HomeMy WebLinkAbout21023-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22093
Date JANUARY 11, 1993
THIS CERTIFIES that the building.
Location of Property 1240 GOLD SPUR DR.
House No.
County Tax Map No. 1000 Section 95
Subdivision
ACCESSORY
CUTCHOGUE, NEW YORK
Street Hamlet
Block 4 Lot 18.11
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 9r 1992 pursuant to which
Building Permit No. 21023-Z dated OCTOBER 16¢ 1992
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 JOSEPH SMALLEY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROYAL ' N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
/Buildinq Inspector
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°_N?
/ ~,....~,--~..~__.....,......xX*~:..'...~....xx~,-~ x~
....~ ....... ~...~:..~.:..;:~ ................. ~-: ......................................
at premises located at .......... '..~'~-...~.,-,~..,..~..;~..y .4~~~.,r ......................................
.......................................................................... ~..~./.~....~'"'- - .. ..................................................
County Tox Map No. 1000 Section ..... ~.~.... ........ Block .....~... ............. Lot No. /~..~..../../.'.. .....
pursuant to application dated ..... ,/..~. .................................... , 19~....~, and approved by the
Building Inspector.
Rev. 6130/80
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 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 B6ilding 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 years - $10.00
4.. ~Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
.....................
Old ' g B ildi
New Construction ........... Or Pre-exzstin u ng ..............
Location of Property..JT-.~.@...~.p~J).. ¥.~....-~f~[F.~ ........ .~ ~'., -..~/.~
House No. Street Ha~nlet
)nwer or Owners of Propgrty ..... .~.?.~.~{ .............
;ounty Tax Map No i000, Section .......... Block .... . .......... Lot ....
~ubdivision .................................... Filed Map ............ Lot ......................
~ermit No.~.~.~. ........ Date Of Permit..~.~./~.~./f..vT7....Applicant .... .~..~.~/.~...~..~.~ ............
ealth Dept. Approval ..... ~..~. .............. Underwriters Approval ..... ..~..~.. ............
lanning Board Approval .... .~..~ ..............
mquest for: Temporary Certificate .......... ~ Final Certicate .......
:e Submitted: ...................
765-~.802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
REMARKS:
DATE
OUNDATIO~'~ (2nd ]
OUGH FRAME &
·PLUMBING
NSULATION PER N. Y.
STATE ENERGY
CODE
ADDITION A~L COMMENTS
BLDG. DEPT.
TOWN OF SOUTI4~LD
LUMBER
Pos #837-91-99
Deluxe Storage Building
OR
USE ~S UNLAWFUL
W~THOUT
CONTENTS
12' and 16' Storage Building Assembly
12' and.16' Door and End Assembly
12'xl 2' Storage Buildinq (Pos #837-11-99)
OF OCCUPANCY
Page 1
Page 2
12'x16' Storage Building (POS #837-12~99)
16'x16' Storage Building (POS #837-14-99)
16'x20' Storage Building (POS #837-16-99)
Materials List
Page4
Page 5
Page 6
Page 7
~CoovriQht 1989, EiQhtv Four Lumber
ocr Assembly for 12' Wide Shed
Cut 4 pcs. (board A) 2x4-89%" with notch cut. See
diagram 1 page 2 for cutting instructions.
Place board A into shed frame and nail into place
using 16D sinkers.
3[ UG. [1EFt'.
End Fram, e Assembly for 12' Wide Shed
1. Cut 5 pcs. (board A) 2x4-89~'' with notch cut See
diagram 1 page 2 for cutting instructions.
2, Place A boards rotc shed frame and nail rotc place
using 16D sinkers.
CU'f'flIg6 INSTI~.uGTION5
~or Assembly for 16' Wide Shed
Cut 6 pcs. (board A) 2x4-895/B'' wflh notch cut. See
d~agram I page 2 for cutting instructions,
Place A boards into shed frame and nail into p~ace
using 16D sinkers.
End Frame Assembly for 16' Wide Shed
1. Cut 7pcs (boardA) 2x4-8g%"w~thnotchcut. See
d~agram 1 page 2 for cutting Jnstrucbons.
2. Place A boards into end frame and nail rotc place
using 16D sinkers
12'x12' BARN
P~.$.
t~O~F
S~EAT~IN6
.SOFFIT
[ILDG. DE:F"£. [
TOWI~I OF SOUTHOLD ~
MIDDLE
FLOC~ SHEATH/KD SIDE WA, LL SI4, E'A-(H4N&
.b
E'~D WALL
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
BOARD OF HEALTH .........
3 SETS OF PLANS ..........
SURVEY ...................
CI1ECKt ....................
SEPTIC FORH ..............
SOUT,O,.D.N.Y. ~97~
/~ / . ,.,., c^L,.. 4.*' .... /./..t .......
