HomeMy WebLinkAbout1839-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-22997 Date MAY 12, 1994
THIS CERTIFIES that the buildin~ DWELLING
Location of Propert~ 860 CARRINGTON ROAD CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 111 Block 6 Lot 11
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated AUGUST 1, 1962 pursuant to which
Building Permit No. Z1839 dated AUGUST 1, 1962
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 ONE FAMILY DWELLING WITH ATTAC~d~D GARAGE & sCREENED PORCH *
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ESTATE OF GEORGE FINNEGAN
MAY 13, 1963 - R. VILL~
N/A
N/A
*NOTE: THIS UPDATES CO Z1586 DATED MAY 31, 1963 & AS INDICATED ON SURVEY
DATED DEC. 27, 1962 BY OTT W. VAN TUYL & SON. /7
y ~Build~g &Inspector
Rev. 1/81
FO~M NO. ~
TOWN OF $OUTHOLD
BUiLDiNG DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ..Q.~.:[~,.IiO. Tk.~ ............................ , ....... Street
Nas~a~ Point ~oc~.
Map No ....................... N ....................... Lot No....~.~..~k .............. ~.~t.~Qg;~ .......................
conforms substantially to the Application for Building P~ermit heretofore filed in this office dated
....................................... .~..~.~.~..~......~....., 19~... pursuant to which Building Permit No. ~..~....
doted ..................... ;~.~.~.1~..~. ....... .~. ......... , 19...~.~.., 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 ........
Private one ~a~ily. dwelling
The certificote is issued to .....~.~..D..~.,:~.~...~,..~.;D;H3D~J4 ............ D.~[lr~ ................................................
(owner, lessee or tenant)
of the aforesaid building.
H.D. approval May
1963
by H. Villa
Building Inspector
FORM NO. 2
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 1839 Z
Dote .......................... ~.lXglX~l;'" ' '~1' .......... 19'62"
Permission is hereby granted to:
· ' '.Te'~' J[ ~'6 ' ' ~'pTg ...................................................
.................. S~;'""~T~m~es .......................................
to ....
'T6" 1~'iI a'' 'fi'~'~'' '6ii'~''' ~'~iZF" ~'~ZIIi~ ..........................................................................
at premises located at ..][25t,...3~l;.....]g~.~.~.~..~.fi~ ........................................................................
............................................. U ~ :~':1:~; i~Z'i"]~"~" H~I~ ib':~" E~I'~ ........ C~t,i~ti~gtt'~ .......................
pursuant to application doted .................................. ~;~l;I. Jl'~'""~. ......... 19..6~.., end approved by the
Building Inspector
Fee $.~.~;~ ...........
Building Inspector
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-I802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate location of all buildings, property lihes,
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.
Submit Planning Board Approval of completed site plan requirements.
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 Buildin~ - $100.00
3. Copy of Certificate of Occupancy - $20.00
~--~. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date .....................................
. ,--,, . ..
New Construction ........... Old Or Pre-existing Building.....~.~ .....
Location of Property ....
House No. Street He'et
Onwer or O~ers of Property .... ~2 .... ~~. ~r~d~ . .
County Tax Map No i000, Section .... ~f./ ....... Block................~ Lot..../.~ ............. . ..
Subdivision ................................ · .. . Filed Map ........... . Lot ..................... .
Permit No .... ~ ...... Date Of Permit .... Applicant. ~ ~..~
Health Dept. Approval ............... Underwriters Approval .......
Planning Board Approval ..............
Request for: Temporary C~ertificate ......... Final Certicate ...........
Fee Submitted: $.' '-- ~ .'. ' ..
..
SCHD
SU2'FOLK COUNTY DEPARTI~ENT OF HEALTH
Building Permit No,__
TO WHOI,~ IT MAY CONCEPJ~:
The sewage disposal facilities for a structure located at
· &
N~g Corner Carri t~ad H%~y~ater~~u Point~,~
....... (Give "dbba
Cutchogue, T~of ~~~
have been inspected by this Department and found to be satisfactory~
FORI~J[ NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
Approved ........................................ , 19 ........ Perm t No .................................
