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HomeMy WebLinkAbout17217-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No 217495 Date NOVEMBER 7, 1988 THIS CERTIFIES that the building ACCESSORY Location of Property 385 SHEPARD DRIVE SOUTHOLD House No. Street Hamlet County Tax Map No. 1000 Section 78 Block Ol Lot 18 Subdivision WEST CREEK ESTATES Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 5, 1988 pursuant to which Building Permit No. 172172 dated JULY 15, 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 SHED. The certificate is issued to THOMAS & THERESA BERKHAN (owner, xxxxxxxxxxxxxxxX) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NJA UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ~~C Building Inspector Rev. 1/81 sows xo. s 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 0 ~ 17 21 ~ Z Date .......~..tcl~..~..1~ 19.~ Permission is hereby grante to: / ~~o I..,~~~~!'r:-~j!,u:4~'....4i.:r.1.....4-5 :~:~-~`'~-~......~..,.ar°.......4'~~12/........ d`.~..n ......................................~............I/ ................../.~......~.....i................. at premises located at ..4~..4.~.......eW3~'.~r4.~K .......................................................................UU...II.//..................................................................................... County Tox Map No. 1000 Section .....~7.~...... Block .......Q..~........ Lot No.......~~ ~ PP Y pursuant to application dated ~ 19. ~ ~ and a roved b the Building Inspector. ~y ~ ~ Fee $.s?.~ . . Buil ng Inspector Rev. 6/30/80 t FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted to the Building In~ec- 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 rind 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 installs- 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 property 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling, $25.00, Accessory Business $50.00 2. Certificate of occupancy on pre-existing dwelling 50.00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ ] 0.00 4. Vacant Land C.O. $ 20.00 ~r S.Uodated C.O. $ 50.00 Date.lV.~.°.`u?:..s~.l..~~.~.~J..:.. NewConstruction,,,,,,OldorPre-existing Building Vacant Land Location of Property , ~ ~ ,~,i,Y;T ~1 Ce%~A, House No. .,Street Hamlet Owner or Owners of Property ,(.?:l!> m~~:ryry~--`-,~. C.(`,~;$~(}, j~K~.~] pp~ County Tax M,ap, ~yNo. 10j0_0 Section ....~.0....... Block Lot ......I,O, , , , , , , . Subdivision ,~('ar.~,~,~.,~S,f,cl~~Filed Map No. ..........Lot No. Permit No. ~ oZ ~ . l~Date of Permit~.~.~~~~~..Applicant /./.~$/i?~+~,{,' g-,~Ee; ; , , ~;~6;'~[,ly, Health Dept. Approval ........................Labor Dept. Approval . , , . , , , , , , . Underwriters Approval ........................Planning Board Approval . Request for Temporrary Certificate . ...............Final Certificate . FeeSubmitted$..! Construction on above described building and p it eets all app ' ble cod nd regulations. AgPlicant...~~~G~. Rev. 10.10-78 ~1BLD I;;SP°C:iU;7 IllliiiC. ~ ~OMMENT° m _ _ y J FOUtdDATION (1st) r'OUNDATIOtJ ( 2nd ) ~ - 2. z o W ROUGH FRAME & PLUMBING ti 3 . x~ m c~ H II7SULATIOP7 PER N. Y. ,,,y STATE ENERGY ~ CODE x ~ ^n i(v'J r- 4. ~ QQ~~ H • !0• FIidAL p ~ T ADDITIONAL COMMENTS: x r ' x ^o H ~ ~ A H O A 2 0 m a ~ • r _ - ~ ~ d m H „•~„~,,t:- ',"~".,a, BOARD OF HEALTH ~ 3 SETS OF PLANS /~may 41. . •Yta~ ~,L~ ~"l,e+Ad.ax. . . . . . . . . . . . D _,,,b..l~'"l!cy.y,;.:/~~~~~~ s9lctb'~ FORMNO.1 SURVEY...... TOWN OF SOUTHOLD CHECK po d • _ i~ BUILDING DEPARTMENT SEPTIC FoxM ,f~J~ 5 ~y~~ , TOWN HALL R r SOUTHOLD, N.Y. 11971 NOTIFY ~`"°"~v°°---~.--•a.. TEL.: 765-1802 CALL TOVVPJUF<• MAIL T0: .,OUTHOLI? . Examined 9~i~. ~ ppp i ~~pproved ~.l.S...., 19~.. Permit No..l.?.a•,1.7:?, Disapproved a/c (Bwlding Inspector) APPLICATION FOR BUILDING PERMIT ~ DateC~~ ~ 15~ . INSTRUCTIONS a. Tlus 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 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. 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 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 all applicable laws, ordinances, building code, housi code, and regulations, and to admit authorized inspectors on premises and in building for necessa ins a ns. ' ~ (Signature of ap icant, or name, if a corporation) • (Mailing address of applicant) fl State whetherp applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .........~J.Z!V~Y~'G.~. Name of owner of premises ..1~'era.• /.kQ~?~S (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. r- (Name and title of corporatefofficer) Builder's License No. . Plumber's License No . . t Electrician's License No. , . Other Trade's License No. Nl . I. Location of land on which proposed work will be done . . House Number Street Hamlet County Tax Map No. 1/0~0~0 Section ~ Block 4"............ Lot ....~.rl........... . Subdivision .~QJ~~-14e'?~-... Filcd Map No . Lot . (Name) Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy : e . b. Intended use and occupancy • . • • • • • • • • • • . 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