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Home My WebLink About16107-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17187 Date AUGUST 11, 1988 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Propert~ 1730 COUNTRY CLUB DRIVE House No. Street County Tax Map No. 1000 Section 109 Block 3 CUTCHOGUE Hamlet Lot 2.17 SubdivisionCOUNTRY CLUB ESTATESFiled Map No. 6736 Lot No. 18 conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 2, 1987 pursuant to which Building Permit No. 16107Z dated JUNE 22, 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 ONE FAMILY DWELLING W/ATTACHED TWO CAR GARAGE. The certificate is issued to TERRY & LAURA WOODHULL (owner, ) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED TERRY WOODHULL 87-s0-78 7/ 6/88 N0t8665 4/1 /88 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-° 16107 Z Permission is hereby granted to: ..... ~..~,....~'7. ......................................... ..... ~o, .~1.~-- ,o ..~.~....~....~.~.~_~;.:.~.~ '~.. ~ ' ..,...~..~.. .~..~ .J.2.a~... ......................... ~~.. ....... at premises located at ~ ..................................................... ~......~~ County Tox Map No. I000 Section ..... .~..~....~ ......... Block ............ ..~ ...... Lot No. ~ ....~...:.!.~ ........ to applicotion doted 4 ~ 19.~...'J.., pursuant ......... ~ .............................. , and approved by the Building inspector. Fee $ ..................... .... :'"'""'"l~ildlng 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 Instructions A. This application must be filled in Wpewr[ter 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 natu re[ or topograph ic featu res. 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: t. Accurate survey of pzoperty 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 $25.00ALTERATTON $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessor¥,~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancv $ 5.00, over 5 years $10.O0 ~ 4.Vacant Land C.O. $ 20.00 // 5.Updated C.Oo $ 50.00 Date .... / Location of Property ./.73. House No. Street Ham/et Owner or Owners of Property . .~"~e~y..~. ~.~R/~., (4~',~o ~//~(z/~ .......................... Cpu nty Tax M ap No. 1000 Section .... /.~).? ...... B lock ..... -.~. ....... Lot... A.,. ~/.~. ...... Subdivision.. z . /C '.. Map No.. ....... Permit No. . Date of Permit . .Applicant .... ~ ~, ....... Health Dept. Approvall. '??/. ,~,"',~O, 7.~, ~' ........ Labor Dept. Approval ........................ Underwriters Approval ........ Planning Board Approval Request for Temporary Cert:ificate ..................... Final Certificate ....... Construction on above described building and per~ meets all applicable codes and,regulations. R TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ttALL $OUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.~ (please- ~rint) P lumber~_y.~~// I certify that the solder used in the water.supply system contains less than 2/10 of 1% lead. Sworn to before me .this Notary Publ is ,__~_~L2~o /~ Count ?; · ~umber s signature) Notary Public J~O'I'^RY R~JBLt~ S~e of ~[* York 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING REMARKS: ROUGH PLBG. I,~,~IJLATION [~/~INAL 7654802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [.] ~OUGN/ PLBG. FOUNDATION :)ND ~/] INSULATION FRAMING FINAL REMARKS: / DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ,~RAMING [ ] FINAL 765-1802 BUILDING DEPT. ?NSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION :~ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: _ DATE INS, PECTO~,_~ 765'~802 BUILDING DEPT. INSPECTION ['] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [] FRAMING [/FINAL ~ UI;DATION /"/(1st) UNDATION (2nd) UGH FRAME & PLUMBING~/ SULATION PER N. STATE ENERGY CODE Ye FINAL/ ADDITIO~L COMMENTS: 3 SETS OF PLANS FORM NO. I SURVEY . ..~,.. . . o TOWN OFSOUTHOLD CHECK ...L ...... BUILDING DEPARTMENT SEPTIC FORM ~?.u.E..~'.8~.[~ ...... : TOWN HALL SOOTHOLD, N.Y. 11971 NOIIFY ~..~.~3 TEL.: 765-1803 CALL ........ MAIL TO: Examined . ..~.~..~.~.., 19 ~.7 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ....... &/jt.~ ...... 