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Home My WebLink About21074-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22106 Date JANUARY 14, 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 1055 CEDARFIELDS DRIVE GREENPORT, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 40 Block 5 Lot 1.17 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2~ 1992 pursuant to which Building Permit No. 21074-Z dated NOVEMBER 10~ 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 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 DONALD J. DeJESUS & PENELOPE A. PAYNE Rev. 1/81 //Building Inspector FOmwr NO. ~ TOWN OF $OU~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJV~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°N9 2107~ Z Permission is hereby grar~e~ to: ~ ~. ....... Coun~ Tox Map No. I000 Section ........ ~ ........ BI~k ..... ~ ....... Lot No ..... pu~uant to application ~ ~ ~ 19.....~., and approv~ by the Building Inspector. Fee $..~~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802z ': APPLICATION FOR.CERTIFICATE OF OCCUPANCY A. 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: I. Final survey of property with accurate location of ail 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 f~om Board of Fire Underwriters. · 4. Sworn statement from plumber certifying that the solder Dsed in system contains less than 2/10 of 1% lead. . -- 5. Commercial building, industrial building, multiple residences an~ 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-e ' i xlst ng" land uses: 1. .Accurate survey ~f property showing ali property lines, streets, building and unusual natural or topographic features. ,2. A properly completed appiicatio~ ann'~ 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. Certif' of Occupan__~_y - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25~00, Swimmin~ pool ~25.00, Accessory building 25}_~.00 ~ Additions to accessory building $25.00. Businesses $5~0~.00, ..... 2. Cer.tificate of Occupancy on Pre-existing Building - $I00.00 3. Copy of Certificate ,of Occupancy - $5.00 over 5 years - $10.00 · 4. ·Updated Certificate of Occupancy - $50.00 5. T~mporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~ Constr~etion....~ ~ ..... Old O~ Pre-existing Buildin~ ..................................... ........ Hamlet unty Tax Map No I000, Section.~.~.%~9 .... Block..~., O0 r · ~mm-ova± .......................... Underwrmters Apor~val ..... .nning Board Approval ........................ ues't for: Temporary Certificate ........... Final Certicate...~.. ...... Ss m tted: ...... 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~L REMARKS: DATE /~////~//~?"2..~.~ INSPECTOR ~/~/ TOU~;DA'TION ( ~ st) =OUNDATIO|~ (2nd) ~OUGH FRAME & .FLUMBING ~NSULATION PER N. STATE ENERGY CODE FI:;AL ADDITIO~/A'L COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: Examined /. ¢0.. ., Approved . . .)/.' ~.; i., 19~.. '.~Permit No~/O.~. ~.~. Disapproved a/c ................................. BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY CHECK .................... SEPTIC FORH .............. /. (Bu~l~ing Inspector) APPLICATION FOR BUILDING PERMIT a. Tins application must be corn / Date... [ .0./.~.0. ........ 19 fJ~. INSTRUCTIONS ~Jetely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scal~. 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 detmled descmp[ton of layout of property must be drawn on the diagram which is part of this appli- cation. . c. The work covere'd by tins appl(cation may not be commenced before issuance of Building Permit. · d. Upon approval of this applicat!on, the Building Inspector will issued a Building Permit to the applicant. Such permit sh',lll 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 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 Towg 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premis6s and in building for necessal3, inspections. ,, /~ F~) -- (Signature/of appli6hnt, or name, if a corporgtion) (I~lailing address of applicant) State whether applicant is owner, lejsee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~..~Z.~:~-gZa~....~g4~..~.~..~...'..~gq_ ........... i ~ (as on the tax roll or la[est deed) If applicant is a corporation, signature !of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... ~ ................ Plumber's License No. ' Electri~cian's License No Other Trade's License No ...... i ................ 1. Location of land on which proposed work will be' done ................................................ }louse Number Street County Tax Map No. 1000 Sectioff ...0.~0.,. P.~. ....... Block .... O..~., O.?... Lot...Q..0. 1: .O..I.~.. .... Subdivision. . . Filed Map N ...... Lot ./'7.. .... ~ (Name) // 2. State existing use and occupancy o? vremises and intended use and occupancy of t~rouosed construction' b. Intended use and occupancy .. I ........ e,;)i'i'"f~ .? ,. 3. Nature of work (check which applicable): New Building . .~. ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... '#~f-)D. ' (Description) 4. Estimated Cost Fee ....................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor.. '~'77 .......... · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... : ............. 7. Dimensio.n,~ of~gstmctures, ifany: Front .... ~5~,.:53j..3. . Rear . .o~..-¥, eight .% ......~_...~ .... ~umber of Stories ... Dimensions of same structur,, with alterations or additions: Front ..... '7':i.. 7' ...... Rear.. ~ ............. Depth ...... ;-:~:w~. ........... Height ...................... Number of Stories.. ~ ........ ~ ....... 8. Dimensions of entire new construction. Front f~/~ ~,^A_ /o' i II ............. v,~ux ... · ........... ~ueprn ../. ~.. .......... Height ...~..'/3 ........ Number of Stories .... / ................................ ,, (~Sizeoflot: Front .................... Rear ..... ~... · Depth og .~<tg. i ........... 10. Date of Purchase ..,~'~ .~/ff. 7~. ................. ]~ame o~ F'o'r~e'r'(3~v~ 1 I. Zone or use district in which premises are situated...$~g.~./~, d~. ...... ' .................. 12. Does proposed construction violate any zoning law ordinance dr regulation: .~(%4.. 13. ?g. ill lot be,,regraded ...... r"~'~,~t~O~'~ 'f~'&~ ~:~' kd/M['' Will excess ill[ be, re~. oye, d f~om premises: Yes (~ 14. eqame of owner of premises '.~'~,~"~5"~Address ./~.~.ff,~¥'Wg~4~/~ Name of Architect ~-~.f.~ '~£' Address ,~~'~7.'¢ '',,, ,,' ............ .......................................... vnone mo ....... . ......... Name of Contractor . ~ ................ Address ........ Phone No .... 15. Is this property within 300 feet of a tidal wetland* *Yes' ..... ~ .J~'~ ............ *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 fron'~ property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. aPPRO /EO AS NOTED . FOLLOWING tNSPECTIO~:S FO~? POURED COiqC~!'~'h 3. INSULATION 4. FINAL CONSTRUCTION 8E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES, N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW ~YORK, e e , COUNTY OF ......... ~ .............. ' ....~ ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Ite is the ......................................................................................... (Contractor, agent, corporate officer, etc.) ~ owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application am true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. 5worn to before me this Votary Public, . .......... .~.qtqT~--~. '~7~... ANN M. 8Oi1'O Nota~ Publte, ~ate ~ N~ ~. 4926M7 ~ml~-~ June ~ ........ County ........... (Sis.at.re ii ;p lici 't)