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Home My WebLink About16197-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-21181 Date NOVEMBER 25, 1992 THIS CERTIFIES that the building ADDITIONS Location of Property 3180 DUCK POND ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 83 Block 2 Lot 19.7 MINOR SubdivisionFELLINGER-IHAR Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 10¢ 1987 pursuant to which Building Permit No. 16197-Z dated JULY 10, 1987 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 ADDITION AND DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to JOHN & MARY TABER (owners), of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. NO20885 JULY 7, 1988 PLUMBERS CERTIFICATION DATED N/A ~uilding Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17738 Date FEBRUARY 2, 1989 THIS CERTIFIES that the building ADDITION Location of Property 3180 DUCK POND ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 83 Block 02 Lot 19.7 MINOR SubdivisionFELLINGER-IHAR Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 10, 1987 pursuant to which Building Permit No. 16197Z dated JULY 10~ 1987 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 ADDITION TO AN EXISTING ONE FAMILY DWELLING. UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED The certificate is issued to JOHN & MARY TABER (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A N020885 JULY 7, 1988 Rev. 1/81 Building Inspector FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ...... at premises ,ocat~..~.....~.~...,~.......~.....~.~. .......... ~~dd~... ....... County Tax Mop No. 1000 Section .... ...(~.....~....~ ..... Block .......¢~..'~., ...... Lot No ......~...~..!...7/. ...... pursuant to application dated ....... ....~..~.....e~...~ ................ , 19.~..7., and approved by the Building Inspector. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHO'LD BUILDING DEPARTMENT TOWN HALL · 765-1802 · APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S_9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in~ system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences ~nd similar buildings and installations, a certificate of Code Compliance from arch{~ect or engineer responsible for the building. 6. Subm%t Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,' Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $I00.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.' Tempokary Certificate of Occupancy - Residential $15.00, Commercial $15.00 ~'~ew Construction ........... Old Or Pre-existing Buildine ............ -.. ' ...... · House No. Street ' Hamlet ' County Tax Map No 1000, Section...~..~ ....... Block...~ ......... Lot...~.~.'..~. ........... Subdivision ..................... . . .............. Filed Map .......... Lot..] ................... Permit No ................ Date Of Permit ............. Applicant ............................. Health Dept. Approval ....................... ·' ' Underwriters Approval ......................... Planning Board Approval Request for: Temporary Certificate ........... Final Certicate .... % ...... Fee Submitted: $ ~. ~:~ .................... APPLICANT FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted aa ~ 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 se~verage 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 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: A~ditJ. ons $25.00 POOLS $25.00 1. Certificate of occupancy New Dwelling $~5.00~ Accessory ,$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated CoO. $ 50.00 Data .......................... New C OhS tcucb i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................... House No. Street (./Ham~et Owner or Owners of Property ..................................... County Tax Map No. 1000 Section .~. ?...'~.; ~.~ ..... Block .~.o~.,.~ ...... Lot...4~./. ?t..~.. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. //4//.~..'7... Date of Permit 7.q/Z~ .~'..7. Applicant . .~..o.~I.~..~ .,~.d~ .~'.,~..~"~'~. Hea~th Dept. Approval ..................... ~ ~ .Labor Dept. Approval ........................ Underwriters Approval ...................... ~ .Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . .V~.. .................. Fee Submitted $..~.~. ................... Rev. 10-10-78 4 o z 1773~ UNO~?ION ~' Ilar) UNDATION (2nd) UGH FRAME & ' PLUMBING SULATION PER N. STATE ENERGY CODE F I'N A L/ · ADDITIOnaL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]/~U~TION [ ] FRAMING [.,'~ FINAL REMARKS. - , DATE INSPECTO~ INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION []FRAMING [ ~'"~1 NAL /~ REMARKS: ~ ~ ~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION 765-1802 BUILDING DEPT. INSPECTION [,~~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE Approved .... /.0.., 19~.?. Permit No..'