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28034-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28372 Date: 04/30/02 THIS CERTIFIES that the building GREENHOUSE Location of Property: 3175 COX LA CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 96 Block 3 Lot 4.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 23, 2002 pursuant to which Building Permit No. 28034-Z dated JANUARY 24, 2002 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 AGRICULTURAL GREENHOUSE AS APPLIED FOR. The certificate is issued to GOERLER REVOCABLE TRUST (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 585937 02/11/02 PLUMBERS CERTIFICATION DATED N/A /-tv "'114 " Aut ize Signa ure Rev. 1/81 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. 28034 Z Date JANUARY 24, 2002 Permission is hereby granted to: REVOCABLE TRUST GOERLER BOX 12 CUTCHOGUE,NY 11935 for CONSTRUCTION OF AN AGRICULTURAL GREENHOUSE AS APPLIED FOR (THIS PMT REPLACES #24740Z at premises located at 3175 COX LA CUTCHOGUE County Tax Map No. 473889 Section 096 Block 0003 Lot No. 004 . 001 pursuant to application dated JANUARY 23 , 2002 and approved by the Building Inspector. Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 • Form No.6 ( ___ _� � -1 6 TOWN OF SOUTHOLD �(� 44 �f BUILDING DEPARTMENT / G 1 TOWN HALL k 765-1802 KATION 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 2/10 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: 1. Accurate survey of property showing all property lines, streets,building and unusual natural or topographic features. 2. A properly completed application and a 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. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $5.0.00 5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00 Date. New Construction: Old or Pre-existing Building: check one Location of Property: House No. Street _ Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section'-('-?*3,?b �) —Block 00o 3 Lot ©©t/, 00 I Subdivision F;13 ap37 c/, Lot: Permit No. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ �, S Applicant Signature THE W9W YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1185077 BUREAU OF ELECTRICITY I 40 FULTON$TRFFT, NEW YORK, NY 10038 nate FEBRUARY 1112002 Application No. on,lisle 14011802/02 N 585937 THIS, O.SRT,l,"f9* THAT only the t/tst►j rd tqurlpmeFrt as described below and introduced by the applicant named on the above application number is in the premises of RON GOERLER, 3175 COX LANE, CUTCHOGUE, NY in thefoAvving Win' BQsement (A lst F1. Q Ind Fl. OUT Section Block Lot was tx4"18 d 4D FEBRUARY 05,2002 and fPund to be in compliance with the National Electrical Code. FI RANOES I COOKING DECKS I OVENS DISH WASHERS EXHAUST FANS ' rrR AML K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. H.P. 2 1 3 2 1 F pltlf p{lr}JQ ASI fDtf13 $PKCIAL IIEC'PT. TIME CLOCKSBELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS ArrT. K!K• R,P• MSi. A.W.6. ,IMT. AMP. AMT, AMPS. TRANS. AMT. H.►. NO.OF FEET I�Mt. wATTs F 5. . E- R V 1 C E A �"', .. TV ;Q - ..G' NO.OF HI-LEG OP NId6O NO.OF NEUTRA{0 OF NEUTRAL OTHER APPARATUS6 Q GREENHOUSE-1 *1 PANELBOARDS11-4 CIR. fig G.F.C.IE-3 ROSLAK ELECTRIC LIC.#3677— L 2, P.O.BOX 164 CUTCHOGUE, NY, 11935-2453 GENERAL MANAGER 11 Per This cOrMflC�to Tt t not pllr 19 tto ot�+�c of ry►q 4oAlr�!M 1nCOmQt.Insp�tors maY til►lRNntltt�0Y their Cr"ennals. P T A -COPY OF 'CERTIFICATE MUST N BE ALTERED IN'A JJU %TE �� iOMMEKiS FOUNDATION ( 1st) II c� c 'ti FOUNDATION ( 2nd ) cn c� 2 . m z 0 ROUGH FRAME & .PLUMBING cn � H 3 . m INSULATION PER N . Y. STATE ENERGY CODE II Uy � 4 . ol ` I) FI14AL I z ADDITIONAL COMMENTS : s .. r. ry ry H ' 9 ' H D - Z rn W a � BOARD OF HEALTH . . FORM NO. 1 3 SETS OF PLANS TOWN OF SOUT11OL0 SURVEY . . . . . . . . . . . . . . . . . . . . . . FEB I I BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN MALI. sEPTic FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 6LR TOWN F S G.DEPT. TEL: 765-1802 NOTIFY: �3 UTHOLD y� g CALL . . . . . . . . . . . . . . . . . Ewini rnecl........ .I,'I..., 19( MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved.. ....... J. 19 .� Permit NO. ./.-7. 0 .................................... Disapproveda/c .................................. .................................... .........................................'............. Olui Idinf, n, /ILDING APPLICATIONFOR It 'EItNIT Date. . . . . . f-�.7. � . . . , 19. INSTRUCTIONS a. 'Ibis application mist be catpletely filler) in by typewriter or in ink and sulmitted to the Iluilding Inspector will 3 sets of plans, accurate plot plan to scale. Fee according to scherhnle. b. Plot plan slowing 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 mist be drawn on the diaprnin which is hart of this application. c. Tile work covered by this application may not be commenced before issuance of Rullding Permit. d. Upon approval of this application, the Jklilding Inspector will issue a ihtilding Permit to the applicant. Snrh permit shall be kept on the premises available for inspection throngftout the work. e. No building shuull be Occupied or used in whole Or in hart for any purpose whatever until n Certificnte of Occupancy shall have been granted by the fluildimg Inspector. A197.TCNIT(N IS IEItERY MALE to the Ihuilding Depnrtnent for the issuance of a Building Permit pursuant to the fkuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, atxl other applicable Laws, Ordinance.; or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. lbe applicant agrees to comply with all applicable laws, ordinances, building code, housing axle, and regulations, and to admit authorized inspectors on premises and in buil(LEW for necessary inspectiorts. .. � .......... ... (Signature of: applicant, or risme, f a corporation) (Mailing address of applicant) State wlletlwr applicant i owner lessee, agent, architect, enp,inleer, general contractor; electrician, plimber or builder. .... .... ................................. 2/0.. . Name of. owner of premises ..r Q�/`K ..,, `.T!.! !........................ � (as on Ute tax roll or latest deed) P If applicant is a corporation, signature of duly authorized officer. mom summe R 7S11 FOL AIWNVW r'1� (Nerve and title of corporate officer) I � • 7� USE IS UINLAWEUL z. � ,,, ww Builders License iJo. ...................U't11Ti�0Ui' CE TiFICATE 3. INSUUMM 4. FINAL - CONSVRl1CTION MUST I'lunbers License No. ...................OE.00CUPANCY BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET Electricians License No. ..................... THE REQUIREMENTS OF THE N.Y. Other Trade's License No. STATE CONSTRUCTION & ENERGY ,)�� � -'�� � `� S. OT RESPONSIBLE FOR I. Location of land on wluich proposed work will be ckxue.�4 .. ^ -.. :C..a _,,, -r-ONSTRUCTION.EA ORS .................... ................................................ Vii...... [louse Numb ...... Street q- !� 1 e ....................... Ccxssty Tax Map No. 1000 Section .`QO t P....... Block ..`f............ In . ......• Subdivision ...................................... Filed No. ............... lot ............... t) Ma (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: .. ................................................................... a. Existing use and occupancy .. !.l b. Intended use and occupancy ! ��.../.1Q"`4 ? ................................................. 3. Nutune of work (d)eck width applicable): New lkcildinll .......... AeklItion ........ Alterati Mika ir ............ Renuval ............. Denial itioiI ............ Other Work .,A ....... . .. .... (Description) 4. Gstinrated Cost ......................... fee ...........: (to be paid on filing this application) 5. If tAxaling. nnLer of dwelling units ............ Dinber of tkaelliug units on eadi floor ................ ifgarage, rxniser of care ...................................... G. if Ixssiness, camrercial or arixed occupancy, specify nature and extent of eacJu type of use...................... 7. Ilimeosicxcs of exisLinsg structures, if any: Front................ Rear ............... Depth ................. Ileiglut ......................... Mni+er of Stories ...................... Dinensions of sale stricture with alterations or additions: Front ............... Rear ............... Deplln .................... 116641C .................... Rmd)er of Stories ............... IS. Diuensiaws of entire new construction: Mont ................ Rear ............... Depth .............. Ileil}ut: ......................... Nnher of Stories ..................... 9. Size of lot: I4rout .................... Rear .................... Depth .................... 10. Dale of PurcJuase ..................... N:ne of Former Owner ........................................ If. Zcx,e or use district in uloids prenlses are situated .. ..................................... ... 12. Does proposed construction violate any zoning law, ordinance or regulation. ........................ 13. Will lot be regraded . (cyk;tr .��..,............q W11i��l��l excess fill be reniovedfiron, pp/remises. YES 14. Nares of Owner of preaises SI F!k' �`.�..I..ld?4!w?4'�... Acklress 1,:0.!,/,' �'.w? ........... Pion No.-73Y4MT.. Nryne of Arcluitect .......<)!`1'L1L.................... Address .............................. dare No. ........... Nine of CcxitracCor ........ .............. Acklress ...............................rlxxie No. ........... 15. is this property within 300 feet of a tidal weLland? * YIS .......... .......... *1F YES, SOSfIUND 70141 7IMSIMS, PCIMrl' MAY ISL PKAHRIM. P1.0'f DIAGRAM locate clearly and distinctly all buildings, wiselher existing or proposed, and indicate all setback dimensions frau property lines. Give street ane! block nsnber or description according to deed, .and show street nnnes and inlicate uA,ell+er inferior or corner lot. „XJJ .�. 7 ok- /1 C- J c. f2eAJ Le. ,... A 11 0 a r Oak I►AN16OfM6 =f4W war awr • Naa�uo� � w�as.r�uol++a� �w s arwa • �x,o�+ s Norr�ual�l LN JA.sI lr,:' S„ 0XINIY (X� 01) Y.N 3 _ • �j7, A 3 SIA.+:Y +' . ................................Ixeiog duly sworn, deposes anal says: Lhat he is the applicalit. 11yi.sluwl, $1lyuing ccxulract) :dxrru.igYrttl,. lit! is Ilne ....cl `. �................................................................................. (tl)iitractor, n(lent;corporate officer, etc.) of. said owner or owoers, nod is duty authorized to perfonn or have performed the said work and to nrske and file this appl ication; that all sLaCeneoCa contained in this app]ication are tnie to the best of his luxmledge and Ixil.ief; and that: the work will be performed in the scanner set forth in Like appticaLion filed dserewith. :Iworn to I; fere ne this . .. ..I.(............day of .F6/4..p.......19.4.31... Notary Pudsl is .. .RAS!" . ... ... . . .�................ w DIANE DeFABPJZIO (Sigrt:ure of Applicant) Notary sa Public,State of New Your No.4895125 Qualified in Suffolk County Commission Expires May 28,te��J � 1 F F� k•�e+3�. ��-�.. Ed I fill Edit If m rtLE I El I �Ew s�z If It _. �� LIE, ' . - '4 P 4 < / If E. ILp'29S �.3F1715G�+ .i6 /v .:- _ It l -LL .. - . - - v �� f - - I Ed - Ed - ' If I of LA - . .N Ell Ed E If to 0 .. L ../yy.� O Ed It ul _ . . l- Ed II Ed _ y h . . . . 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