HomeMy WebLinkAbout31953-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: OS/26/06
No: Z-31586
THIS CERTIFIES that the building
ACCESSORY
Location of Property: 770 (AKA #19) MIDDLETON RD.
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 40 Block 5 Lot 7
GREENPORT
(HAMLET)
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
APRIL 25, 2006 pursuant to which
Building Permit NO. 31953-Z
dated
MAY 1, 2006
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 IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to WILLIAM E ADAMS, JR.
(OWNER)
of the aforesaid building.
SUPFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
7P1~J:'~~
Au orized Signature
Rev. 1/81
7~5- /55.5
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
;R 2 5 TOWN HALL
I 765-1802
G,______~;_"~cl)_1 APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 2/1 0 of I % 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.
..
,
r
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existiug" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and 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
1. 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 - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
A,\'l.(\Ob
/'.
Date.
New Construction:
Old or Pre-existing Building:
(,'1.,0) n
Location of Property: \ ~ "^ \l>to\.~'l'o" ''1'-.,,,,1:>
House No.
Owner or Owners of Property: ---:S:..'" ~.
(check one)
C- /i'"..~~of.l'
Hamlet
~''-''-'A''\ -C. P-.l>A"''>(-;se.
Street
f\bA."'.,. {,'1-'t:,.....,.olt. rt b-r",.." 61=-
Suffolk County Tax Map No 1000, Section
,\0
Block
~
Lot '1j
Subdivision
Permit No.
Date of Pelmit.
Filed Map.
Applicant:
Lot:
Health Dept. Approval:
Planning Board Approval:
Underwriters Approval:
Request for:
Temporary Certificate
F"", C~'fi~L'h~k '=---
Applicant Signature
Ebw..."'b -:'S. ~b.l M--(ue.r.E-<.
~,,~ i:li.-rM" ~ v.),I.....,Mo1, C..A.4""/"":fQ,
Fee Submitted: $
~ ')O:f,s<6'
<:0 f: 31 5g<(,
FORM NO. 3
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)
PERMIT NO.
31953 Z
Date MAY
1, 2006
Permission is hereby granted to:
WILLIAM E ADAMS, JR.
770 MIDDLETON RD
GREENPORT,NY 11944
for :
CONSTRUCT AN ACCESSORY STORAGE SHED IN THE REQUIRED REAR YARD
AS APPLIED FOR. (REPLACES BP #24138-Z)
at premises located at
770 MIDDLETON RD
GREENPORT
County Tax Map No. 473889 Section 040
Block 0005
Lot No. 007
pursuant to application dated APRIL 25, 2006 and approved by the
Building Inspector to expire on NOVEMBER 1, 2007.
Fee $
75.00
/
!
!
V
Authorized Signature
ORIGINAL
Rev. 5/8/02
?/7S?~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] I~LATION
[ ] FRAMING I STRAPPING [ &{FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
?J~~c().
DATE
o 5~-~ "
, ,
INSPECTOR ~.~~~
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l'OIlM NO. I
TOWN OF SOUTIIOLIJ
BUILIJING IJEPAIlTMENT
TOWN IIALL
SOIlTIIOl.IJ, N. Y .
TEl.: 765-IR02
BOAIlIl OF IIIiAI.TII ...............
/3 SETS OF PLANS ...............
,/ SIlIlVI!Y ........................
-,",CIIECK .........................
SEPTIC FORM ...................
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11971
NOTI FY ,
CAU. ..................
MAn. TO:....................
.'
..........................................'..... ..-.....
.ICATlON 1'01l 1l1l1l.01NG PlmMlT
'Uate. .~9........ ,197'/.
A
1 NSTRIlCTTONS
8. "his nppl icatiou m.lst he c(JT"{Jletely filled in hy Lypewr-iter m.- in ink mxl sul:mitted to t.he nuilding ln~pector wil
3 sels of plans, accurate plot plan to scale. Fee according to schedule.
h. Plot plan slKJWing location of lot and of buildings on premises, relationship to ndjoining prBllines or ....dJ} ie
streets or areas, and giving a detailed description of layout of property IflJst be drawn on the diagnm loihich is pm.t of
Ihis npplication.
c. 1he 'WOrk covered hy this applicnti(xl tTOJ not he cCJTlrenced he fore issuance of IkJilding Pennit.
d. lJ1X"1 appnJVal of this 8pplicntion, the I\lilding Tnspeetor '.Jill .Jsmle a nuilding Permit to the l1pp1icl1nt.. Such
penuit shall be kept on the I7renises available for inspection througlKJUl the work.
