HomeMy WebLinkAbout21219-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22339
Date MAY 19, 1993
THIS CERTIFIES that the building
Location of Property 840 FLEETWOOD ROAD
House No.
County Tax Map No. 1000 Section 137
Subdivision
ACCESSORY
CUTCHOGUE, N.Y.
Street Hamlet
Block 5 Lot 6
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEBRUARY 9, 1993 pursuant to which
Building Permit No. 21219-Z dated FEBRUARY 11, 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 N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
ALBERT & WINIFRED WEISS
Rev. 1/81
· 0~ NO. 0
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)
No-~°. 21211Z
Permission is hereby granted to: ,
...~.-.....~x~.~..~,~,~/ ~,~ ..............
.,., o, ....................................................
c~t prem~
CounW Tax Mop No. ,000 Sect,on ....... ../.~...~ B,~k......................~ Lot No ....... ~ .............
pursuant to application dated ...... ....~....~.. ..................................... , 19~..?...., and
Building Inspector.
Fee $.~K...~.~.....~
approved by the
Rev. 6/30/80
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 in~ 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 i% lead.
5. Con~ercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
'g. Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-exist~ng" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. ~ 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,
AIterations 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 - $100o00
3. Copy~ of Certificate of Occupancy - $5.00 over 5 years - $i0.00
4.. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date ..............................
Tew Construction.....o...../ Old Or Pre-existing Building .................
,ocation of Property ...... g.~.~. ......... ~.~f~-~a..~ ....... .~/~..~?~[~ .............
House No. Street Hamlet
,nwer or Owners of Prop~rty...~g~..~
ounty Tax Map No I000, Se on .............. Block ............ Lot .......
................................... Filed Map ............ Lot ......................
ubdivision .
ermit No....~./.~.~. ~..Date Of Permit.~.~.~.~ ...... Applicant~.~Z...~../~ .....
ealth Dept. Approval ......................... · Underwriters Approval ................
lanning Board Approval ........................
~quest for: Temporary Certificate .......... f Final Certicate ...........
~e Submitted: - D~
...
0 ~ APPLICANT
765-~802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION ZND [ ] I~.~ATION
FRAMING [ ~]' FINAL
DATE
INSPECTOR
:~J, NZNNOD qVNOI£IGG~
(pug)
'r
i'iO I.L V O Ilno~
.!
2GOD
'i
r
CARRIAGE HOUSE
Our most popular model. An excellent "on loca-
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area for your home· A bea'ufiful way to meet your
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able on ALL MODELS.
BARN
Another very popular model, which will surely
complement the natural landscape of your prop-
erty. L~ke other models, the dquble doors are 5'
wide and 6' high which w~ll accomodate every-
thing from your tools to the heavy lawn & garden
tractors. Available maximum 10' high.
GABLE
Shown here are one of the roomiest bu~ldincjs.
The Gable is as versatile as your needs. Maximum
head room. The wide double doors can be placed
on the front or $~de of the building.
DUTCH BARN
An old-fashioned look with storage capacity for
the 90's. This style is higher than any other model
plus ~t comes w~th a loft.
CON,
Why Don't Other Sheds Measu
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· No middle man.
· Completely constructed and assembled.
· All wood construction.
· Stronger, longer I. ife.
· Foundation: 4x4 Pressure Treated Timbers.
· Floor Joists: 16" On Center, Pressure Treated
· covered with % inch Pressure Treated Plywood.
· Maintenance-Free %" Exterior Grade T 1-11.
· All Wood Corner Molding.
p?
· Roof Trusses 2x6 and 2x4 Double'Gussetted for
maximum strength.
· Exterior Grade Plywood Roof.
· Self Sealing 240 lb. Asphalt Shingles.
· Aluminum Roof Edge. ~
· Heavy Gauge Galvanized Hinges & Door Latch.
· Galvanized Nails.
· Reinforced and Framed Double Swinging Doors.
· Fully Painted and Trimmed.
When you purchase a North Fo'rk Wood Design Storage Building, Gazebo, or any of our many other products,
you own a high quality wood product, soundly constructed, with the finest construction malerials. Built here
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FEB'- 9 1993
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765 1802 ,
Examined ..... 19 .~,_~
.'",pprovcd . . /.. ., 19 .~,~.. Permit No. ./.~../..~.
Disapproved a/c .....................................
. (B~il~'n~·
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTII .........
3 SETS OF' PLAN!i ..........
SURVEY ...................
CIIECK ....................
SEPTIC PORN ..............
