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Home My WebLink About20679-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20858 Date JULY 14, 1992 THIS CERTIFIES that the building Location of Property 3450 DEPOT LANE House No. County T~x Map No. 1000 Section 96 Block 5 Subdivision Filed Map No. ACCESSORY CUTCHOGUE, NEW YORK Street Hamlet Lot 12.2 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29~ 1992 pursuant to which Building Permit No. 20679-Z dated JUNE 2~ 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 OUR LADY OF OSTRABRAMAR.C. CHURCH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROV~-L UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 N/A N/A uilding Inspector !~0~ NO. 0 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~N? 2067JZ Permission is hereby granted to: .... ............. at premises located at ............. ~,,. ,~, ,.~.,, ................. ~...~.: ............. ; ................................. ....................................... ................................................... County Tax Map No. 1000 Section ....... .~..~.. .......... Block ..... ..~...-~.... ........ Lot No ...... ./..~...:.~. .... pursuant to application dated ........ ~ ....... ~.. .......................... , 19.~....~., and approved by the Building Inspector. //Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Itealth 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. 3. 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. '. 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 - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $I5.00 Date ........ ~w Construction...~. ..... Old Or Pre-existing Building ................. llouse No. Street Hamlet lwer or Owners of Property.~f~ ~.~ ~ ~ .~.j'~~ unty Tax Map No 1000, Section. ~. ..... Block... ~O~ /~,~_ ..... · .......... Lot bdivision ................................... Filed Map ................................. · Lot rmit No..~e.O.;rf..~...Date Of Permit..'~.~'-/..~. ...... Applicant..~.~..g~/~ alth Dept Approval · ' ......................... Underwriters Approval ....................... arming Board Approval .............. ~uest for: Temporary Certificate ........... Final Certicate ........... ..... . ............. ....... £ 0 20 ........ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .... ~./¢~-. ....... , 19 ~.~. ApproYed ...... ~/~. ...... 19~,J:'., Permit NO...~..~. ~...~..~. Disapproved a/c ..................................... BOARD OF HEALTIt ......... 3 SETS OF PL.IN$ .......... SURVEY ................... CIIECK .................... SEPTIC FORH -r ....... / .7." ................. /~tguilding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 'a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- -ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hail 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pdrmit pursuant to the luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ',egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessa~ inspe~ctions. ................. -- /f~ (S'[gnature of applicant, or name, if a corporation) . (Mailing address o/~p~?licant) ;rate whether applicant i~ owner, ~essee, a~,ent, architect,~ engineer, general contractor, electrician, plumber or builder. ...... ............. · .............. - .... ............ · r' .............................. ' ...... ;4,: '/"3,~ ~d ............. (as on the tax roll or latest deed~EE: .~,?,t,~ '_B~ .~' '~ . ' NOIllY BU}LDING DEPAflT~ENT AT f applicant is a corporation, signature of duly authorx_ed officer. · 765-1802 9 AM 1'O 4 PM FOR 'rUE FOLLOWING INSPECTI(~N8: .... (Name and title of corporate officer) 1- FOUN,~ATI,ON~ -' TWO REQUIRED Builder's License No .......................... 3. ~NSUL~TION 4, FI~AL CONSTRUCTION MUST Plumber's License No ....... ' ~E COMPLETE FOR C.Oo ALL CONSTRUCTION SHALL IVIEET Electrician's License No ....................... ~'~-~ R[~QU~REMENTS OF THE Other Trade's License No. ,.-~- -, ....................... L,.,~. NOT F~ESPONSIflLF. : ~F~;!;:~V O~ CON~TItUCTION ERRORS Location of land on which proposed work will be d'one ...................... : .................. ' ......... ..... ................ ................. ' ............. House Number County Tax Map No. 1000 Section .................. Block .................. Lot ................ Subdivision ..................................... riled Map No. ~.~ ...... 5~ /R*.~.. Lot ............... (Name) State existing use and occupancy of premises and intended~s~ and occupancy of proposed construction: a. Ex~stmg use and occupancy ....... ~ ...... ;~ .. ~ ?:~ ~L~ ~ :? · ' ;:;. ,. ............... , ............ b. Intended use and occupancy f~ .~.~ ~ ~ . " 3. Nature of work (check which applicable): New Building ....... Addition .......... Alteration .......... Repa/r .............. RemOval .............. Demolition ~" ! .............. Other %Vork ............... ' ' ' (Description) 4. Estimated Cost ...... /. ~..~.....! .o-?. ................. Fee ...................................... ! (to be paid on filing this application) 5. If dwelling, number of dwelling ~Units ....... ~. ....... Number of dwelling units on each floor ............. · arage, hum bet of cars ..... i ..... ' If b d ify t of .~r5.~. ~ usiness, commercial or mixe occupancy, spec nature and exten each tyBe of use ............ 7. Dimensions of existing structure~ if any. Front '~'"~' . '- ~ ~, - ,.-~" ..... D~menmons ofs structure w aerations or a o s ron a ...... pth '~ tgi 8 Dim i tn Fr ././~ .............. ' ...... . ens ons of entire new cons ration: ont. R ..... De Height ............... Number of Stories o.4/e_ ................... 9. Size of lot: Front .......... i R .................................. 10 f p ·, ........... ear ............ Depth ............. · Dated urchase ........... [ ...... fF ......... ............ Name o ortner Owner .................. 1 1. Zone or use district in which preinises are situated ................ ' .......... 12. Does proposed construction violate any zoning law, ordinance or regnlation: ............................. 14. r;~n'i}d n.' Ill .~_' ' ' ;'P'0~'3t'" .... Will express fill }~e removed from premises: Yes NoX , · ........................ Address . Phone No N ~e et Coq tractor ,. -~ , 233' ........ ~ .............. aaaress ................... Pnone,.~ o ................ 15. Is thi~i~r~Pese,rtsYouW~ohi~ T3Sw0nf~ut ~efea tidal wetland? *Yes ........ No..'.~. ..... p s. s Permit may be required. , ' PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ffumber or descriptioh according to deed, and show street names and indicate whether P ;TATEOFN'E~I/"Y~RKQ/O . /~- i' ' :ou ¥ OF.. r-5.Srqt-. //,( S.$ ........... b-" ' .(Name ofindividutal signin~contract) ' ' ' '/" ' ' DUTCH BARN An old-fashioned look with storage ity for the 90's. This style is higher than any other nodel plus it comes with a loft being duly sworn, deposes and says that he is the applicant is the ....................... i (Contractor corporate officer, etc.) said owner or owners, and is duly a:uthorized to perform~"--~or have performed the said work and to m ' ake and file th~s *plication; 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 set forth in the application filed therewith. ~om to before me this~ CLAIRE I. LEW .,~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment ~ ~scrlbed be~w a~ int~duc~ by t~ applicant ~ed on the abo~e application number in the prem~es of Lot FIXTURR FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES NCANDE$CENT FLUORESCENT OTHER DRYERS MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: E R V I C E NO, OF CC. COt, ID, PER ~' OF CC, COND, 3/0 OF HI-LEG ~10 a'l'lt R)~RCt'R T.e ROl)K'f POZN'i', )IY, 11.778 GENIEI~AL MANAGER This certificate must not be altered in any manner; return to the office of the Board if idcorrect. Inspectors may be identifiad by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ~OUNDATION I 1st) ?OUNDATIO|~ (2nd) ~.OUGH FRAME & .PLUMBING INSULATION FERN. Y. STATE ENERGY CODE FI;IAL ADDITIONA'L COMMENTS