e. No huilding "hall be occupied or u"",) in ~lOle or in part for any PJrpose ~latever until a Certificate of
Occuparx:y "hall bave heen granted hy the l\.i Id.ing In"pedoL
M".TCATltfl IS IEREIlY tltllE to the I\.i Iding Ilepartn.,nt for tbe issuaoce of a nuilding rennit pursuant 10 the
IkJilding Zone Onlinaoce of the "l'own of SoulllOld, Suffolk C.ount)', New York, and olher applicable Laws. Ordinances or
Regulations. for the construction of buildings, additi008 or alterations, or for raroval or denulition, as herein
descrihed. 'Ihe applicant 8blTeeS to cu'llly wilh all applicahle laws. ordinances, building code, housing code, and
regulntiof1s, and to ar..hit authorized inspe<:tors on premises and in huihling for necessary inspections.
(tV . S?~' /7 n
y?:....e..e:.e~"',.k;~ ~. r ......................
(Sign.."lture of appli nt, or nme, if a coqxlTation)
. XJ:(J. ./J1l.</.o!/e I.-an. J.('d.... c; /:-Ce.14-.a~~
(Mailing 8<klre"s of applicant) / 91'
State ~tetheT appli(:ant is owner, lessee, agenl, flH:hitect, engineer, general contractor, electrieian, phl1her or huilder
... QW/.1.er.:'......................................................................................................
Nate of ,...",r of (lmnises .kJ!;Jlta/.7-:>. .g..:'l.o!ar.u.J)JI.,J. ,..................................................
(as on the t.ax roll or llllest deed)
If npplicc.lllt is a corporation. sigr18tl...e of (hlJy lIlIthori?ed officer.
Yo
.,-.......................................................
(Nm~ find title of l.'Orpornle officer)
Hui Iders License It,.
Phl.hers l.icense No.
E1<~d.rkiHmJ I.kcn!".e tb. .....................
Other Trade's l.icense lb. ....................
I. loclltion of Imxl on ~.ich I'ro(lo"e" work will I", ,h"'../.r7e...ar.'..(y.)..<:>.t:.....................................
... '''k'''.~'~.~-';'~'';; .7'0............ '~~~~;'/J1';:id;~ k;~ .;e.;i............... '''~].;,l~~G~~';';p';~;.::''''''
C.ounty Tax Mal) to. 100:) Section-17.S.1?<?:'?'.:-:... mock :1!~~.r.'.7...... I.ot ................
&.I)(Jivisiou ...................................... Filed 11;1(1 No. ............... Tnt ...............
(!me)
2. State existing use and occupmx:y of premises and intended tL<;e arK) occupancy of proposed construction:
h. Intended use and occupancy
~~...::.::.~:::'..::~::::::::::,.:~.\:~~~~~....~.~.~:::::::::::
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. :,\'~rg..,.)n~O r,f,t
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fl. Existing use and occupancy
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H.-Illllc of \.J(}lk (chet;k \lAdeh upplicuhle);
Hel)ili,- ............. Itell~ul .............
NL..ow lk.liltlilln~.......
llenIll itioll ............
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!\(Iditipn .......... Altenltion ..........
Otller-link ../............................
(I>ellcdplioll)
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lisl i"..led eosl'~1~t?<?......,.......,.
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fee....................... _......................
<1"0 he paid Oft filinu lllis UI.plil:ntion)
If (~...ellillg. II.llhe... of (~lling units i<-......... U...i>el< of Iko/el I illg IInils on eoc:h flcXlI'" K.............
If gUl"ilge, 1"1~)cI- of curA X...................................
If 1l'tISilK!SR. cellllercial 0[" mixed ()(:cllpmlcy. sl~c:ify ualUII! .!lId f~Klellt of end. lype of uae.K..................
UinJ:!IHlions uf existiug slru.:lul"es, if nllY: I!ronl.8/J....... Hem- 8/-/....... llepth 1-:1./1......
Ik:;I~II...9. /'/-......... ',:"';' l>I."her ~f S'cnies~....:............
UlneJl:J1ons of ~nlle shHc~ure ':'11.11 "Iterations or ;Nklll.lons: l'["()nt~ '~/3..... Henr .9Er.........
""1"11 ./.";1.'1--'/.......... 11c11~ll .9.;:,?............ l>I."h"r "f Stonesp............
nilll!ludoll9 of entin~ new (:(Klslructioll: Floul . $./.;:1....... Hear tEtF.-/-....... I\~pth /.-l/: /C...
