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Home My WebLink About5860-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22674 Date OCTOBER 21r 1993 THIS CERTIFIES that the building ADDITIONS Location of Property 1050 WEST COVE ROAD CUTC~OGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 111 Block 5 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 8r 1972 pursuant to which Building Permit No. 5860-Z dated MAY 9{ 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 GARAGE & WOOD DECK ADDITION & ALTEI{ATIONS TO EXISTING ONE FAMILY D~Tw. INGAS APPLIED FOR * The certificate is issued to STEPHEN ROMAINE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *THIS UPDATES CO Z-5807 DATED 2/26/74. PENDING N/A / ~ilding inspector Rev. 1/81 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5860 Z Permission is hereby granted to: ............. ..c.~.e.,l~.... ...... ..J..~.,~. ........................... at premises located at ...... ~g;l~.~ ................... ~[llk~qaL..~.~;..~.~l~ .................................................... ................................... il~l~,..R,.mm..J,e~ ....... J,~a,,,...~'.t,....,.g.td~m.,,.ll,~ ..................... pursuant to application dated ............................. ~..~. ....... .~. .......... , 19..~.., and approved by the Building Inspector. Fee $...J,.~..aO~J ......... Building Inspector Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ; APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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. 3. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and '-'pre-existing" land uses: I. 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. 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 $15.00, Commercial $15.00 Date ..... Q~tQ~ .ZL~. ~93,~ .................... Construction Old Or Pre existi ' aw ............ ng Building ............. ocation of Property ....... JP~. ~/~. ~p.ve Rd. ..................... C. utchomue, N X. House No. Street Hamlet .S.t .ep.hen Romaine qwer or Owners of Property ............................ ~unty Tax Map No 1000, Section .... .lJ.I ....... Block .... 5. ........... Lot .... ! ~bdivision ................................. Filed Map ............ Lot ...................... ~rmit No. 5860Z ...... Date Of Permit 5/9/72 _ ~. C. Orlowski ~alth Dept. Approval ......... ............. Underwriters Approval arming Board Approval ......... ~ ...... quest for: Temporary Certificate ........... Final Certicate ........ e Submitted: $ ~.0: .O.Q. ' ' Ga.~ Olsen Atty APPLICANT FOB, M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupnncy No. Z~80.~. ...... Date ......... F.e.b .....~ ........ , 19 .?~. THIS CERTIFIES that the building located at ... l'las%, gave. P&. (1~. Loo~reet Map No. I~assmll..P~;. Block No ........... Lot No..XX .... Cuf, chogue .. N...v. · ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ l~y. - {~. -, 19. ?'2 pursuant to which Building Permit No. ~8h0Z.. dated .......... 14a~ .... 9 -'-, 19.-72, 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 P.rivate -one..f-ami. ly. d~elling..with .addition. &. a~ter~tion ....... The certificate is issued to . 1.I~..&. ~.s. · ~tlllam. Itomain, ........ ~n~r~ .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.o.R o ............................... UNDERWRITERS CERTIFICATE No .... pe~lin~ ................................. HOUSE NUMBER ....1.0~0 ...... Street ...Weat. Caxte. Kaad ...................... ....... ........... ' ' Building FOR~ NO. 6 TOWN OF SOUTHOLD Building DelMrtment 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. Approva~ 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 3. Copy of certificate of occupancy $1.00 $5.00 Date ....~.~../,~. :....~......~. · ~...~. · ......... Sworn to before me this ......... .. day of ..... Notary Public .................................... County New Building .................... Old or Pre-existing Building ...... ~ ................. Vacant Land ............................ · oca,,on of Property Owner Or Owners Of Property ..:...~.. .~ ...... ~.~ ....................... Subdivision ~.~~ ....~....~......P/5~..--~/....:....Lot No ...?,, .... Block No....--~... House No.-~, ......... , Permit No...,,~.x~...~.~..Zgate Of Pen-nit. ~....'.~..~7~..~pplicant .~...~~.'-~...-~...'....~.~ Health Dept. Approval ............ ~...~....~..~ ............. Labor Dept. Approval ........ ..'T~........~....~.. ........................ Underwriters Approval ...~..~..~...~.!..~....~.. ....................... Planning Board Approval ......~........~...~.1..~.. .................. Request For Temporary Certificate ............. ~ .......................... Final Certificate ~.~.'...~.~.: ................. Fee Submitted $ .....~..A..~ ................ Construction on above described building and per. mit meets all a~plicable codes and regulations. (stamp or seal)/~ ~' ~ O '~ '* ~"'.-CL~ / ~ ~ ~ TOWN OF souTHoLD BUIL~G DEPARTM~I~IT TOW~i CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... ~......~... .... 19...?...? ........................................ , 19 ........ Pemit No ......................... Disapproved a/c ......... Application No. APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ~' a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Build ng nspector, with,~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. .7~ 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 diagram which is pert of this application. ¢. The WOrk covered by this application may not be commenced before issuance of Building Permit. d. Upon aj~?.val of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept o~'~ the premilee av~ble.~for inspection throughout the work. e. No bulkl, i, ng shelt\beloccupied or used in whole or n part for any purpose whatever until a Certificate of Occupancy shall have beeq~ granted by the Building inspector. · / AP~PL, ICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone/~ Ordin~Lt~ o~ tl~e ToWn of Southold, Suffotk CounW, 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 taws, 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) .............. .............. State whether applicant is.qwner, lessee~ agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ :.?..~..:....~...~ ~...~ ~ If applicant is a corporate, signature of duly authorized officer. . ......... , ....................................................................... .~ (Name and title of corporate officer) 1. Location of land on which propo, sed,~work will be do. ne. Map No.: .................... .Lot No .............................................. Street and Number ......l~.....~...~....g.~..?....~...~oen~...?..~.,/..~.;..~. ' ~ ~ c>~r2, ' MuNicipality 2. State existing use and occupancy of premises and in~nded us~ and occupancy of proposed construction: b.a' Existing use and occupancy '"'~"~//__c~n.~ ...................... '~ ........... ' .............................. Intended use and occupancy ....~'.....~...~....~.~.~ .......................... 3. Nature of work (check which applicable): New Building ....................... Additien ....../~.....:...../~,lzeretlt~:~l~;: ....... Repair ......................... Removal ......................... Demolition ........................ Other Work ............................... ~.... (Description) 4. Estimated Cost ..,~,...~..,..~..:.....a~.. .......... Fee .......... ...~./., ..~..C.....~... .......................... : ..................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ~ ........ Number ~f dwelling units on eacl~ floor .......... ~ .......................... If garage, number of cars .............. ~ .............. , ................................... i ..................................................................... 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 .......~,.._~....i' ....... Depth ...~..~... ...................... Height .............. L.~-~.....~ ................................ Number of Stories ......... ~.....x .................................................... Dimensions of same structure with alterations or additionS: Front .~i~..~....~.. ......... Rear ....... .~...~...'. ........... i ........... Depth ........~...(~. ............................. Height ........ -/....~.. ........................ Number of Storms ........................................ 8. Dimensions of entire new construction: Front ........ ~ .......... Rear ....,,....:. ................ Depth .......-~... ....................... Height ............................ ~ ............... Number of Stories ..................................................... ~ ................................... 9, ' 'Size of lot: Fl;ont ..~....../....~...~....~ .............. Rear ..~...?...~.,~...~..~...t. ...... Depth .~..~..~...~.....~.....~:....~.. ............. Height Number of Stories ............................. 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. Will lot be re~'aded ..... ~ .................. Will excess fill be removed from premises: [ ] Yes 14. Name of Owner of premises ..¢.,;,.,,,..~....¢n,a~.....,,~............,~,; ........................ (Address) h ....... . ........... ~ r~ ~ ,q · /,~ (~ddr, qss} ~ (Phone No.) Name of Contractor ~, ~Jc~....~,=~ ...... ~dre~ .b..'. ..... ~ /......~...~h.~Tn.~N~.~..~..*~. ....... PLOT DIAGRAM Locate clearly and disti'nctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property tines, G~ve street and block number Or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK, ) COUNTY OF ...................................................... ) ...~.....~~.~. ............................ being duly sworn, deposes and says that he is the applicant above named. He is the ......... ~ ............... ~ ....................................................................................................................................................... (Contractor, agent, corporate 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 th~u~'~ ~ ~,ll~Rowledge'and belief~ and that the work will be performed in the manner set forth in the application filed therewith S~[~glk.~Coun~ .................. of ................ ~ {Signature of applicant)