HomeMy WebLinkAbout12222-zFORM NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No .Z14099 Date Decem. ber 18 1985
THIS CERTIFIES that the building .... g.g .r .i.c.u. ~..g .u ?.a. 1...s .~.o.v..a .g.e.. b..u .5.3.d. J:..n .g. .........
Location of Property S/E cop C.g. 48 & Cox Lane Cutchogue
County Tax Map No. 1000 Section 0$t~ . .Block 0t~ .Lot 003
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building permit heretofore fried in this office dated
· g ~r.c.h..~ Y ............ 19 .8.3. pursuant to which Building Permit No. 1 2 2 2 2 Z
dated M ~ r.c~. 3 0 ................... 19 ~.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 .........
Agr~.c.u~tur. al storag.e building.
The certificate is issued to PLANTINGS BY THE SEA INC.
..................... ..............
of the aforesaid building.
Suffolk County Department of Health Approval ..... N / A
#N627193
UNDERWRITERS CERTIFICATE NO ..................................................
Rev. 1/81
Building Inspector
12222
SUlLD~NG ~ D~PA R?~
(THIS PERMIT :MUST ~BE Ki::j~T
COMPLETION OF THE WOR~ AUT~RJZE~)
ant to a cation dat~
and ,approved by the
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 features.
2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal).
3. Approval of e ectr cai nsta ation from Board of Fire Unde~vr~iters.
4. Commercial buildings, Industrial buildings, Multiple ResideriCes 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"
[and 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.
Fees:
1. Certificate of occupancy (, $5.00
2. Certificate of occupancy on'pre-ex-~ing dwelling
3. Copy of certificate of occupancy $1.00
land use $/5-/$5.00
Date .........
New Building .../.". ....... Old or Pre-existing Building ............ Vacant Land .............
Location
of
Property
Hou~ No. Street Ham/et
Owner or Owners of Property ...PJ/L .... (/*.t .........
County Tax Map No. 1000 Section ............... Block ............... Lot ................
Subdivisio~ ................................. Flied Map Nb ........... Lot No ..............
Permit No.,/~z~-2~ gate of Permit Z'-/'-~'~ Applicant
Health Dept. Approval ........................ Labor Dept, Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $..v4, .........................
iELD INSPECTION
1.
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
FLUMBING
COMMENTS
INSULATION
FERN. Y.
STATE ENERGY
C,ODE
FINAL
ADDITIONAL COMMENTS:
PLANTINGS BY THE SEA INC.
BISHOP~ LANE
~OUTHAMPTON, NY 11988
3436
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because of the following reasons.
1) The check is out dated.
2) No final inspection has been made.
Please contact our office On this matter.
Thank you for your cooperation.
Please find enclosed check #3436 for $5.00.
Building Permit 912222Z for Pirrone.
FORM NO. 6
TOWN OF $OUTHOLO
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 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 Architecl~ o~ 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 featu res.
2. Sworn statement of owner or previous owner as to use, occUpa'ncy 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.
Fees:
Certificate of occupancy $5.00
Il Certificate of occupancy on pre-existing dwelling ~r land
/
3, Copy of certificate of occupancy $1.00
t
use ~;/5'/$5.00
Date... ,.~..~ -~Z/.. ~4~. ·~ ....
New Building ,...~. ........ Old or Pre-existing Building ............ Vacant Land .............
Location of Property ....... ,~..~.~i'....~-.~. ~??..... ~. ~ .~. ,~..(~.?: ....... ~. ,~...~,
Owner or Owners of Property .... ~./.~..~..~.~ ~t;.p...~.~'.~;..~: .~.c~...~.~...(~..fi . .~, ..~..~.~. ~. ..........
County Tax Map No. 1000 Section ............... Block ..... : .......... Lot ................
Subdivision ................................. Filed Map I',1o. ~q ......... Lot No ..............
Health Dept. Approval ........................ Labor Dept. Ap~proval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $....~'..~ .~. ....................
TOWN OF SOU~THOLD ~j
~cribed building an~mit m/~s al~cod~d~ regulations.
Applicant' ~ '~'~'~'"¢~?" ~'~'Z"' '~' '//~' ' ' "; ..............
/
/
/
/
/
/
zoooso~ THE NEW YORK BOARD OF FIRE UNDE, RWRITERS
*~'[S BUREAU OF; ELECTRiCiTY
1~58~OHN STREET, NEW YeRK. NEW230~68_83YbRK 10038
~ Decet~be~ 20,
Oa,e Ap,,,ic~,ion No. o. ~lle N 627193
only the electrical equipment as described below and introduced by the applicant ~, rn~d on the abo~ application number in the premises of
Plainti~gs by the Sea Ind,, S/E Corner COx La, & Rt. 48, Cutchogue~ N.Y.