1I(~i'~lt ..9.f~I:-............... "'-ll'K!r of :;IOlirm ~..............._.
I;;"" ,,1'1,,1': 1',...1 ..7t:.1..,?h..... IIellr .7..;l...QJ/.'<..... 1"1"11 ./29..1'1......
Illle of .\....'111111" .6/.Ifi'..:,t-:d.... ",,,., "f ",,",cr O""er .//41'!c:J/d.,flr:.~..I7.d<2.~.
7J.H~ 1)1' {me (Iisl-ric( ill \J.idl prOlliHt~6 Ille Hlluatl!'<1 ~_............................:............................
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1)0<-':-1 IJlol'oned cousl:nw:licHI violnte nllY i".uuillg I,...,. orcliuHnce or reglllutioll: ........................
Uill lot he l'egrat\e(1 ...hCJ............. will ext:e6S fill he H~IIJ:1Ved hUll (lH.'miseu: n:s "
"'''''''' "f 0,.",,' of I,,,,,nise. . ~ . 4.6.<1 V. t'-... . " ^,klres. 4s. .d.bcJJ:'~. . . . .. .. . .. ilK'''' 1>1.). .........,....
Nil''::! of An:llilecl ~CJn.e-...................... Address.......................... .... l'w.H'IP. Ii). ..............
",,,., "f em, flle'nf ~ad. .LJe:.:r'3/2............. Mhes. ':I?au/;: A4,1]7 ~"OI1IC.:.IlKlI'" n.).'/.'W~ 3.Q.'l.d
IH this lu-opEnly within](X) feet of a tidal '~llan(11 .. YI~ .......... t{)" .~....
'II' mil, SllIl1l1Il 'IUll 'mIlSlr~tS mitt IT BI\Y IYl m;i~lIlam.
1'1.
1'1.0'1' Illl\Glll\B
I.ocule clearly on:1 distinctly all hl.lUclings. \J..ether existing (n- proposed. lUxI
~IUll phlpcny 1 ines. Give sheet and hlock lan'ler or- ,lescrilll irK) according to deed,
_~lCl"er illlerio!" or corner lot.
.4.#c.; ch eel.'
indicate all set-hack llimension&"
and 611G1 slr-eet uflnes and incllclIl"e
OCCUPANCY OR
USE IS UNLAWfUL
WITHOUT CERTIFICATE
OF OCCUPANCY
DArE:ii'~::' :OT
FEE:. ~.s-~.
NOTIFY BUILDING EP.
765.1802 9 AM
FOl.lOWING INSPECT NS:
1, FOUNDATION . TWO REQUIRED
FOB POURED CONCRETE
2 ROIJGH. FRAMING & PLUMBING
:3 :NSUl.ATlON
... m.!AI. .. CONSTRUCTION MIJST
BE COMPLETE FOR C.O.
Ail. CONSTRUCTION SHA\.L MEET
,Ii}; HEOUIREMENTS OF THE N,Y.
"TAIl' CONSTRUCTION & EN"P.GY
. "r,:'f' NOl RESPONSIB\.E FOfl
,'; ".Ii,,; Ofl CONSTRUCTION I::RROf~S
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f Iglting (~outHlct)
bVo'lJfll. d('~poHes l)u(1 sayn lllnl he jn lite fJ(lpl ic.unl
HIve llill,-!'<I,
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(Colllnn.:lur, nl~ellt. c:orporale offic~J.-, l~le.)
I' :mid "'Jller or oWIN'!rfl, und in dilly uuthorizcc:l 10 per form Of hav(.! 1)(~d:OII1Il~t1 Ihe nahl work WKI 10 milke Ell wi Ii Ie Ihin
'pi icaUoll; Ilmt. nil. nt.nleuellls c:ouluinetl ill thin nl'pl icatioll are I nil! t.o Ihe 1)(!;lt of hin knowledge nud hl!l.ier; flIKI
lilt the wOlk wi 1I he perfmulL.d in the 1Il;IIlUer nel fOfth ill lbe nppl icntioll filed Iherewith.
.'oln 10 1)(.rOlMlin J ~
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tl,tillY l\'hILrLtZut. ;,........ ~;~'f2. ~Or-..
~..__, (Sigllnltlle of ^pplj('1Il1
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aullllloclln SufIoIk County f qC(r1
Cammlq'l\lt)n Expires Dec. 8. . 0
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