HomeMy WebLinkAbout32554-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32065
Date: 12/12/06
THIS CERTIFIES that the building
ADDITION
Location of Property: 10725 OREGON
(HOUSE NO.)
County Tax Map No. 473889 Section 83
RD
(STREET)
Block 2
CUTCHOGUE
(HAMLET)
Lot 16
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
DECEMBER 7, 2006 pursuant to which
Building Permit No. 32554-Z
dated
DECEMBER 7, 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 ADDITION TO AN EXISTING AGRICULTUAL BUILDING AS APPLIED FOR.
The certificate is issued to RICHARD & JAMES MCBRIDE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
~ f!. 'ill}."
/~
Aut rized Signature ~
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
I 0 L( 15 Orur Q4jl
~1/1.o/ ~
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:
I. 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 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 Plarming Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land nses:
I. 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
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 - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. . /)-/7/ D6
, I
New Construction: ft} e.0 OI~Jlre-existing Building:
Location of Property: 01'" ~ on k-" d (
House 0'/1 Street
Owner or Owners of Property: ___ ~l Co ha n:l cL ~ /Y7 e<;;
Suffolk County Tal' Map No 1000, Section _----2~7_ Block
(check one)
Hamlet
)l)cD,'J ~
:;2 Lot __.LG>
Subdivision
__ ~ Filed Map. _~
Lot:
Permit No.
Date of Permit.______ _____ Applicant:_
Health Dept. Approval:
Plamung Board Approval:
Request for: Te~Orary :ertificate
Fee Submitted: $ :)7,00
Underwriters Approval: __ __~____ ___
Final Certificate:
~
( check one)
;igp{J~
Applicant Signature
~ 7 PfC?'f
C. 0 -l-3,zo ~ .$
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.
32554 Z
Date DECEMBER
7, 2006
Permission is hereby granted to:
RICHARD JAMES MCBRIDE
OREGON ROAD
CUTCHOGUE,NY 11935
for :
CONSTRUCT AN ADDIDTION TO AN EXISTING AGRICULTURAL BUILDING
AS APPLIED FOR.
(REPLACES BP #23171-Z)
at premises located at
10725 OREGON RD
CUTCHOGUE
County Tax Map No. 473889 Section 083
Block 0002
Lot No. 016
pursuant to application dated DECEMBER 7, 2006 and approved by the
Building Inspector to expire on DECEMBER 7, 2008.
Fee $
50.00
ORIGINAL
Rev. 5/8/02
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.
32554 Z
Date DECEMBER
7, 2006
permission is hereby granted to:
RICHARD JAMES MCBRIDE
OREGON ROAD
CUTCHOGUE,NY 11935
for :
CONSTRUCT AN ADDIDTION TO AN EXISTING AGRICULTURAL BUILDING
AS APPLIED FOR.
(REPLACES BP #23171-Z)
at premises located at
10725 OREGON RD
CUTCHOGUE
County Tax Map No. 473889 Section 083
Block 0002
Lot No. 016
pursuant to application dated DECEMBER 7, 2006 and approved by the
Building Inspector to expire on DECEMBER 7, 2008.
re
Fee $
50.00
COpy
Rev. 5/8/02
jrSS-fz-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING p<f FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
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I NSIILATI ON PER N _ Y.
STATI, ImERGY
cOlm
ADIHTlONAI. COMMENTS:
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-J-J,bL!'_~__~_$ 50,t/f) ~~.lL~~.9-~ @.,,,,",,,r--.11Y__fll:
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTH OLD, N.Y. 11971
TEL.: 765-180:1
Examined... ./!;{t:....., 19 '1.r
Approved. . /~c:f.. ., . ., I 995.Permit No. ,).J/7/.'2-
Disapproved ale
..... -...............................
UU,\hu UI 1\L.J\L1U .........
'/3 SETS or PL.\NS ..........
/jSURV~Y ...................
//ClIECK ....................
/ SEPTIC fORfl ..............
1l0~~~~ : . 7 y::l:-.4.?~.t.,. . . . .
H^lL TO:
..................... .
..................... .
I'; i--, !_, ji
............................... AP:7d~~~:GPER~1T
INSTRUCTIONS
.
m:-f' - 1190:;
Date.................., 19...
a. This 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 tllis application may not be commenced before issuance of ~uilding 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, housing code, and regulations, and to
admit authorized inspectors on premises and in building for neces~~~~~. .~. ~ . . . . . . . . . . . . . .
(Signatur'/if applicant, or name, if a corporation)
. (!)~...4..~. U.cr.3.~.....
(Mailing address of al'plicallt).
, \
State whether applicant is~ssee, agent, architect, engineer, general contractorA;~RO~~ASp~OT~Dr or builder.
. . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . .. . .. . . . . .. . . " . . .. . . .. . .. . .. . . . 'om:' . .. B:P./1 J} ! :7,(, i. . .. .
