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Home My WebLink About10342-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy September .5 8.6. No. Z14854 Date ........... '. .' ........ 19 Inground swimming po.o.1 . THIS CERTIFIES that the buitding .............................................. .31~5. L]ittle Neck R.o..a.d Cutchogue, N.Y. Location of Property .. ............ ' ....... Mouse Ivo. 1 0 3 S{r~et 3 Hamlet' County Tax Map No. i 000 Section ............ Block ............... Lot ................. Subdivision ............................... Fffed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in fids office dated · .A.u. ~ .u.s.t.. 2. ~ ......... ,197. 9.. pursuant to which Building Permit No. 1 0 34 2 Z dated ....Au. gus......t 3...., .............19.7.9.,wasissued, andconformstoalloftherequirements of the applicable provisions of the Jaw. Tile occupancy for which this certificate is issued i~ ......... In~qou.n.~ S..w.~.m.m.i.n,~ p.o..o.1 -~, The certificate is issued to S.te. phen & Frances Steidel of the aforesaid building· N/A Suffolk County Department of Health Approval .......................................... N445877 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 FOE~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 103~2 z /~ . ....... ~_.~..~_ _.~. ................ ; ...... .u ............................................................ ,. .... at premises located at~.....~..~........~...~....~..~f~.~?~.~.~.i..~.~.~:..~~ /x ~,.¢. pursuant to application doted ..... ~~....~.. .......... , 19.Z.~.~ and approved by the Buildin~ Inspector. jF Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted -, ~ 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. 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. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date .... ~/. ,~?,,/.~.~, ............ New C on s t ruc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ~1o5 £i~-rl~ kJe,c,l< l~,~,:.. C~,o-i-.cJ4oGo .~ House No. Street Ham/et Owner or Owners of Property . .~.~.~.~'jl .~.r~....~...]~.~..~.~..~.~ ~. .... .~..T~.; .( ~ .E..L,. ............... County Tax Map No. 1000 Section ...1. ~..'~ ........ Block ../.~ .......... Lot.. ~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. J.Q. ~.L.~,.. Date of Permit . ~J.q.?....Applicant .................................. 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 ~,it meets all applicable codes and regulations. Applicant....~..~~ ..................... Rev. 10-10~78 fl c. 301q BUILDING DEPT. ~ INspECTiON [ ] FOUNDATION 1ST [ ]"ROUGH PLBG.' [ ] FouNDATION ,2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS,: DATE TOWN OF $OUTHOLO 5UII. OlNG D£PART~I~NT ........... . . .......... · ............................ APPLICATION FOR BUILDING PERMIT I~STRUCTIO~S o. This application must be completely filled in by typewriter or, in ink and submitted in triplicate 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 oF areas, and giving o 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 o Budding Permit to the apphcant. 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 whcrtever until a Certificate of Occupancy shall have bee~ granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~issqapce~ o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yor_~, and f~th.er applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or f~¢' removal or demolition, as herein described. The applicant agrees to comply with all applicable, laws, ordinances, builc~g code,~,~ousi~-o~cLregulations, and to admit authorized inspectors on premises' and in b~u?dings for. necesso .ry/nspectT~ ii!i-~.)~.~.~.~....,~t_~~ ....... ......... ../.. .............. ........................... ~.[~.~i .......................................... (A'~dre~ss 9f applicant) 1 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e?ectrician, plumber or builder. Name of owner of premises ..... $~'.E~?.I~I~J~...E,~...~.E,[D.t][, .................................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .............................. 3.°~ .................. Plumber's License No ................................................. Electrician's License No ....... ~.~.~.~,,1,y. ....................... Other Trade's License No ............................................... ]. Location of land on which proposed work will be done. Map No. T,TBEjE..~9~.0..,..~.e.. [~tCjNo ......................... Street and Number ......... ~,.t,i:~L.e..~e~,k..~oe, d ................... 4~u.t.v~o§..~e .......................................................... ~/ ~c~ ~,4L~/C~,.~J P~,~C~- Municipality 2. State existing use and occupancy of premises and in~,ended use and occupancy of proposed construction: Residexce a Exisiting use and occupancy .............................................................................................................................. b. Intended use and occupancy ............................ .~...~..m...e ........................................................................................... 3. Nature of ~pr[~[(cbeck which bpphcable). New Bulldlf~g .~ .............. ~N~i~ .~..O..O...Ie...A~DA~,~ . ,:~ ..... Repm, r .................. Removal ~ .................. Demohttor'. .................... Other Work ............................................... , ~ ,! ~ (Description) 4. Estimated Cost ..... Z..~C.500~.¥i ..................................... Fee ............... .5....'~.. .............................................. ........ i (to be pa~d on filing this applicahon) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor .......................... If garage, number of cars ...... ,.2. ............................................................................................................................... 6. If business, commercial or mixed occupancy, speofy nature and ext~nt of each type of use .......................... 7 Dimensions of existing structures, if any: Front .12CI .................... Rear ...],.]~.9..~. .................... Depth .................... Height ........................ Numbbr of Stories ............ ~ ............................................................................................. Dimensions of same structureJw~th alterahons or additions: Front .................................... Rear ....................... Depth ................................Height.., ........................... N.,umber~. of Stories ................................ 8 Dimensions of entire new construction: Front ........... '. ........................ 'Rear ............................ Depth ........................ Height .................... Number jot Stories .........................................................., ........................................................ 9. S,ze of lot: Front ..].2.0. ......... i ...................................... Rear ..... ~.~L. 9. ................ ! .............. Depth ....... .]:..6...1. .................. 1~), Date' of Purchase ......... .A..u..gg..s..t....7..6. .......................... Name of FoFmer Owner ........................................................ 11. Zone or use distr~ct in which I?remises are situated ........................................... . ................................................. 1:~ Doemproposed construction vi~late any zoning law, ordinance or regulation: J ....Bi~ ............................................... 13, Will lot be regraded .~o ...................... WJJl excess fill be removed fram pram ses: (×:~ Yes ( ) No 14. ~Name of Owner of prem s~ teg.hea..&teid.el ................... Addres~i.i~;i;J~f~..] ;[~...~-.~ ..... Phone No? 3.(t...,5.~.~.8. ...... Name of Architect .............. i .............................................. Address ................................Phone No ....................... Na ~')e of Contractor ....... II PLOT DIAGRAM !.ocote, clearly and distinctly all buildings, whether existing or proposed, and property hnes. Give street and whether interior or corner rd~cate all set-back dimensions from tnd show street names and indicate ............ ~~ ......... ~,.~.being duly sworn, deposes and says that he ,s the applicor, i "(Name of individual sig~contracf) above named. ~ J ~ . % ,, ................ ..................................................................... ~ , ~ J ~ontractor, agent, corporate officer, eta ) oF said owner or owners, and is duly authorized to 'peFform or have performed the said work and to make and file d~is application; that aU sfatement~ contained in this application are true to the best of his kdowledge and belief; and that the work will be performed in t~e manner set fo~h in the application filed therewith. Sworn to befare me th~s / :NOTE: ELEVATIONS APJE DR.GED'ON AN/-..~DJIHED" -.- -. '::ELEV^TION OF IB.O'AT N.W. CO~.OF cot. "' MAP OF PEopEr~T'Y ~T PLCONIC SOUI'HOLD HOLE ..... V..XCA I'-.LT' FOR APP2OVAL OFCONSTf2UCTION ONLY _'," 5UFFOLK COUNI'Y OEPA, RTt'IENi OF APPLICANT'