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HomeMy WebLinkAbout21610-zFORM NO. 4 TO~TN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22741 Date NOVEMBER 22, 1993 THIS CERTIFIES that the buildin~ Location of Property 315 PARK AVENUE House No. County Tax Map No. 1000 Section 56 Subdivision Filed Map No. ACCESSORY SOUTHOLD¢ NEW YORK Street Hamlet Block i Lot 2.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 4~ 1993 .pursuant to which Building Permit No. 21610-Z dated AUGUST 18~ 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 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 RALPH & CAROLYN SINOPOLI /~ Building pector Rev. 1/81 FODM NO.3 TOWN OF $OUTHO~D BUILDING DEPARTMENt' TOWN HALL SOUTHOLD, N.Y. 21610 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: Coun~vTo×Uop No~ ~000 Seet~on..~.~ .~7..~. .......... B~ock ...... /... ............... to~No..~...~...Z ............ pursuant to application dated..~./..,f~,. ............................................ 19..~....,,~... ..... Building Inspector. and approved by the Rev. 6/80/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEP~JtTMENT 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 "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 Certif'icate 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 ././././. ?/.~...~. ............................. New Construction ........... Old Or Pre-existing Building ................. Location of Property...<?./.~.. ....... .~?~ ~.~..~./p~.~..~! ............ .~.~..~..~.~..O./..~. .............. House No. Street Hamlet Property..~.~ .~..~..(>..~O .~[ ~.~)~. ~% .... Onwer or Owners of ............................ County Tax Hap bio 1000, Section...~. .......... Block.../. ............ Lot .... ' ............... Subdivision .................................... Filed Map ............ Lot ................. ... .. Permit No..~J.~.l.~....'~.-...Date Of Permit...~./~.~.~ .... Appl±cant o~0{~0~.~ .~F~.~..~.~.o.~.~ ~. Health Dept Approval Underwriters Approval ........... Planning Board Approval ........................ Request for: Fee Submitted: Temporary Certificate ........... Final Certicate ........... ........................ APPLICANT fiELD FOUNDATIO,~ ( ls t) FOUNDATION ROUGH FRAME & .PLUMBING' (2nd) 3. INSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: FINAL World's Leading Maker of Storage Buildings ® BUILDING DIMENSIONS * Size rounded off to the nearest foot CAUTION: SOME PARTS HAVE SHARP EDGES. CARE MUST BE TAKEN WHEN HANDLING THE VARIOUS PIECES TO AVOID A MISHAP. FOR SAFETY SAKE, PLEASE READ SAFETY INFORMATION PROVIDED IN THIS MANUAL BEFORE BEGINNING CONSTRUCTION. WEAR GLOVES WHEN HANDLING METAL PARTS. Exterior Dimensions Interior Dimensions *Approx. Foundation Storage Area (Roof Edge to Roof Edge) (Wall to Wall) Size Size Sq. Ft. Cu. Ft. Width Depth Height Width Depth Height 10' x 8' 121" x 92 3/4" 74 487 1231/4" 951/4" 877/8" t181/4" 90" 865/8" FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 BOARD OF HEALTH 3 SETS OF PLANS SURVEY CI1ECK SEPTIC PORf! ............. ' TEL.: 765-180;~ ~, /.,, Exaui,ed ~/.~ 19~ ' ~ __ ~'~ ..... L ~J ......... ' .... "'" ' ~ ' ~.:.~ ~ ~ ~ ' ~p~ov~. ~/~ ~. ,~&~,,~o~/~/o~ . _ , .. , ............... ............... ............. ¢ ,._ ...': ., ~.~ .......... Date INSTRU6'i'IONS a. Tlds 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 sti'eets 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 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 l?y 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 removal or dem~llition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing c~fle,"and regulations, and to admit authorized inspectors on premises and in building, for necess~rr~~. ~Z. ~-~.~~;~ // ' .......... -- ' ' . ~-~/Signatur-~ applicant, or name, if a corporation) (Mailing address of applidant) State whether applicant is owner, lessee,"agent, architect, engineer, generai contractor, electrician, plumber or builder. Name of owner o remises ~, (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 .......................... Plum her's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................. : ................ House Number Street Hamlet county Tax Map No. I000 Section ... *.~... ...... Block ..... J ........ i... Lot.~-q~ ............. Subdivision. (Name) ' 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy b. Intended use and occupancy · 3. Nature of work (check which ~pPlicable). New Buildin · · Addition .......... Alteration .......... · Repmr ............. · · Removal . .; ........... Demolition ·; : . Other Work ..... ~ ' (Description) 4 Estimated Cost ~.~0 ' · ' ...... "; .............. Fee ....'.. i ' .. (to be paid on filing this~application) 5. If dwelling, number o f dwellin~ units ' Number of dwelling ' ' If garage number of cars ............... units on each floor If business, co~nmercial or mi.xid occupancy specify nature'and 'extent of.each type of use .......... 7. Dimensions of existing structures, if any: Front ........ : ·. ar .............. ight mb ..... He ............... Nu er of Stories ' ' ....... Dimensions of same structure with alterations or additions: Front ' ' Depth ' ~ Height .................. Rear .................. ................... l' ' · · .................. .... Number Of Stories ' ' 8 Dimensions of entire new consl~ruction: Front ............. ' Rear Depth Height Number of Stories " ~ Size ofiut: Front 'i Rear 10' Date of Purchase ........................................ Depth ' Name of Former Owner 1 1. Zone or use district in which p~emises are situated ....... . ........ ............. 12 Does proposed construction vi61ate any zoning law, ordinance or regulation: .. ' '" ...................... 13. Will 16t be regraded · i ............................ 14 ........ ' .................... Will excess fill be removed from premises: Yes No · Name of Owner of premises .. i ........... ' ..... Address .. Phone No ....... · Name of Architect ! ' ' ................. · .... : · · · ......... , ............ . Address .. Phone No. Name of Contractor ............................ : .... .......................... Address.· .................. Phone No ................ 15.· I.s this property within BOO feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM : Locate clearly and distinctly all~ buildings, Whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block,lnumber or description according to deed, and show street names and indicate whether interior or corner lot. ,. NOTIFY. BU~L.D~NG DEPARTM~[~' 765-1802 9,AM ~ 4 ~M FOR FOLLOWING ~. FOUNDATION 1l~O REQUIRED FOR POURED CONCRETE 2. ROUGH . FRAMING ~ PLUMBING ' 3. INSULATION 4. FINAL CONSTRUCTJON MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ~HE ~EOU~REMENTS OF THE N.Y, STATE CONSTRUCTION'& ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, COU~NTY OF ........ SiS (Name of individual signing contract) ' ' ....... being duly sworn, deposes and says that he is the applicant above named. , . · ' '~ '" ................. (Contr'Jctor ...................................... ' .............. , agent, cori~orate officer, etc.) Df said owner or owners and is duly huthorized to perform or have performed the ~aid work and to'make and file this pplication; that all statements containled in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith. ;worn to before me this '~e°;m4~fr4~O'jOu~°~,~l~,y:- , . ', (Signature of applicant).