Examined../j~/./r,~ ....... , 19 ~:~'. 7''~ / .% t't^ l:t, TO:
Approved X< 0. ./_.~?. 19 .~.~. Permit No ,~/a~. ~ ~ ~}eg:~i~,r;!;~,'i'-~. '' '' ~"
..... ),. ........v- ............ / ~;<.,:? !, , _~- .
· .l ~! .................
~ sapproveda/c ............................... ~;i ~..~_" ~ '5>"'"'
...... --~ ,~3~,11,II - ~'G'%~O
............................................... ....
[~l ~, {~ Ig [J ~/ [~_]~'~1' (J~ildin~ector)
BLDG. DEPT.
· INSTRUCTIONS
~1 0~ $OU~HOL~
a. This 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 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 thc 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 Count~ New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings additions or alteratiS~s, or for removal oi' demolition, as heroin described.
The appli'cant agrees ~o comply with all applicable laws, ordinances, building code, hous~&g code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspect'r~
........ .~,~--. ff~.~. -, .~.>.~, e,~...~---~.<: .~.. .......
.... ~(~_~kof~tYlioa~h~, or nam e, i f 7 q~on)
(Mailing address of applicant)
State whether applicant is owner, lessee, ag6nt~i arcJxffect, engineer, general contractor-, electrician, plumber or builder.
............ ~. ~. lqr.~.: ............ ..,:..~:.~.,:.. .................................................
N.,m ,- -- -- ......................... ...........
· /I ,, , ' ' aso* etaxrollorlatestdeed
If applicant is a corporation signatureX'J of duly authorized .dffi96r.' / ·
(Name and title of corporate officer) ~ ~
Builder's riccnse ~o...0. ~V. ~.~5,(~..', .'i...::'...
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be' done ..................................................
..l~.q.0 .... ~.o.l.~...5.f.~....:~ ,~'*.~ ..C~:T~a~.G. ~:~.~.,~.,l~~,~
llouse Number Street Hamlet '
County Tax Map No. 1000 Section ..... ~ ........ Block ...... ~ .......... Lot
Subdivision ...................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended us~ an0 occupancy of proposed construction:
b. Intended use and occupancy ............ Vt Z.~. ............... ; {.~ .}. i'~ .'.~ ~ J..'3 ;
10.
11.
12.
13.
14.
15.
property lines. Give street and block n~mber or.
interior or corner lot.
Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...........
Repair .............. Removal .............. Demolition ........ Other Work .
.J?.~ ~ ~ O~.~_~ '" ,,fl~'~ ~ (Description)
Estimated Cost ............... ~ ...... Fee
(to be paid on filing th? application)
If dwelling, number of dweliing udits ............... Number of dwelling units on each floor ................
If garage, number of cars '
If business, commercial or mixed Qccupancy, specff.y nature and extent of each type of use .....................
Dimensions of existing structures, :if any: Front ................ Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dime f ith It tio dditio
nsions o same structure w a era ns or a ns: Front
................... Rear ..................
Depth ' ' I Height Number of Stories
Dimensions of entire new construdtion: Front R D pth
, ............... ear ............... e ..... . .........
Height ............... Number of Stories .........................................................
Size of lot: Front i Rear ' Depth
Date of Purchase ' ' Name of Former Owner
Zone or use district in which premi~ses are situated ............................. tllS~., ~. · .~ .,:. ......
Does proposed construction violat~ any zoning law, ordinance or regulation' .. ~
........ ! ......
Will lot be regraded .......... 4 ................. Will excess fill be.removed frg~l!l s;" ~.~. c No
Name of Owner of premises .................... Address ................. r, ~hb.n.e ~N(~: , r ...... i. .
Name of Architect
........... ~ ............... Address ............... ' . .. Phone N~'.
Name of Contractor ........... : ............... Address ................... Phone No ................
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 all b/tildings, whether existing or proposed, and, indicate all set-back dimensions from
)tion according to deed, and show ~ indicate whether
STATE OF NEW YORK,
COUNTY OF .............. S.$
' being duly deposes and says that he is the applicant
................................................. sworn,
(Name of individual signing contract)
:~bove named.
is the .... ...
(Contractor, agent, corporate officer, etc.)
said owner or owners, and ~s duly ~uthorized to perform or have performed the said work and to make and tile this
~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
~vork will be performed in the manner set forth in the application flied therewith.
~;wom to before me this
.............. ' da 'of
/ _ ................
'~otary Public
',~'~' f' '~r*~' '" · ' '~nty t', ~ ~
. ...... .....
~ Publl(~BtllteofNow,'~t~g~ ~- ~' . ' · ''
~o[~952246, Suffol~ ~-- ~- -f~ ~ (S~na~; applicant)