HomeMy WebLinkAbout32705-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No, Z-32209
Date, 02/20/07
THIS CERTIFIES that the building ACCESSORY
Location of Property, 3040
(HOUSE NO.)
County Tax Map No. 473889 Section 55
OLD NORTH RD
(STREET)
Block 2
SOUTHOLD
(HAMLET)
Lot 1. 3
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
FEBRUARY 8, 2007 pursuant to which
Building Permit No. 32705-Z
dated
FEBRUARY 8, 2007
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 "AS BUILT" ACCESSORY STORAGE SHED AS APPLIED FOR.
The certificate is issued to GLEN & RUTH DAVIS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
N/A
Signature
Rev. 1/81
,
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
,;;:,?" G
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,
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Departmel1t 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 2/1 0 of I % lead.
5. Connnercial 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
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,
Swinuning pool $25.00, Accessory building $25.00, Additions to accessory huilding $25.00. Businesses $50.00.
2. Ce11ificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Cel1iflcate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
Subdivision
Permit No. .3 2-1 (J t;
Old or Pre-existing Building:
o LV NcJ~1
Street
&lC?NIIJ t p.\A1H-
~5
I Filed Map. _ ..
Dale of Pennit. i I ~ { 0 7 Applicant:
V
r2-0,~_.5QJ11t1<J LfJ
o All [S
Block 0 0 () '2-
(check one)
New Construction:
Location of Propel1y:
3o~o
House No.
Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section
Lot_Q.Q.. \ ; 003
Lot:
Health Dept. Approval:
Underwriters Approval:,._
Planning Board Approval:
Requesl for:
Temporary Certificate
Final Certificate:
Fee Submitted: $
QJ<<:.1rSc, 'V
Co ep,2J01
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)
8, 2007
PERMIT NO.
32705 Z
Date FEBRUARY
Permission is hereby granted to:
GLEN & RUTH DAVIS
16 HANS BLVD
LAKE RONKONKOMA,NY 11779
for :
AGRIC SHED AS APPLIED FOR PER AC ZONE AS BUILT. THIS PERMIT
REPLACES BP 24347.
at premises located at
3040 OLD NORTH RD
SOUTHOLD
County Tax Map No. 473889 Section 055
Block 0002
Lot No. 001.003
pursuant to application dated FEBRUARY
8, 2007 and approved by the
Building Inspector to expire on AUGUST
Fee $
50.00
ORIGINAL
Rev. 5/8/02
p , ~ ' 1:7 "'- 3:l'~
-If / .L.-'
765.1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING
[ ] ROUGH PLBG.
[ ] INS TION
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[ ] FIREPLACE & CHIMNEY
REMARKS. ~~=r:;;;:
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DATE
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INSPECTOR 7r41::f:
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LAND IMP, TOTAL DATE REMARKS
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I'OHM NO. I
TOliN Ol' SOOTIIOLIl
IIlJl \.Ill NG IlEPAHnmNT
TOlIN IIA\.1.
SOUTIIOI.Il, N.Y.
TEL: 765- I B02
11971
3~10o (~~'r:
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EX<lIli..,L.....*<l.:-.., 1992
AwlUVC'I... ..9//'1.-:-:.., 19)1'7 Pelmi I:
nisappHIVE...>{1 ale......................... -........
.....//M.4:..
(Jkllldill0'~~~:-)-
Al'PI.lCATlON FOH IllJll.lllNG I'EHMIT
'NSTlnJCTIONS
1I01\IW IW III':AI.TII ...............
] SETS OP PI~NS ...............
SOHVI~Y ........................
_ CHECK .........................
SI~I'Tl C FOHM . __ . . . . . . . . . . . . . . . .
-
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NOT I I'Y :
CA\.L($)IP.). 5Si.-:':-I.~.~.S
MAIL TO: qle.~n.D(A\(.(s. .. ..
..[(g. .\10.\'\:;' .61.'1..:\............
. ..k4-k.e.,..RQr:\k/.J.~_.......
