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HomeMy WebLinkAbout17196-z FORM N0.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 1 7075........ , , Date .July. .l 1 , 1988 THIS CERTIFIES that the building A c c e s,s o r y, , , , . , . , . _ . Location of Property ...2835 Mill Road Peconic House No. Street Hamlet County Tax Map No. 1000 Section ..Q6 .......Block ....04.........Lot ~ : 3......... . Subdivision ...............................Filed klap No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated June 30, 1988 pursuant to which Building Permit No. ..Z 17.1.962 dated .July, .8 0 1988 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 building as applied for. The certificate is issued to , ,GEORGE & BERNADETTE ALDCROFT (omner~(lBCcYelt 3iXtBdi~Xdd% . of the aforesaid building. Suffolk County Department of Health Approval ~1/7+ . UNDERWRITERS CERTIFICATE NO............ N /A PLUMBERS CERTIFICATION DATED: N/A Building InspectoL~ Row. 1/87 n~osas xo. a TOYVN 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) No 017196 Z Date 19.4)..0 Permission is hereby granted to: 2 ?~,,,nn nn ct premises located at ..~.~sx.~`........'.~(..4rf.X.... ~..r.....lt...ter!T.^..:f:`.:1 Caunty Tax Map No. 1000 Section Block ......Q..~....... L9ot No....o'Z.t!:..~........ pursuant to application dated ......~...eLA~t'4A........t~eS? 19.~.Y, and approved by the Building Inspector. Fee ~S . „~J.. ../.5.......~' I ing Inspector Rev. 6/30/80 ~H~"D 9 ~~~y~ FORM NO. 8 JUN 3 0198 ~K~~{~ TOWN OF SOUTHOLD ~J Building Department ~,FO-_aw~,,, Town Hall a-sl.©G. 17~~ r Southold, N.Y. 11971 rr~wr~ of sou~Hai_b 765 - 18oz """""~"~~~ry~~~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~r~ to the Building Inspec- torwith the following; 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, acertificate 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 property showing all property lines, streets, buildings and unusuai 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: Additions $25.00 POOLS $25.OOALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Ac~.e,~ssory 10.00 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 /~3o~p'~i 5. Updated C.0. $ 50.00 Date......,, Q NewConstruction,,,,,,:{OldorP/rJ~/,-~/existing~uAilding Vacant Land Location of Property !:.~G...".'N~.. . ONtC, , , . , ~~,/~J~/ House No. ~F~t!'~ r d trees ~ Hamlet Owner or Owners of Property ....L~...... ~©~~I~ . , , , ~~t , County Tax Map No. 1000 Section Block . l..... Lot . Subdivision .................................Filed Map No. ..........Lot No. . Permit No. Date of Permit ..........Applicant . Health Dept. Approval ........................Labor Dept. Approval . Underwriters Approval ........................Planning Board Approval . Request for Temporary Certificate .....................Final Certificate . Fee Submitted $ Construction on above described building and permit is all appC'i/cab4'e code and ulat' s. ( 9 Applicant........ Rev. 10~10~78 35a ~ ~/~/t~ :-rlcl;D'I::S:'FCiiU.J ~~llATE ~ 4MMENT° ~v 1 . a~ ,.7 ~0 FOU1dDATION (1st) = CO~/~ cn --yy~ FOUNDATI01d (2nd) 2. z fV o ~ ROUGH FRAME & PLUMBING ~i ti H 3 . c~ IIJSULATIOPI PER N. Y. y STATE ENERGY CODE x y. FIiJAL I ~ z ADDITIONAL COMMENTS: x,. 4 to x ro• M A y H ~ O z O ~ m r H x d m ro H ~-L~j~c~2o c= i ~ ass-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~INAL REMARKS: D ~ . ~ , DATE INSPECTOR L - . ~ y i 3 L. + ~ t rL°s~~C.CncH ) • } 2i ~ ~ ~ +tr ' ~ B U.'GT I S r-'L fi 6.r.r _ . ~ _ . _ e w ',i~ i J• ~ _ , ~y.) ~ r t a, ,may _ , ' v, ~ ~ 2 o x yo ~r , , x ~ Ff . ~ ~ ~ ~ - ~ ~ I loo 0 4 Y ~ t i ~ ~ y U ~ 1 Ba' ~ M1 ~ to cf, ~ ~ F ~ 30- - ~ 1. , -T~ w/ dJ ~ G~ ~ t Its ~ . p .t j ~ ' i'a 1 ~ ~ _a zo , ,r, i? > i i 'PSO~Ta~€ >°a"O gR°£ 9 S. .Z 27'00"G. - ~ ,2,20.00 1 , ~F ~ n= i `ESN ~ O °H-~i^O~ Khoo o~'"so, n^;.y _ Wit-- ...~o.