HomeMy WebLinkAbout21323-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southotd, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22446
Date JULY 8~ 1993
THIS CERTIFIES that the buildin~
Location of Property 370 BENNETT ROAD
House No.
County Tax Map No. 1000 Section 40
Subdivision
ACCESSORY
GREENPORT~ N.Y.
Street Hamlet
Block 5 Lot 1.5
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 2, 1993 pursuant to which
Building Permit No. 21323-Z dated APRIL 8~ 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 IN REAR yARD AS APPLIED FOR
GEORGE SAKELLARIDIS
The certificate is issued to
(owner)
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
FOu~e NO. ~
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)
N~°. ~13~Z
Permission is hereby granted to:
...... .~...o..:..~.....~..... ........................
.... .~'.~..~........,o..;~ ....... I..~..~..4..~. .........
County Tax Map No. I000 Section ....~..~.~. ......... Block ...... ...0....~'7.. ..... Lot No...J..,..~. ............
pursuant to application dated ..... .~:~.. ......... ...~T. ................. , 19~..~.., and approved by the
Building Inspector.
Rev. 6/30/80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN RALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by ~ypewriter 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 2½10 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.
Submit Planning Board Approval of completed site plan requirements.
'6.
For existing, buildings,, (prior to April 9, 1957) non-~onforming uses, or buildings and
"pre-existzng land uses:
i. 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 - 35.00 over 5 years - $10.00
4.Updated Certificate of Occupancy - $50.00
5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
7..z
Date ................... , ........
Sew Construction ........... Old Or Pre-existing Building .................
Location of Property ......
House No. Street Hamlet
Dnwer or Owners of Property ..................................................................
3ounty Tax Map No 1000, Section' ........ ' ..Block... ........... · · Lot ......................
iubdivision Filed Map Lot
~ermit No ................ Date Of Permit ........ Applicant,
tealth Dept. Approval .......................... Underwriters Approval .........................
~lanning Board Approval ........................
'~equest for: Temporary Certificate ....... .... Final Certicate ........ .. .
, . ....... . .... . .....................
FOUNDA'TION (1st)
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
CARRIAGE HOUSE
Our most po~pular model. An excellent "on Ioca-
Jion sales office", pool house, or general storage
area,for your home. A_beautiful way 1o meet your
storage needs. Single or double doors are avail-
able on ALL MODELS.
popular model, which y
complement the natural pe of your prop-
erty. Like other models, the double doors are 5'
wide and 6' high which will accomodate every-
thing from your tools to the heavy lawn & garden
~"~ ~,~tract°rs'~[~/(~Available~ maximum 10' high.,~/,~ %.,,,,j ~.~
Shown here are one of the roomiest buildings. An old-fashioned look with stor. age capacity for
The Gable is as versatile as your needs. Maximum the 90's. This style is higher~han any other model
head room. The wide double doors can be placed plus it comes with a loft.
on the front or side of the building.
CONSTRUCTION
· No middle man.
· Completely constructed and assembled.
· All wood construction.
~ Stronger, longer life.
· Foundation: 4x4 Pressure Treated Timbers.
· Floor Joists: 16" On Center, Pressure Treated
covered with 5/8 inch Pressure Treated Plywood.
· Maintenance-Free %" Exterior Grade T 1-1 I.
· All Wood Corner Molding.
Why Don't Other Sheds Measure Up?
Compare Our Quality
· 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 Laich.
· Galvanized Nails.
· Reinforced and Framed Double Swinging Doors.
· Fully Painted and Trimmed.
When you purchase a North Fork Wood Design Storage Building, Gazebo, or any of our ma'ny other products
you own a high quality wood product, soundly constructed, with the finest construction materials. Built here
on Long Island with pride. Door and window placement can be changed to suit your needs. Single Doors
also available. Free Delivery To Most Areas. We reserve the right to make design, option & specification
improvements. Custom Designing To Your Specifications. Other Designs Are Available All Sizes.
NEW FOR '92
AT
BACKYARD STRUCTURES- 100% BUILT BY
North Fork Wood Design, Inc.
Pauls Lane
PeconJc, NY
765-3090
Pioneer with Eagle's Nest Clubhouse
STYLESINCLUDE:
Eagle's Nest Clubhousei/Climber
Commander's Tower
Scout Tower Lookout / Explorer
Scout West Point
Scout Plus 16' Fivestar
Pioneer PLUS ANY COMBINATIONS
AVAILABLE 3i WAYS:
#1 - Hardware Only
#2 - Hardware & Lumb( r Precut
#3 - Fully Assembled
THE GAZEBO
Special attention to quality sets the North Fork
Wood Design Gazebo apart from the rest.
Our Gazebo is not only beautiful, but each
gazebo is hand-built by skilled craftsmen. Only
the finest, most durable wood is used in Con-
struction. Fragrant Cedar or Pressure-treated
Pine. Both are long-lasting and will maintain
their natural beauty for generations.
Precise attention is given to every de-
tail.., right down to the steel galvanized
screws. These screws will insure your gazebo
will maintain its structural integrity and will
weather the years without rusting.