Ill1q
Dale. . . . . _ _ _ .. . . . . .. , 19. . . .
a. 'Jhis appl ication lllJst he co,.)letely filll."<.1 in by typewdter or in ink and 5uhuiUed to tile nuilding Inspector \"j
"J sets of plaus, accurate plot: plan Lo scale. Fee according to schedule.
h. Plot plan shc"",ing location of lot and of huildings on prt1uises, I'elaliouship lo adjoining pn.:mises or puhlic
slr-L"efs ()(- areas, 1Ul(t giving a detailed description of layout of property !lIlSt he dnll.'lJ'l on (he diagran which is pari of
thiR appl kat ion.
c. 'Ille \.Jluk covered by this application l'lilY lIot he c(llllleneed hefore iSsu..llK~e of Building Permit.
d. LJpClfl appnNal of this appl ication. the Hui Iding Inspector Hi \ I issue a llui Iding Penni t 10 the appl kanl. Such
II(~nlli t shall he kept Of) the premises .<.Ivai lc.lhle for inspect ion thnAlghout the \.,l()rk.
e. l*l huilding shall be occupied or used ill whole or in ll<lrt for any puql()ge YlCltever lUltil a Ceaifkal-e of
OCC1..IIl<lIK:y shall have he~n granted by the Bui Idillg Inspector.
APPLlCATlfJII IS llElUmV ~WI~ to the Building Hepartnenl: for the issuance of a Building Permit punmClllt to the
Bui I cli ng Zone Onlina_llce of the lh..tll of Southolcl. Suffolk Co.Ulty. New York. arKI other appl icahle l.aws. Onlinane:es or
Hegulations. for the constntel.1on of buildings. 8(klitions or alterations. or for raroval or dL"Ilol itioll. as herein
described. "lhe applicant ,agrees to cUllply with all applicable liMS. ordinafK:es. huilding code. housing c(xle, and
r.egulal:ieXl". al.lto ~lllil: altlmizal insl~'tors (XllllBllises aId;' I..il, 'n~~~~:~~.:(:SI.~.':(~:~:.................
~" Signature of Hpplkalli, or Balle, if Cl COqXll"<.1l ion)
Nalle of owner of premises
l r appl iCdut is a coqKnatioll.
)(
(Nc.l(~ ;:uwl lit Ie of coqx)nJte offit:er)
OCCUPANCY OR
1~lil,lm License ttl. ..............U.s.EJS UNLAWFUL
l'1",llers License No. ..............WIIHOUT CERTIFICATE
I<leCI:.-icoimls License ttl. ..........Of.OCCUPANCY
Other Tntde's 1.icense N::l.
I.
Il)(:at ion of land on \.Alidl (lr()lx)~1 wOlk wi II l)(-~ tl<'j)e..
,
..
2. 1IIl181 .
3.
4. FINAL. . _
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ALL _...... ... _
THE fIIO'JIIV'TT III . _ ..
STATE .....JlIAlliOll . - JiIf
CODES. Nor ..t__.GJIJ HI ..
DESIGN OR ~mJIOM
...... ..~Q. .40.............. .C.ld.... NQr.th. .1?o.o..d........ .~0~+'h.. ho..Hy. .tV., V........
U:::lllse t-llli>er Streel lunlet { .
l",,,,'y TdX Map ttl. 11m Se<.li(~l .o.65...D.U.... IIIcx'k .0.;).0.0..... 11)1: .O.0.L.o.Q3 .
sul.r '.' Ii"1 I . . .
~ IVlstOu .............................._....... _I ec t-lap No. ............... Lot ...............
(Nane)
2. Stale existing llse mod 'XO"'I"U"'y of premises ",.1 inl:er.lerl nse al.1 cxTllpancy of pn>jX,,;ecJ cnllsl:lUction:
iJ. Existing use and ocelJpancy ... _.......................... _....... _......................................
h. 'n'''Ix,,"' usc alld IXClII"Jlq^..~0.r.;<.'~(~J...S~rf:3~;.~!f{<"--;~K...............
\,111;:"<;' '>:' rq~. ,!)',:..J~
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"I'pl icahle):
~1l.~J Bllilding ..........
1)(':1"rnlition _._.........
Atklilioll __........ ^llenll,ion ......
OlhN \~"k .....1flH.&IJ.............
~1)(~f",(:r- i pl: ion}
I~!;I imal {'d Co~;1 . _ .
fef~
..............................................
(to 1>p. paid Oil Ii I illl~ thin "ppl ici'ltion)
If IkJ'l.llillg, IJlllh'r of d';-1f'llillg IIldlq -..... -':t'" n.~.;1 or;l\-1ellillg wdl!; on ench floor ..............
