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Home My WebLink About3715-zFORM NO. 4 TOM OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22891 Date MARCH 8, 1994 THIS CERTIFIES that the building. DWELLING Location of Property 4800 NASSAU POINT ROAD House No. Street County Tax Map No. 1000 Section 111 Block 8 Subdivisien Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 11 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 10, 1963 .pursuant to which Building Permit No. Z2061 dated MAY 11, 1963 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 ATTACHED GARAGE & ADDITION * The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMEERS CERTIFICATION DATED JOHN P. & SUSAN M. GANTLY OCT. 14, 1963 - R. Villa N/A N/A * THIS UPDATES CO Z-1711 DATED 10/16/63 & CO Z-3081 DATED 5/21/68 Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO%VN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No....Z~..3.CIB,1, .......... Date ...................... Jf,~,y. ......... .2..~. .......... , 19....6..8.. THIS CERTIFIES that the building located at ..~sattt..~.o.il~.~..~Qa~ .......................... Street Map No. ~.a~,~.,.,l~.lr,.Block No ....................... Lot No......C..%1.~...c..h...o.q'.q.e.~....~..e...~.....~..o.,.~..k. .................... Property Map conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................... ~a'~remher......[.8, ............ , 19..~.7.... pursuant to which Building Permit No....~.?..]....5......~. dated ............ ~o.v. ettl~ez.....21.~ ........... , 19...E~7.., was issued, and conforms to all of the requirements of the applicable provisions of the Iow. The occupancy for which this certificate is issued is ........ · ..pz.;l,?~.a.~e...~n~.. f.amJ, l~...cl~ell~g. ........................................................................................... The certificate is issued to ..... JvJzs.o...~,....~a. dc~,,..owrle= ............................................................... (owner, lessee or tenant) of the aforesaid building. TOWN OF SPUTHOLD BuILDiNG DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION ,OF THE WORK AUTHORIZED) N? 3715 Z Permission is hereby granted to." .: .......... ~t,.~.~.~,,~....~..~.,....i...,.. :... .......... et premises Iocoted at ..~..~..~.~J~J....~tl~,l~..~.~..~....~.~.:..~ ............................................. pursucm¢ to application 'doted ............................ ~,..,..~.~. .......,~...., 19.~,~,,,.., and approved by the Building Inspector.' Fee ........ TOWN OF SOUTHOLD BUILDING DEPARTMENT ~6~-1802 ,(~ /, ~PLICATION 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 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: ~J 1. Accurate survey pf property showing all property lines, streets, building and unusual nataral or topographic features. ~ 2. A properly completed application and a consent to inspect signed by the appiicant. 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 - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.O0, Commercial $15.00 New Construction ........... Old Or Pre-existing Building...%~. ............ House No. Street Hamlet County Tax Map No 1000, Section..~ll ......... Block .... .~. .......... Lot .... I.l ................. Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.~.~)~.~ ~{~ Submitted: $ ...... ............. (Sk c, s(/7 FORM NO, TOWN OF SOUTHOLD Building Depar~mem; Town Hall Southo~d, N.Y. 11~71 APPLICATION FOR C2RTIFICATE OF OCCUPANCY Instructions t This application must be filled in typewriter OR inkl and subrr~itted in duplicate to the~ Buildlng Inspec- tor with the following; for new buildings or 1low use: . . 1. Final survey of property with accurate location at all buildings, property lines, streets, and unusuaJ ' natur3l or tol3ograoh c fe,3tures, 2. Fina~ approval of Health geDz. of water supply and sewerage disposal-(S.9 form or equal). 3. Approval of electrical installation from Boar0 oi Fire Underwrhers. 4. Commercial buildings Industrial buildings, Mu tiplo Residences and sim ar t OhS, a certificate of Code compliance from the Architect or Engineer respons;ble'fo0r and installa. 5. Submk Planning Board approval of compmted site plan requirements whero applicable, the building, For existing buildings (prior to April 1957), Non.conforming uses, or b~ildinrjs and "pre-existing" land usas: 1. Accurate survey of peoperty showing all property lines, srrests, buildings and ~nusual natural or topographic features. 2. Sworn statement of owner or previous o~vner as to use, occupancy'and condition of buildings, 3, Oa[e oi any housMg code or safety inspection o{ buildings or prevnises~ Or o~her pertinent informa. tion required to prepare a certificate. Fees: 1. Certifica~'e of occupancy $5.00 2, Cer[,ficate of occupancy on pre existing dwelling or land use $5.00 .3. Copy of certificate of occupancy $I .00 Date ,, 8/18/83 New Building ............. Old or' Pre-existing Building(X} .._, .. ,~ ~Vacant Land ............. Nassau Point Road Locadon of ProperW . ,. ................ ' Srr~er Homier 0 or O of Property JP,q~ S ~q~ ~0 ~y. CeuntvTaxMapNo,.lOOOSectlon , ZZZ 8 Block Lot ' Subdivision Filed Map No - Lot No ' Permit No Date of P- r Health Dept Approval ' ......................... Labor Dept. Approval Unde~riters Approval ' Planning 9oard Approval ' Request f~r Temporary Certificate ..................... Final Cardficate Fee Submitted S .... ~: ~ ........... Construction on above d ...rtb.a budmng a,.a ~r s a~;a~q~ble ceaa.~and r~-ulation~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~ ~-( 19 ~' Examined ............................................... Approved ........................................ 19 ........ Permit No ...................... Disapproved a/c ...~.::.~,~~ APPLICATION FOR BUILDING PERMIT Application No. '~ 2/r_.~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in 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 location. 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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ................. .................... (Addres~ of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. premises .............................. ~'~'~'~. '~ ' ....~...~... $ Name of owner of -,~ .................................................................i: .................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~r..~..J"~4~;, ..~..~ ~,,~,~/~ , Location of land on which proposed work will be done. Map No: ..,...,...... o: .................... Street and Number .....~m~.~.~.,,~...P.~. ............... ]~'.~ .................... ~/..~.....y ............... Municipality State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: o. Existing use and occupancy ...... ..~...~....~.::...~......~,~.~.. .......................................................... b. Intended use and occupancy ........ ~..~,~.~, - ........ ~. ............................................................................. /N,~,~-'~-~ ,-- property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building .................... Addition ......~... ........... Alteration .................... Repair ................. ~Eemoval .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ....... ../....~...~....:...~...'~.. ......................... Fee ......... ..~--7...,...(?.'..-~. ............................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ................................ Number of dwelling units on each flaor ............................ 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 ...../..~r'.....~ ........... Number of Stories ....... ~.~ .......................................................................................... Dimensions of same structure with alterations or additions: Front ....... b.-~.....~ .............. Rear ...~.~...,~ .................. Depth ......~....¢.. ................ Height ....... /...¢~... .............. Number of Stories ....... .¢%...'_..:...-~..: ............ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ......... .~......6~.. ......... Rear ....... 2~..&.'T ........... Depth .....~.....~i~...¢. ........ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated ........ /~..~~ ............................................... o e construction wolate an zonin /aw ordinance ar re~ulationP '~ " ]2. Does prop s d ' ' y g , - . .................................................... · ~, 13. Name of Owner of prem.ses.....~....,~.~..~.,...~...~.~.~'.Address ..~~ ...... ¢.Phone NO ..................... Name of Architect ...................................................... Address ............................................ Phone NO ..................... Name of Contractor....~.....~.~:.....Address ~-~'~"~-' %' ~¢~' ................ ......... T one NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate STATE OF N~W YORK~ ) S S. COUNTY OF ............................ ................. ~ ..................... be[no duly sworn, deposes ond s~ys that he is tho applicant (~omo of individual si~nin~ opplic~tion) ~ obove nomod. He is the ............................................... ~.~ .......................................................................................... (Contractor, agent, cor0orote 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 file~he~with. Sworn to befcre me this , ~ ~ C~, - ~0 ~ da' of~/~ ~-¢~:...~c.-', 19 ~ ~-~oature of applicant) ........................ -,. ~ ,. '"*['~"'*: ...... ~' .............. 1~ ......... ~0TARY PUBLIC, State o~.N? ' ~Z' ' o 52 3233120 S~f~olK ~out~ty -- ' % ] ~erm ~xplres ~,~- 3~ 19~