The URL can be used to link to this page

Home My WebLink About16100-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20347 Date NOVEMBER 15, 1991 THIS CERTIFIES that the building Location of Property 405 COX LANE House No. County Tax Map No. 1000 Section 27 Subdivision ALTERATION CUTCHOGUE, N.Y. Street Hamlet Block 5 Lot 2.1 'Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 29~ 1987 pursuant to which Building Permit No. 16100-Z dated MAY 29, 1987 was issued, and conforms to all of the requirements of the applicable previsions of the law. T~e occupancy for which this certificate is issued is ALTERATION TO EXISTING AGRICULTURE BUILDING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A LEJkNDER B. GLOVER, JR. - Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 16100 Z Permission is hereby granted to: .............................. ..... ~ .................. ~"~'~'~'" ......... .... .o~~.~....~.:.~..:....!..!.~.~. ,o at premises located at .............................................. County Tax Map No. I000 Section ....... ~...~.....:~.. .... Block ...... ..~.....~.. ...... Lot No.......e~...,...) ........... Building Inspector. ./ Fee $.....~.....~ ............ Rev. 6/30/80 Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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. Cormnercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance 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 Inspector shall state the reasons therefor in writing to the applicant. ;. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelliag $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 - $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 $15.00, Cozmmercial $15.00 .... I ocation of Property .... .~..~. ~ .............. C~..~..~. ......... ..~.~.. Nouse No. Street Hamlet ~unty Tax Map No 1000, Sectioa...~...~.. .... Block ...... ~ ....... Lot .... ~bdivision ........................ '' · ......... Filed Map ............ Lot ...................... 'alth Dept. Approval .... .'~... · · ................ Underwriters Approval arming Board Approval quest for: Temporary Certificate ........... Final Ccrticate... ,.~..... Submittod: $ .... .,. ..... ... %~~ APPLICANT ' U~DATION (1st) UNDATION (2nd) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: BOARD OF HEALTH ...... : 3 SETS OF PLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL MAIL Examined...~.~ J..t~,., 19' .7 Approved . .'.~.,.&"Jth~. Disapproved a/c ..................................... (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 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~qde, housing c~,and Legulations~and to admit authorized inspectors on premises and in building for necessary inspecC6~ns)~~,~ ...... ~~j :_',...' _' ..... (Sign~ituf~ of ap~plicahf, or nameM~'a corporation) · ...... ..... ~ ~Mailifig add?ess of applican.t) State whether applicant is owner, lessee, agent, architect, enjneer, general contqfictor, e*ec~rician, l~umoer or ouilder. ..... [: ........................................................................... Name of owner of premises ........................ ;; i.i; '; "i i; If applicant is a corporation, signature of duly attthorized officer· F~JE: ~'~'-~ .............................................. 76fi41~02 9 ~ FO ~ ~i~,~ ~OR l'H~ (Name and title of corporate officer) FOLLOW~NG ALL CON, TRACTOR'S MU~T/ BE SUFFOLK CpUNT¥ LICENSED Builder s License No.. / Plmnber's License No ......................... Electrician's License No ....................... ~L CONF;1 ~4UC'F~O~ Other Tr~de's License No ...................... 1. uocation of lano on wnicn proposed work wm ee done ...... '1' · :'f~ ~ ~' 'm~ <~80 NS~iC~'OV-' ~:~{~R¢' · House Nmnber ~Street ~ Hamlet County Tax Map 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 ..... ,...~....,..~..~...~.....c¢~..~,., 3. Nature of work (check which applicable): New Building ' Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 0 !' · (De rip i ) 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 i · · ...... 6. If business, ommercial or mixed occupancy, specify nature and extent of each type ofmse ..................... .... ~ ' pth 7,. D~menmons of existing structures, if any: Front ........ Rear ...... De Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... ~.. Height ...................... Number of Stories ...................... 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 prbmises are situated .............................................. ~ ...... 12. Does proposed construction vioilate 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. irs this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alt buildings, whether existing or proposed, and~ indicate 'all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. i STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..................... i ................................................................... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this applicatio¢; that all statements contlained in this application are true to the best of his knowledge and belief; and that the work will ~e performed in the manner set forth in the application file~t iherewith. Sworn to before me this i ,,." HELEN lc DE VOE NOTARY PUBLIC, State of New Yolk_ ' ' ' ~*ti No. 4707878, Suffolk County f2'c/ T~m Expires M~ch $0,