The URL can be used to link to this page

Home My WebLink About12411-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-15252 Date February 5, 1987 THIS CERTIFIES that the build~g ACCESSORY BUILDING Location of Propert 935 Southern Cross Road & 1095 Holden Rd. Cutchogue,N.Y. County Tax Map No. 1000 Section I 10 .Block 05 ...... Lot 048. 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 3, 1983 12411Z ..................... , ~. pursuant to which Building Permit No ...................... dated Ju 1 y 8, 1983 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 BUILDING BERTRAN L. SAUL The certificate is issued to ........................................................... (owner, of the aforesaid building, Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CgRTIFICATION DATgD: 1/81 lrOB3g NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12411 Z Permission is hereby granted.~ / <~ .~..z~.~'~ .... Z~;....~.¢//. ..................... .../~.i~ ....... ~..~ ............... ......, .,g../~ ~. ......... :~ ~,~:~ ....... ~_.~...~ ,, .......... z~ .?. ~'~- ,o ...... ~~....~..~.~~~ ........ ~..~.~..-.~.--~ ...... ......... ........... -__ o, premises located/at ....~~ .~.ff~.C.......~..~.~..~.. ....................... ......................... .......................... County Tax Map No. 1000 Section . ./../...~. ....... Block ...~..~.... ........ Lot No ....... .~./C~..-..~..... pursuant to appJication dated ............ ./.-~.~........~... ................. , 19 and approved by the Building Inspector. Fee $ ... ,/..~... · · ,'::~, · · ...... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY FEB 2 ' 1987 Instructions A. This application must be filled in typewriter OR ink, and submitted ~a laa,a,a,~aa to the Building Inspec- tor with the foltowing; 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 Hea[th 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 Coda 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 pm~perty 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy New Dwelling, $2,5.00, Accessory ,.$10.00 Business $50.00 2. Cortificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupaocy $ 5.00, over 5 years $1~1.00 4. Vacant Land C.O. $ 20.00 6. Alteration $25.00 New C ohs t ~ u c t ion Old or Pre-existing Building Vacant Land Location of Property ........................... Hou~ No. ~ / C Street ' Ham/et . Owner or Owners of Property .... ; .................... ' ........................... County Tax Map No. 1000 Section ............... Block .......................... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No .... Date of Permit, . ...... · ................ Health Dept Approval Labor Dept Approval · Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ./~,~, ...................... Construct,on on above described building and pe~~b~ ~d regulations. /%ppl~canr . /.~ ~ r ~'H'~'~,-~'~..:. ;~ ~ .............. Rev. 10-10-78 CO~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no, 12411Z. issued to B. L. Saul on ~.8/83______ for Ac6essory is completed and a final inspection has ( ) has not ( X ) been done. In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly ~, Victor Lessard Executive Administrator VL:gar encl. FIE~D.I~SPECTION COMMENTS FOUNDATION /1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY q?DE FINAL ADDITIONAL COMMENTS~ 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING ~.,~\/ ] FINAL REMARKS: INSPECTOR ~ 'r~~' FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. '11971 TEL.: 765-180:3 Examined.. 7/~ ........ , 19..~.''~ approved . . .7../...~. ....... ,19 .~..~Permit No../..~7..5~..f/.,/ Application No. ~.~'~5~,f./. ........ Disapproved a/c ..... f_.~ . : T ............. . ~// ...... k, APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspectigr~ throughout ~e 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 B~ilding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other ~tpplicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal o~emolition, as he, x.e{n described. The applicant agrees to comply with all applicable laws, ordinances, building code, h~ing code, a~j~t re~/ulalfi'ons, and to admit authorized inspectors on premises and in building for necessary inspections. / (Sig~nature of ~[pplicant, or name, if a corporation) ...... (Maifing address of applicant) State whereat is owner, lessee, agent, architect, engineer, gene}al contractor, electrician, plumber, or builder. ~- - Name of owner of premises ~.~ .~. 0-4~ K, .~.~, ,~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... ,~. ............... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................. ./ ..... ?.&5..'7 ............... ................ House Number t/ ~')([ 5 /40 ~dp-.~ Street Hamlet County Tax Map No. 1000 Section ....... /](..~ ........ Block ~ Lot ................... Subdivision ............... ~.)(: .................... Filed Map No...)}. ........... Lot ....... (Name) 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 ...... .~..~../~?...~....~'..17...'~.. ~ · .~.~../.~.~../""fir' ¢ ..... C.,~..,{?~..-.~.~.jfl ..... 3. Nature of work (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ (Description) 4. F. stimated Cost .................................................................. , ,~,/~, (to be paid on filing this application) 5. If dwelling, number of dwallinglunits ... ,/ir,/..~?'. ....... Number of dwelling units on each floor ................ If garage, number of cars .... : ....g/~/~.. .................................. '. ........ . .............. 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 wlith alterations or additions: Front ................. Rear .................. Depth ................... i · · Height ............. ? ........ Number of Stories ........... ./ ........ 8. Dimensions of entire new construction: Front ..... /.O. ....... Rear ............... Depth ...d~.... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front ...................... Re~ ...................... Depth ...................... I0 Date of Purchase : Name of Former Owner 11. Zone or use district in which promises are situated ..................................................... 12. I)oes proposed construction vioiate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ : ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .... ................. Address ................... Phone No ................ Name of Architect ......... i ................. Address ................... Phone No ................ Name of Contractor .......................... 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 whether interior o] corner lot. STATE OF NEW ¥/~,~7/ // : S .... .......... /'..~.~. ~ ... ~~ing duly sworn, deposes (Name of individual signing contract) above named. and says that he is the applicant He is the ...................... . ................................................................... : (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perforn] or have performed the said work and to make and file this application; thgt all statements contained in this application I are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .day Notary Publi qunty .IBOB'14et~e et tle'~ ~nt~/A~'~ C/ ' Iqo. ~'~o~ Expires ~"~ ' pplicant)