HOW TO FIND US ;
Also
Sheds;
Barns,
&
Gazebos
Immediate delivery from Inyentory, 3 to 4 weeks
on custom orders, Free Delivery within 20 miles
WE BUY THE BEST MATERIALS, TO BUILD
THE BEST PRODUCTS, TO SELL TO THE
BEST PEOPLE- OUR CUSTOMERS
COUPON
WE WILL BEAT ANY
ADVERTISED PRICE
ON ALL Swing N Slide
BRING IN
COMPETITOR'S AD
AND WE WILL
HONOR IT + 5% OFF
FORM NO. 1
' '.'"TOWN OF SOUTHOLD
.BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
' ( '~ ' TEL.: 765-180:3
Examined~· . · .~. ·., 19 ~.~. '
Appr°vedX'~:qnv. · · .~..., 19 .~..~ Permit No..o~../. ~..~..~ ::~
Disapproved a/c .....................................
_. (Building Inspector)
APPLICATION FOR BUILDIN(
INSTRUCTIONS
BOA'RD OF HEALTH
3 SETS OF' PLANS ..........
SURVEY ...................
CI1ECK ....................
SEPTIC FORH ....
s-/ V-ii
hot ~Py;
CALL
HAIL TO:
'a. Tlds application must be completely filled in by Wpewriter or in ink and submitted to the Bhilding 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 w6rk.
e. No building shall be occupied o'r 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 Buildiog Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the T0,wn 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, ordihances, building 6ode, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary insDelalions. , ]' · /~_ ~..__~ .
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . 'f
(as on the tax roll or latest deed)
If applicant is a ~orporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..........................
Plumber s L~cense No .........................
'' ' ' No
Electr~man s L~cense .......................
Other Trade's License No ......................
Location of land on which proposed work will be'done ...........
- '70 7
}louse Number Street Hamlet
County Tax Map No. 1000 Section ~0. - 5"- io 5" Block Lot.. ;~.,., ...,...': .........
Subdivision ..................................... (Name) Filed Map No .......... .... -'~? Lot, 5~ ...... ..... O'~ '' ~×'"'~" ': ....
tate ex~stmg use and occupancy of premises and intended use_and occupancy of proposed co~istrucYibff: : ~':
a. Emst~ng use and occupancy . ~ . ' , ' -- :-
- '"' ' ................. '"" ' ' ::' '"-:. · ......
b' 17tended use and °ccupancy ...... -- '''7 '~ :'''' ''''~ .............
;3. Nature of work (check which ~pplicable): New Building .6ddition
Repair Re,oval . ' ................ Alteration '
........... · ............. . Demolition .... ..'. . Other Work
4. Estimated Cost , . ' (Description)
If dwelling, number o ~ (to be paid on filing this application)
5. f dwelling units ............... . Number of dwelling units on each floor ..........
· If garage, number of cars .... · ....
If business, commercial or mixed occupancy, Specify nature and extent of each type of use
7 Dimensions of existing structm'es if any: Front
Height Nmnber of Stories ' Depth · '
' ............... Rear ... .........................
Dimensions of s~ime structnre With alterations or addit ons ..............................................
Depth ' ' Height Front Rear
................... ~ .... ' ' Number of Stories ' ........
· Dimensions of entire new construction: Front .......................
............... . Rear ............... Depth ...............
9 Height ............... Nur~ber of Stories ........................................................
· Size of lot: Front .......... .~ ............ Rear .......
I0 DateofPurchase ~ ............... Depth .....................
· · ......... .......... ' ......... Name of Former Owner .......... , ....................
.... hpI '
11. Zone or use district in whlc rem~ses are situated ......................... . .........
12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ' .............
13. Will lot be regraded .i ...................
........ , ................... Will excess fill be removed from premises: Yes No
14. Name of Owner of ' '
premises .., ................. Address .... .
Name of Architect I ................ Phone No ............. ....
......... ~ ................. Address ........... . ........ Phone No ............ ; ,...
Name of Contractor ........ j ................. Address ................... Prone'No... ........... ,...
15. ' Is this property within 300 feet of a tidal Wetland? *Yes ........ No ......
· If yes, Southold Town Trustees Permit may be required· '''
PLOT DIAGRAM
Locate clearly and distinctly alli buildings, whether existing or Proposed, and. indicate all Jet-back dimensions from
property lines. Give street and block Fumber or descmption according to deed, and show street names and indicate whether
interior or corner lot..
NOT~FY ~Ut[DI~G OEPA~T~[NT ~T'
765-1802 9 AM TO ~ PM FOR THE
VOLLOWtNG ~NSP~CTIOfgS: '
? FOUNDATION ]¥VO REQUIRED
~2 ~OURED CONCRETE
4 ~,~',¥u, ,';NqTRUCTIf)N MUST
;TATE OF NEWARK ....
SOUPY OF...
(Name of individual signing contract) - · · sworn, deposes and says that tie is the applicant
bove named.
is the .. ~ ........... .................... ~ ........
(c rfi ,,'o}; ......................
ontractor, agent, corporate o ce .
said owner or Owners, ~d is duly ~uthorized to perform or have performed the said work and to m~e and file this
pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the
'ork will be perfo~ed in the manner set forth in the application filed therewith.
worn to before me this
...... ......
~ln~, , , r / .................
.~ t~¢e ~ ~, 1~ (Signature o f applicant)