H~Y'L TO:
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
:ts ~f plans, accurate plot plan to scale. Fee according to schcdule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
r ar,~as, and -iv'
alien, o mo a detailed description of layout of property must be drawn on the diagram which is part of this appli-
¢. Tile work covered by this application may not be Cbmmenced before isSUance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
~ail 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
mil 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
uilding Zone Ordinance of the Town of Southold; Suffolk County, New York, and other applicable Laws, Ordinances or
~=utat~ons. for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
lie applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to
Jmit autlionzed respecters on premises and in building for necessary ~fl~//~/~
(Signature of applicant, or nam~,ff a corporation)
(Mailing address of applicant)
tale whefi~er applicant is- owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
amc of owner of premises
(as on the t,.a~x roll or latest deed)
applicant is a corporation, signature bf duly authorized officer.
(Name and title of corporate office?)
Builder's License No. /. g..'.'~.¢,/.../.'/..~. .........
Plmuber's License No ........ '. ................
Electrician's License No .......................
Oilier Trade's License No ......................
Location of land on which proposed work will be done.
· ....... .....
llouse Number Street Hamle$ '
Co,mb' Tax Map No. 1000 Section . ./.~..7 ............ Block ./%'.~. ............ Lot~.~..~.i...
SubdM~ion
...................................... Filed Map No.
(Name) .............. Lot ..... · ...........
Slate existing use and occupancy of premises and in tended use and occupancy of proposed construction:
Existing and occupancy ~'. 7'0 .~. ~' ,ff.../Z'..~-..~.
a. USe · ·
b. Intended and
occupancy ·
.3. of work ( h h~ ~' Addition ... Alteration
.............. Other Work ....
4. Estimated Cost . ~.~ ~ ~ (Description)
' ' '~ .................... Fee . .
garage, number of c~s ~ ............... (to be paid On filing this application)
dwelling, · ~ .
5. If number ofdwelh~g umts
. If ~ · .............. Number of dwelling units on each floor...~.
6. If business ..... ' ...... . ..........
~ · ~,,mcrc al ormixed occn .......... ,, e ........................................
7. wi llenslo~s el exlstlllg stmctu.res, If any: Front ..... ~. fuse
'~ ' ' . · 'i . ~,-,~y. ~pccny nature and ex.tent of each type o
· .. Depth..~ ..........
He g ~t .... ~ '" ........ Nu;mber of Stories .~..- ....... .. . .....
D~ensions of same structure {v th alterations or additions ~ ...........................
Depth = / ' re t ~ ~ .......
D ~ .' ' ' ;' ' '. .... ; ........ lleight ........ ; ................ treat ................
8. m~cns~ons oz~ntirc new construction. Fro-~ ~ ~ ......... Num b~ ~ Stories ...........
10. DateorPurcmse zqz7 ..... ' .......
. · ....... Name of Fo~er Ow~ er~4~ ~ '~ ~z$~ ......
Zone or use district in which'p~emises are situated
12. Does proposed constructio- .,:2,_. . ' ..................... ' ..................
,, *,u,ate any zomng law, ordinance or regulation: . ~ .......................
13. Will lot beregraded .. ~
14. N ...... ' ' ' '~ .......... ' ..........................
~,,e muwner of premises fifthS. ~ .......... Will excess fill be removed from premises: ~ Yes ~ No
N~e of Architect ........ ' .............. Address~q. ~/~r~Peff. ~.. Phone No 7.7~7~ff ...
................ Address ................... Phone No .....
N~e ofContractor~O,r~ ~?~ .~q~ Addres ~e'' d
15. Is this property within'sbb' z;& eTv.v . ~ ~'?~..~., ...... PhoneNo. Zd~-~eM~. '.
· If yes, Southo~ & - a cloaz wetland~ *Yes X ......
~ ~own i'rustees Permit may be requirg~'~ ..... No .........
L ... ~ PLOT DIAG~M :
ocat~ clearl~ and distinctly MI[ buildings, whether .' · = '- . .
yJy?2~Y ~nes. G,~e.street =d block ~mber or deschntio?~Stj~ra?Z_~ff~¢~d' '~dm~D ~kset' acC d' sions from
,mc,or or comer Ion ~ ....... u,~ t~1~a,i sh~ st~et ~e~i~te whether
rATE OF NE'I' YnR~C 'i
( amc ofmdwidual s~gnmg Contract)
eve named.
being duly slvorn, deposes and says that he is the applicant
' is the ........................ l .... ' '
I (Contractor, agent, corporate officer, etc.) / ....................
said owner or Owners, and is duly aulthorized to perform or have performed the saki /york ~nd to make and file this
d/cation; that all statements contained in this application are true to tile best of bis knowledge and belief; and that the
rk will be performed in tile manner set !forth iu the application filed therewith.
om to before me this
............. · of...
Quaffied in ~uffoW, Co. e.}a .......