__ _z_ _ 1 r y r ^ S~ f e y AA< r _ q~ s v~ r ~ x f J. l_ l ~ . ~ ~ ' ' w ~ _ U! ~ n 6a ~ : ~ ~ ~ . d : ~ t ~ 4. ~ ~ 4 ~ , r~ ~ p'' ~i e ,r ~ j, ' ` t ~ 1 f ';l 1~,'; r't,; i t i'~~~;i~l`. ~ BOARD OF HEALTH . ti i i;~ i ~ 3 SETS OF PLANS k ~ f FORM NO. 1 8j ~(,3 ~^il iik SURVEY si o' 1 ~ .JUN S Q ~~c~m~~;l ~~1 TOWN OF SOUTHOLD CHECK . ~i jf` BUILDING DEPARTMENT SEPTIC FORM U~,y--n,•Rb-~-..... ~ TOWN HALL TOWHPIO~gOUTHOLt) SOUTHOLD, N.Y. 11971 NOTIFY • TEL.: 705-1802 CALL Examined ML~..4...., 19~ 8 MAIL T0: Approved 1 .h 19~. Permit No. ~ ~ / 9~,'Z-~, Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT Date 19 . INSTRUCTIONS a. Tltis 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 property must be drawn an 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 Yo ,and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or f r emoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, build' ~ ode, housing de, and regul ions, and to admit authorized inspectors on premises and in building for necessary inspec s. (Sim ature of art pplicant, or na rf a cow~raison) ' (Mailing address of applicant) , State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~Grr.VC Name of owner of premises ~P~. L . ~ .~~!~~.~'.1.7,~• ./../.~C~O~ (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 . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which p osed work -Il be done. ~/L , t, , ,l, • !.C~IVIG ~ p / ....0~0 3S ~IGL ORD 1~C0/vtC. ffgS~' . .......................r..... y House Number Stnet~ Hamlet County Tax Map No. 1000 $eCliOn ~ BI'ock , , , , , , , , , , . Lot Subdivision Filed ~iap No. Lot . (Name) t` State existing use and occupancy o(preml sand in [ended u$e and occupancy of proposed construction: a. Existing use and occupancy G~~~~~~~ b. Intended use and occupancy .....~~~.'~P~r~.~ ~~~~'y,r'.. , j~~e.. ~~%G .~f'C/.~i~C~Es'... . 3. Nature of work checl. which' ,1~~ ( ~ ',applicable): New Building , , , Addition Alteration Repair Rejnoval Demolition Other 1Vb~k,•'•tGl~........ . (Description) 4. Estimated Cost . Fee..................................... n ~ (to be paid on filing this application) e ins, umber of dwelli ' g g units Number of dwelling units on each floor . 5. If dwme s, commeorcialror mi~ . 6. If bus if ar ed occupancy, specify nahtre and extent of each ty e of use . Height 6.... res, if any: Front ; p p • • . . rme' NtV Rear De th nstons of extsttn structumbcr of Stories • • • • • • • • • • • Rcar ~ • ~ ~ • ~ • 'with alterations or additions: Front . . . . . . Demth stons o same structure IIcrght Number of Stories . 8. Dimensions of entire new cons~tntction: Front Rear , , Depth • He,i~ht , , , , , , , , Number of Stories . ' ' • • • • 9. Size of lot: Front Rcar 10. Date of Purchase Depth p. Na ~ P cr Owner . 11. Zone or use district in which remises are situated , , , , , , , /PC=>,.•T~d:e. ~ ~ • ~ ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' p p p 4lytite any zoning law, ordinance or regulation : . 13. wVill lot be regraded Name of Arce construction yr I ~ 0 Will excess fill be removed from premises: Yes No 14. Name of Owner of remises . , , , , , , , , , , , ,Address . hitect ..................Phone No............... . Name of Contractor . ~ • ~ • ~ ~ • • • ~ • • • ' ' ' ' ' ' • • • Address ...................Phone No............... . If es Southold Tow 'Address ...................PhoneNo. IS.Ys this property looted with in~00 feet of a tidal wetland? *YES....NO.... * y p Trustees Permit may he required. ' . PLOT DIAGRAM Locate clearly and distinctly all 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. ~x i~ ~~~„~yE ~ . ~o . _ _ ~K ~ 1'0~~,. - _ - - . I~ STATE OF NEN YORK, COUNTY OF . S.S (Aamc of individual signit) ' ' ' ' bcmg duly sworn, deposes and says that he is the applicant ~ g contract) above named.' fie is the I (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 arc true to the best of his knowledge and belief; and that the work will be performed in [ite manner set forth in the application filed therewith. Sworn to before me this ....dayof.: \ i~ ~ . 19 Notary Public, , , , . , ~,1; , • , , , , County DE VOE ' ~ //~/,,~1v~f NELEN K ~ New Yak • N0T11RY PUBLIC, State • . ierm~E4xWr?e8a t~Aarch 30, loon. • . . (Signature o applicant) I i I