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Home My WebLink About9072-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20530 Date FEBRUARY lB, 1992 THIS CERTIFIES that the buildin~ Location of Propert~ 8415 SKUNK I2%NE House No. County Tax Map No. 1000 Section 104 Subdivision ADDITION CUTCHOGUE, N.Y. Street Hamlet Block 3 Lot 12 Filed Map No._ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 17, 1977 pursuant to which Building Permit No. 9072-Z dated MARCH 8, 1977 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HF~LTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBF~S CERTIFICATION DATED ~,T.~'_~ & SUSAN HILT,RNBRAND H-026761- 1/31/92-N-2222955-2/3/92 N/~ 2~uilding Inspector Rev. 1/81 FOENI NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P'REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 9072 Z Date ....................... ~ .a..r...e..h.. ....... .~. ............ 19.22.. Permission is hereby granted to: }~ichae~...R~omeo..... A./~...A.l.f.~ed...~.~m. ............ ................ gu.robe ~.~e .......................................... to ..$.~$Ld..~r~.m&di.tio~..~m.exis.t ing.. :Lwe&l.£ng. .............................................................. at premises located at .~.°..~...s....~..I.~..s.~..A.a~.A. ....... ..N..~..~..~.a...~....F...~.~.~ ..................................................... .......................................... ~]Z~...S~unk..Lane ......... Cu~ho.gu.e ..................................................... pursuant to application dated .................. .~.f~.....].~. .................... , 19r~.~...., and approved by the Building Inspector. Form ~o.~ 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT 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 I% 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. 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 Building - $100.O0 Copy of Certificate of Occupancy - $5.00 over 5 yenrs - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ..... Zew Construction ........... id Or Pre-existin~ Build~ Location of Property .... ~f.~ .. ~ /~C~ ~ . ...... ~ ............................ House No. Street Hamlet Gn~er or Owners of Property ................................ .. .. County Tax Map No 1000, Section. Block ............... Lot ............... :;ubdivision ................ ~ . .............. Filed ~ ~p ...... Lot..~] ............. ;?Appli J ..... ?er~lt No.. ~" t d f~ ' ' ......... Date Of Permz ........ -..,... cant... . .... ~{ealth Dept. Approval. '- · ..... Uuderwriters Approval .... ................... ~ /.3~-~" ' 1 ' Board Approval .~eq~est for: Temporary Certificate ........... Final Certicage ........... ee Submitted: $. , ¢20 APPLICANT 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ]FRAMING [~NAL REMARKS: INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD SCOWl' L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 JANUARY 17, 1992 SUSAN HILLENBRAND 760 WEST END AVENUE NEW YORK, NY 10025 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~X~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT 9 9072-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. whether int~-" Gwe Street on4 ~°,l.bmldmgs. wh..c '.. ~ ...... -,,or or COrner lot. ~ u,ock OUmber or~eesrcrei~;~to~g Or proposed and, ~. . aCCording to de ,nu~cate all set--- · ~.~ ~ ed, and Show Stre~k d~mensions fr t l. ~ ~ 1~.o ~ and red,cate /