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Home My WebLink About4116-zFORM NO. 4 TOWN OF SOUTHOLD~ BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold~ N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22617 Date SEPTEMBER 27~ 1993 THIS CERTIFIES that the building DWELLING Location of Property 9280 NASSAU POINT ROAD House Noo Street County Tax Map No. 1000 Section 118 Block 6 subdivision Filed Map No. CUTCHOGUE¢ N.Y¢ Hamlet Lot 6 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 1,. 1.968 . pursuant to which Building Permit No. 4116-Z dated NOVEI~BER 4¢ 1968 __ 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 ENCLOSED POR,C~ & ATTACHED DECK * The certificate is issued to H. ELLSWORTH F~ (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROUAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED * THIS CO UPDATES CO Z-3611 DATED OCT. 21, 1969. Rev. 1/81 OCTOBER 20 ~ 1969 , ' / B~ding Insp~6~or FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-22617 I~te: 09/27/93 T~IS u~TIFIES that the building NEW DWELLING Location of Property: 9280 NASSAU POINT ROAD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~ap No. 473889 Section 118 Block 6 Lot 6 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Buildin9 Permit heretofore filed in this office dated NOVEMBER 1, 1968 pursuant to which Building Pe~it No. 4116-Z dated FEBRUARY 4, 1968 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 ENCLOSED PORCH, ATTACHED DECK AND ATTACHED TWO CAR GARAGE.* THIS CO UPDATEDS CO Z-3611 DATED OCT. 21, 1969. The certificate is issued to H ELLSWORTH FULLER ( OWNER ) of the aforesaid buildin9. ELRt-l~IC2%I~ C~RTIFIC3k~ NO. PLIERS CERTIFICATION DAT~U Corrected to add garage. 10/20/69 N/A N/A ~-Signature Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUP~ BLDG. D£PL NCY I'OWN OF SOLITHO[D 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. Commemial 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 propeO:y 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 $15.00 Date. New Construction: Location of Property: C~ c~ ~ ~) House No. Owner or Owners of Property: ~f Suffolk County Tax Map No 1000, Section Subdivision Pennit NO. L~ \ \ ~,p Health Dept. Approval: Planning Board Approval: Old or Pre-existing Building: Street Date of Permit. ~-~'/~ [ /~ (check one) -- Hamlet Block ~ Lot 5 Filed Map. Lot: Applicant: Underwriters Approval: Request for: Temporary Certificate Fee Submitted:$ ~--O.O O Final Certificate: (check one) A~pli~aant Signature -- q'--~ FOE~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 4116 Z Permission is hereby granted to: · G%~.~.~ ..~I~...A~.....]~ ,,..~1 ].,swan'.th.. F~,lle~ ............. g::t .~.~. o.g~ ......... ~I, ....... : .................. to ...... ~.~!~.1...~.. ~..e.:~.:..p.~m.f~. ~¢~:..~.~.~.e.~Ll;k~g .............................................................................. at premises located at ....~.,0...~......~. ....... ~.:~....~.O.~.3...t,.....~..,~...~,....~.,~?p, ............................................ ............................. ~t~..~.~:~..~,~;~ ......... .C~,t~--~ .......... N-,~-, ........................................ pursuan,t to application dated ........................... ~DJJ.. .......... ~. .............. , ~9.~.~..., and approved by the Building Inspector. Fee $..t~..,.(,~ .......... Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .Nal~la~l. PoSit..Road ..... Street Map No..t]az~all. P.~,Block No ........... Lot No..~2. Px. opert~.e~ l~ap No. 7~ ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .... }Iovelllhel7 .....1 ,~, 19..68 pursuant to which Building Permit No. ~.'[16.7... dated .... l~ove~beI, ..... ~,.., 19..68 was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... pr. iva~;t~..one..fam~'[y, d}zelling .................................... The certificate is issued to ...It,. gll~.oX'~h. Fulle~. .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .0e.~.o~er .... 20.,... 19.6.9. ........... Building In~;~t;;~ '~i9 ...... TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building locate~ at . .]~aasau. P~iat. 2,oad. .... Street Map No..I~a~a~l. P,t.Block No ........... Lot No..