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Home My WebLink About16265-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16700 Date March 14, 1988 THIS CERTIFIES that the building Add i t ion Location of Property 1575 Beebe Dr. & 25 Moose Trail Cutchogue h~ds~ ~io: ....................... 's't/o~i ....................... h~d, iei County Tax Map No. 1000 Section l 0 3 .Block 04 . .Lot 0 3 . .. Map of Moose Cove Sub&vis,on ............................... Filed Map No .... .3.2.3.0. Lot No. 10 conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .J .u.l.y...2.1.,.. ! .9 .8.7 pursuant to which Building Permit No .... 1.6. 2. 6. .5 .Z ............ dated July 23, 1987 . wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Deck addition to an existing one family dwelling. BURRIS T. JESTER The certificate is issued to ..................... [o~,n'o'r,~t&~'~)~ ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO ..... N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 ]YOR~ NO. B TOWN OF SOUTHOLD BUILDING DEPAI~TMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 16265 z Permission is hereby gronted to: .... ~....~..I...I .......... ...L.. ............................... ...~....,u~.~,.~...q..,..!..(..~..~l~,C.. to ..~~......~.....~..~...~,..~...~.....~ ........... ..........~ ......... .~ ......................... ~, ............... ~(~ ............. ~ .............. ~'"'";"W'""T"~ ......... at promises I~ated at .~.~.~..~.~.~..~..~.~~......~~ ...... County Tax Map No. 1000 Section .... /....0....~. ......... Block ....... .,O...,.LJ ....... Lot No ...... ..~....~L ......... pursuant to application dated ........ ...~...~..~.) .................... , 19~..~.., and approved by the // Building inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY fo, Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 Hca{th 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 property showing ali 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: Additions $25.00 ?OOLS $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessor:f ,$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 :feats $I0.00 5.Updated C.O. $ 50.00 Date../ ...... ' ...... NewC°nstructi°n ...... Old or Pre-existing Building ............ Vacant Land .... ,% ........ LocatonofProperty/.,.~.~.~ .... ,~l::,~..~ ., [~,~.i)(~).,~./',-- /.t~!L. ..... (, ~,/. / ~l . House No. Street ~lam/er Owner or Owners of Property . ~.%,; I.,~ ........ ~ ...... ,, . ............................. County Tax Map No. 1000 Section ... 4,P ....... Block ............ Lot ..... C.,~. ~ ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.l.(O.,~.(~';2... Date of Permit ...... pplicant .. .W;~&4.~../ ...... ~.,,~.~ (~ Health Dept Approval ' Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temp.o~a/y Certificate ..................... Final Certificate ....................... Fee Submitted $. , .~.~. ~-~'~ .................... Construction on above describod building and permit meets all applicable¢~des an,,d regulations. Applicant .... ./,~,~...,,,;4/./~,~..'/~4<~ ................. UNDATION ( 1 s t) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. STATE ENERGY CODE FINAL . ADDITIONAL COMMENTS: ~d $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined...~4~fflfl..~..~1,, 19~..~. Approved...~. ~..~..~., 19~..~. Permit No.J. ~ .~..~..~.."3 Disapproved a/c ..................................... ................................ ....... (Building Inspector) BOARD OF HEALTH ..:~- 3 SETS OF PLANS ....... FORM NO., SURVEY TOWN OF SOOT.OLD c~EcK >~] BUILDING DEPARTMENT SEPTIC PORM TOWN HALL MAIL T0: APPLICATION FOR BUILDING PERMIT Date .................. ,19... INSTRUCTIONS a. This application must be completely filled hi by typewriter 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 ot'~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, or.,d, inances, building code, housing code,t'gnd regulations, and to admit authorized inspectors on premises and in building for n,.cessary inspe/~ns. . ..y ~ ./. (Signatnre of applicant, ort'fia~nhe, ifa corporat.'o ) P.O.: .~. ~.', ~/2..C.u..rO~ ,~,.,"-" ~ ,~..>(... ,,~ (Mailing address of ECplicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ~..c~...~...c:,.../¢., ~ Name of owner of premises. ~.6t./~}'.-5.. i ./..: ~...%~. ~d.K..~.W-/~. ..................................... (as on the tax roll or latest deed) If applicant is a corporation], signature of duly authorized officer. · '(~qan~e' ina 't~t~e~ f ~;~;r'aiJ ;}h~r') ......... ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... nee[ve- l. Location oflhnd on which proposed work will be done~/~.'7.O..~..D ~ .~/..~Q....~/~/fA.~°-~...0.../Q....~.~...e'~..~.o.. O..15.... ¢)~.¢.A .s../Tb. oa.e. T~.~./.z. ................................. ¢....% q..* e~ ................... House Number Street Hamlet',J County Tax Map No. 1000 Section .... /../57..~. ......... Block ...... L~. .......... Lot .... :~. ............ Subdivision . .//)9./.(P... ~../,O..O.~..~-.'"...~. (.~ ~.O,_, ....... Filed Map No..~.~.3.O ..... Lot... 1.O......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and ocqupancy .......... O.~..e,.: .~)~..~.~[.x]. ~..er/..(( .~.% ................................ b. Intended use and occupancy .~.. f,4~..kC..~ (~o~Q,.~.. ......... . ..................... 3. Nature of work (check which aCplicable): New Building ..... ' ..... Addition .......... Alteration . .~ .......'.. Repair .............. ~Rempval .............. Demolition .............. Other Work.. ~) !~Ow.~ ...... ~.. /r9~ .~..~. (Descriplion) 4. Estimated Cost ........ .q4,¢~.,~ ............... Fee ...................................... ~ ~' (to be paid on filing this application) 5. If dwelling, number of dwellingjunits ............... Number of dwelling units on each floor ................ If garage number of cars .., . .. 6. If business, commercial or mixe'd occupancy, specify nature and extent of each type of use ' ... 7 Dimensions of existing structures, if any: Front......:. : .' .......... Rear ~ ~. . ;...: ~...Depth ' Height ............... Number of Storie ...................... D~rnensmns of smm~st~ture with alteratmns or addmons: Front ................. Rear .................. Depth ......... Hm .................... Number of Stories ...................... · 8. Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ............... Number of Stories ................. :. ...................................... 9. Size of lot: Front .......... . ............ Rear'. ......... ,~, ............ Depth ...................... 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................. 1 1. Zone or use district in which pr~mises are situated ............ 12. Does proposed construction rio,late any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ i .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. 1 ............. Address ................... Phone No. Name of Architect ......... ! . Address ............... Phone No. Name of Contractor ........ ! ................. Address ................... Phone No. 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .i~i ........... *If yes, Southold Town Trnstees Permit maybe required. ~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all s~t-back dimensions from block number or description according to deed, and show street names and indicate whether property lines. Give street and interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF .... .... ~. ~ l~ .... /..,... ~ t~ ~ ............ being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) above named. He is the ................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly authorized to perform or have perfomed the said work and to m~e and file this application; that ali statements conCained M this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m=nCr set forth in the application filed therewith. Sworn to before me this HELEN K DE VOE TARY PUaLIO, ~te of New Yo~ No. 4707878, guffo k ~oun~ Tam Expir~ Ma~oh nature of applicant)