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Home My WebLink About21767-zNo Z-22807 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date DECEMBER 21~ 1993. THIS CERTIFIES that the buildin~ Location of Property 2375 HARBOR ROAD House No. County T~xMap No. 1000 Section 136 ACCESSORY Street Block 1 CUTCHOGUE¢ N.Y. Hamlet Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 25~ 1993 pursuant to which Building Permit No. 21767-Z dated NO--ER 9¢ 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 STORAGE SHED 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 Rev. 1/81 KARL & PAULAJOBNSON N/A ~ ~~ding Inspector FOgM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ 21767 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....... .......................................... 19..?.. ,~,..- at premises located at..,...,-~,, ................................................................... .................................................... ...................................... ............. CountyTax Map No. 1000 Section ...... ../....~....~. ....... Block ....... ~ ............... Lot No. ../.,..~., .................... pursuant to application dated .,..../.~.~...... ................................ 19...~..~.. ..... Building Inspector. and approved by the ~,~ ~"BuiJ'ding p Rev. 6/30J80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE 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 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 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 yea~s - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 t.>-cc'=' /5" Date ............. New Construction ..... i ..... Old Or Pre-existing ~il~ng...~ ...... iiiiiii Location of Property .... ..~'..~.3.-.~. ........... .~...~.Q~.....~?. f. ..C ............ House No. Street Hamlet 10. ! ?...r. County Tax Map No 1000, Section... ; .- ..... cc ............... Lot ................. Subdivision .................................... Filed Map ........... . Lot ...................... Permit No.~./.~..~..~.~....Date Of Permit ................ Applicant....~..~..~.~ ....... Health Dept Approval Underwriters Approval . . . Planning Board Approval ........................ / Request for: Temporary ~e~_rtif%cate ........ Final Certicate... Fee Subml ~ 5' ~'-~ i i iI ..~. ~/i~ ~.~.. ~ 'tted: $ ....................... '~ / ~ x¢/ ........... FOUNDATION ( ls t ) FOUNDATION (2nd) 2. ROUGH FRAME & .PLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] I~ULATION ~'INAL FRAMING Examined ../7~ ........... 19~..~. Approved . ./'./~..~ ........... 19~. Permit Disapproved a/c ..................................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 No. ~./. 2G. BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: ( ilding, mspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and 9f 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 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 iemoval 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 inspel:tio,7~s. -- r~, ........... i~i~d ~;e~ ~'~i~¢)' _ .. ..... : .~ State whether applicant is owner, Jessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ....... ........... //~ .~./. Jg?..g'7~ ......................... ..................................... Name of owner of premises . .~..R...4...~..~.. J.~. (~¢. ~. .... 4 .c3. l"/64.' .~..o.t~..: ............................... (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. t .~..-.? .~..0.'.. l~.'. [, ....... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ' · .e..c.....xL .... ..... .alT/.. ........... ........ 7' 7. House Number Street County Tax Map No. 1000 Section ... 1.5. ......... Block t Lot / Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .. 3. Nature of work (check which applicable): New Building · · ' . Addition .......... Alteral~n ......... Repair .............. R{moval .............. -Dem;lit};~ '. ............. Other Work~~... i f ~Uescrifftion) 4. Estimate'd Cost.. ~! (to be paid on filing this application) 5. If dwelling, number of dwellihg units ............. Number of dwelling units on each floor . . t::: i i}: i :/~ ' If garage, number of cars ...I .... 6. If business, commercial or miqed occupancy, specify, nature and extent of each type of use ....... ]. ....... 7. Dimensioj~l. of existing structures if any: Front ~...0, 9_ ~>o~ f, 0, 2- n~,,,h ~ -7 ..... Height .~ilr. ............ NOm ber of Stories ./. .. l Dimensmns °f same structureiwith alterations or additions F .... ' .................. ~ ....... ~ ........... Depth. ~ Hei,,ht . . ' ........... ~ · · · ~ ....................... murat)er of Stories ......... . .. 8. D~mensmn. s,ofrentire new con!truction: Front .... /../-r~.. ......Rear ../'..P~f. ......... Depth . i .~'.'... Height ./(.2. ........... Number of Stories / ........ I I 0. ~ate o~ vurchase ~---' ~ ~ ,- ~ ' ' ....... : ................... rqgr~e oi vormer uwner ................ I ...... 11. Zone or use district in which Premises are situated.. .J.(.~'f~../. ~.~.7'7..4tT4-r..~ . . I ..... 12. Does proposed construction violate any zoning law ordinance or r;-t~latio'n'.' .~" ."'..I ' 13. Will lot be regraded ./~..Cf. · · '.. Will exc ~' .... ' ' ' J ~' ....... :' ' '; ........ ...... M ..... ,., · · ~ ./ ...... ess Illl oe removed zrom premises: xes Name of Architect ~.~.~ 5.Is thJ_s property lot~ated within I00 feet ~ a tidal w~"~'i'~aand? *YES ~If yes, Southold To*m Trustees Permit may be required. ... 1 PLOT DIAGRAM Locate clearly and distinctly gll buildings, whether existing or proposed, and. indicate all set-back [imensions from property lines. Give street and block number or description according to deed, and show street names and ndicate whether interior or comer lot. 7(~S.-~802 9 AM TO 4 PM FOR THE FOLLDW~NG ~NSPECTIONS: 1, FOL}ND/~T~ON 1VqO REQUIRED FO~ POURED CONCRETE 2. ¢qO[IGH - F~;IAMING ~ PLLIMB~NG BE COMPL,ffFE FOF~ ALL CO~'F~UCT~Oh~ $'[ATE CONSTR[JCFBON & ENERGY COD~?$. NOT RESPONSIBLE , FOR DESIGN Og CONSTRUCTION ERRORS STATE OF NEW YClR~'_" , COUNTYOF .... ~ .... amc of individual si~,mng contract) above nam ecY. He is the ................ I ontractor, agent, corporate officer, etc.) of said owner or owners, ~d is du~y authorized to perform or have perforated the said work and to m~e and file this application; that ail statements con(dined h this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~nor set forth in the application filed therewith. Sworn to before me this ,~,..,,. T ' ' ' c' '.EWATE NAME ~L.FI 'S~VICE~,. '~.t'O~AE' FOR ; .;lq RESIOENC~ ~AL ~m C,.:NRT ON~.~' WILL CONr~>NM '~O THE STAND- E[:.~, "~ ARO.., CF THE SUFfOlK COUNT R~F NO DEPT OF HEALTH SERVICES .(~iI~E~O ONLy r~' 'LED MAP NO. ..... )OK NO ~ '~ ' NO~TH ? JOP, NC 78-2~o SURVEYEO FOR LOT NOS. //.~-//& //VC-'. MAP OF ~U~E~E SITUATED AT DATE DATE PAGE T~,',~:CH~N jf~ PC St,RYE YOR ' COUI~TRy ~ ROAD- ~,~IN~ NLJW YORK 117q2 /