The URL can be used to link to this page

Home My WebLink About21477-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22701 Date NOVEMBER 4~ 1993 THIS CERTIFIES that the building. Location of Property 255 HARVEST I~%NE House No. County Tax Map No. 1000 Section 97 Subdivision ACCESSORY Street Block 2 Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 13.3 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 3, 1993 pursuant to which Building Permit No. 21477-Z dated JUNE 10, 1993 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 HORSE BARN AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED EUGENE & GAIL BUTTA PENDING- 10/24/93 if~g Inspector Rev. 1/81 FORM NO.3 TOWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALL BOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 21477 Z Permission Is hereby granted to: .... ~.~,~...~.,./...~..~.~ ........................ Counh/Tax Map No. 1000 Beetion_~.._'.7.."~' ~'"~ ......... Block ....... ~ ............ Lot No. .,.X..~..,...~... ..... pursuant to application dated ..,~ ........... ~. ............ 19.,~....~,. ..... and approved bvthe Building Inspector. ~ee S.d-.~.,...~.. Building Inspeoto~ Rev. 6/30/80 Form No. 6 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10,00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ... /~/~ ~ .,ew Construction ...... ~.... Old Or Pre-exzstmng Buzld~ng ......... House No. Street Hamlet On.er or Owners of Property ..... ~F~, ........ r4- ............... County Sap Ne 1000, Sectioe .......... Block .... .......... Permlt No..~./..~.Z~..~.Date Of Permit...~.~.~ .~.~...Applicant...~~ .... [j[j[[j[[ !{ealth Dept. Approval .......................... Underwriters Approval ......................... d'lasnisg Board Approval ........................ ~{equest for: Temporary Certificate ........... Final Certicate. '.~....... · ~'IELD 1. ATE COMMENT~ FOUNDATION ~ ' (~lst) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: NOT RESPONS~ FOR O~ CONSTRUCTION ERRORS '1 ; I '9040 765-1802 BUILDING DEPT. !NSPECTION [ L,]/FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FRAMING REMARKS: FOUNDATION 2ND [ ] INSULATION [ ] FINAL DATE INSPE~rOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~]/~RAMING [ ] FINAL REMARKS: ~/~1~/~ INsPECToR _~'//J~~/ DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION / FRAMING [~'~NAL REMARKS: ~' THE NEW YORK BOARD OF FIRE UNDERWRITERS P~,~ t :[045130 BUREAU OF ELECTRICITY J--- 85 JOHN STREET. NEW YORK, NEW YORK 10038 OC~OP,~;R 29,1993 8~06~93/93 ~ Date ~pplieation No. on file THIS CERTIFIES THAT o~y the electrical equipment ~ ~scrib~ be~w a~ int~uc~ by t~ ap~icant ~d on the a~ve appl~ation numar in the p~m~es of ~s exam[ned on and found to be in compliance with the Na~onal Elect~cal Code. FIXTURE FIXTURES RANGES C~KINGDECKS OVENS DISH WASHER! EXHAUST FAN! F~I~RS~2-3 ~ 12 I~SE~N~ TO i03 B~}I'PIIORNB Per This certificate must not be altered in any manner; return to the office of the Board if incorrect Inspectors may be identified by their credentials. FORM NO. 1 TOWN OF SOUTHoLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 1197'[ TEL,: 765-180;3 Examined ................ , 19 ... Approve../~/. .... 19~.~.. Permit No. ~./..'~..'.~.'7,~.. - Disapproved a/c ' e*x ~. BOARD OF HEALTH . SURVF.¥ ............... CUECr ................ sEer c ............. (Buildin,, Inspec[or) APPLICATION FOR BUILDING'PERMIT Date ... ; .......... , 19 .~,.~. INSTRUCTIONS a. This application must be completely filled in by typewriter orin 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 mu~t 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 i~sued 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 !he 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 inspec.tors on premises and in building for n~cessary inspections. - - ,(Signature of applicant, or nd.ale, if a corporation) · . ~ ' ' ~ ~dress o'f'applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder· Name of owner of premises . .