19 ~.'). INSTRUCTIONS a. Tiffs 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 code, housing code, and re~l~lations, and to admit authorized inspectors on premises and in building for necessary~ns./~,/,~,.t.~~?... _ "~' ~'/ ...... ~¥. "J; 'g; ' ;;a'~/~i .... (Signa,~e of applicant, or na e, if a p ' ) ,a:, x ./'/.'?.o,. :,, .- State whether applicant is_owner, lessee, agent, architect, engineer, general ~ontractor, electrician, plumber or builder. ........... ~ ~.'FX. ......................................................................... N ne of owner ofpr 'mises ............... (as on tee 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 Builder's License No .......................... LICENSED Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done] ................................................. -~i~~. 1:23.0... ~a. ,,,.'t. ~. .X ~ ~, ~ . . m ................. ~ ~, ~ c ~. o. ~. t,, ~. ................ House Number -- Street Hamlet County Tax Map No. 1000 Section ..... J. O.~ ........ Block ..... .,~.. .......... Lot... ~,..J.7 ......... Subdivision ~_o{.z.a.J:F.t~y..dt-.U~ .~'~S~'/t-TL-'-.,..~ ..... Filed Map No... ~,~ .~.3 .¢ .... Lot .... /..~ ........ (Nan~e) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... LzA-C.~-.4-x. ',T',. ..................................................... b. Intended use and occupancy ...~. ~//T2. z~.~.~'..../~ .... , ................................ 3. Natureofwork(checkwhichaplplicable): New Building .......... Addition . Alteration .......... Repair ............... Remqval .............. Demolition .............. Other Work. i ............. : ( i (Description) 4. Estimated Cost .... .cL .0 ..................... Fee ........................ , ............. · (to be paid on filing this ~pplication) 5. If dwelling, number of dwelling U~nits ..... ~. ........ Number of dwelling tinlts on each floor...; ............. If garage, number of cars ..... ~ .................................................... i ............. .6. If business, commercial or m~xed occt}pancy, specify nature and extent of each type of u~e ....... i ............. 7. Dimensions~of existing structur s~, if any: Front...~.~.~f4~.'~.. ..... Rear .... , ....... .. Depth. ~ ............. Height :. Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .... , ............. Depth .................... :.. Height ...................... Number of Stories ........ ~ ............. .... 8.Dimensions of entire new constrUction: Front r r · Height' ' . .......... Number of Stories ........................................ i ............. 10. Date oft~urchase ........... ! .................. Name of Former Owner ............... ; ............. 11. Zone'or ffse district in which r mises are situated [~ ;~t . 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 ~a~^~..bc/oc.~/A~,[~. Address .~30 )< P.0.$. ~r/-ii,,o?~hone No. ,~g ~C9 ...~3. .... Name of Architect ~v,,z.r~.. p/zWltt g ........... Address ~(~'.,S'~,.~'..4~Oe'B.O.c~a: Phone No. ~,&,& ?3 ~'././. .... Name of Contractor ......... .i ................. Address .... : .............. Phone No.;t"~' i ............ 15. Is this property located .within 300 feet of a tidal wetland? *Yes ..... No .P~... *If yes, Southold Town TrUstees Permit maybe required. ~ PLOT DIAGRAM Locate clearly and distinctly Mil buildings, whether existing or proposed, and~ indicate all set-back idimensions from property h~es. Give street and block :number or description according to deed, and show street names andiindieate whether interior or corner lot. STATE OF NEW YORK, ,~ ~ Acqame o~i uivi ual signling contract) above named. , being duly sworn, deposes and says that he is the applicant He is the ....................... . ................................................... : .............. (Contractor, agent, corporate officer, etc.) of 'said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that ail statements contained in this application are 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 Notary Public, .. . ~'3[l~,~'tai, 0~ " '~~ are ~of ........ l~88,f~nl~l~l~ltO[ ,Y~ ...~i (Signa No. ,~707~'18, 8uffol~ ~ 0 t/ ~~ applicant) Te~ Expires Ibrch 30,19..-.~-/ /? ?~' /2' ~'~0 0 E