propeCty 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 Vpre-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 I. 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 Buildinz - $i00.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy.- $50.00 5. Temporary Certificate of Occupancy - Residential $i5.00, Commercial $15.00 Date ................... ~%~.~ ~.~ ............ New Construction ........... Old Or Pre-existing Building ................. Location of Property .... ~.~. ..... [1~.%~....~.~qg..~.~. ....... House No. Street Hamlet Onwer or Owners of Property .~.~ ..~.~.~ ..... County Tax Map No 1000, Section. ~1' Filed Map Lot Subdivision ...................................... .. Permit No,,.~...~--~...~.(.~/..Date Of Permit..~.~.~.~.~ ..... Applicant ............................. Health Dept. Approval.' ......................... Underwriters Approval ............... ~ ......... Planning Board Approval ....................... . Request for: Temporary Certificate ........... Final Certicate.~.. Fee Submitted: $. ~: .C~ ..................... p...6pV.L% ........... .......... (- 0 ~ ~ APPLICANT OUI~DATION (1st) OUNDATIOU :OUGH FRAME & (2nd) .PLUMBING fNSULATION PER N. Y. STATE E~;ERGY CODE FINAL ADDITIONA'L COMMENTS · . "~ .., ~ '- ~,' ; ng ga(e: ~~L~,-;, ' I~(~ - t~0~ r ; ...... ~; ~ . · ?~ .,C JPO~ ..... ,~, . ':~: . =,E,,TRA DOUBLE D~ORS ~,, , -, , t,-,;, , ~ ..... ': '" TERIO~'PARTITI~NS ' ")' : ' :'' ' ' '": ...... .... ~., Iff,, ' '~ ~ '"~" ~7 '~-~ Ft.OWER BOXES ,,, ,, -:. ~ ' ~.~ ..... ,,. . --- CFHER - , '" " - ,,~;, , F OOF SHI'NGLE COLOR ;',; '~ -:~ ~'~ ~ f~,,~::~;,, '-'. .... ~'* . ..... _ , ~', ,' ,~ ~ ~ H'~ .,.~,,~,~ . ,,, DELIVERED BY -~: ~,' ' TiME,,~ ,,. ~, DATE. ,,: , ...; ';.~ '~ ' .: · BARN S I GNATU~ ? ~" "~ - /;F~ 2_ 9 199,4 ' BLDG. DEPT, r i lu~ro4~ (:o~eil'y~ Fi~w ~ 'r FORM NO. 1 .......... TOWN OF $OUTHOLD , ~ BUILDING DEPARTMENT ~ 9 1994 TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Bi'~di'2g I"'~e~tor) ' APP!.!CATION FOR BUILDING PERMIT BOAED OF HEALTH ......... 3 SETS OF PLANS ......... SURVEY .................. CIIEEK ................... SEPTIC FORH ............. CALL ............. HAIL TO: ..... INSTRUCTIONS a. Tiffs 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 tiffs 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 CounW, 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 apphcant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspecgigns. ,-~ · -.- (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 ....VI~..~'.[t.~.... ~).O.(P.OY.I.C:. .............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................... ................ (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ....... b) l/~ ............. t:lectnclan's License No ..... ~O/.1~ ............. Other Trade's License No ..... .D/~ ............. Location of land on which proposed work will be done .................................................. Ilouse Number Street Hamlet County Tax Map No. 1000 Section ...... 0.~..-7. ....... Block ...0-'~ ............ Lot...0..~.~.: .6 ......... Subdivision. k~.'r .T~,iE.. ~[EC.~...~RO.~.~,T.t~.S ....... Filed Map No. 6.0.~/~~. ........ Lot . .6 ............ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .'~C~.I.-:... ~.}i).~.~...'~..l~.~...~).C-..C'~.~F).bg..C.~, ............. b. Intended use and occupancy ...'~Q-~.L....~.~ .~.~...T...~}.0....OLE..C.O.~I.~..C.~..: .......................... '.'~ .......... oval .............. Demolition .............. ther Work. . ' .... .... ' ./e~ (Descriptiob). 4. Estimated Cost ........... , ...... .c~.: .'.'7 ............ Fee . .,~.~: j'.::. ............................ 14/~ ,(tp,~e,.p~i¢ on filing this application) 5. If dwelling, number of dweliin~ units . - ...... ~.3~ '~ ¢*~ ,. ~ .,/^ If ara e nu , · ....... ~umoer oz aweuingamR~mn,eacn noor.., tv././3 · g g , tuber of cars ~ . J?./6 ,~':-;-.~ ;~": ......... If bus~ness, commermal or mixed occupancy, spec ¢ [se ~.'/~ ...... 6. ify nature and extent of each t ne o u 7. Dimensions of existing structures, if any: Frontn .............. Rear....,~ .......... Depth ...... Height ............... Nun] ber of Stories .~: .~.C:..k~.~,~ .17.. ~.O. i~,y.E.)'.2 ...................... ........ ' ' ' ' Dimensions of same structure with alterations or additions Fron ....... , : t .. ~8 . '" Depth ....... n~_~, .. ~ .. Rear ................ · ·. · ,,~;m ....................... Number of Stories .............. ~ ..... 8. Dimensions of entire new construction: Front . ~. ........ Rear ..... /.0 .~ ....... Depth . ~. ~. ........... Height .... q'./ ......... Num, her of Stories ........ ~ ........... · Rear .............. Date of Purchase I ....... Name of Former Owner ... ~l~ ....................... Zone or use i ..... ' .... ~ ' d strict m winch Premmes are mtuated ....................... . ............................. Does proposed construction violate any zoning law, ordinance or regulation: ... b}.O. .......... ~ ......... ' ...... Will lot be regraded ........ i' ~'~ ............... Will excess fill be removed from premises· Yes . No Name of Owner of premises J°on.vB.~..~.GC).V.I.C.... Address 3 !~.~q .&55f]~.~.RIgjqq(,. Phone No Name of Architect . ./~ ... i ... ·. Address ................... Phone No ................ Name of Contractor lq .1'~ i~¢ ~.'~1~ i~ . Address ~Paqt,:~ ~-IlOg.~O~.t¢.lt~?~Phone 15. Is this property within ~300 feet of a tidal wetland? *Yes ........ No..~.. · If yes, Southold ~own Trustees Permit may be required. '''' PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. ~ ~S~ __~t~f-, E/o~kO~i2 5 ~4 E1)5 ,'. NOTII ;IUILD~NG DEPART~T AT 802 9 AM. TO 4 PM FOF~ THE '~0 REOUIRED R POURED CONCRETE )UGH * FRAMING & Pt. UMBING CO~STrqLICTION MUST ; COMPLETE FOR AL CONSTRUCTION SHALL MEET THE REOIJ~REMENTS OF THE CONSTRUCTION & ENERGY NOT ~ESPONSIBLE FOR DES~Gt~ OR CONSTRUCTIOA~ ERRORS STATE OF NEW YORK, COUNTY OF ~ ....... .~% ...... S!S ......... [.E.T.fi.~..~. ~ .o.q/..C. .................. being duly sworn, deposes a~d says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly ~uthorized to perform or have performed the said work and to make and file this application; that all statements contaiqed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner s,et forth in the application filed therewith. Sworn to be. fore me this ' ' ..... 2;5... davo£ : //~r' / ~.~7/ ' . :' Notary Public,. ,..o, ............... ' ................ Oomrni~ion Explms Jmy ~}, ~-i~ applicant)