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Home My WebLink About18942-zFORM NO. 4 TOWN OF 80UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19099 Date JUNE 4¢ 1990 THIS CERTIFIES that the building Location of Property 1675 PEQUASH AVE. House No. County Tax Map No. 1000 Section 103 ACCESSORY CUTCHOGUE Street Hamlet Block 007 Lot 016 Subdivision BIG GREEN ACRES Filed Map No. 5757 Lot No. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6~ 1990 pursuant to which Building Permit No. 18942Z dated APRIL 9~ 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 STORAGE SHED. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A FREDERICK J. & DOROTHY J. CHARNEWS Rev. 1/81 / ~ilding Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18942 Z Date .... .~. ......................................... ..... f. '~'"~~ ........................... County Tax Map No. 1000 Section ..... ./....~.....~... ...... Block ....... ~....~... ...... Lot No ....... ./..~.. ......... pursuant to application dote~J~ ..... . ..~.../..~;.. ...................................... ,19...:~..~..., and approved by the Building Inspector. ~'~""~ '~',~/~:~' Fee $.. ~.~..~ Rev. 6/30/80 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: i. 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. C. 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. 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 Date ........ .O~.//~. Z~.~. .................... ... New Construction ......... Old Or Pre-~.xisting Building.. Location of Property. []...~ ~..~..~f .... f.~.~..~.~...~. ]]~~ ................ House No. ~ Street ~ ~ Hamlet Onwor or Ownors of ~roporry ................................ County Tax Map No 1000, Section ..... ~,.~Block ...... ~;~.Lot ..... ~[.~O~ ..... Subdivision ............... Filed Map ..... Lot ............... /~ ~l~ ~ · .q[.~kO...Applicant...~C.e~CJS~ ~ Permit No ................. pate Of Permit .... . ......... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $ ....... ~...:..~. FOU:IDATIO:! (2nd) 2. ~OUGH FRAME & .~LUMBING IlZSULATION PER N. STATE E~ZERGY CODE Fi;~AL 'ti ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~'~FXNAL REMARKS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTI4OLD. N.y. 11971 Examined ............ 19 Approved .,~..~. ........... 19~.~. Permit No..: ........ Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CttECK ...................... SEPTIC FO RI-! ................ NOTIFY~ CALL APPLICATION FOR BUILDING PERMIT APR - 6 1990 , BLOG, DEPF, TOWN 0 Date . INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 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 isparl of this appli- cation. o. 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 orin part for a0y 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 Sou!hold, 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 11 applicable laws, ordinances, building code, housing code, and re~oulations~ and to admit autbohzed inspectors on premises and in building for necessary inspections. _ ~ -- ' ,~, ,,,, t-~: ~ ' - ..- .'. .C, cz_,_,_,_,_,_,_<:,¥,a,~...~-~_~· .... - (Signature o! applic~,nt, or ~ame, if a co~t~o'ral:~n) ' . .... (Mailingidddress of applicant) ........ State wh~ther applica~nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. / r~_, ~ /'~ .......... · ................ ~ame of owner of premises.,. ~-./'7~/~./~.~ .0~¢jL44~., ~. ~~~.. ', C,/ (as on the tax roll or latest decorS/ ........ '. ..... .- .... If applicant is a c?poranott; si~naiure of duly authorized officer. (Name nd f~tl~/~f cbrpbra'te 6fficer~ Builder's License No ........................... Plum bet's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done: · ........ ?~ ~.,.,, ..~, ~ .................. ~? '~' ~'"" ""~ -~' '-~/'¢~-....~A-~ ....... 0 .C~<.. llouse Number L~ Street, ' H.