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Home My WebLink About16267-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. z-16606 Date January 22, 1988 THIS CERTIFIES that the building ....C.o.n.s..t .ry.5 t...H.a.n.d..i 7.c.a.p.. y.a.m.p. ................ L ..... 3300 Depot Lane Cutchogue, New York ocauon oI ~'roper[y ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section 096 .Block 05 .Lot I 2.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 21, 1987 pursuant to which Building Permit No. 16267 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 ......... HANDICAP RAMP AS APPLIED FOR The certificate is issued to LADY OF OSTRABRAMA CHURCH ..................... ..................... 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 FORM[ NO. '~ TOWN OF $OUTI4OLD BUILDIN~ DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N*_ 16267 z County Tax Mop No. 1000 Section ..... .?..~...~. ........ Block (~' Lot No. // Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.0,0, Accessory ~$]0o00 Business $50.O0 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 Fears $10.O0 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date Jan. 22, ~988 NewConstruction X Old or Pre-existing Building Vacant Land Location of Property 3300 Depot Lade Cutchogue, N.Y. House No. Street Ham/et OUR LADY OF OSTRABRAMA R.C. CHURCH Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 96 Block 5 Lot 12.2 Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. 16,267 Z Date of Permit 7./..2.3/8.7.Applicant,Our .Lady. of Ostrabrama R.C.Church Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ -O- Construction on above described building and permit meets all applicable codes and regulations. Applicant Rev. Richard Kopinski Rev. 10-10-78 UNDATION (1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL - ADDITIONA'L COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y, 11971 BOARD OF HEALTH ...... 3 SETS OF PLANS ~ ...... SURVEY SEPTIC FORM ............. : , TEL.: 765-1803 CALL Examined.. ., 19~ ...................... ' pp o ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in 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 of a Building Permit pursuant to thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances m 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 tc admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant, s a corporation, signature of duly authorized officer. ..... .......... (Nhme and title of corporate offic-' - --' er) · ALL CONTRACTOR'S MUST BB SUFFOLK COUNTY LICENSED Builder's License No.../~¢..~. ?...'~. · ~.~-. ..... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done....~..~...o~...,~:~..,, .... .~~ ~ .~.~ ....... House Number Street Hamlet County Tax Ivlap No. I000 Section ....... ~.~. ....... Block .....~. ............ Lot.../..~.-. q,~ ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 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 .. - ...... . ........ 3. Nature of work (check whic applicable): New Building .......... Addition .......... Alterati~ ......... Repair '. ............. Rembval .............. Demolition .... Other Work ~ · (Des~rip~tion) 4. Estimated Cost .... ..~..~. ...... · ....................... Fee ...................................... " (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ................ If garage number of cars : 6.If business, commercial or mlxe'd occupancy, specify nature and extent of each type of nsc ..................... 7.Dlrae~nmons of existing structures, if any: Front ............... Rear ........ * Depth ........ ' Nmnber of Stories ...~ ..... .- ...... ~ ' ' Height ........................................................ Dimensions'~ll~e~tr~.u. re Wtth alterations or additions: Front ................. Rear Depth ................... ;.. Height ...................... Number of Stories ...................... Dimensions of entire new constructmn: Front .......... . ..... Rear ............... Depth ............... Height .. ............. Number of Stories ........................................................ 9. Size of lot: Front .......... ~ ......... ~.. Rear ....... ............... Depth ...................... 10 DateofPurchase .......... N .................... amc of Former Owner ............................. 11. Zone or use district in which pr~mmes are situated .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................. Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ........ ~ ................. Address .... : .............. Phone No ................ 15. Is this property locatedjwithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town TrCstees Permit maybe required. ~ PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all s&-baek dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~_K]/~ /'~1/ i'S S COUNTY OF.. ........... .. ~. ~'.. t~t.~r~.~ ..... .~;. ~..~. e ~4 ~.' .... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dujy authorized to perform or have performed the said work and to m~e and file this apphcatmn; that ail statements con,tuned m th~s apphcat~on are true to the best of his knowledge and belief; and that the work w~l be perfomed in the m~n~r set forth ~n the apphcatmn filed therewith Sworn to before me this Note, Public, ~~..~~~.. County . .......,... ........ ~ ~1~. 8mt~ ~ N~ ..... (S~gnature of applicant) no. 4879fi~, C~mtss~ ~ires ~D~ember 8,