~¢.~. ·. (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 ...... ,/.',~-~.~c~./~.~. .... Plumber's License No .... .~'.~. ~.. ~¢,~r. ~ ;~f/ Electrician's License No. /~ /r ~ / Other Trade s Lmense No ...................... Location of land on wbich proposed work will be done ...................... ~ .......... ; ................ : ...... ............ ' ........... llouse Number Street Hamlet CouhtyraxMapNo. 1000 Section ...:.~..~. ......... Block ...~ ..... ' .. Lot../,~.,.~ ............ Subdivision...'~O £.l.Yl~'.. rl ¢~,~.F.~.¢¢~.~ ,q.~. ' Filed MapNo ............... Lot ............... · ,..,/ (Na~ne~ ' 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 ..... i ' (to be paid on filing this application) 5. If dwelling, number of dwellingi units ..... ff ......... Number 0f dwelling units on each floor ............ · If garage, number of cars .... i ................... ' .................................... xe~d occupancy specify nat : .... ' .... 6. If business, commercial or m{ 3ro and extent of.each,t2y/pe of use ......... . ......... 7. Dimensionsof,existingstructur?,ifany: Front .... ~.. ........ Rear ...~./... Depth. ~ ' Height ...~.. ......... Number of Stories...-...':~ ii '" Dimensions of same structure with alterations or additions: F'ront ................. Rear ......... ~ ........ Depth .. ~ , ,, · .~ ' Dimension o' ' :.' ........ '.1 ' ..height ........ ~' '~"2 ....... ;.. Number o~f Stories ........ '. '.: ..... 8. s oa entire new construction. Front.....~ .~. o~ _ R o · .~ · · · w~' i,, /Z" i " · ..... ~. · ·; ,~a, .... v ....... De"th . ,~.o. · .~Ig ...... ,.~, .......... Number of Stories . /. d~..eo/~qo ,, ,~,~,~,- -j~ -/o~,22 v ......... 9. Sizeoflo;, Front. /d/Of ,~' ' ',,,z.(.t',~"~77.'~'...~'."r,d/.~.~w' ...... :...... .. .... · · ' · ~', v ............ t~ear...,5.~?.' · .':. . . De"fl' ,q~$~O/ ' 10. · · .-..~,., .................. ~ame ct t'ormer Owner .~.~.,-~d~ Date oi Yurchase o~,-/o/¢[:~ ,- ,, ,, .. _ _ · ..... ~,-_t, ~, :.. ,.._.~., ......... 11. ' · · . ~ · · Zone or use district In which pr~mlses are situated ....... . ............................................. 12. Does proposed construction viol.ate any zoning law, ordinance or regulation: ,~.0 .. ' . 13. Will lot be reeraded lga~,sT)~Jx/ ..... · ................ .......... ~.~/. ~, ....... 1" o~'~" · ~. · ~ ~. ;/.. wm excess fill .be ren]qvcd from premises: Yes .... ,¥-,~v.,... ~..,-;~ ..d7'.~.o.~ .~.... Address ............... Phone No ' ' Name of Contractor .... ~x'.'.~. ra,~ .-~Jd~ r'~e., ....Address ............ ; ...... Phone No ................ 15.' 19 this property within ~00 feet of a tidal 'wetland? *Yes ........ No.~C/. · If yes, Southold ~own Trustees Permit may be required. '''' '". i PLOT DIAGRAM Locate clearly and distinctly all ibuildings, Whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block mmber or description according interior or corner lot. to deed, and show street names and indicate whett~er STATE OF NEW,;~'ORK, ~ .... .'S.~ coot, Fry oF. d.'.')~ above named, of individual signin~ contract) .... being duly sworn, deposes m~d says that he is the applicant He is the I (Co~ntfactor agent co~'~orate ......... ') ............................ , , 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 con[ainCd in thisapplication are t'rue to the best of his knowledge and belief; and that the ~vork will be performed in the manner set forth in the application filed therewith. ' ' 5wom to before .n}e this ......... ...... :..dayo ...... . · u: ,i . J~NA M. ~'nINo~ .... ~ .z--',,,~... . .' N°tav/P~?~.Sgt~-~NewYolk . ' ' d' ~ (Signature of applicant). Qualified n Suffolk County ~_,~ Cbmmlaslon Expi,res November 16,