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Home My WebLink About19008-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19045 Date MAY 14, 1990 THIS CERTIFIES that the buildin~ ACCESSORY Location of Property 565 SOUTH HARBOR ROAD SOUTHOLD, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 075 Block 04 Lot O1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 7, 1990 pursuant to which Building Permit No. 19008-Z dated MAY 11~ 1990 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 CHICKEN COOP AS APPLIED FORr TO HOUSE NO MORE THAN 25 FOWL. The certificate is issued to EDWARD & BARBARA LUKOSVICUS (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Buildin~OInspector Rev. 1/81 FO~t~ NO. ~ TOWN OF $OUT~OLD BUILDIHG DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERtlY (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 '~9008 Z Permission is hereby gronted to: ...~.~..~.~....~.~.~....~ ~ , .~**?....L~....~~.....~..,. ..~.....~.:..':l..,....u..~.~.l .......... . ~ *o o, prem,s, ,ocoted o, .~. ~....~.~.~...~, ...... ~~~.. County Tax Mop No. 1000 Section ..... ..~,,.,~.~., ...... Block ....... ~.,,~, ....... Lot No....~..~. .............. Building Inspector. Fee $ ........ : .............. Bu~Tdlng Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD , Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the fei[owing; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: ~ 1. Accurate survey of pzoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1, Certificate of occupancy $25:00-- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 ~, 5.Updated C.O.~ ~ $'50.00 Date ........ ~.~,~,~ ....... NewCOnS ~uc~ ~o~,~, Old or Pre-existing Building ............ Vacant Land ........ . .... Location of ProperW u~ No. _ Street ~ . ~ Ham/et ................... ~n~ Tax ~ap Subdivision ................................ Filed Map No ........... Lot No .............. Permit No] ~ ~)~).~. 7~... Date of Permit ......... Applicant .................................. Health Dept. Approval ............... Underwriters Approval ............... Request for Temporary Certificate ...... Fee Submitted $ .................... ........ Labor Dept. Approval ........................ ........ Planning Board Approval ...................... .............. Final Certifidate~,~. FIELD FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ z.~l NAL RrMARKS: C~l~¢¢.~ COO ? MA' '~ r ~ '~ ''YOUNG & YOUNG~ ALDEN W, YQUNO . ' HOWARD W, YOUNG URV[Y FOR: .... WARQ. KOSVICUS &.BARBARAH LUKOSVICUS ' ~- , .... SOUTHOLD SAV NOS BANK "' ' .... HOME TITLE: DIVI]ION DF tow~e~ 80'UTHOLD t~T~ I~u~.co. . SUFFOLK CO,, N,Y ' ~ / .... ~. Ill ~ ~., JDATEJ ..~ 'FORM NO. 1 TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL MAIL TO: BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... FORM ............. Disap roveda/0 v ...... [ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... .~.~.: .'~. -~.. .... . 19~. INSTRUCTIONS 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 properW 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. . A~PLICATION 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 ox Regulations, for the construction of buif~lings, additions or alterations, or for removal or demolition, as herein described, The applicant agrees to comply with al! .appli~90~le laws, ordinances, building code, housing code, and regulations, and tc admit authorized ~spe~iOl~ on premi~es'"~hd in ,building for necessa,ry i~pe~n~z~;(,,~~ ~.~,v~/~-~ ^ . , . ,,,,..,. ¥ . . . . . . . . : ...... '., ' ,~: ~t' (SigCa~uy~e,%~'Oal~icant, or name, if a corporation) ,, .,. :'! : ? ~ '(~aiiing ffd~}~p~f applicant) State whether applicant is_owner, lessee, ag~ht, architect, engineer, general confractor, e[eut, ficlan, plumber or bmm~x .......... Name of owner of premises ................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co¢orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... 1. Location of land on which proposed work will be done~ . . )...: .':. ~.Y~. .> 1} House 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, j~,tended use and occupancy of proposed construction: a. Existing use and occupancy ........ '..~...~\~..~ .......................................... b. Intended use and occupancy ............. .~.. fx/X%%~._: ............................................ 3. Nature of work (check which applicable): New Building ..... '..'i.. A--ddition .......... Alteration' '. ....... Repair .............. Removal .............. Demolition .............. Other Work ............... .~ .~ O..~_~.~' .., (Descriplion) 4. Estimated Cost ............................. Fee ..................................... : " (to be paid on filing this application) ' 5. If dwelling, number of dwelling finits ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing stmcture~, if any: Front ............... Rear .............. Depth ............. Height ............... Number of Stories ...................................................... Dimensions'of s~& slmctux¢~with alterations or additions: Front Rear ~;~ '~ '- ~"~ Height Number of Stories . Depth .................... :. ............................................. 8 .... Front Rear Depth Dimensions of entire new constr~ctlon: . Height ............... Nmnber of Stories ........................................................ 9 Size of lot: Front ' Rear Depth 10. Date of Purchase ........... .................. Name of Former Owner ............................. 1 1 Zone or use district in which premises are situated 12. Does proposed construction violate 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 . ~ ........ Address ' Phone No 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town TruStees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all i buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. APPROVED AS NOTED ~,=E:~s', *---* .v: ?.~.L. NOTIFY BUILOING DEPARTMENT A~ 765-1802 9 AM TO 4 PM FOR THE FO~OWING INSPECTIONS· 1, FOUNDATtON TWO REQUIRED FOR POURfD CONCRETE 2. ROUGH - FP~AMING & PLUM{~ING 3. INSULATIOA: 4. FINAL Cf~r4~TrP.JCTION MUST BE COMPLEX' FO~, C C' ALL CONSTRU{ r~)~ ~>,'hALL MEET THE REQUIRE~:FN]'S OF 'rile NY, STATE CONSTR[ c"tff~N & ENERGY CODES, N~ P~P('}NSIRLE FOR STATE OF NEW Y, OI{,I{, x~,S S uNTY OF. 9..~.'~./.~ ' ............ ~ ......................................... being duly sworn, deposes and that he is the applicant (Name of individual signing contract) above named. ~e is the ....... D..~...~.~....: ................................................................... : (Contractor, agent, corporate officer, etc.) of said 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 are true to the best of his knowledge and belief; and that the work will be performed in the manne? set forth in the application filed therewith. Sworn to before me this ............. ...... dayo . ..... ' · .............. ........ No. 52-2959600 Qua if fed in Suffolk Cbuntv Commi~ion Expires Ma cb 30, /