~2 ............................. Properties Hap No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ltove~her ..... l ~., 19..68 pursuant to which Building Permit No..~.l. 16. Z. dated .... l~oVembel· ..... I~t. ., 19.. 68 was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ... pm. lva~;a .one..fam~r. d~elllng .................................... The certificate is issued to ...H.. P,,lls~.o~gl~. P~le~.. ............................. of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) · .O¢.t.~ber ....20.,...19.69 ........... " ...... House ~ 9280 Nassau Point Road S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date /~-- ~'~ Bldg. Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure (Giv~ deed location) .... J located have been inspected by this department and found to he satisfactory. District Engineer Form No. 6 TOWN OF SOUTtIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 an UPDATED APPLICATION FOR ~ERTIFICATE OF OCCUPANCY This application must be fil~ed 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 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 ~lan 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 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 - $5.00 over 5 years - $10,00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residengial $15.00, Commercial $15.OO Date September 24, 1993 New Construction ........... Old Or Pre-existing Building,,.X, ......... .... ~Location of Property. .......... i~S_$~ ....... P. oi.n~ Roa,d, ........... ................................... House No. Street Hamlet f ~r - H. Ellsworth Fuller Onwer or Owners o r oper[y ............................... · ....... · ........................ iCounty Tax Map No 1000, Section .... ~.!.8...0.q...BIock' ,.q6..00 . T t 006.00 iSubdivision0 .Map.of .Nassau .RQ%nt .C%u~ .P.~o~2~.~t.~e. sFiled Map...1.5,6, ...... Lot. 92 ' George Ahlers A/C i'ermit No,..4,116.,.,......Z ..Date Of Permit .... ~0~./4/68 .Applicant. H. El,lsworth Fuller !{ealth Dept. Approval .....................- · · · · Underwriters APproval ........................ ilanning Board Approval ........................ ~equest for: Temporary Certificate. ~ ..... Final Ccrticate. . ~ee Submi/ted, $ 50.00 y~ ~, TWOMEY~ LATHAM~ SHEA ~ KELLEY 400 TOWNLINE ROAD HAUPPAUGE, N.Y, 11788-2830 516 - 265 - 1414 Town of Southold Building Department P.O. Box 1179 Southold, NY 11971 Attn.: Tom Fisher Re: Application for updated of Certificate of Occupancy No. z 3631; and Application for a Permit to Build a Shed Premises: Nassau Point Road, Cutchogue, NY Dear Mr. Fisher: Pursuant to your telephone conversation with David Dubin on September 23, I have enclosed a completed Application for an Updated Certificate of Occupancy for the referenced premises and an Application for a Building Permit to build a shed. Also enclosed with the applications are the following documents: 1. Copy of existing Certificate of Occupancy No. Z 3611 dated October 21, 1969; 2. COpy of existing Building Permit No. 4116 Z dated November 4, 1968; 3. Copy of the updated survey reflecting porch and deck which should have been included in the original Certificate of Occupancy; and 4. Photograph (original plus two copies) of the front shed; and Page 2 September 24, 1993 Hr. Tom Fisher 5. Checks in the amounts of $50.00 and $35.00 for the respective application fees. Please update the Certificate of Occupancy as soon as possible to include the porch and deck. Mr. Puller's closing is scheduled for October 1, 1993 and we will need to deliver the updated CO at closing. If you require any further information to expedite processing the enclosed applications, please contact us immediately. Thank you for your assistance. Very truly yours, Secretary to David M. Dubin LAS:me encls. V. P'~ ~../-- ~ [. q BUILDING DEPARTMENT'~,~,,'¥^ ............ ........................... . ~.~r~ ~lc .............. ~ .......................................~ ' . ~ ~ ~ ~ " ~ .......... ................. ~, ........... ~.Z ...................... , ]~...~.