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Home My WebLink About13403-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... .g.~ .~fi. 9..7 ....... Date June 9 1986 THIS CERTIFIES that the building . remodel & add. to garage & convert to dwellin~ Location of Property 6270 Wunneweta Rd. Cutchogue House IVo. Street Hamlet County Tax Map No. 1000 Section ..... 1.1. ! .... Block ~ 4 .Lot 2 2. ~ Subdivision .~.a..s.s.a.u...~.~....C..~.u.b..?..r.o.p.e.r..~y..Filed Map No. 156 .Lot No. 230 Amended Hap A conforms substantially to the Application for Building Permit heretofore filed in this office dated August 30 198.~ gp 13403Z ....................... pursuant to which Buildin ermit No ...................... dated ....... .~.uti. u..s .~..5.1. .......... 19 .~. 4. ,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 ......... Remodel & addition to garage & convert to a one-family dwelling. The certificate is issued to THOMAS SAMUELS ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval 14 - S O- 08 UNDERWRITERS CERTIFICATE NO. . . N 7 z, 5777 Building Inspector Rev. 1/81 i~0u-re' NO. It TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13403 Z Doto .... .~ ......... ~] .... I9.~.~ Permission is hereby grantedJ~, ~ . .... ...~?..~.~ ..................................................... ,-.-:v ,, . ,.,:";':'Z~ ....... '_'"""'¥~ ........... -- .... ~' " ~ ,. ,o'..~,~..~...~,...T~......~.~..~...~..~.....~......c~.... ........... ....................... , ...................... .... I ....~.~...6........~.~.~6/~ a Co-n~ To× Mo, No. ~000 Sec,on~....tt..~ ......... B~ ....... ~.~ ......... ~o,,o ....... opprov~ by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao Bo This application must be filled in typewriter OR ink, and submitted I~ 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 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), Nomconforming 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 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 $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ?_/~,.~./..~..~. 5. Updated C.O. $15.00 Date .................... New Building ............. Old or Pre-existing Building b'~ Vacant Land Location of Property .......................................................... House No. Street Ham/et County Tax Map No. 1000 Section .. ({.I.-'.;.~3,~/,'~lock ............... lot ................ Subdivision{v~,"'~.~,. ~.~, ,~. ~ ,/~,~. ,'..Filed Map No ........... LotNo .............. Permit No..~.3..4.0.3.~... Date of Permit .......... Applicant ~.~-L...~...~. · · . .~. · . .t~.O..~.~ .'~..~..~M~ Health Dept. Approval . ~". ' : ............ Labor Dept. Approval ........................ Underwriters Approval .~~']7 .......... Planning Board Approval ..... /../ ........ Request for Temporary Certificate. :(~_ ................ Final Certificate ...... .~' ............. Fee Submitted $..'~ ~.~..~.. ~'~..?.~) Construction on above described building an~lfl~.,e,~fi~ .meets all,~pplic.~t~le codes and regulations. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. owner '-~. ~o,,.w,,~,z.l_'3~ (please print) ~p±ease prxf%t) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s-signature)d~' - Sworn to before me this 3/ day of ~.~ , 19 ~- Notary Public Notary Public, ~,/~/f~__County FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING COMMENTS INSULATION PER N, STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: d A~ lr~ ~ Ct, d ~. o4'-f J.O Cc) L~ I~oo ~L~6 Loss '70 -_ 376o O.oq7 -= 2~7~o o.~% = 7_zt ~o o.~-~ = sStto 6.5-0 : 33'0 Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 3/12/86 Dr. Samuels was notified that 3-BP are waiting to be finalized. 10448Z 12208Z 13403Z Greenhouse--Leanto Inground Pool ND--~onvert garage to) C.O. applications were sent. He will be scheduling inspections for all. Or he will be having the builder get in touch with us. George Pontino YORK STATE DEPARTME[~T OF~ENVI?DNt,~NTAL CONSERVATION Regulatory Affairs Unit Bldg. 40, SU~Cf--Room Stony .B.r~aok~-NY ..... ~-';"'(5i6) 751-7900 be;n oL ou, proposal ork S~a~ Depar~n~ of parcel ~ project CO be: X __Greater than 300' from inventoried tidal wetlands. -- Landward of a substantial man-made structure ~,h.%e~ ~l<Le~ greater tha 100~ in length constructed prior to September 20, 19~7. ~ __ , ware oz lu contour e&evat~on above ma~ sea level ~ a gratual, nat- ural slope. __ Landward of topographical crest of bluff, cliff or done in excess of 10 feet in elevation above mean sea level .... Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental Conservation Law) is required at this time since the current proposal is beyond State mandated ]urlsdiction pursuant to this act. However, any additional work or modifications to the project may r~qulre a permit. It is your responsibility to notify this office, in writing, if such additional work of modifications are contemplated. Baniel J. I~arkin Regional Supervisor of' Regulatory Alfa/rs DJL',RNT: cz 765-18~2 BUILDINO DEPT. INSPECTION [ ] FOUNDATION IST [~ROUGH pLBG. [ ] FOUNDATION ZND [ ] INSULATION [~/~RAMING [ ]FINAL REMARKS: DATE BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. [] FOUNDATION')ND [ !~..ATION []FRAMING [//~FINAL REMARKS: DATE INSPECTOR FORM NO~ 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examine~ ~q?P.xr . .....3.~ ..... 19~.!\. \° Approved~P~.. 3.~.., 19~. 1. Permit No..~..~. ). ~ Disapproved a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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, zmd to admit authorized inspectors on premises and in buildings for necessary inspections. " ': (Signatur%o~/adpplicgfir, or a , ', :?rp ' (Mailing a{dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... %.t. '¢: .......................................................... Name of owner of premises .T.~..(3..~...oc.~.~.. ~-~'... :?..c~..~ .~..~... ~..: ................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......... .~.../7/. ............ Plumber's License No.../.~..%. ... Electrician's License No .......... Other Trade's License No ...................... 1. Location of land on which pyoposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section I I [ Block /.~. Lot. ~.~.~ 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 ...... ~T ~ .~.~ ~ ....................... ~ .......................... b. Intended use and occupancy ... ~:e~r .c{.~.&~ ~.~...~¢~y~.. '. ........................... 3. Nature of work (check which app' icable)' New Building Addition ~ ' ' Alte;at~io~J?' t~c~ ~ Repair .............. Removal .............. Demolition .............. Other Work ............... ;~ ~ ~ (Description) 4. EsfimatedCost .............. ~ ...... ~6 ~,~ ...... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling u aits ...... .:[ ....... Number of dwelling units on each floor ................ If garage, nmber of cars ......... ~. ~ ........................................................ 6. If business, commercial or mixed, ~bccupancy, speedy nature and extent of each type of us~ ..................... 7. DimensiOns of ~st~g, stmctur~s~ if any: Front...~.C Z. ~.... Rear ... ~, ~ .... D~pth .. ~/.~.( ..... HeiSt . ...... '~ ~. .... Number of Stories ..... ~ ..................................... ~ .......... Dimensions of same structure with alterations or additions: Front .... ~ ~f~ ...... Re~. · ~. ~ .~ ........ Depth .......... .~. ~ ....... .~. He~t ..... ~ ~ .... , .......... Number of Stones ........... ~. ~ ........ 8. D~mens~ons of entire ~ew construction: Front ...... ~ ....... Rear ...~ ......... Depth . ~ ........... HeiSt ....... ~ ..... N~m~e~ of Stories.. ~ ...... ~ ..................... , .__,.~ ...... . ....... 9. S,zeoflot. Front ...... ~.~ .......... Re~ ......~ ........... ~th ~.~ ............... 10. Date of Purchase ....... [. ~,~ ................ Name of Former Owner ,~ ~..~ ~.. ~.~.~ ~... 11. 12. ~13. 14. Zone o~ use district in which premises are situated ........ ~ ~ .S z~.~a.£ ............................ Does proposed corn 'u~tion ,iol ~ Any zoning law, ordinance or regulation: ... ~. ~ ..................... Will lot be regraded ........ ~ . ............. Will excess fill be remoEed from premises:~_ Ye~ of of r Pnon No. Nme c c X . .~..~Address .~'~ .~,~, ........ Phone N~e r ' ~ t- . Address / PhoneNo .3 /~.~. ....................... · ',osed, and. indicate all set-back dimensions from and show street names and indicate whether Notary Public~, .............. ' ....... . ~ EXpires March 30. .............~ ~~ .......... being duly sworn, deposes ~d says that he is the applicant.' (Name offndi~duai~igning contract) above n~ed. , He is the ...................... ' ...................................................................... ~ ~gent, corporate officer, etc.) of said owner or owners, ~d is d¢ly huthofized to perform or have perfomed the said work ~d to m~e ~d file this app~cation; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be performed in ~e m~er set forth ~ the application filed therewith. Sworn to before me this ....... i~/~ ........ day bf ......... , 19 (Signature of applicmt) ~ c.~l~* $0%1" POND