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Home My WebLink About13176-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall 5outhold, N.Y. Certificate Of Occupancy No....z.1.2.6. 0..8 ........ Date ..... ~..u~.y.. ] .7 .................... 198..~. THIS CERTIFIES that the building .T?..o..b.e.d.p..o.o.m.s.. ,o.n..2. n..d..f.l,o..O~.. ................. Location of Property 1660 Sterling Road Cutchogue 6 ~5 County Tax Map No. 1000 Section 1 06 .Block ............... Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated ..... .M .ay.. 2. .9 ..........198. ~.. pursuant to which Building Permit No, 1. .3 .1.7.6. Z. .............. dated ....... .M.a.y.. 3. J .............. 198.6. ., 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 ......... .0.n.e...f.a.m.i.$y. dwellin~ with two bedrooms on 2nd floor finished from non-habitable to habitable. The certificate is issued to .................... $9.o?.g~..T,.., S. 9.h,n.e..i .d.%r. ................ (owner,/~.~rxt~t1~tl. tt~ X X of the aforesaid building, Suffolk County Department of Health Approval .......... ~f.fi. ............................ UNDERWRITERS CERTIFICATE NO ........ # N 3 8 3 2 6 0 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13176 Z Permission is hereby grant, ed~to: ,., , ~ ~i~.~.~.,~~ ....................... .... ........ ........ ......... ...~... ~ ~.... ] '~ · ' .......... 'w~" ~-"~'; "~~'" .~ ............................. at premises located at ..[ ................. ~..~ ....... ~~~ ............... Court,-, To,< Mop No. ,000 Sec,on / ,~ ,.,L B,ock d Lo, No ...... /..6 ............ pursuant to application doted ................ )~..~......~...~. ............. 19.~..~.., and approved by the Building Inspector. Fee $.~.'~"..: ............ Building Inspector Rev. 6/30/80 FORI~ NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submittedr~u~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, B. For existing buildings (prior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing a~ property ~ines, 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/ land use --?re-Existing C.O. $15.00 3. Copy of certificate of occupancy $1.00 Vacant land C,0. $ 5°00 Date ....... .~. .............. ~ew ~uildin~ ............. Old or Pr,-~x[stin~ Buildin~ ............ Vacant kand ............. Location of Property ~ ~ Hou~ No. ~reet HamNt Owner or Owners of Property . .~~.. County Tax Map No. 1000 Section Subdivision .................................. Filed Map No ........... Lot No ............. PermitNo ....................... ~t .~..i~..A,, a t ........................ Health Dept. Approval ........................ Labor Dept. Approval ....................... Unde~riters ~proval ....... -, . ............... Planning Board Approval ..................... Request for Temporary Oertifioate ..................... Final Bertifieate .... ~ .............. Fee Submitted $...~ ........................ Construetion on above described building and p~eets all ap~l~des an~ regulations. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ODE FINAL ADDITIONAL~COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1802 . .~..~.~..1. ., 19~.~. Permit No. 1..~ ~ -/~ '~: Approved Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERI~/IlT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 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 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 pumuant 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 ail applicable laws, ordinances, bujJ, ding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessar~ection~./,~/ ff '~-~Signature of applicant, or name, if a corporation) I ~ ¢ o ~., .~:..r:~. 4.~...~...~.%....~?. ~.c~.. ~., (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... ~.~..4.~.& ............................................................................ Name of owner of premises .. ~.'~.~..~(../.~.. · · . .~...,~....~..~.4~. ~ .................................... (as on the tax roll or latesj~,~¥FD AS NO'FEB If applicant is a corporation, signature of duly authorized~;<~_l~_~officer. DATE: ~]~//-- ~. t B.P.~.~ I ~ ] '7. ~' :~ .. ..................................... ~t...~u ti ~O~p,~roa~ FEE: ,.1 ~.< -- BY: (Name and title of corporate officer) '~" I~1 ~J.J~ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE Builder's License No .......................... FOLLOWING INSPECTIONS: ~_ l. FOUNDATION - TWO REQUIRED Plumber's License No ......................... FOR POURED CONCRETE 2. ROUGH - FRAMINC & PLUMBING Electrician's License No ....................... 3. INSULATION 4. FINAL - CON'STr'J""[ ION MUST BE C'mMPLETE FOq C. O. Other Trade's License No ...................... ~ ~,c) O ALL CONSTRUCT!ON Sh-IALL MEET I. Location of land on which proposed work will be done. ~..3..'..~...'~1~ .~0! [~ '.~.~UT$. DJ:..-EktE. N~ .Y. ...... STATE CONCTRUCrTcFbN & ENERGY ..............j.. t_/D ......... .......... ..... House Number Street DESIG~Hi~il~ONSTRUCTtON ERRORS. County TaxMap No. 1000 Section .~. ].~...~.. 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 ................................................................. b. Intended use and occupancy . · ~.~/. ~>..~. G.~.. .................................................. 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ..... Alteration .......... Repair Removal Demolition Other Work ~. .~! _i~q ;b/ (Description) 4. Estimated Cost....,,(..o-~..... i ........................ Fee ...... '. / i '" (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 type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ....................................................... Dimensions of same structure With alterations or additions: Front ................. Rear ................. Depth .................. i .. Height ...................... Number of Stories ..................... 8. Dimensions of entire new const:ruction: Front ............... Rear ............... Depth .............. Height .. . Number of Stories ....... , ............... 9. S,zeoflot: Front ...;./..t~...I ...... Rear .... ./¢'J. ....... Deot~' '}.~ i. i ...... .. 10. DateofPurchase x~.~.//-- .XT?F~ Name of Former t~; ~,~." ~r~,,~,,~,~ ......... 11. Zone or use district in which p~emises are situated /~ ~s./. I>~,¢. 7Y. ~. .............. 12. Does proposed construction vidlate any zoning law, ordinance or regulation: ..,,M'..~P. ........................ 13. Will lot be regraded ..... ~.?. ................... Will excess fill be removed from premises: Yes (~ 14. Name of Owner of premises .~..~q.~..-~g4~d.~l~. --~. Address ~'~r'~.~.~?..~./~..~. ..... Phone No..7.~.~.~. .~././.7 .... Name of Architect ......... ! .................. Address ................... Phone No... Name of Contractor , Address Phone No PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property hnes. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF 'NEW YORK, JS.S COUNTY OF ................. . ............................. .................... being duly sworn, deposes and says that he is the applicant (Name of individual sign!ins contract) above named. 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 cent tined in this application are true to the best of his knowledge and belief; and that the work will b6 performed in the manta ~r set forth in the application filed therewith. Sworn to before me this ............ · ~..~,...~ .... day o~ ...... ~.Fgx~ ........ , 19 .~.~ ' · ~ // .. County HELEN K. DE VOE ~ ......... ....... NOTARY PUBLIC, State o[ Ne~ York (SignatUre of applicant) NO, 47078~'$, Sullol~ Cell~tlt ..~ j I~flll [l~pl~es March 30, 19~':~ J