~. , INST~U~TION$ ,. ' ~is ~pplication must be ~ompletely fHl~d in by typewriter or in ink ~nd submitted in duplicate to th~ Building In~ector. b. Plot plan s~owlng Ioc~tion of lot ~nd o~ buildings on pr~mises, r~l~tions~ip to odjoining premiss or public str~et~ or areas, ~nd giving ~ detoil~d d~scription of layout of property must ~e drown on t~ diagram w~ic~ is ~rt of t~i~ ~pplic~tion. c. ~e work covered by t~is ~pplic~tion ~y ~ot be comm~n~d b~or~ i~sua~ce of Building P~rmit. d. Upon ~pprowl of t~is ~ppli~tion, t~ Building Inspector w~ll issue a Building P.rmlt to t~ ~ppfic~nt. Suc~ permit shah ~ ~ept on t~e premises ~v~il~bl~ for inspectio~ t~roug~out t~e pr~r~s~ of t~e work. e. No building s~il ~e ~upi~d or used in w~ol~ or in p~rt for ~ny purpos~ w~t~v~r until ~ ~e~ffic~te of Oc~upanc~ s~ali ~aw been granted by t~e Building Insp~tor. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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 oil applicable laws, ordinances, building code, housing coc~e,~and regulations. (S'g ature of ~plicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engi~~l contractor, electrician, plumber or builder. Name of owner of premises ..................~..,. ....... ~.//3....1~..~...~..~. .............. ...~.~./.~..~.~. ............................................................. If applicant is a corporate, signature of duly authorized officer. ................................................................................................ (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Mop No,~: ..................................... "~1~ ~. ~.pt No.: ....i~..~,i ............ ............... ...... ........ ...................... .......................... Street and Number 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ................................................. ~..~_..~.~..,..~.....; .................................................... Intended use and occupancy ........................................... ...~.'..~ .......................................................... 3. Nature of work (check which applicable): New Building' '~'"~ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated ................... ..a~. ?./..~'. ~.~..: ~..0. .................. Fee .......................................................................................... Cost (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... .? ............. Number of dwplling units on each floor ....?...~.~...d.~.'~.. ........ 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 .................................... Rear ............................ Depth ........................ Height ....... ~...~. ....... Number of Stories .......... ./...J./~ ......................................................... 9. Size of lot: Front ......... /...~.,~ .......... Rear ..... ./...O..(~ ...................... Depth ........... ~..~..$~ .......... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........................... ~. ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ~ ......................................... 13. Name of Owner of rem ses ~/.J.~'~°¢Jrj~ .~.~.J..~.¢ 'e'oI ~ ~,1 1 ~..o/ q ~ ' p ................................. Address ....... ~.ff.q,.~...¢)......~.~.;.il~....~Yhone No. ~.~/....~..~..~.. Nome of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .~.~.. ~.~1.~.~...(.~ ...... Address ....~..'?..~¢.,~....l~.~...~.~.~'..c.~ Phone No..?.~..~.,.~..~.~.~. 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. ? Z S ATE OF N~ YORK, t c e COUN~ OF ................................ ~'~' ........................... ..................................... (U~me o~ ind~duol sionin~ opplic~tion) ' ~' ~ ~ obovo homed. He is the .................................................................. ~ ......................... .~ .................................... {Co~tr~ctor, ooent, corporot~officer, etc.) of soid owner or ownors, ~nd is duly outhorized tO perform or hove performed the soid work dnd this oppllc~tion; that oil stotements contoined in this opplicotion *to true to th~ best o{ his knowledge ond belief~ ~nd thor th~ work will bo performed in tho monner set {o~h in the opplicotion filed therewith. Sworn to before me thi~ ~oto~ ~ lic,. unty ~ ............................. ~ommission [x~res ~arch 30, 1~ AREA = 1.261Acres to tie liees SURVEY OF LOT 92