HomeMy WebLinkAbout18464-z FORM NO. 4
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCOPANCY
No Z-18380 Date SEPTEMBER 19, 1989
THIS CERTIFIES that the building ACCESSORY
Location of Property 5750 NEW SUFFOLK RD. NEW SUFFOLK N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 117 Block 02 Lot 19
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 24, 1989 pursuant to which
Building Permit No. 18464-Z dated SEPTEMBER 11, 1989
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 AS APPLIED FOR
The certificate is issued to SHERWOOD & BARBARA COOPER
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE N0. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
1'OSM NQ f
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMtT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N 8 4 6 4 Z Dote '~-ra.~c.tt......... i.1 19. ~q
Permission is hereby granted ta:
~~s:~... ....~~.r
..lt~.9.~t<>2...... .
,
ra .C~c~?~,:cr....S.~,:,......~..~.....~.,CJ.ks,a.r~.`t~ta,:q..R.....~-....R~~e.Q.~f-R-r.~.
ct premises located at ...~...~s~.~?........~::ot~^)....~ct,~ ~a.Q~...p.h7..........~:L~`)...........~
County Tox Map No. 1000 Section ~.7.......... Block ~ Lot No....,.~....(.
pursuant to application dated ......lM...l........~~..:.T..........., 19...1.., and approved by tfie
Building Inspector. yy
Fee ~..~~:.t...
G..l 0..l
.
Bu ding Inspector
Rev. 6!30/80
a- ' G' c • ~ (C~
. ~ TOWN OF SOllTIlOLD ~~J n~
BUILDING DEPART?PENT "~`~o-~
` TOWN HALL I J/ Sr
SOUTIIOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY g
DATE _
HEW CONSTRUCTION L. ...OLD OR PRE-E%ISTIHG BUILDING......PACANT LnAHD.~..._.
LocaCioa of Property....7:5~..: _rUr`Vf ,~~:{'~'o L.JC ~L`"1l ~ri-(-~o_L
HOUSE NO. STREETrr ~¢~H-AMLET
Ovner or Ovners of Property.. d I'~-F°~t~ ~pl'~c ~
• County Tax Map No. 1000 Section ,~~1.. Block G.a~.. Lot~...~
Y
Subdivision Filed Map ........Lot........_.
Permit No. ..........Date of Permit .._.......Applicant
Health DepC. Approval Underwriters Approval___...._..._._
Planning Board Approval
Request for TemporarylCertificate Final Certificate
crG
Fee Submitted: $
APPLICANT. !_~:°..2~'f~'•'-~!:":°ra~. C!°~`E. Q.~ .~4'Fi~:'`.G_
. 3 ~a`~s
C o X183$°
rev. 10/14/88
~(C/ `f 765-1802
` BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST f l ROUGH PLBG.
[ ]FOUNDATION ZND ~ ~ INSULATION
[ ]FRAMING [~-Fii~IAC
REMARKS:
DATE INSPECTOR
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IIJSULATION PER N, Y, y
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ADDITIOPIAL COMMEtlTS:
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n'M ~ j ~ 3 SETS OF PL.1N5 -
Hw ~f FOAR9 N0.1 SURVEY
TOWN OFSOUTHOLD CHECK
.BLDG. DEPT. BUlLD1NGDFPARTMENT SEPTIC FOAM
TOWN OFSOUTNOLp TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
TEL.:7G5~1802 CALL
n MAIL T0: Pa• Jb~
Examined • t! 19 .
\pprovc~~r?°'.`~~. tl., 19~~.PermitNo1.~ Tb~..`.'`. ~2tur r~~~
Disapproved a/c
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(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ]5$
INSTRUCTIONS
' a. Tlus application must be completely Citled 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 street
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 permi
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 th,
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
Rcculatians, 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, housin; code, and regulations, and tc
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, tf a corporauon)
• (Mailing address of applicant)
State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder.
Ls+-~/--iu.~
Name of owner of premises ,..G244'~°r-~. ~s•"l~• • `'~GZ" //c~
. ~°~"~'PPRtSVED'AS NOi
k'Q ' .
(as on the tax roll or latest deed)
fC applicant is a corporation, signature of duly authorized officer. DATE: B,P N
FEE: ~5~..~ gY Y. ~.L.