If g""lg(', nll.h., of emu .........SH€.D...-. r1.t:. _. $;
I r hll!li'Y'!l!1, (,flllI"~lrinl 01 lIlixpd ()(Ttlprllk'Y. HllP(- y nnlut(> nnrl f'xl(.>nl of ench I ypp of tHle.. _ .~..... _... _ _ _. _.
'.
lJill1('Il,;iow; of exisl ing HI ftK:(\In~ll. if :lilY:
Flonl _. _.
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IH,~'1
Ill'", II
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t."llel- of fJlorie!; _. _ _.. _. _ _...... _... _.
allenllionli or additif)Il!;~ Fn)lll. ..._._..._..... I~nr .............
. . . . . _ . " n 11.)("- of !;l ori (~~; .. . . . . . . . . _
!)im.'II~;jOIl!; of Hfll~ sf luc(ure with
I.
l)inf'I1!;iOWI of ('III ilf! 1...-"... ('ou~;II,,<<:1 ion:
FII)!ll _.
Itt~ .11- .......
. . _. I)t~pl II
Ik! il~11
N.."~!l
of !,I.mie!J
J.
~l i Y.(' of 101: FI{H,I
... Hp;fr _.....
').-~pl h
HL
Il;-ll(~ or I'\ln.hall(' ..................... N:Il,(~ of FOlI\I~l 0...1)(>1-
II.
Zone 01 \Il;t~ tliRl1 iet in l..hkh pt-nllis~R fHe si:tO<II-pd
12. Hop!; I'l"oflO!;t!d cow;lnlC":lioll violate mlY 7.oning law, (H(lil\;ul(~e or legulntion: ....._..................
I\.
Hill 101 he H'g"wk>c1 .._...__........._.. Will exn'HR fill he nmNed flun plnllise~n
YES
tn
If,.
Nal'(.-'!l of (),-I1~r- of I'n."lIi !le~l _.......................
^,klrewl
nIOfl(~ No.
nil..' of ^rdd(pcl
^,kln!m~
l'hOtlP. N-L
tl;m. of nKllraclm- .._................_....._._....... 1\ckhe!l5 ........._.....................l1U)l)('! tkl.
I,.
>.
I~l tld!~ lHolx-!rly within )(X) [pet of il til);lI 'Jetlnnd'{ *- Yl~f.j
'IF YI'S, !UrllUn .IUM .11~1!;lFm; ml!HIT flAY IU, 1U~~I1HEIl.
fl) ..........
PI.OT 1l1^(;IIMI
IOGlle clc.u-Iy nlld distinctly nil IJ11lilllillg~, \.Alelhp.r ('xinling or propo!'>ed, 1Il~1 illC"licnte all .m:~t-hnd~ c1il11('llsionH
flfllllH"OllPlly lincn. (;iVf~ r;ln~el. nnd h10ck ,ulher or (~Rcriptioll.lf:TOIfling 10 lteed, nnd RJICXoI Rtrcet IlmeR .md if)c1iC:"'-f~
\."'II'II1I'r illtC'lim- 0'. C:0I1)(~1. 101:.
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dilly ~""0Ifl, d('l'm;p!; Horl BnY!1 111:11: lu:i j!; lllf~ nl'l'liC:ll1l
flf ~:;Jirl (1"'I)(~r III fMll(~ln. llud in duly ""lh().-i7.{-~d (0 Il(',follfl III !t;n;p Ile,rmlll(-'rI 1Il(~ rlnid wotk "ndlo mnhe and file lhin
;ll'plicalioll; llHlI: :111 nl_nlor~IlIH cOIlI..1il)(">fl ill thin npplicalifnl me '-1'K~ 1.0 (he henl of hi!l kll(~I€'1:'ge nod 1)(~li(lf; and
111i11 the l,.JI;llk will I)(~ pe,fotm::~d inlll(! 1l\'lllllf'f" net: !"mllt in the nppliclltioo filed Iherf:'Wilh.
~JWOlIl 1 f) IX! 101 (l Ilr~
tlolnry P\lbl ic
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SURVEYED FOR:- .:' ... E "j
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SUFFOLK CO TAX MAP DATA,
OIST ,''''-'00 ,SEC. ,",::",c 00
BlK C,C' 00 LOT .~,'.--:;'/ .:.?03
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
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PIO BOX 377
JAMESPORT, L.t, N,Y. 11947
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