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Home My WebLink About6274-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-19791 Date MARCH 14~ 1991 THIS CERTIFIES that the building NEW DWELLING & ACCESSORY Location of Property 8795 NASSAU POINT RD. House No. Street County Tax Map No. 1000 Section 118 Block 4 14.2 Subdivision AMD A NASSAU POINT Filed Map No. 156 70 conforms substantially to the Application for Building Permit heretofore November 2, 1960 & filed in this office dated November 3t 1972 pursuant to which CUTCHOGUE { N.Y. Hamlet Lot Lot No. Z-1248 (Dwelling) November 2, 1960 Building Permit No.6274Z(ACCY) dated November 30, 1972 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 DW~.LLING & ACCESSORY GARAGE (ZBA APPROVAL) * The certificate is issued to of the aforesaid building. ROSEMARIE BURNSIDE (owner) N83791-APR. 12t 1973 (GARAGE) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *THIS CERTIFICATE UPDATES CO Z-1079 DATED 7/27/61 (New,~Dwelling) and CO Z-5233 DATED 6/28/73 (Acce?ory/arage). _ ~ %J~'u~ding Inspector Rev. 1/81 FOB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PR, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 627 Z Date .............. M o~'~llhel'. ......... ~ ........ , 19..~2. Permission is hereby granted to: · To~el2t.. J~ ezka sJ;J......AZC..~.~u~ .~mmstde ......... ~,~.t~aok ......... : ...................................... to ..~.d....p~.~..~IIIl[~...~ala ............................................................................................... ................................................ .(. ~.~..r..o.y..e..d....~...~.d....i~.e.~S~ ....................................................... at premises located at ....~.~.....~AJ.S&U..~.o~Ltl~,..~:Io&CL ...... ~-at..~...7O.= ...................................... .................................... ...~...tch.o.~. ~,.~ ................................. pursuant to application dated ..................... ..~.~).T. ....... ~ ................. , 19~,..., and approved by the Building InSpector. Fee $.1. .0. ,.~. ........... / ' Buildln~ Inspector I FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy NoZ..~233 ...... Date ............. ~Tg~e ..... 28..., 19. THIS CERTIFIES that the building located at . .1~/1~ .l/as~u.. P. oint. Road Street Map No.lla s s,..P.t o. Pl~k No .... xx .... Lot No... F0 .... ~u.~.ch0glt~ .. N...Y.: ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... l~ove .... 3', 19'~2 · pursuant to which Building Permit No...62.~-Z dated ......... I{~.... 3.0. .... , 19.~.2., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .Pr~.vate. ~arage .(accessory ~utJ,d,tng,. apprav, ed. by. .Bd. Appea~,s) The certificate is issued to . .P. elk]...~.~..B~.n$~..d.e' .......~..~n.~. ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . I~oRo .............................. UNDERWRITERS CERTIFICATE No .... p~l~ ..... /~f' '-'' 'q(~' 2' ~'l .................. HOUSE NUMBER.. $~)~[ ...... Street ..... Naasall. PIll:iAI'I;. Road ........................ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Delm~tment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of accupancyv $1.00 Date ~ (~ ...~..~..l.~..~..,.~,.~ New Building ......,.~. .......... Old or Pre-existing Building Owner Or Owners~, -" ~/~ . ~9/-~Of Prope,rty .../...L,g,,4~.......~.../~../.Cf~.~ ........................................................... Su avis,on ,,ack ,o ............. .ouse Permit "o.--,~ ~e,,-, ~.~. :/..~,.~, Dote' Of Permit .......... App cant ........................................................ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .................... Planning Board ,~4~proval ........................................ Request For Temporary Certificate ........................................ Final Certificate /~'" Fee Submitted $-~..:.. ............................. Construction on above described building and.,,qermit meets all applicable codes and regulations. Applicant .....~.~ ~.'... ~/~.....~..~.... Z~.?. ~ Sworn 'o before me this ~'~' ---- _.~_ · ~ ...... day of ~.,...~.~..~ .............. (stamp or sea,) ~ Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 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. Cormmercial building, industrial building, multiple residences and similar buildings amd installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-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. 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. Busimesses $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 $15.00, Commercial $15.00 Date March II, 19~J ~ co New Construction ........... Old Or Pre-existing Building ........ Location of Property 8795 NASSAU POINT ROAD CUTCHOGUE, N.Y. House No. Street Hamlet ROSEMARIE BURNSIDE Onwer or Owners of Property ....................................................... ... .. . ... . County Tax Map No 1000, Section .... {!8 ..... Block ..... ~ .Lot .... !