Disapproved a/c ............................................. --
................................. i' Ji .................................
Application No...L...~....~....~. ..........
INSTRUCTIONS
o. This application must be completely ill. led in by typewrit~n ortin ink and submitted in duplicate to the Building
Inspector.
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 application.
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 progress of the work.
e. No building shall be occupied or used in whole or in pa rt 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 and regulations.
(S gnature of apphcant, or r~me, ~f a corporatlon~'v
J~ICHO TORNPIKE, ST, JAMES
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... ~l.~.e.r. .................................................................................................
Nome of owner of premises ....G..e...o~.~e....J..~....~.~.~..e.~.~.~. .............................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
l. Location of land on which proposed work will be done. Map No: ..g,C..~.O.O.~.zJ-...°..~..~ ........... Lot No: ..~.~!~- ............
_N/W Corne,,r. C~rrin~tpn ,~d. & H~ywaterNassau ~nt ~lub Properties
Street and Number Road. N~,ft~t~!-t .~o. 1.~.~ ......................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy oF proposed construction:
a. Existing use and occupancy ................................................................................................................... . ................
b. Intended use and occupancy dwelling
3. Nature of work (check which applicable): New Building ......... .~.. ...... Addition .................. Alteration ..................
Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estimated Cost ,.,.~..~..Sj~...0..0.~. ........................................ Fee '
(to be paid on filing this application)
5. If dwelling, number of dwelling units ........ .~'J~ ................ Number of dwelling units on each floor ............................
If garage, number of cars ............ ~..o. ...........................................................................................................................
6, If business, commercial or mixed occupancy, specify nature ,and extent of each type of use ................................
7. Dimensions of existing structures, if any: Front ...... f,;l,,.'...;.'/..' ..... Rear .......................... Depth ..............................
Height ............................ Number of Stories ...... : ......................................................................................................
Dimensions of same structure with alterations or additions: Front ........ . ......... v...........,.v.. !~gr ................................
Depth ............................ Height ................................ Number of Stories ........................................
8. Dimensions of entire new construction: Front ................................ Rear ............................ Depth ............................
Height ........... ..1.~..! ........... Number of Stories.' ......... .o...z~.. ....... ...........
9. Size of lot: Front ..... 2-].l)~k,.~.0. ...... ~..~..... Rear ....2.2.4~.~ ............ Depth ..~/.8.~k~..~!,:~,6~ ...... ]~/.lside 90.30
10, Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are situated .................................................................................................
12. Does proposed construction violate any zonina law, ordinance or reaulationP ... ~O
- 7- -t¢o,~ e~e"Zd ,~?e. ...................... -'"~ ............
13. Name of Owner of premises .g...e..o.~g.e...~..[~.~,~.e.J~.rt.....Address .~'~_'_~,~,~l]~,..~l~'~..~O~'k ....... Phone No~...8...~.~.,6.~.....
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor New £ngl~-~ T~:omes~Inc. Address J~t'i~,~o T~n~.ike Phone
................................................... ................................... :.:... ......
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block numbers or description according to deed, and show street names and indicate
whether interior or corner Jot.
STATE OF NEV~'"~RK,- ~ ) ~ , r
COUNTY OF i.~ ~,'$' ~ , ' '
........................~widual sianinn a~g 'i~~~'"'i'"'~"~beir~g ~bly swoi~, dep~es a~d s~ys that he is the applicant
(Name of individual sigh'rig appl'c~ion) ~ ~ ~ ~ ~1 ~' ~ ~
above named: He is the ..~.......~....~.~.~..~.~~~
' ' /J ~ (~6c~g~ corporate off,c~ er, etc.) ~
of said owner or owners an~ is duly ~u~griz~ to ~rform or hav~performed the said work and to make and file
this application; that all statements contained in this app icatJon are true to the best of his knowledge and belief;
~dortr~t% ~he~?~°~e~lisbe p;~r~d ~ ~he manner set for~L,~ap~~ ~.~ %~
. ..... . .. ..................... . ....................
OF' EAt-iD