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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-32874
Date: 02/08/08
THIS CERTIFIES that the building ACCESSORY FARM BUILDING
Location of Property: 31215 CR 48
(HOUSE NO.)
County Tax Map No. 473889 Section 74
PECONIC
(STREET) (HAMLET)
Block 1-- Lot 36
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JANUARY 10, 2008 pursuant to which
Building Permit No. 33625-Z
dated
JANUARY 11, 2008
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 FARM BUILDING FOR CROP STORAGE AS APPLIED FOR.
The certificate is issued to FLORENCE WICKS
(OWNER)
of the aforesaid building.
SUFFOLK COUl!lTY DEPAR-nmNT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3057666
01/28/08
PLUMBERS CERTIFICATION DATED
N/A
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Rev. 1/81
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Form No.6
TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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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 smvey 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. Swom statement from plumber certifying that the solder used in system contains less than 2/1 0 of 1 % 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.
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
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
Date. / / () '7/0 25'
,
Owner or Owners of Propeliy:
F
Old or Pre-existing Building:
L.D .:.1] .25
Street
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7Y_
v
(check op ~
~eQ.-,.0. <:...
Hamlet
New Construction:
Location of Property:
7-;/')--1'7
House No.
Suff(llk County Tax Map No 1000, Section
Block
I
Lot ~ ~
Subdivision Filed Map.
Pcnnit No. ~ 7 (.. ;)- 7 Date of Permit.--L / (1 /0 8: - Applicant.
Lot:
Health Dept. Approval:
Plalming Board Approval:
Underwriters Approval:
Request for:
Temporary Certificate
Final Certificate:
(check one)
Fee Submitted: $ d- <]
~~~ ~
Applicant Signature
~,/3753
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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)
11, 2008
PERMIT NO.
33625 Z
Date JANUARY
permission is hereby granted to:
FLORENCE WICKS
PO BOX 314
SOUTHOLD,NY 11971
for :
CONSTRUCT ACCESSORY FARM BUILDING FOR CROP STORAGE AS APPLIED FOR.
(THIS REPLACES BP #10408-Z)
at premises located at
31215 CR 48
PECONIC
County Tax Map No. 473889 Section 074
Block 0001
Lot No. 036
pursuant to application dated JANUARY
10, 2008 and approved by the
Building Inspector to expire on JULY
11, 2009.
Fee $
150.00
ORIGINAL
Rev. 5/8/02
FE8-08-2008 11:33 From:BURGER CONSTRUTION 631 734 5249
To: 16317659502
P.2/3
BY THIS CERTIFICATE OF COMPL.IANCE THE
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FUL. TON STREET N NEW YORK, NY 10038
CERTIFIES THAT
Upon the application of
upon premises owned by
G & S ELECTRICAL CONTR.
P.O. BOX 215
SOUTHOLD. NY 11971,
CHRIS PIA
31055 CNTY RO 48
SOUTHOLD, NY 11971
"
31055 CNTY RD 48 SOUTHOLO. NY 11971
Application Number:
Certificate Number:
3057566
3057666
1000 Biock,
Building Permit,
BDC: ns11
Lot:
36
741 ,
..;
Described as a Commercial. ,occupancy. wherein the premises electrical system consisting of
electrical devices and wiring. described below, Io..tated in/on the premises at:
Fi1st Floor, stomge bldg, Outllde. ,.
.
A visual Inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed
herein, was conductad In ,accordance with' the requirements of the applicable code and/or standard
promulseted by the State of New York, Department of State Code Enforcement and Administration, or other
authority havlns jurisdiction, and found to be in compllanca tharawith on the 28111 Day of January, 2008.
l:lAoJg QIY ~ Bmiui s;Jwili IxllS
MIRcollaneou.
equipment sloroge bldg.
as built 1975 (1)
Wlrlnll and Devlcea
Receptaole
Switch
Fixture
1 0
2 0
5 0
Oenerel Purpose
aeneml Purpos.
IncandeSllOnt
An.s builllnsp..Uon, oflh. delinealod olcclrlc~1 \nsUlIIQlion. delomllncd thai an obvious hozard Is net pmonl nnd 1110 109l01l0110n I. bollovcd 10
be In oamfonn.nCD with tha 'pplicubl. reroronco SUlndord ror Iho eJIlmaled p.rlad ofcon.Lrucllon oftha praml..s wiring s)'ll101l'l.
sea'
I or 1
This certificate may not be altered In any W1fI and is validated only by the presence of a raised seal at the location indicated.