~. the followi,~g Ioc.~io.~; [] Base,..en~ [~ ls, FI. ~] ~.d FI. Section Block Lot
~ase~am~,~edo,~ Decemb~'~r 5 , 1983 andfo..d~oVei,~o,.~p~ia,~e~i~&~he~q.i~e,.en~softbi. Boa~d.
FIXTURE FIXTURES RANGES DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES FLUORESCENT
17 5
DRYERS
SYSTEMS
NO. OF FEET
OTHER APPARATUS;
Motors:l~3 H.P.
Panetboards: 1-5C~ ·
125amps.
E R ' ~ i c
A.W. OJ
OF CC CO~D
~/o
A,W. G. NO. OF NEUTRALS A.W.G.
OF HI-LEG OF NEUTRAL
3/0
John Lademann
P, O. Box 123
Cutcho~*e, N,Y.~
11935
, manngr; return to the office of i
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180;3
19Z--'~
Application No../dq~.?. ·~. ........
Disapproved a/c ........... ~ ....... ''"'~" "/W//
........................ : .......
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. Tkis application must be completely tilled 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 bnildings 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 code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of ffpplicant, or name, if a corporation)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
....... .~.?.~.e.?. .... .,,, .¢e~e,,'-~-/ do~,-/"~c~'~
· y z,..... .... ;" 'id' ".;;'~ ............... ? 7;d.~,';; ¢' 7o' 'd~' ')hP'di),' 5 ;') .....
Name of owner of premises . . '.~/.. ./'.~. d. .e.~. . .rf'7. ./~. : . ./_..~.~. ?. .~.~. .e. . . 7. .... ~ ....... '. ................... ./. .....
(as on the tax roll or latest deed)
If a~.~.nt i~°~.ncgnature °/5~ lY auth°rized °fficer'
........
(Name and title o'lbdorporate officer)
Builder's Lioen e 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 ..... .~ ............ .~.Q.~.~...~..~...~t ...................
................................................... ~.q~,~ ...................................
House Number Street Hamlet
County Tax Map No. 1000 Section ..... ~.(~ ...... Block .. ~.~". .......... Lot .... ~).~ .........
Subdivision ~ Filed Map No. M.. Lot .~.
(Name)
2. State existing use and occupancy of premises and intended use and oocupancy of proposed construction:
a. Existing use and occupancy . ..~ .........................................................
b. Intended use and occupancy .. .~4~.~.....~. ..~ ...... ~.~....~ ..................
3. Nature of work (check which applicable): New Building ....~.. .... Addition .......... Alteration ..........
Repair .............. Remgval .............. Demolition ............... Other Work ...............
4 tim d C
Es ate ost t 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 nature and extent of each t,me of use ,~..t'c.~/-/,~,-~f,
7. I)~mens~ons of ex~st~ng structures, ~f any Front ............... Rear ...... ':.~ ...... Depth ~: .' .............
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. .lear ..................
Depth ................... ~.. Height ...................... Number of Stories ......................
8. I)~ensions of entire new construction: Front .. ~ O. ~ ........ Rear .. ~.~ ~ ........ Depth . .~Q ~ .........
}{eight ...g ~ .( ....... Number of 8to,es ..... ~ 4~ ~ .............................................
9. Size of lot: Front .. ~ 9.~. ~. '
11. Zone or use district in which premises are situated ........................
12. Does proposed construction violate any zoning law, ordinance or repletion: . . ~2~22~2~2~~'.~
O
........ Yes ~o~
13. Will lot be regraded .... ~..: ......... Will excess fill be removed from premises:
Nme of Architect "~'2 ...... ~"'"~', ........... Address . PhoneNo.
Nme of Contractor ~g.¢. ~( f~.~. ......... Address ~;2g~' 2;~ ..... Phone No.~} ~=~ .....
~'~ ~'~'~}' ~ ~' ..............
PLOT DIAGRAM
Locate cleariy and distinctly alli buildings, whether existing o~e__~and~ indicate all set-back dimensions from
property lines. Give street and block inumber or description according~ed, and show street names and indicate whether
interior or corner lot. q2X Z?
_:~4e ~ (-o-IL>
STATE
COUNTY
(Name of individual signing contract)
above :named.
· being duly sworn, deposes and says that he is the applicant
He is the ............ ~.~~ ..............................................................
! - (Contractor, agent, corporate officer, etc.)
of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this
application; that all statements 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 forth in the application filed therewith.
Sworn to before me this
Not!l!y~Public .................... ~~ County
.... ·