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Home My WebLink About10182-zFORM NO. 4 TO~R~ OF SOUTHOLD BUILDING DEPARTMENT offlce of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17278 Date SEPT. 12~ 1988 THIS CERTIFIES that the buildin~ Location of Property. 28450 MAIN ROAD House No. County Tax Map No. 1000 Section 102 Subdivision FOUNDATION CUTCHOGUE Street Hamlet Block Q6 Lot 18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 9, 1979 pursuant to which Building Permit No. 10182Z dated APRIL 19~ 1979 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 FOUNDATION UNDER EXISTING D~ELLING, The certificate is issued to LAWRENCE KIRK (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N4 87 7 /4/79 Building Inspoetor Rev. 1/81 TO~N OF $OUTSOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING P, ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 10182 Z Permission is hereby granted to: ~t pr~mises located at ............................................................................................................................ pursuant to application dated /~f'~'~ ~' 19.~.~. and approved by the Building Inspector. Fee $...~...~..~ ..... /~- Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - [802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 features. 2.Final approval of Health Dept. of water supply and sewerage disposel-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Res dences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. §.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 pzOperty 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 an,/ housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of OCCupancy New Dwelling,$25.00, Accessory ~,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ................. NewCons f. ruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............................. .... House No. Street Hamlet Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section ............... Block ............... Lot .............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /P./. ,~.~ .... Date of Permit. ........ . Applicant .............................. .., . Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Cer~:ificate ..................... Final Certificate ....................... Fee Submitted $ ........................... ../~ // Applicant... ,//~. ,~'..~.~..~..,..~~/~ ...................... Rev. 10-10-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES ~AT Lawrence Kirk, Main Rd., Cu~chogue, N.x. was examined on April 2, ]~9 , ~ and found to be ln compliance with the requirements of this Board. 'DRYERS FURNACE MOTORS PJTUI~! AFPuANC. ~ ~T. K.W. ~4g. H.P. GA~ H.P. ~T. NO* X. W, G. EXHAUST FANS DIMMERS S E R V I C E Walter FlngeP ~05 Birch La. Cutehogue, N.Y. 11935 I1 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. _ __ COPY FOR ~ B~J,I~NI'. TI,IlS COPY OF CERTIFICATI MUST NOT MI AL . !M TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TF-~. 765-1802 Lawrence Kirk Fishermans Rest Main Road Cutchogue, N.Y. Dear Sir: This is to notify you that Building Permit No. issued 4/19/80 to Lawrence Kirk will expire on 10182Z & 10183Z If more time is required to complete the Certificate of Occupancy, you may apply, six (6) month extension. Job and obtain a >,y letter, for a If the work is not completed and the Certificate of Occupancy not issued after the six (6) month extension period, you are than required to apply for a new building permit. Very truly yours, GEORGE H. FISHER Sr. Building Inspector TOWN OF SOUTHOLD /~0 SOUTHOLD, N.Y. 11971 ~ ,'~ '~? ~/~ TEL.: 765-1802 t ~..f',./,:'4 -- --¢~/~ ~j~ ........................................ .5 L' ...... ~ 5 .~ ; T ........... ~ ...... ' (Building Inspector) ~ d b~-Q~. ~ ~- ...... IN ST RUCTIONS the a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to Buildin% Inspector, with 3 sets of plans, accurate plot plan to sclc. Fee according to schedule. 1 b. Plot plan showing l~cation of lot and of buildings on premises, relationship to adjoining premises or public street~ or areas, and ~ving a detaded description of layout of property must be drawn on the dia~am which is part of this appli*~ cation. c. The work covered by this application may not be commenced before issuance o~ Building Pe~it. d. Upon approval of ~is application, the Building Inspector will issue a Building Pe~it to the applicant. Such pemit} sh~l be kept on the premises av~able for inspection throughout the work. [ e. No building sh~l be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy sh~l have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe~it pursuant to the~ Building Zone Ordinance of the TOwn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Reg~afions, for the construction of build~gs, additions or ~terations, or for removal or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, ~d t~ admit authorized inspectors on premises and in buildings for necessa~ inspections. (Si~atum of app~cag~, or n~me, if a corporation) .............. :: ................... (Mahng address of applicant~ 7~ ' um or u der State whether applicant is owner, lessee, agent, ~chitect, en~neer, general contractor, electrician, pl ber b ii .................. ................................................................ Nme of owner of premises ......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ........................ Electrician's License No ...................... Other Trade's License No ..................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax map No. 1000 Section .................. Block .................. Lot ................. Subdivision .................................... Filed ~ap No ............... Lot .............. (Name) ' ~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /26.~ ~ ~ ~ b. Intended use and occupancy ........................................................ - ............ 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .. 1;,~,~-... Repair .............. RemoVal .............. Demolition . ~ ........... Other Work ............... Estimated Cost ..... ~' '~ i ~(~0 ~ t,~ , ~, (to be paid on filing this applicat!on) ..... If dwelling, number of dwelling units ........ I ...... Number of dwelling units on each floor ........ ?. ..... If garage, number of cars ..... , ..... ';..~.~ ~,,,.~. ................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ....... /.6. ~r~.. Rear ..... .t.~. t~F,. · Depth .... 2~ ~,' ' 1-- i~. ' Dimensions of same structure w~th alterations or additions: Front ....... ~.,~ ,-... Rear ....... ~ ~ .... Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ...L ~. ~'.-.~. ..... Num~ber of Stories ....................................................... Size of lot: Front ...........i ........... Rear ...................... Depth ...................... Date of Purchase ..... Jr?-. ~..~.~ .~.¢ ............. Name of Former Owne · '/4'¢~;W · · to~Ot'C-r-~'d~; ....... · Zone or use district in which premises are situated ............ ~t ........... " ...... ; ........... ~ ........ Does proposed cohstruction vic!ate any zoning lhw, ordinance or regulation: ....... t~ ~ ..................... Will lot be r~g'l'aded ......... i.~z. O. .............. Will excess fill be removed from premises: Yes Name of Contractor ......... ................. Address . .t~4~.'r~ Crvo%.t~. r; Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed and, indicate all set-back dj,mens]onS from property lines. G~ve street and block~number or description according to deed, and show street names arM'mdmate whether interior or corner lot. ' ' STATE OF NEW.. YORK, COUNTY OF .-).~..~:~.c?. ?)~ ...... , S.S .... .~..~.",?~..~.e¢. ?.e-.~. .... /.~. ! [~. ~..*-x, ................... being duly sworn, deposes and says that he is the a~)plieant (Name of individual sig~ing contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements confaine, d in this application are true to the best of his knowledge ahd belief; and that ~he work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary Pubhc, ............... : ......~ ~ County , ~.,, :~... NOTARY PUBLIC, State of New Yo't'~ ~o 52.812b$50, Suffoll{ County ~.-,, r×mro5 Ma/ch 30, 1~ I