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Home My WebLink About21719-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southotd, N.Y. CERTIFICATE OF OCCUPANCY No Z-22705 Date NOVEMBER 4~ 1993 THIS CERTIFIES that the building. Location of Property 3610 BRIDGE LANE House No. County Tax Map No. 1000 Section 84 Subdivision ACCESSORY Street Block 5 Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 11 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 5, 1993 pursuant to which Building Permit No. 21719-Z dated OCTOBER 19~ 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 (PONY) SHED AS APPLIED FOR The certificate is issued to BRAD & DENISE DAMIANI (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 FORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N£ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 21719 Z Date ../.~//..~.. ........................................ ] 9...~.-~... Permission Is hereby granted to: .......... CounlyTax Map No, 1000 Sectlon.....~..~...~.'. ......... Block .......................... LotNo../Z ...................... pursuont,oopp,,cot,onda,ed ........ ~..~//.~ ...................... ~ ........... ~9...~..¢.. ..... andopp,ovedbythe Building Inspector. Fee ~..,~.~...~... Rev, 6/30/80 Form No. 6 . ~. ~ TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN HALL 765-1802 . APPLICATION FOR 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 ~nd 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.Certificata of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 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 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 .................... ~w Construction Old Or Pre existing Building :cation of Property~ ............... ~' ..... ~..~ .............. . ........ House No. Street Hamlet ,wet or Owners of Property ..... .//. ~unty Tax Map No I000, Section...~..~. ..... Block ................ Lot ................... ............ Filed Map..~. fZ~.. ...... .~d ............... · Lot rmit No..~,./..~,./f.Z.Date Of alth Dept. Approval .......................... Underwriters Approval ......................... anning Board Approval ........................ quest for: Temporary Certificate ........... Final Certicate. e Submitted: $ ........................ . .. FOUI~DATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY CODE (2nd) FINAL ADDITIONA'L COMMENTS 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ROUGH PLBG. [ ] FOUNDATION ZND [ ] FRAMING REMARKS: [ ] I~ULATION [ ~J//~l NAL INSPECTOR OF I£L~'rRAT'IO~.J ~ f',co,,.z 7 EC~VA?'xo,'./ tx4 5/o6 ,Oo TtTeO ,~7,~uc.7'uree' ILLUSTRATION [] FRONT 81DING r I / I I i \ I I Examined ./. ........ 19~.~.. Disapproved. a/c ...................................... .................. (Bu/lding I~rpector) APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 755-1803 B~ARD OF HEALTH 3 SETS OF PLANS SURVEY SEPTIC FORH CALL . . . · HAIL TO: 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 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 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 Bu/lding Permi~ 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 ins~_.~. ~<7_,~g~ .~..._.... -- (Signature of applicant, or name, if ~: ~orporation) z . . . , . . , (M~iling address of 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) Buil'der's License No.-~. ........................ Plumber s L:cense No .......... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be'done ............. ' House Number Street Ham/et cotmty Tax Map No. I000 Section .(~):~.~.'. .......... Block ~ ' Lot.. Subdivision . ....~..~.Yr}Jff~. ~..6~e~ ' Filed Map No ............... Lot ....... . ........................... ............... (Name) 2: 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 property lines. Give street and block number or description according to interior or corner lot. · 3. Nature of work (check which pPlicable): New Building ...... Addi ion .......... Alteration .... ; ..... Repair .- ............. RemovaI ....... ; .'. Demolition Other Work ............... 4. Estimated Cost.,. · ................... Fee .............. (tq be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor If garage number of cars I ................. 6. If business, commercial or mix6d occupancy, specify nature and extent of.each type of use ............... , ..... 7 Di sic f ' 'ngst ctu ~s if any: Front R · men nsc exmt~ ru r , ............... ear .............. Depth .............. Hight Nu~be fSto' ' ' D' ' ' ~ "th ' dditi .............. lmenslons of same structur,~ ;vi alterations or a OhS: Front ................. Rear... Depth ~ ~ Height ' .'. ....... ~.. Number of Stories .............. 8 Bimensions ofj~tire new const~ction: Front ~. Rear ~-~/ ........ ~ ~ ......... · Depth Height ?.: Number of Stories ' '' ................................ 9 Si fl ' R · zeo ct: Front ......... : .i.... ...... ear ................ Depth ....... I0 of P ........ · . Date urchase ' ............ ' Nam of Forme Own . , ': ......... i ......... ' ......... e r er ........................... 11 Z d t ~ hich p cmis ituated ' 12 Does proposed co ti vi liate ny lng 1 din I tion: /1Jl~ ' ' ' 13. Will lot be regraded ....... ; .i ................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises ' Address i Phone No Name of Architect ' ' Address I Phone No ' Name of C'ontractor .... I ............ . .... Address ......... : ..... Phon~qo ....... ' 15.' I.s this property within 3100 feet of a tidal 'wetland? *Yes ........ No .... · If yes, Southold Tiown Trustees Permit may be required. , PLOT DIAGRAM Locate clearly and distinctly all ~uildings, ~heth&r existing or proposed, mid. indicate all set-back dimensions from deed, and show street names and indicate whether FO~t POUI~E~ CO~CR~T~ ~[1 .3. ~SUt ATIOB BE COMPLETE FOR C.C. ALL CO~STRUCTIoN ~HALL ~IE~ THE RBQUIREME~S OF THE N.~ CODES. N~' RESPONSIBLE FOR DESIGN OR ~NS~UCTiON ERRORS STATE OF NEW YORK, S·S !i COUNTY OF .......... ~_~ ..... (Name of individual signing Contract) above named. (Contractor, agent, cor~porate officer, etc.) of said owner or owners, and is duly auihorized to perform or have performed the said work and to make and file this application; that all statements containe,~ in this'application are true to tlie best of his knowledge and belief; and that the~ work will be performed in the manner set.forth in tlie a ' ' ' pplication filed therewith. Sworn to before me this HELENE D. HORNE, . .... Notary Public, State of NewYork . No. 4951364 , ' (Signature of applicant) Qualified in Suffolk,CountY ~.< -- (g'~mmission E~pires May 22, 1!~