~[nlct' ' '' '~'" ''~' ........... County Tax Map Nol I000 S,ction .... ./03,~.0.'0. .... : Block ~'~) O/h /) .,,~.., ~ .... '-~. s-,..c/ ....... Lot . ~ [, / Sub - . ~4 .... f.d9. ....... :. ,.. division..q~l.q.{,~//~0,.4~ .~-~O'[IL.,O ............ Eiled Map No .~/7.~..?~. _ . (~ (Name) ' · .~ ...... Lot ..../¢. ......... · ~tate existing use and occupancy of premises and intended use and occupancy of proposed constrtflction: - a. Existing Use and occupancy ...... ~ .......... !t~l~ ,~-{ b. Intend~-~ ~--,~ ri _ / ' rD ¢,~q&.~'~ a~a~ e:~i~u~ ~ ............... ~ Use and occupancy ..... ~.. .~..'~'~'~'~'~'~'~'~]~... $. Nature of work (check which applicable): New Building .......... Addition .......... Altcration ........... Repair ........ ,....... R~moval .............. Dcmglition,.~ ............... Swlmrain8 poor ............ ~ .Teanis Court/ .... Accessory.~ ~-~ -.Building .......... . Fence . . ..... Other Work ........... .. 4. Estimated Cost ........ i" ~C0 ............. Fee ........................ · [ (to be paid on filing this application) $. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ........... If garaee number of cars ' 6. If business, commercial or mixed bccupancy, specify nature and extent of each type of nsc ........... 7. Dimensionsofexistingstructuresiifany: Front ............... Rear .............. . Depth ....... . .. .... Height ............... Nu nbicr of Stories ..................................................... . . Dimensions of same structure with alterations or additions: Front................. Rear ......... .. .. ... D pth ..................... ~.Hmght...e ' .................. Numbcr of Stories ......... 8. Dlmenmons of ent:re/new construction: Front ..... L ~..' .... Rear ............ t ....... Height ...... .~ :. ..... .Number of stories .... ' ..; ................... · ;711' ................... .. '. i ]'. 9. fiizeoflot Fron~ ..~.,'-~ ....... ; .......... a ................. Depth ........ 10. Date of Purchase ............ ; ................. Name of Former O,wner ............................ . 1 I. Zone or use district in which premises are situated ..... ~,.,%4~~..~ ............................... 12. Does proposed Construction violate any zoning law, ordinance or regulation: ..... ,~ ....................... 13. Will lot be regraded .; .......... ;... ~ ............ Wiil excess fill be removed from premises: Yes .... N~.. 14. Nacne of Owner of premises/~&/4fff44~....O,~ddress .~/~:/~.~..t,~'. [9~',~.~,,.v'~, Phone No. Name of Architect ........... [ .............. Address ................... Phone No ............ Name or Contractor .......... , ....... i ....... Address .............. Phon%No ..... ~ N'O .' ~." ' 15.I~ this property locat!ed within 100 feet of a 'ti~l' wetland? -YES... · If yes, $outhold TownlTrustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from proper~y lines. Give street and block n'umber or description according to deed, and show street names and indicate whether interior or comer lot. AP O 'D AS NOTED . 76~-1802 9 AM TO 4. P~FOR THE FOLLOWING ~NSPECTIONS; 1, FOUNDATION ~0 REQUIRED FOR POUR[D CONCRETE , 2, ROUGH - FRAMING & PLUMBING 3. ~NSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME~ THE REQUIREMENTS OF TNE N.Y. STATE CONSTRU~ON & ENERGY CODES. N~ RESPONSIB~ FOR DESIGN OR CONSTRU~ON ERRORS STATE OF NF, w~YORK. - ~ cou, r¥ ~Name o~h~iviOual signfftg contract) above named. ~ . ~ ...... being duly sworn, deposes and says that he is the applicant is ,' ....... ............................ of feet ere) '-'i"','--': .............. ' ............. ~ ' (Contractor agent corporate of said owner or owners, and is duly authorized to pe,rform 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 perforated in the manner!set forth in thc application filed therewith. Sworn to before me this i . :' ' ' .., ,,..,e ............. County