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Home My WebLink About21083-zF. ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21184 Date NOVEMBER 27~ 1992 THIS CERTIFIES that the building ACCESSORY SHED Location of Property 95 EAST ROAD/5875 PEQUASM AVENUE Mouse No. Street County Tax Map No. 1000 Section 110 Block 6 Subdivision Filed Map No. CUTCMOGUE Hamlet Lot Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 6, 1992 .pursuant to which Building Permit No. 21083-Z dated NOVEMBER 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 SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A FRANK J. & ANGELA F. DEROSKI 6ilding Inspector Rev. 1/81 !~,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~.9.N? 210~ Z Permission is hereby gran.ted to: --~'...~/.,...~ ....... ~.~,~ ~.-) ..... , , ....... _....,.~...,....,~.,....,../../.?.... ,,~ ,o .~~....~....~ ........ ~~.....~.....~~.... Co.nw Tax Mop No. 7000 Sec.on ..... /../..~ ........ B~o~k .......... ~..: ..... Lot No.../..,~/..~ ......... pursuant to application dated ............... /,Z,,,/.,,.~, ......................... 19~ approved by the / Building Inspector. Rev. 6/30/80 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 NOV 2 3 1992 ': APPLICATION FOR,CERTIFICATE OFOCC~PANCY 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, ~treets, 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 Bsed in system contains less than 2/10 of 1% lead· . $. Commercial building, industrial b~ilding, 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 Cempleted site plan requirements.' 3. For existing buildings (prior to April 9, 1957) non-conforming us~e, or buildings and '.'pre-existing" land uses: ml. .Accurate survey'of property showing ali property lines, streets, building and unusual natural or topographic features. 2. A properly completed application an~'~ 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. Fees I, 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. Ccr. tificate of Occupancy on Pre-existing Building -$100.00 ~. Copy of Certificate ,of Occupancy - $5.00 Over 5 years - $iO.00 '~" · 4, ~Updated Certificate of Occupancy - $50·00 5o Temporary Certificate of Occupancy - Residen~ial~$15.O0, Commercial " · ... :w Construction· Pre-existin Bui ' ' ................... ................ ~..!..~ z~.. . ..... .... tlouse No, Street ........ vet or Owners of Property· . ,ty Ta, , ap 'o 000, Section .... ..... Block ...... G. · 2-10 3 ............... Filed ~ap ............ ~ot ................ 'mit No ............ Date Of Permit .............. Applicant. lth Dept Approval ' ' · ' ......................... Underwriters Approval ........................ nnlng Board Approval ' ~es't for: Temporary Certificate ........... Final Certicate ' ~OU~DATIO:4 (2nd) ~OUGH FRAME & .PLUMBING [IlSULATIO~I PER N, STATE E~IERGY CODE FI:IAL ADDITI~AL COMME~;TS: Z C 0 '--4 m m ~xaminea../ ......... , 19 .~."Z.- Disapproved a/c ..................................... APPliCATION FOFI BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. CALL ................... MAIL TO: INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 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 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 all applicable laws, ordinances, building code,~houjShj~ code,,,and regulations, and to admit authorized inspectors on premises and in building for necessa~~..~/../y..Z~,.,/j~..~.....' --' ~(Si~ature of EpiC_can.t, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~.QQ...5~e*~} .~ (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. :~)/~.L]/~/.~ ]~ ............ Plumber'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. 1000 Section ..... I.[ Q ......... Block . ~¢ Lot .l.L Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy t~C~ %'~ ~ ~ ~ ~Q ~ ~q. ',, , :... 