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Home My WebLink About11001-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-18054 Date MAY 24, 1989 THIS CERTIFIES that the building Location of Property 995 GLEN COURT House No. County Tax Map No. 1000 Section 83 Subdivision ADDITION CUTCHOGUE, NEW YORK Street Hamlet Block 1 Lot 10 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 12, 1980 pursuant to which Building Perfait No. ll001-Z dated DECEMBER 16~ 1980 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 GREENHOUSE ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ROBERTA H. RIMLAND N/A N/A N/A B~i~ing Inspector Rev. 1/81 ToWN OF: BUILDING TOWN HXLL~ SOUT.'O~O; N, BUILDING'P'~RMiT (THIS PERMIT MUST BE KEPT. ON TH, tlS[S~. UNTIL EULL COmPLETiON F THE WOR AUTH ~ N? 1~10 )1 Z Date ..... ~ ........... , 19...~ Per~ ss on is hereby granfed to: ~. ~ ~, ~ ~ ~ ...... ~~.~.....~.~.~ ~-~ .... ~ .... Z~.~...~....~Z~.,..~..,.: .......... at pi'emiseS- located at .., , ~; .~ ...~ ............ .~ ...................... ~""~i ~i:i :. ~ ~ ~.?.';.'.'~2 ..... ~.~,... ~ .............. ........................... Couh~ Tax ~n Nn ln00 Sect on ......... B ack iL. ~. ........ ~Lot No ,..,.~ZO ....... PUrsbant ia application dated ~~,}....;~ ...... ~,, 19. , and opprov~ by the Builalng I~Spector. i ~ Bumldmng Inspecto FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 76,5- 1802 APPLICATION FOR CPRTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~m ammm.mmm to the Building Inspec- tor with the following; for new buildings or new use: I. 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 dlsposal-(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 respons b e 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 property 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: I. Certificate of occupancy New Dwelling $25.00, Accessory ,$10.00 Bus"~ness $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ....M.a.y..2.4.,.~.9.~$ ........ NewCOnstruction...X... Old or Pre-exlsting Building .......... .. Vaear]tLand ............. Glen Court Cutchoc~ue Location of Property ..9.9,5. ..................................................... ..... .... House No, Street Ha~nlet Owner or Owners of Property Ro~erta .~. R±mland County Tax Map No. 1000 Section 083.00 Block 0] .00 -,,. 0'10.000 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 1.1001 Z Date of Permit .1,2/~.6/80 .Applicant . Windswa Bui ' . ........................ ~ ..... ],c] % ~g..Cg~p ...... Health Dept. ApprovM ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...... X. ................ Fee Submitted $ ............................. Construction on above described building andpermit meets all appljc, able co~es andre ulati~ , ~ ~ FIELD DNSPECTION !. COMMENTS FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY CO~E FINAL · , ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;2 Examined~":~..:..~ .... ,192..O Approve~* .... ~. ~. .... ,19~eermit No.//.n.~ ./. .Z (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.//..~.~.../. ........ Date ........ .~.~. i.., 19 INSTRUCTIONS a. 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 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 issue 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 buildings for necessary i~s~ctions. ~ ¢ ~ ...... (Signature of applicant, or nan,, iffa c~ogfforation) .../~.~ .b:4.~..~... ~..~. ~y.,.... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. l~.~./.o.~-.,..~.. .................. :./. ........ :'". .................................... Name of owner of premises....~.~.~..~?.~ .~....~...~.."~.....(~.a~l.n. t~h.h~t./:./~ :o',i ;} i:t~;t' ~d') ......................... If applica!~ cg, rporation,,sign~re,~f duly authoriKed officer. (Name and title of corporate officer) Builder's License No ........ ./rj. · .,¥~ .......... Plumber s License No.. ~..~... './(./~..~.~.. ~J Other Trade's License No ...................... 1. Location of land on which prgposed v/.orl~ will be done .............. ..... .~ ............................. ...... ~ .......... ~,,:..:...... ~./..:'~. (-.>~ ............ ~.:.. ~.: ~.~..¢~, .......... Itouse Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No...~.:~..~'.£? ...... Lot.. (il ......... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .'.~../~/'f /~ / o~f~ ~'?l /~¢r~'~ b. Intended use and occupancy ¢~2~"---- O ~ 3. Nature 0fwork (check which applicable): New Building ......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~'" i e,~ .ff..~.,_~..o~..~. (Description) 4. Estimated Cost ....... ~.m. o4-----' ............ Fe ............................. (to be paid on filing this application) 5. If dwelling, number of dwelling 9nits ............... Number o f dwelling u'nits on each floor ................ If garage, number of cars ..... ' ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurei, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure width alterations or additions: Front ................. Rear .................. Depth .................... !.. Height ......... l .~.1/ ........ Number o~_Stories ........... i~i ........ 8. Dimensions of entire new construction: Front.. ,~.~ ...... Rear..,~')d. ~..~ ....... Depth ...~. 2; ...... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ........... i .................. Name of Former Owner ............................. H. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Willlot be regraded..........., ,,..: -- . ..... . ... ......... Will excess fill be removed from premises: ..Yes_ .~ No 14. Name of Owner of premises/-~/~J'J,~ .{,J.~.af../(..D.~.~.~ Address ................... Phone N~t .~. ~'.-f')...~/f..~. Name of Architect ............................ Address ................... Phone No ................ Name of Contractor ......... j ................. Address ................... Phone No ................ Locate clearly and distinctly all property lines. Give street and block: interior or cbrner lot. PLOT DIAGRAM buildings, whether existing or proposed, and. indicate all set-back dimensions from iumber or description according to deed, and show street names and indicate whether STATE OF NEW ~K, · .- - COUNTY 0~//~' 5 . ......... · .f~. - ~.67~..'~../~.: · .f~...~..~'?..e~.'~. ·/ ............. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above, named. He is the ...................... ..~<~...~7~'~'~'~VY77'>~.~ .................................................. / k.. (Contractor, a~ent, corporate officer, etc.) of smd owner or owners, and ~s/~r~ly. au.t~6 .~..~to~6rm or have performed the smd work and to make and file th~s 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 manne~ set forth in the application filed therewith. Sworn to before me this ....... /~.~.~ ......... day o.~.~ .., Notary Public, ...; ........... ~'D~r~ ./ ,~ /~/~ ~ County .... ..-.~/2/~ ~l.Jl38k-i~ A~N NEVELE ....... ~ '/ NOTARYLF'UBLIC, Stat0 of New Y~'~"ff" ~ ~' (Signature of applicant) No., 52-8125850, Suffolh Count ...... ' ~' ' Term Fx~ir!s March 30, 19~,~ CONSENT TO INSPECTION ROBERTA H. RIMLAND · the undersigned, Owner(R) Name(g) do(es) hereby state: That the undersigned (is) (~1~) the owner(~) of the premises in the Town of Southold located at 995 Glen CourL, CuLchogue,' New York , which is shown and designated on the Suffolk County tax map as District 1000, Section 083.00, Block 01.00 , Lot 010.000 . That the undersigned (has) (~m,~r~) filed, 'or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: ........ CerLificate of Occupanqy - qreenhouse addition That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon, to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws. ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so xvith the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evfdence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: May 24, 1989 Roberta H. Rimland (print name)