~f? ..... Subdivision___..%~;248 .......................... Piled Map ............ Lot ...................... 11/2/60 Permit No.. 6274 Z .I.~(~/~ BIRTWHISTLE ~9~ .............. Date Of Permit ...... Applicant ................ ~. %.~.C. Health Dept. Approval ......................... Underwriters Approval ......................... Planning Board Approval ....................... UPDATED Request for: Temporary Certificate ........... Final Certicate.. 50.00 Fee Submitted: ~ 50.00 ~9~L_~ q~qV. CRAIG GIBSON, ATT¥ TOWN OF SOUTHOLD ~'- 7- ~ - . ~ -- BUILDING DEPARTMENT ~/ ~~/ ~ ~ ~ TOWN CLERK'S OFFIGE ~ //~ ~ [ ~ ~ ~ ~pplicotion No ............... ~. .............. (Building Inspector) APPLICATION FOR BUILDING PERMIT -~ Date ...]~9.~:~l.]~.~I~ .............. ~ ........ , 19..7..2.......g', INSTRUCTIONS. a. This application must be cor~pletely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, w 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets or areas, giving a detailed description of layout of property must be drawn on 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 O~ 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 Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction (~f buildings, additions or alterations, or for removai 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 inspections. (Signature of applicant, or name, if a corporation) Main Street, Southold, N.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ ............................................ A~emC...f~.. 4)wae~ y .. ~AI&L.. J.v..~..~][~E ................................................................. Name of owner of premises .................................... pAITT.,.J....P, UR~S.T. DE ..................................................................... If applicant is a corporate, signature of duly authorized officer. IName and title of corporate officer) Lo 70 1. Location of land on which proposed work will be done..Map No.: ...[.5..6. ........... t No .............................................. East side of Nassau Po~.nt Road Street and Number ........................................................................................ _,%]a~sau../{.o~ztC. .................................. ~ 7 ~ ~- 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 ............... .3......c...a...~...~.a.~..a:.j~..e. .......................................... ~ ........................................... ur r ~c : m ..... s .............. n.. ........ .......... . Alteration ............... Repair .................... Removal Demolition Other Work (Description) 4. Estimated Cost .......... Fee ............... (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 3 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 ................................... i ............. Number of Stories ............................. ; ........................................................... ' ont 100o 05 Rear 1.00 9. Size of lot: ~r ................................................................................ Depth ......... ~..~.2..,.Q ............................. Height .................................................... Number of Stories .................................................................... 10. Date of Purchase ....A...u~.u. jLt;...~,~.~7.[ ........ Name of Former Owner ..,.~ar~.DII..R~..~CA].[ ................................... 11. Zone or use d strict in wh ch prem scs are situated .............. l{,{l~,~l,p,,~;I,~.J. ~.~q[ ~l;Z,C:l&l,t;' .......... m-al 'A" 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be regraded .......................... W excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owne r of pre mises ...P..A..IJ~...~ ~...I~.I~.~ I)t~ ~...~...~.f~.~.{g;.e. lllf, .,p. J,~.Cff, ......... G~.lc~l,en...C i.t:~ ................. (Address) 747-5608 (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Nameof Contractor JOSEPH DEJ~RKOSE Box lOl7 M~*'~'i~,~-~ ~ 9eR./,~gt, (Address) (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 wheth- er interior or corner lot. STATE OF NEW YOR~ ~ ~/~ ~. ) ~ COUNTY OF ..... ...~...~E~ ..... ) ~ .................~--~~ '"'"'~'"~'"t'~-'~'.'..~. ........................... being duly sworn, deposes and says that he is the applicant above named (ContractOr, a~ent, corporate officer, etc. J 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 knowledg~ and belief; and that the work will be performed in the manner set forth m the apphca I I r[ E K '-~ ~-~ No. 52-61611295 ........ ~.. ~ da~[~fied in~ ~o d7 ~ ~ ................. ...... z ........... // ..................................................................... uounw .................. ~...h..:....:..~..~.~~ ................................... (S~m~ of ~l~t) 44~ .0