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Home My WebLink About11842-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15876 Date June 24, 1987 THIS CERTIFIES that the building ACCESSORY STORAGE BUILDING Location of Property I030 Horseshoe Drive Cutchogue, New York House No. Strost I-lam/et County Tax Map No. 1000 Section 95 ...Block 4 .Lot 18.17 Subdivision M/o Oregon View Ests. . .Filed Map No. 6241 .Lot No. 17 conforms substantially to the Application for Building Permit heretofore filed in this office dated May 17, 1982 11842Z ........................ pursuant to which Building Permit No ...................... dated August 5, 1982 ............................ 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 ......... ACCESSORY STORAGE BUILDING AS APPLIED FOR The certificate is issued to JAMES P. & BARBARA W. ANDERSON ..................... ioYn'd', 'f,~4~;~:~Z~x x ................... of the aforesaid building. Suffolk County Department of Health Approval 14 /k UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: ~ Building Inspector Rev. 1/81 No. ~1842 I~ermissiofi is , T~N~O~ BUILDING BUILDING eERMiT (THIS PERMIT MUST BE KEPT ON COMPLETION OF THE WORK AUTHORIZED) Z ~ote ~ at;p~emise~ located at COU~ Tc~x Map No. lO00 !Section p~rs)dant to application dated ~lS~S UNTIL ~ ULL ~pproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted t ~ to the Building Inspec- tor 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 installa- tions, 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Cartificate of occupancy New Dwelling.$25.Q0, Acc~ssory~ Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50. ~) 0 3. Copy ofcertificateofoccupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..... .~...~....j ..... NewC°nstruction ...... Old or Prmexisting Building ............ Vacant Land ............. Location of Property . I)~ '.~./~,~SH'.O~: House No. - Street Hamlet Owner or Owners of Property · , ...... ' .......... ' ............. County Tax Map No. 1000 8action ........... Block ............. Lot ......... · Subdivision..~.~..~..~..~...¢.~?e.. ?. 5. ~.~.'<~ ..... Filed Map No.. ~7.~.~.~..Lot No .... ./.2 ....... II ~. %t,~. Appli OU) ¢J .~? ' Permit No ..... Date of Permit .......... cant ................................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ ....... Construction on above described building and pej~it meets ,~, · .~. - · · .~.' .~ '~ ppl[c~ble codes and regulations. Applicant .. . .. ~j ;~ L~.'. ....................... Rev. 10-10-78 ~FiE~D INSPECT~O~ FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER STATE ENERGY C~ODE (2nd) FINAL COMMENTS ADDITIONAL COMMENTS: 76S-1802 BUILDING DEPT~ ~ · INSPECTION FOUNDATION 1ST [ ] ROUGH FOUNDATION 2ND [ ] INSULATI~I! FRAMING REMARKS DATE INspECTOR* REMARKs: 76S'1802 IIq$ 'l'lO [,] FOUNDATION 1ST [ ] ROUGH [ ] FOUNDATION' 2ND [ ] INSULATI0~ ~/~FINAL [~ ] F~MING TOWN O* BUILDING D~!PARTM[NT TOWN CLIiRK'$ SOUTHOLD, N. Y. ApprovedDisapproved .................... a/c .~...'5..?......~.~....,_~ ~---~'~19 ........ Permit No. ............................................................................................... (Building Inspector) Application No. / / ? '-// // g~/T APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Buildin~c Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the 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 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 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 oppllcable Laws,,,Q*dinances 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 laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. · ~'~0. ~- ~60 .y(Sign/Tre of apph~n~, or ~mT; ,fl.a corpor~t~o~ (Address of applicant) / { ~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ........ h. ............. ........................................................................................... Name of owner of premises ~.~.~.~..~.~.~.'~.~.t~.~l~..~.~.~..~.~..~....~..~.~`~{~ .~.. ......................................................... If applicant is a corporal, e, signature of duly authorized officer. ............................... ............................................. (Name and title of corporate officer) Builder's License No .................... .~../../-/. ........................ Plumber's License No ............................................ E,ectr,c,an's 'icense No ........... Other Trade's License No ...................................... Subdivision Location of land on which proposed work will be done. Map No.: .:...=...~..~...~..1 ................. Lot No.../.~. ................ Street and Number .l.O...3...O......~.o.~k}...O~........~.~-.~.~/.~. ................... O Municipality State existing use and occupancy of premises and in.~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ... ! ~ I/} .~ i .... ~ ......... b. Intended use and occupancy 1.. .~ ,~0..I ...................... ! .......... · County Tax Nap No. Dist. 1000 Section q~ Block ~ot 1 .!7 ............ Rernov6l Demolitiar ..................... Oher Work ' ~ (to be paid o~ filing this application) 5. ~ dwe Ing number of dwe. ng un ts , ./ ............. Number of dwe Ing units on each f.oor ......... [. ................ If garage, number of cars ..f ............ ~ ............................................................................................................ 6. If business, commercial o~ mixed occupancy, specify nmure and extent of each ~pe of use ...... ~ ............. 7. Dimensions of existing structures, if any: Front....Hb.,.~...~....... Rear ...~.~.:.~..~.: ........ Depth ..~.t~...~. S H~gh~ ...... ~..~,:... N.~b~ of ~o~i~ ..... J.~ ................................................................................................. Dimensions of same structure with alterat,ons' or add,t,ons:' ' Front ................. q~ '~ ]~' Rear ...~......~..~ ..... De th. ~,0 ~' iHei ht ~O~. Nbmber of Stories . J'J~ ~. , ............ :.. ........... ~ ~ ~. ~..~.A. H~,g~ ...... ~.~ ....... N~m~ o~ Sto.~ .C~ ........ ~ ........... V. ........ Sze of at' Front ,L~q,~ ~¢~t Rear 9 ............. ................................................................... Z ........ "Z ........... '"'~'""~ ...... ,0. ~,~ o~ ?p~ ....~,%...~%..~z~ .................. ~m~ ~ ?o,m? 0-,~, ....... ~.0~. .................................... 11. Zone or u~e district in whic~ premises are situated ........ ~~].~J. ............................................ 12. Does proposed construction ~iolate any zoning law, ordinance or regulation: .......... ~ ....................................... 13. Will lot be regraded ........ ~ .............. Will excess ~ill be removed from premises: ~...... ~ ~.~Address 14. Name of ?wner of premises ~.~...~:..~.~ ~' ~m~ or ~h,,~, ............ : ........... ~/~ .................... ~d~ ......... ~/4 ........ ~ho.~"o ..... ~Z~ ......... Name of Contractor ~D~ ........................................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locme clearly and d stinctly bll buildings whether existin~ or ~r . . , ~ ~ ~ .... , __~ indicate all set-~ck dimensions from prope~y hnes. Gtve street and Nock number or description accord ng to deed, and show street names and indio~te ~(.: ...... . N~ ~ LoT -/ ~, k ~,~ LoT ~ STATE OF NEW, RI(._ cou~zv o~~;..,.~~.~ ............... ~.~6 .......g. ........ ~.0.~ .................. being duly sworn, deposes and says that he is the applicon, (Nome of [nd/v/dual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dgly authorized to perform or have performed the said work and to make and file this application; that all statemen;ts 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 fo~h in the application filed therewith. Sworn to before me this ~ ' ~/ (S~gnature of applicant)