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Home My WebLink About11917-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate OF Occupancy No. Z12245 Febru~.ry 7 84 ................. Date ................................ THIS CERTIFIES that tile building addition & cella..r 375 Eugene' s Road Cutchogue Location of Property ......................... House No. ' ..................... Stree~ Harn/e~ County Tax Map No. 1000 Section ,...0.9.7. ..... Block ....0.2. ......... Lot ....0.].6....4 .... Subdivision . X Fil d M p N X L X .............................. e a o. ........ ot No .............. confonnSMarchSUbstantiallY26 to the A~lication for Building Permit heretofore f'~d4 ~n [his office dated ...... 19.8..2pursuant to~hich Building Permit No...1.1.9 J..7 March 2 6 _~ ............ dated ..... S..ep.t.e.m.b..e.r..1. 6. ......... 19.8..2, 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 ......... an addition to existing dwelling (8449Z) & full cellar under existing structure (11917Z). ..... The certificate is issued to ..................... KA. REN ROBINS. ON (owner, ~,~,e-o~n~t) of the aforesaid building. Suffolk County Department of Health Approval ....... N../.A. .............................. -. N609971 &. N610237 UNDERWRITERS CERTIFICATE NO ..... Building Inspector Rev. 1/81 TOWN SOUTtl01~D BUILDING DEPAI~TMEN~ TOWN HALL SOUTHOLD, N~ Y. BUILDING PE~IT: ev~ 6/30/80 Fee $.../...~ ............ (THIS PERMIT MUST BE KEPT ON ~H.E PREMISES UN'elL I ULL COMPLETION OF THE WORK AUTHORIZED) N0' ~.~_~.7 Z Date i..."~'~'~..~.'~l ~.~.../.~.., 19..~,~ Permissio~ is hereby granted to:~~ . ...... ~:.....~..L...~,~ ....... L..~..~. . ........ ~Z~~.~ ....... ~..;%.....~:¢~ . ~..~ ........................ f:~_~...~...~~..~~.~ ......... ............................................................................................. ......... .......................................................................... ~ ........... .', ....... ~.. · .... : ........ : ......... .~ ................... :.~..., ....... ~' -- I and approv~ by the Building I~spector. FORM NO. 6 TOWN OF SOUTHOLD Buildin~l Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This ~pplication must be fiiled ir. typewriter OR ink, and submitted in duplicate to the Buildir~g In~ec- tot with Lbo [ollowlng; for n~w buiMings or new use: 1, Final survey of property with accurate location of all buildings, property lines, streets, and unu~al natural or topographic features, 2. ~inal approval of Health Deph of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical in~ailation from Board of Fire Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and h~stalla- lions, a certificam o~ Code compliance from the Architec~ or Engineer responsible for th¢~ building, 5. Submit Planning ~oard approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming u~s, or buildings and "pre-exist'rig' 1. Accurate ~]~ey of peoperty showing all property li~es, s~reets, buildings and unu~al rmtur~l or topogrephic features. ~. ~worrl statement of OWl-~r or previous owner as to iJ~, occupancy and condition of bui d R~. 3. Date of ~ny housing code or safety in,peet[on of buildings or premims, or other pertinent informa- tior~ required to prepare a cerfficete. 1. Certifmate of occupancy $5.00 2. Certificat~ of occupancy on pre-existing dwelling~ land u~ -. - [' ;',~ - Ex ~ :s t, ~n~; C. 0. ~ ~ 5 · 00 3. Co[,y of certif~cate of occupancy $1,00 ~ V~c~ [~nd C,O. :~ 5.00 Dam ................. {q~ ~mk~ng .. ~, ..... O d or Pre-exisLing Buildin(l ............ Vacant Land ............. .Filed Map No ........... Lot No .............. Subdivisio,~N~ ...................... ~ ~ Permit NoJ(~ ~ ~ ~,.. Date of Permit~, t(~.~.Applicant .................................. Undo~Hter* Aoprovat... ~, ~.: ............. Pla,mi~ Board Approval ...~ ............ Request for Temporary Cerd[icate.. ~ ................ Final Certificate ................ Fee Submitted $ ......... ~ ............ AND/OR FROM DATA OB~'AINED FRO3~ OTHER~ ~ ] ., ' _ .~m,o-; ~':~L.}-~, ~.:~:.~.7'. YOU,O · ~ou~o ~ 4001 ~STRANDER AVENUE, RIVERHEAD, NEW YORK : T~W. O~ SOUT~O~D'~ I rU~ r/ret ~u~urE~ ca, FORM NO. 1 TC",VN G? SOUTHOLD BUILDING D£PARTMENT TOWN HALL / SOUTHOLD, N.Y. 11971 APP LICATIO~ 7OR-BUi L~iNG PERMIT Date .. 