02-08-2008 11:42 SOUTHOLO 8UILDING DEPT 16317659502
PRGE2
--
-
JAMES]. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
Date: January 9,2008
To: Town of Southold Building Dcpt
Re: Building Inspection
John Wicks
31055 North Rd.
Peconic, NY 11958
Permit# 10408z
To Whom It May Concern:
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An Inspection was preformed on the structure of the (Crop Storage Building) at the above
mentioned location. TIllS structure was built as per manufactures specification, met all
Codes at the time of Construction (1979), and is suitable and safe to use as intended (Crop
Storage Building). Any questions please feel free to call.
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180:!
Application No. . b. ~~. . . . .
APPLICATION FOR BUILDING PERMIT
Date_<~ II. . . . . ., 19 .'/.1
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary inspectio ~" .
...............~~...............
ature of applicant, or name, if a corporation)
c13'9<,;'~?'))~&./?~ d.y./(~f1
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.. .~~. ~~..............................................................
Name of owner of premises ~~~. a . w~~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer. .
(Name and title of corporate officer)
B 'Id ' L' N 5= ( F
Ul er s lcense 0..........................
Plumber's License No. ........................
-:~ ----,
EI t.. , L' N rE7J:f;C: i....,--<S ...:,v/r
ec flcmn S lcense o. ........... .~. ~r.-. .' '---
Other Trade's License No. .....................
I. Location of land on wh:~osed work will be done. -r~. . . ~ ~. .~:" f'~-.(~
~.~l.~l...."....... .5..u:Q,.. 9~.~................................................
House Number -3/05:5- Street Hamlet
County Tax Map No. 1000 Section .. Q. 7 Y: . . . . . . .. Block ... () /. . . . . . . . . .. Lot. cr. 5.' b. . . . . . . . . . . .
~-
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot...............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . .7::~I<H...<F. /?c:;.:'.?/.'??~.(!-"P .<~,................. ,..........
bIt d d d ~ ~~ - F/.:JI't'M /5~D~ . .0'. .
. n en e use an occupancy.. ..>. (~ . . . .'. . . . . . . . . . . . . . . . . . . . . . . . .';.]. . . . . . . . . . . . . . . . . . . .
. ~ ~ . .
,
1
9.
10.
II.
12.
13.
14.
3. Nature of work (check which applicable): New Building /. .. . Addition. . . . . . . .., Alteration ..........
Repair .............. Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . .
/' (Description)
4. Estimated Cost. . k. ~.. .Or-.J . e..('~I.~ (;;'9 C?po.). Fee J~ ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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 business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions of existing structures, if any: Front .~ . '. . . . . . . . . Rear ~ . . . . . . . . .. Depth...............
Height ............... Number of Stories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front ................. Rear . . . . . . . . . . . . . . . . . .
Depth. _:. . . . . . . . . . . . . . . . Height. . . . . . . . . . . . . . . . . . . . . . Number of Stories. . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front. :"/0. : . . . . . . .. Rear .L(q:. . . . . . . . . . Depth .~ $:< . . . . . . . . . .
Height .I.'!;./.......... Number of Stories. /. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Size of lot: Front .. . . . . . . . . . . . . . . . . . . .. Rear...................... Depth ......................
Date of Purchase ............................. Name of Former Owner .............................
Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
D~es proposed construction violate any zoning law, ordina~ce or regulation: ............................. ~
Will lot be regraded .. t-.o. . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes ( .lio--'
Name ofOwnerofpremisesH::A'''''''':''?:'-.~~~... Addressn~. ~-.t>r.'i<;-.. . Phone No.7.::3'1..s:'?':~.....
Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. .... . . . . . . . . . . .
Name of Contractor W 0... ~(<.Nt. /01>. . . . . . . . . Address 11. ~. . ~.L ~ . Phone No.7~~<(~ . . . . .
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.
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above named.
. " . . . ~ . ..:z:t"being duly sworn, deposes and says that he is the applicant
e of individual signing contract)
He is the . . . . . . . . . . . .
.. .................... -......... ........... .... .......
(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 are true to the best of his knowledge and belief; and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
............/.~. .day of... .~19 7.'1
Notary Public, ................. .
~A~'_~l~
No. 52.8125850. Suff,t Cq\!"!!.
Term Expir.s Mirth 30. 1~
ounty Ii
...... .. ... ..dt~c-:L<:?>............
(Signature of applicant)
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FORM NO. 2
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09
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TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH'OLD, N,. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 10408
z
Date ..4:-.~.:..I.J:....., 19..77.\
Permissian is hereby grant.~~.~.~~. . /:.. . .......t:......Jt-~.J'Jr..
..... ...OQ.K...d(f...~.~...Al'!d..
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to......~~... .... ............ ......:........Uyl.............
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........../~...t.LtHf/......::T~~...u.....\ ......"f.L.IVY...................................................
,................................................................................,...............................................................................
pursuant to application dated ...
....... ....I.C...., 197.f.., and approved by the
Building Inspector.
~~
Fee $../.....:...::-:-......
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........,.......~~........
Building Inspector