3. Nature of work (check which appl{cable): New Building .......... Addition .......... Alteration .......... Repair ....... ....... Removal .............. Demolition ............ Other Work ', ~/ . ' (Description) 4. Estimated Cost ....Z~. ?..~ ....... i ....................... Fee ....... ! (to be paid on filing this application) 5. If dwelling, number of dwelling units ................ Number of dwelling units on each floor ......... · If garage, number of cars ............ ~. .............................................. ' ...... 6. If business, co.mm, ercial or mixed occupancy, specify n_ature, and extent of ea_c~h, type. of use ...... 7. Dimensions ot cresting structures if anv' Front ff-~, z. ,___ :~ ~, ~- ~. ., ' .............. · ,- ............... ~xcar .............. uepm..'g., g. '. ~. ~. ....... Height ............... Num be,'r of Stories ../'. ................. Dimensions o~s&me structure withialterations or additions Fro~t 'i ~i. ii..' i i i' 'l~;ir'' '~... Depth .... ~ ............. .J Height . · .'~il-l-l-l-l-l-i-i~. · ........... Number of Stories .~. ............ 8. Dimensions. of entiret new construction:, Front ...... /R ...... Rear .... ./rp. r. .......Depth .. ~f. .......... Height .... .?..' .¥ ....... Numbe'r of Stories . .../ 10. Date of Purchase ..; ........... Name of Former Owner ........................... 1 1. Zone or use district in which premises are situated .................. 12. Does proposed construction viql~t~ any zoning law, ordinance or regulation' ~.' ~ . ' ' '. ................... 13. Will lot be regraded /~/O. I ...... Will excess~fill be r .... i ~' .............. . ........ ................... emovea ~rom premises: Yes 14. Name of Owner of premises~..~¥~..[.-~.¢.(04~..~..' .... Address ................... Phone No.?. 3. .c(.._.~. Jo.6. .... Name of Architect ............ I ............... Address~ ................... Phone No ................ Name of Contractor .......... ~ ............... Address ................... Phone No ................ Is this property within 30~ feet of a tidal wetland? *Yes ........ No..~ ..... · If yes, Southold T.'oWn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all b¢ildings, whether existing or proposed, and. indicate all set-back dimensions from rnber or description according to deed, and show street names and indicate whether property lines. Give street and block nu interior or comer lot. STATE OF NFt~?~O~ [~.,- S.S COUNTy ..... j , (Name of individual signing~ contract) above named. , APPrOVeD AS NOTED 765~1802 9 AM TO ¢ PM FO~I FOLI_,OWIk~G 4, FINAL CONSTRUCTION MUST BE COMPI,.ET~ FO[I C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE ~.Y, STATE CONSTRU~ION & ENERGY CODES. N~ RESPONSIBLE FOR DESIG~ OR CONSTRUCTION ERRORS being duly sworn, deposes and says that he is the applicant He is the ........................ . .............................................................. (Contractor, agent, corporate officer, etc.) f said owner or owners, and ~s duly ~uthonzed to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the *ork will be performed in the manner s~t forth in. the application filed therewith. ~;wom to before me this ........ f'~. · .~,.~..~alq~..~.. ,,. ,~..k~....0v~,..(, 19 .~.~-- /"~ //~// 'V°tary Pu~,:~ · ,~, ,' .... ~...'. County NOtSW Public, Stst® of New Yoffi ...... ~ ~ ...... / '2~ · ¥ ." ....................... No, 4879508 , ~ / ? [ (Signature of applicant) Qualified in Suffolk CounW' Commission E~ires Oe~embe~ ; ; 765-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PL~BG. [ ] FOUNDATION 2ND [ ]~*N* i- ] FRAMING [ ,,,,]"FINAL~~/ MARKS: v (/ INSPECTOR of ~o ~ ~e¢ie ¢. HEALTH OEPARTMENT-DATA FOR APPROVAL TO ¢ONSTRUCT NOr£~ ~ = MONUMENT STORy SURLY FOR JUN~ ~5~ 198~ AT CUTCHOGUE DATE: dUNE ~4, ~N ~ ~OUTHOLD SCALE= / "= SUFFOLK COUNTY, NE~ ~RK ' NO. ALDEN W, YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S, UEENS/NO. HOWARD W. YOUNG, LAND SURVEYO~ ~~ N.Y.S. LICENSE N0,4589~