/./~../..c/.7..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 'FORM NO. 1 TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT gEPTI¢ TOWN HALL $OUTHOLD, N.Y, 11971 TEL.: 765-1803 CALL MAIL ./. ~).., 19 ~.7. 3 SETS OF PLANS 0.~ .... PORM ............. : TO: Date .................. , 19... INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, acc_~u_ra3.e_ plot vlan to .~scale. Fee according to schedule. ~. b. Plot plan showing location of lot and of'buildings on premises, relationship to adjoinihg 13remi~es ~r public sireets or areas, and giving a detailed description of layout of prope/ty 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 pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Cou.hty, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, ad&trane or alterahons, 6r for removal or demohtlon, as hereto des nbed. The applicant agrees to comply with all applicable laws, ordinances, building comte, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary i p tions. - , (Mailing address of applicant) /O,y State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. .... ................................................................................. Name of owner of premises. ¢/~./.~..A~..'fT. ~/'_~jtf-/~.Z ~.L. ~ ................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No.. G:-.....~7.. ~; .~.~..q .~...d'.~ ,~r ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done... ~v-~/~ .... ~.~.Cf~.. ~.Z~.. ~. ................ ..,0.:/x,:. .................................................. ............. House Number Street,?3 Hamlet County Tax Map No. I000 Section :'/'J~..'.~',~.-z-~tt~. Block .c~ .............. Lot.. / .~,. ~7 ............ r ,'nor TY .! o * OI,'w' ll,' 4e.c-. Tho c.... 5~ap No. Subdivision ........... Filed .............. Lot ............... '(k'a~r~e)" ......... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... f2/~ ' b. Intended use and occupancy ...,t~ZO./'.~..c~..~.....c~....~/f..~d'f/~..~.~.... r/Cz'~5~d .Z(' .,g~. ............. 3. Nature of work (check which applicable): New Building ' Addition ......... Alteration .......... ~ Repair Rembval Demolition Other Work (Descriplion) 4. Estimated Cost .~..~tptZ!(~. C~ ....................... Fee ...................................... · (to be paid on filing this application) ~. If dwelling, number of dwellingI 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 9f use .'.'. '..' ~,~. ,.ff/~_ ........... 7'. D~menmonsofexishngstmctures if any: Front· ,4~:... . . Rear .. :~ , ~ Depth .':A,~O~. ...... Height .. ~. ......... Number of Stones ....... .t~,. .......................... : ......... '/ ......... Dimensions'of_same structure with alterations or additions: Front .... .Z//./. ........ Rear ... ,~-/ ........... Depth·..11~.. ~ ...... ;... He,ght... ~...... .......... Ntu~nber of Stones,·· ~ ........ / ...... ---8. Dimensions of~,ntire new construction: Front t,,~.~/t..... Rear .. ~Q.~./. ..... Depth ...~/. ........ 9. Sizeoflot: Front ...... .,...!..., .....'-i , 'Rear..i';. ..,~, '..,..¢. ...... Depth . ............ , 10, Date of Purchase .:. '~'~.'.~i' · '. ...... i ....... ~_. Na, me of Former Owner .'~/7~, · 11'. Zone or use district ~n which p~emmes are mtuated/t/~,~/C_g~v~.j¢~/_,-.. ,,~/~4- ../,J~;(,..- ............ 12. Does proposed construction vi,olate any zoning law, ordinance or regulation: ...zqY4~ ......................... 13. Will lot be regraded .... 4JDI. , ............. .. ....Will excess fill be removed from premises: C/X~es No 14, Name of Owner of premises--t~/~y¢~/.~/~. ~.~Address--~. [~!~d .~. Z~.~2. Phone No, 7.~.~. '~..~-~.~. ~. · Name of Architect ......... (L/x/~ ...... _...,~ . . Address ................... Phone No ................ Name of Contractor-~.'O~/,).._~/x~/~..,~..~,~.. Address .... ..~'~.4~t~ ...... Phone No.... ~I~F(~.. ..... 15. Is this property locatediwithin 300 feet of a tidal wetland* ~Yes ..... No · If yes, Southold Town Trflstees Permit maybe required. i PLO'r DIAGRAM i Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate whether inter' ............ ~ PPS. II ' STATE OF NEW YORK, COUNTY OF. ~ui~ol,k ..... S.S ............. .Og.h.n' .A... ~'ia.b.eF ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named . He is the ..................... ~ .................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du'ly authorized to perform or have performed the said work and to make and file this 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 mann ~r set forth in the application filed therewith. Sworn to before me this ..... 0'UO~ ............. 19 87. ................ County ///fi~...~~ , NANCY T. Fu$CO (Signature of applic ) QuaBfJed Suffolk