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Home My WebLink About16663-zFO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20348 Date NOVEMBER 15~ 1991 THIS CERTIFIES that the building Location of Property 405 COX LANE House No. County Tax Map No. 1000 Section 97 Subdivision ADDITION CUTCBOGUE~ N.Y. Street Hamlet Block 5 Lot 2.1 Filed Map No. Lot No. conforms substantially to the Application for B~ilding Permit heretofore filed in this office dated DECEMBER 4,.1987 pursuant to which Building Permit No. I6663-Z dated DECEMBER 4~ 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 EXISTING AGRICULTURE BUILDING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED LEANDER B. GLOVER, JR. N/A H-023613 - AUGUST 1, 1991 N/A Building Inspect6r Rev. 1/81 IN)BM NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 166,65 Z Permission is granted to: ...~..z.~...~......~~. ................... ,t premises I~ated at .................. .~..../...~......~.....~ ........................................... '~'~ ':, ':"~" '~ ~':"'"~ ~'~'" ';~ '::";' ':, ':, ':," '~ ::;; ':-'~ '; ~:~i 7; i'"~ 'C' '~_...ZZ:" 'i '~;"';C"'~ZT.Z'" pursuant to application dated ..... /~2..~.. ............. ~ ............... . 19~....~. and approved by the Building Inspector, Rev. 6/30/80 Form No. 6 TO,iN OF SOUTIIOLD BUILDING DEPARTMENT TOWN ~ALL 765-i802 APPLICATION FOR CERTIFICATE OF OCCUPANCY \. 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 and similar buildings and installations, a certificate of Code C~mpliance from archiuect or engineer responsible for the building. 6. Submi~ Planning Board Approval of completed site plan requirements. ;. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all 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 Insp%ctor shall state the reasons therefor in writing to the applicant. ~. Fees 1. 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 BuildSng - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $i0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.O0, Commercial $15.00 ,/ Date .... ......... ew Construction .... .~ .....Old Or Pre existi - '~f' .... ocation of Property ....... .~..~...~. ........ C.~.-.~~i ......... .~.~...... House No. Street Hamlet .... qwer or Owners of Property ~'~...~..,.~..~..~.., ..... ..... runty Tax Map No i000, 8ection...-~...7. ..... Block .... ~ ....... Lot....f~,..~ ....... ~bdivision ................ .................... Filed Map .......... Lot .................... alth Dept Approval : ......................... Underwriters Approval ..... ~ ........... arming Board Approval ..... ~ ............... quest for: Temp~ary Certificate ........ Final Certicate ........... 6k c, q0 5 .... . ............ APPLICANT · , FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITION~L COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS R026/.74 BUI~AU OF ELECTRICITY l--- 85 JOHN STREET. NEW YORK, NEW YORK 10038 ~[~GUST O~ ,~qg~ ~ppli~ionNo. onfil~ THiS CE~IFIES THAT ,E~NDF:R (II,OVER, 40~ COX I,ANE~ in t~ f~lowing l~ation; ~ B~nt JULY 08,1991. w examined on andfound to be in compliance with the r~ui~men~s of ~h~ ~rd. SWlTC)IlS RXTUIES OVENS EXHAUST FANS MOTORS OTHII AI~ARATUS: PANK~,BOARDS:I-4 CIR. tOO C;. F.£. 3::-3 OF CC. C~D. I,EANDEK ~I,OVER 835 COX LANK CUTCHOGUK, NY, Per This certificate mu~t not be alt&ed in any manner; return to the office of the ~)ard if incorrect. Inspectors may be identified by their COPY FOE BUILDING DEPARTMB4T. THIS COPY OF C:ERTIFICATE MUST HOT BE ALTERED IH ANY MANNER. BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEFTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N,Y, 11971 TEL.: 765-1802 CALL ................ MAIL TO: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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, 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 throushout 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, and to admit authorized inspectors, on premises and in building for necessary inspections.A t_.~.~..~ ..~. ~ ¢ .. , (Signature of applicant, or nafffe, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~- o k7 e ~ t~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) . 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 ...................... 1. Location of land on which proposed work will be done .................................................. / · .................... ............... .... ...... ...... House Number Street Hamlet County Tax Map No. 1000 Section .... .~2 ......... 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.. ~.~. Z~t ~ ~ ........... b. Intended use and occupancy ../~. ~. ~. ~. ~.,. /.&. ~ 7 .......................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .i ......... Alteration .......... Repair .............. Removal .............. Demolition .......... ! ....Other Work ............... 4. Estimated Co ............................ Fee ..... ,.~. ........................... (to be paid on Eilng this application) 5. If dwelling, number of dwelling units ............... Number of dwelhng umts on each floor ................ If garage, number of cars ........................................... i ............................. 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 ...... i ........ Depth ............... Height ............... Number of Stories ........................... i ............................. Dimensions of same structure with alterations or additions: Front ........... i ...... Rear .............. .... Depth ...................... Height ...................... Number Of Stories ...................... "8. Dimensions of entire new construction: Front .......... ' ..... Rear ....... ! ........ Depth ............... Height ............... Number of Stories ........................... i ............................. 9. Size of lot: Front ...................... Rear ...................... i Depth ...................... 10. Date of Purchase ............................. Name of Former Owner i ............................. 11. Zone or use district in which premises are situated ........................ i ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...i ............................. 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ,~.~.~.~ ~.~;~.. ~.;.~.o.~.~¢.4'rAddress .~..~."/7c. -.~. ~.~t gl. 'i ''//'~'' Phone No. 7~tt~.-,57. Name of Architect ........................... Address .............. i .....Phone No ................ Name of Contractor ........ ~ ................. Address .... : ......... , .....Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and sh6w street names and indicate whether interior or corner lot. °k2 STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .......................................................... et~.'~ ........................ : ' ' ' (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed th~ said work and t6 make and file this applicatioh; that all statements contained in this application a~'e true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . z~ day of ~) ~ ,19 f7 ................ - ...... Cony ¸IS' .f,