NOTIFY BUILDING DEPARTMEP.t'i AT
765.1802 9 AM TO n Pi~F FOr THE
(Name and title of corpo~% fficer) a~G~~~GPs~~ FOLLOWING iNSPEC'K.'•~~!S
Builder's License No. o~` V P 1. FOUNQATION TWO REOUtPED
~r~` ` FOR POURED CONCRETE
Plumber's Liccnsc No . C~ Ci 2. ROUGH - FRAMING R PLUMBING
`'~~~`S.` ~~p'~ 3. INSULATION
EIectrician's License No . Y~~d~,.,r~v~ 4. FINAL - CONSTRUCTION MUST
~l BE COMPLETE FOR C.C
Other Trade's License No. 04 ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N Y.
I. Lacat~on of land on which proposed work will be done. ATE CONSTRUCTION ~ ENERC;v
7S'v COOS ' NOT '"RE'S'PONSIBLE • • Fro .
`C.... OO. o L',,~......7leuJ.u2P oFe~ ,7~ DESIGN OR CONSTRUCTION ERRCS~
]louse Number Street Hamlet
County Tax \fap No. 1000 Section . l~?: • • • • Block ......Q.q~, , ~
Lot......./..........
Subdivision Filed ;11ap No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occupancy oC proposed construction:
a. Existing use and occupancy ~~'9' " " " " " • • • • • • - • .
b. Intended use ~~~'7~ • • ~ • • • • • • . , ~ ~ • ,
and occupancy .....,ll~~• a.'c¢+2'a~>
-
3. Nature of work (check which applicablel: New $uilding Addition ~('1~teration . .
Repair Removal Demolition fN`cr Work .:~d': ~a.t•Z
(Descriptio
4. Estimated Cost ~ y.: ~.C Fee .
([o be paid on films this application)
5. If dwelling, number of dtivelling units Number of dwelling units on each floor .
Ifsara;c.nuntbcrofcars
6. IC business. commercial or mixed occupancy, specify natt,re and extent of each type of use .
7. Dimensions of existins structures, if any: Front Rear Depth . .
Flci^ftt Number of Stories .
Dimensions of same structure with alterations or additions: Front Rear .
Depth ......................Height Number of Stories .
8. Dimensions of entire new construction: Front y.~ t...... Rear Depth ..,:~'~rr': , . , ,
Hci;ltt . Number of Stories .
9. Size of lot: Front Rcar•• Depth
la. Date of Purchase , 7/27./. Name of Former Owner .
1 1. Zone or use district in which premises are situated .
i y. Does proposed construction violate any zoning law, ordinance or regulation: ./.UU . .
l3, Will lot 6e regraded . . .............Wilt excess fill be r moved from premises: Yes ~
14. Name of Owner of premises C;~;e~;t ; , , ,Address 7.T.`z~':1~;~, .Phone No. J; : ~G ~ .
Name of Architect ...........................Address ...................Phone No............. .
Name of Contractor . .............:........Address ...................Phone No............: .
15.Is this proper [y located within3()0 feet of a tidal wetland? *YES,.,.NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing ar proposed, and. indicate ail set-back dimensions fro,
property lines. Give cording to deed, show street'names and indicate wheth:
interior or corner lot ~ Pa
Xo N, sl~~ i"-"1 Atrv `oar PtK osa
pa-r'~ 0 3' ~a•m -y--~d
LiK• pt[. y
[,`ORNG4f l~AC 4
~jtLf i'jiWM
W.t7'N real QRtadeti
wrTH d~r~e~5 ' Faro Z
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STATI=OF\EIVYORI:, 3.3 ~~.~I~u~~ ~
• ~~s_r~ ~°Ue)na duly sworn, deposes and says that he is the applican
(Name of individualaigning contract) s~ ~ ~ `
,
about named. a ,:,ycT%'.",
r
~ ,
ffc is t1[c .
?5 tea..... Si ,-V!~~"
p
; x , (Contractor, anent, corporate officer, etc.)
~f said owner,gi owners, aloft: is;dilly authorized to perform or have performed the said work and to make and file thi
~Pptication; chat ail statements contained in this application arc true to the best of his knotvlcdse and belief; and that thi
wor}; will be perforntcd in ttte manner set forth in the application facd therewith.
~tvom to before me thi~~s//
..............~.7.....da of........... 19~/.~
Y
'otarS' Public, /~~?:~~?c!.. 15:... 61.f? County
NELEN iC DE YDE
1K1T,Ut(ru~t,c, sense ~ ~ cork .
~.~>o~~~s~x~ .
Term Expires ceh 30. i
(Signature of applicant