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Home My WebLink About12294-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No...g.1.1.8.1.7 ......... Date ...... .J.u.l.y..2.9. .................. 19 .8.3. THIS CERTIFIES that the building ...ag.c.o.s..sp.ry.. s..tp.r.a, cj?..s.h..o.d .................... Location of Property ..... ~..~.6.5. .............. Dean Drive Cutchogue House No. ' ..... 'S'tle~i ....................... h~l'ei County Tax Map No. 1000 Section .... 1.1..6 ..... Block . ...0.5. ......... Lot.. 9.0).'. 99.2 Subdivision ........ .x ...................... Filed Map No ..... x....Lot No .... .x ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...~.p.r.&~..4 .......... , 19 .8 .3. pursuant to which Building Permit No...1.2. 2. .9.4.Z. ............ dated ..... .IV.l~y..4 ................. 198..3. , 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 tool and tractor shed. ROBERT & MARGARET RUSHMORE The certificate is issued to ..................... /o'~'n'o'r, '~) ...................... of the aforesaid building. Suffolk County Department of Health Approval .......... 31/.3, ............................ UNDERWRITERS CERTIFICATE NO .................. 31/A ............................ Rev. 1/81 Building Inspector BUILDING ToWN HALL I, SOUTHOLD, N. ¥. BUILDING~ PE ~F~i~ (THIS PERMIT MUST BE KEpT ON THE PP, E~IS~S UN~IL ~ULL COhAPLETION OF THE wOEK 'AUTHORIZED) ? [2294 Z Permissior~ is hereby gronted to: ~ .... i.~ . ~ ' ................ ~ ............. ~....~ ............... ,.~. .............................. County Ta~< Map No 1000 Secton ./.~. ........... BI°C~ .~:.;,~,~'~... ,.. ~Lot No !~.~.:~'~ pL(rs~ant tO application dat~ ~Z ........ ~:...;..:,,~...¢...., 19~ and ~pprov~ by the B~lldlng Inspector ~ · ' ~ ~ Fe ;~ ~ ~ ' ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approva~ of e~ectrical 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 peoperty 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 $5.00 / / 2. Certificate of occupancy on pre-existing dwelling ~'r land use ~/5-/$5.00 3. Copy of certificate of occupancy $1.00 ~ Date ~'- New Building ............. Old or Pre-existing Building ............ Vacant Land ............. L°cati°n °f Pr°perty~'//' ~' ' '~' ' ....... ~'~)' '~ ....... ' '~-~' ' ?"~' ' '~' ' '~' a~'~'/~ Owner or Owners of pHr~:~rt/~' . ~..~-....~..~. ~-,-~ ............. County Tax Map No. 1000 Section .. [.I..~... ....... Block . .O..~' ~.. ........ Lot..~.C2../'.-'...O..O..~t'.' Subdivision ................................. Filed Map No ........... Lot No .............. .~.~.~.o~?'. Date of Permit .~.'.~.'~.~/~..Applicant ...~:....~¢-.~....-~...~... Permit No. Health Dept. Approval .... ' .................... Labor Dept. Approval .... ~ ............. Underwriters Approval Planning Board Approval ~'- - Certificate '------ Final Certificate Request for Temporary .................................... Fee Submitted $ ............................. Construction on above describedApplicantbUilding ' ' '~' '~'~and permit ~neets all applic,~ r, egu lation s.~ ,.v.,0.,o-,a (-/ C-O FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CpDE FINAL ADDITIONAL COMMENTS: 'JOB No. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL .....~...~..Z...~' ~.~.. ............. - PLEASE TAKE NOTICE that your application dated .. ~.~.. (/....."~/. ........ 19 ~ for pe~it to construct..~aees ~e~... ~z F~;~M ........ ~ .......... at Location of Property ~ ~ ..... ~" ~ ~' '$'t/,~f .......... ~ ~0~~ Nf.,~/~i~ ./ County Tax Map No. 1000 Section .... ff/~ ...... Block .. ~ ~ ...... Lot ~.(1 .~ Subdivision ................. Filed Map No ................. Lot No .................. ~ 7 is returned herewith and disapproved on the following grounds . .~..~/./.~d~. ~-~.. f..o..../~..CJ. ..... .Ct~.,,~z~/.~.~...--....~.~.. ~ .,,'/~.c,,..../.~.. ~z¢.....--,~.~.e~..,v...-- o.~ ....... ..Ocli. e. C~. ................................................................. / Building Inspector RV 1/80 FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined t'/ / ~ /Z~f~. ......... , 19.?J Approved .~. ,*~....