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Home My WebLink About21178-zFOPS4 NO. 4 TOWN OF SOUTHOLD BUILDING DEP~JRTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22091 Date . JANUARY 11, 1993 THIS CERTIFIES that the building Location of Property 34640 House No. County Tax Map No. subdivision ACCESSORY SHED MAIN ROW CUTCHOGUE~ Street 1000 Section 97 Block 2 Lot Filed Map No. Lot No. NY Hamlet 8 conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 4, 1993 pursuant to which Building Permit No. 21178-Z dated JANUB_RY 7~ 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 BUILT The certificate is issued to JOHN BRUSH, JR. & ANO (owners) of the aforesaid building. SUFFOLK COUNTY DEP~RTMENT OF HFJkLTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED - ' ' InSpector % Rev. 1/81 ]~OB~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N.o :Bl178 Z / Permission is hereby granted~to: ..~ = - ~.~,....~,~../m~ ......................................... .... :, , at premises located at ,,,,,,~,, ,~,,,,~,, ,~,,,,~,~,,~. ,~:.,~,r,, .............................................. ~,, ................ County Tox Map No. 1000 Section .......... ~...7.. ...... Block .......... ~ ...... Lot No ...... ~ .............. pursuant to application dated ........ /..~. ..................................... , 19...~,~., and approved by the Building Inspector. Fee $*..~.....'~.~. Rev. 6130/80 /~ Form No. 6 / / BUILDING DEP~TMENT 'TO~ ~LL 765-1802 ~PLICATION FOR CERTIFICATE 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 - $i00.00 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 $15.00 Date . .. ~ .c~..~>. ................................ New Construction ........... Old Or Pre-existing Building ................. Location of Property... ['~ i.~ ............. . ........ House No. Street Ham-let · 3nwer or Owners of Property .... ~ .. ..... ;ounty Tax Map No 1000, Section ........... Block .............. Lot .................... ~ubdivision .................................... Filed Map ........... . Lot ...................... ?ermit No. ...Date Of Permit../. ' ...Applicant ............................. {ealth Dept. Approval ......................... - Underwriters Approval ......................... ~lanning Board Approval ........................ [equest for: Temporary Certificate .......... ~ Final Certicate ....... 'ee Submitted: ~?- ~'~ .... : ............. ,.:..: ~--e~-~ '~ 'zZd'"~'~,~:' ...................... APPLICANT ~OUNDA~ION (1st) 50U~DATIO:~ (2nd) ~OUGH FRAME & -PLUMBING P~SULATION PER N. Y. STATE ENERGY CODE FI;;AL ;%DDITIONA'L COMMENTS 765-~,802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. DATE jo~~ ::IM NO~ 1 SOUTHOLD DEPARTMENT HALL N.Y. 11971 : 765-1802 Examined ............ , 19 . ........... Disapproved a/c ..................................... APPLICATION FOB BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH 3 SETS OF PLA~$ .......... SURVEY ................... CllCCK .................... SEPTIC FOR~I .............. HAlL TO: Date...~j .............. a. This application must be completely filled in by typewriter orin 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 wdrk. 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 removal or demolition, as herein described. The applicant agrees to comply with al[ applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in~p~ectioAas. (Signature of applicant, or name, if a corporation) ....W.~.~. ~.~..~... G~...~..~. (Mailing address of applic,~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ Es on the tax roll or latest If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .................... Plumber's License No ......................... : El i .cian's Li No ' "- ectr cense ....................... Other Trade's License No ...................... · Location of land on which proposed work will be'done. ~ ....... · ............... ................. . ,ii House Nmnber Street ?,.7. &. ~. County Tax Map No. 1000 Section ................ Block ' . ........... ' Lot ................. Subdi ision Filed Mhp No ' Lot ' (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~../~ ~~ '' '' i'" · ...... .......... z ....... ....... .... b. Intended use and occupancy : ' ~ 3. Nature of work (check which applicable): New Building ........ Addition .......... Alteration .......... Repair .............. Re,oval ......... Demolition ............. ~ ....... Other Work .. ~ i (Description) 4. Estimated Cost ......... ~.~.~)..~ ...................... Fee ................................. ' (to be paid on filing this application) 5. If dwelling, number of dwellingI units ............... Number lfgarage number of cars of dwelling units on each floor ................ 6 ' If busine'ss .... ' ................................................................... · , commercial or mixeld occupancy specify nature and extent of each typ~ of use ' ' 7. Dimensions of existing structures, if any: Front ............... Rear .............. De ......... Height ............... Number of Stories ............. pth Dimensions of same structure w~th alterations or addit ons: Front ' Depth ! Height ................. Rear .............. 8 .......................................... Number of Stories ................... '. · Dimensions of entire new construction: Front Rear .............................. Depth ............... Height Nmiber of Stories 9 Size of lot: Front ........................................................ · · .............. Rear I0 Date of Purchase " ........................ Depth i ' Name of Former Owner 11 Zone or use district in which prdmises situated ............................. 12. D.o. es proposed construction viollate any zoning law, ordinance or regulation: ....................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..................... Address .......... Phone No~ Name of Architect . . ' ........................ ........ , ................. Address ................. Phone No. Name of Contractor .... i ........ ' " ................ .............. Address ......... . .......... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes.' ....... No ......... · If yes, Southold Town Trustees Permit may be required. .... PLOT DIAG RAIvl Locate clearly and distinctly all Ibuildings, whether existing or proposed, and. indicate all set-back dimensions frdm property lines. Give street and block fiumber or description according to deed, and show street names and indicate whethbr interior or coruer lot. A RI £D AS NOTED ,. / NOTIFY BUILI~NG ~)~='p~' 765-1802 9 AM ~ 4 PM~OR THE FOLLOWING INSPECTIONS: I. ~OUNDATIC)N TWO REQUIRED FOR POURED CONCRETE 2, ROUGH . FRA~ING ~ PLUMBING 3. INSULATION 4, FINAL CONSTRUCTION MUST 8E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF THE N.Y. STATE CONSTRU~ION & ENERGY CODES. N~ RESPONSIB~ FOR DESIGN OR CONSTRU~ION ERRORS ~ ;rATE 0 F NEW ~'RK~,/~f~..//~e ..... i ........ ' ....... b'eing duly sworn, deposes and says that he is the applicant (Name of individual signing contract) hove named. " . ... e is the ' ' ,: (Contractor, agent, corporate off/cer, 'e't~.i ? said owner or owners, and is duly a~thorized to perform or have performed the said work and to make and file this ~plicalion; that all statements contained in this application are true to the best of his knowledge and belief; and that the h ' ork will be performed in t e manner selt forth in the application flied therewith· yom to before me this./~ ' · . ....... ~..day o£ .... ..~..(.:(.~.K..., 19.~..~ CLAIRE L..GLEW 'i ' Notary Publld~ St,tb of Now York ........................... - No. 4879505 - .uuallfled in Suffolk Counts/ 0 zL (Signa~t~'e of applicant) ~ommleSlen Explre~ December