9r/,9.f. 82 .......... /9. INST RUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted-ir, '-'"-':--*~ -,,v ...... -to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. PIot plan ~ , ' - sac.wac location of lot and of buildings on premises, relationship to adjoining premises or pubEc stre or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part oP'this ap cation. c. The work covered by this application may uot be commenced before issuance of Building Permit. d. Upon apprc:al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen shall be kept on 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 Occupar shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for th~ issuance of a Building Permit pursuant to Building .Zone Ordinance of the Toxvn 'of Southold, Suffolk County, New York, and other applicable Laws, Ordinance_~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, ,-md admit authorized inspectors on premises and in buildings for necessary inspections. ..,.. .77,.. ....... (Signature of applicant, or name, if a corporation) . .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, ~'~mber or build N,'une of owner of premises ,..Karcn..Robi~sq, B .................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) O Builder's License No .......................... Plumber's Licens: Ns ......................... Elactrician's License No.' ...................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ........................ ~ ..................... ..., · .3.7.5 ................... Euger~e: S. ¢t~4:l ,. ................ ~o.utho J_& .................. House Number Street Hamlet County Tax Map No. ~ 000 Section .............. ...~ Block ................ ..~.~ ..... LotO!~'4 .... Subdivision ~ ~'~ ~t~O~ ~1~ ~ ~ .... :., ............ , ......... r~lea ~lap NO ............... Lot ........... , , . . (Nmne) 2. S~ate existJ/Tg.use ~n'~ occupancy of premises and intended us~ and occupancy of proposed construction: Existing use and occupancy I ' ?:. b. Intended use ~d occupancy . - ' ' Removal Demolition Other Work~l~ O~ Repair ............................................ / ~ (Description) 4, Estimfited Cost ......... I' '" .......................... Fee .. (to be paid on filing this application) I 5. If dwelling, munber of dwelling un/ts ............... Number of dwelling units on each floor .............. If garage, number of cars ...................................................................... 6. If business, commercial or mixed occupancy, speedy hature and extent of each type of use ................... 'l. Dimensions of existing structures, if any: Front ..... ~ ..... Rear .... ~ ...... Depth .. ~. ~ ...... M ~ Number el Stones Height ...l .............................................................. Dimensions ef same structure With alterations or additions: Front ....... ~ ...... Rear ...~ ......... Dcpt~ ~ Hei~lt ~ ~ Num bet of Stories 8. Dimensions of,:nfirc new construction: Front .... ~ ~ .~ Rear ............... Depth .............. 9. Siz~oflot Front I~a [~ ~ il.~r~r. Depth .............. ............. Re r ... ~ .... ~.~ t0,. Date o'f Purchase ........... ~ Name of Fommr Owner H. Zone or u~e district in ~vhich cruises are situated .... ':. I1. Does proposed construction violate any zoning law, ordiaance or regulation: ........... Name:of Archi[cci ' Addres~ Phone No N of Co ~ Add ~ Phone No PLOT DIAGRAM Locate dearly ~d distinctly ~I buildings, whether existing or proposed, and. lnd~cate ~1 set-back d~,nsions property hnes. Give street and bloc~ number or description according to deed, and show street names and indicate wheth~ ;atehor or corner lot. G'TATE OF NEW YORK, COUNTY OF..,l'¥ff~.~.'w...'.. S.S ..... ~fl~ ~ ~ ~ ~ (~*~ being duly sworn, deposes and say~ that he is the app!~ea,~ ~ (Nanie of indMdual si~ning contract) ' obove nanled. is the ~~ (Contractor, agent, corporate officer, etc.) said owner or own'e~, and is d~dv authorized to perform or have performed thc said work and to m~e and file a/}plication; /hat all statements cogtained in this application are true to the best of his knowledge and belief; and that t~ W'ork will be performed in the rammer set forth h~ the application filed timrewith. ~worn to before me this z ....... d.y~ ' .... Suffelk ~un~y Ne. $2-~792800 ~ Cemmtsslen Exotics Ma~h 3~, ~o~u~z~c ....... ~ ....... i ........... ~ .... ~.. County '~