~. ..... ,1 .9~.TPermit No. (Building Inspector) APRLICATION FOR BUILDING PERMIT . Date .t. .... INSTRUCTION~' Application No../..~..~....~.. ....... a. This application must be completely' filled in by typewriter or in ink End 'ihbruitted :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 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 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 laws, ordinanceS, building cgde, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary)fis, pecti{~, ~~s. ' L.qdgnatu~~or name, if a corporation) State whet.~_i~licant i~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~ 1(~ ~ .... .~.'..S. 1~..14~...If/~t-~ ........................................ ~ ~x ~Oaf e /q, (as on the tax roll or latest deed) If applicant is a corporation, signature of du'fy 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. Loe. at.~on of land on which pr, oposed work will be done .................................................. .... ....... ..0o<.. ..... ................................. House Number~ J Street ~ ~ Hamlet County Tax M~-':~00 Section ..... t.(. [o ......... Block ..... .CD. ~. ......... Lot..0.?..I.: .h).O...~. .... 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......[....~.--~??.v~.,.t-..~......dYe.....'~..~..&)...~ ......................... b. Intended use and occupancy ...... '"'""-w-~. "~...O~.k~....~.. ~'~..O..~ ..... 4 . . .~<..~ ..................... 3. Nature of work (check which applicable): New Building .......... Addition ........ .1>~%?.... teration .......... Repair .............. RemOval .............. Demolition .............. Otlier Work... ~ 1'-/.~. ~.... ~ ~ ~o~ ~['- "~ .. ~/O ~ (Description) 4. Estimated Cost O ~ o ax~ Fee-.; .,~-.:...' ........ (to be paid on filing this application) 5. If dwelling, number of dwelling 'units ............... Number of dwelling units on each floor ................ If garage, number of cars ' 6. If business, commercial or mixed occupancy, specify, l~re and extent of eac_h t_,,vpe of use ..................... 7. Dimensions ofexisting structures, ifany Front ............... Rear . .T~? ........ Depth...~i~. ....... Height Number of Stories r)imensions of same structure wlth alterations or additions: Front ................. Rear .................. Depth .................... '.. Height .... "~'. ·.. ? ......... Number 9f~Stories .............. ? ....... 8. Dimensions of en¢re new construction: Front /..~. ....... Rear .../.t'tr ......... Depth .... /..~.... Height ... fl~,~.: ....... Num~ber of Stories ........ e~. ..................................... 9. Size of lot: Front ..... ~. ......... .. Rear ....... ~.l .5'~. ......... Depth .... /.oc~..-:..~.~.~. .... 10. [)ate of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ...... ~. ¢ {~ .~ 73...~ ~ ..................... -12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~.O ................ i31 Will lot be regraded L i; .'...,f~O ...... ; .... ~. .....Will excess fill be removed from premises: Yes Q~No 14. Name of Owner of premises .. ~.,../~.~.*.~.... Address ~).~.. ~..~ ....... Phone No ............... Name of Architect ......... . ................. Address ................... Phone No ............ ,_~.. Name of Contractor. i .~.~ .~.' ? .~.~,5 ......... Addres~~/~ .... Phone No. ~.~..-~../~... PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~--YORK, s.s ........ ~;'. '. '..'~.....~ .... being duly sworn, deposes and says thane is the applicant (Name of individual sigmng conf-r~ct) above named. ~e is the ........... t5¢-?~.~. ~_-~<_~..~.....~ ................... ................. ~ ~/ ~t~,.agent, corporate officer, etc.) ' . . ~ of said owner or owners, ~d is duly au~zed to perfom or have perfomed the said work ~d to m~e and file this application; that all statements contained ~ this application are tree to the best of~nowledge and belief; and that the work wffi be perfomed in the m~ner set forth in the application filed ~erewith. ~ Sworn to before me this ................ day ofl ....... Nota~ Public, ~' ~ ELz~BET ILLE, ; ~OTA'R¥ of ~ew York' ~0. , Suffolk Ooun~ .,19 (Signature of applicant) t[~e t