Name of owner of premises ~'~.i:'l.tRb. .'4:-.~t.Ii\. fot:I.. v... .^-4~~~~t. y lJlJ1lO;: ~1'.d;::;AT""
(as on the tax roll or la'ffl5.~ 9 AM TO 4 PM FOR THE
If applicant is a corporation, signature of duly authorized officer. FOLLOWING INSPECTIONS:
1. FOUNDATION. TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH . FRAMING & PLUMBING
3. INSULATION
4. FINAL . CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE R!:C1UiREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENEF,GY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERi-lORS
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corpo1)tc~D~~)
B 'Id ' L' N u ANCY OR
UI ers Icense o. '''''''USE'IS'UNLAWFUL
Plumber's License No. ..... WITHOUT- CERTIFICATE
Electrician's License No. ... .OF .OCCUPANCY
Other Trade's License No. .....................
1. Location ofland on which proposed work will be done. .......................... .~. . ... . . .. . . .... . .
........ ./(7, fl.~.... .~.tE.~.IfI...... .RD. .~.......... Q~rf... .~. ~~....... '"
House Num ber Street Hamlet
County Tax Map No. 1000 Section ....' 8;>. .. . . . . .. Block .. ..0. . . .. . . .. ... Lot...f (..f. .. . ., . . . . . . .
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot...............
(Name)
2. State existing use and occupancy of prelllise~ and intended use and ~c~a/c.y of prop01 construc~n:
a. Existing use and occupancy. . . . .. ......... if .Ii}~/.. n~f~.. o/...d?1~. . . . .. .
b. Intended use and occupancy .. 4:J~. .~#~. . ." 4dt:ne.. . .~~. . . . . .
!
3. Nature of work (check which applicable): New Building. .. .. .. ... Addition. .x,. . .. .. Alteration ..........
Repair ............... Remov~&:l< i C' .~ t:. ~e~~~ . . . ~;:~ 'R .~ ~t~r Work. . (D~~~ri~ii~~; . ,
4. Estimated Cost ,.~tr.7?o,.'?:? r . ... .. , . '" . .. . Fee. . . .o!;1r~... '" . .. . . ..... . . .. .....
(to be paid on filing this application)
5. If dwelling, number of dwelling units.. , . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . .. .
. If garage, number of cars ........................................................................
6. If.busin~ss, co~~er.cial or mixed o.ccupancy, specify natur, and extent of each type of use . ... . .. .. . .. .;-.. ... ..
7. DimensIOns of eXlstmg structures, If any: Front. . . . If 0. . . . . . , . Rear .. 60. . . . . . . .. Depth... 5? a. . . . . . . .
Height .1:-~~ !O::...... Number of Stories ,..r.....".......,......,...............,.............
Dimensions of same structure with alterations or additions: Front .7. f'. . . . . . . . . . .. Rear..7 1."., . . . . . . . . . . ,
vA r ...,' )/1" r
Depth... .0....... . ... .. . . ... . .. Height...2,.,.. ~. .. .. . .. . . . .. Number of Stories.. . . .. .. ... . r' ... . . . ..
8. Dimensions of erttire new construction: Front. . (<1. . . , . , . . . .. Rear. /r. ~. . . . . . . . . Depth. <6 .1.. . . . . . . . . .
Height .. /'7,: [f. ~'. . . . . . Number of Stories. . . /. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , .
I~: ~:;eo:/~~:r:::s:t:: M~: :i:<1:~tf: .~~~~:: Na~~~fFo'~~r'O~~~~' .~~:l-t: :7h~:::
II, Zone or use district in which premises are situated. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance Or regulation: ................................
13. Will lot be regraded ......1'6...,;.....~,.. .f)., Will excess fill be removed from premises: Yes No
14, Name ofOwn~rofpremises ~~i:7..~JI:{C!~ress .e.~IJ<I""'" Phone No.7.'Jlf,. 'lytb" ·
Name of Arclutect .. .~' . . . . . . . . . . . . . . . . . . . Address. . . . . . . . . . n' : :.: itl' . Phone No. . . . . . . . . . . . . . . .
Name of Contractor .. ................... Address .C~/.J P.:Ldt.. Ph'one No. . .~.....
15. Is this property with 300 feet of a tidal wetlana?' O'Yes........ No.l1~....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
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STA TE OF NE~RJfx{k S S .
~~~~~~.1!T~'I/. ~k}.','. .'. . ?~l f.dr. . . , . , . . . ,
(Name of individual signing contract)
above named.
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being duly sworn, deposes and says that he is the applicant
~I: ~:i~leOW~~~ 'a: ~~~er~,' ~~~ ;~ ~~;~ ~:I:I:~~~::i;:~;t:;~~:~:;:~;f::::':;:~':~i~' ~~~~ 'a~~':~ ~~~ ~~~ ';'I~' ~I:i~
application; that all statements contained in this application are true to the best of his knowledge and belief; and that the
worl< will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
. .. , .. , ,. : . j. s;f: . .day of.. .. .. " .... .......,19'7.<::
NotaryPubhc,~....,... . ......... County . 1, ~~_
CLAIRE L GLEW \ ~(../ / II
NotIIryPu~~~~~~tg~NeWYork ~ .....1-::...................:...... .........
Qualified in Suffolk County a 19 (SIgnature of applicant)
Commission Expires December ,