HomeMy WebLinkAbout16526-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. z-16727 Date March 21, 1988
THIS CERTIFIES that the building CONSTRUCT HANDICAP RAMP
· 29685 Main Road Cutchogue, New York
Locatxon of Property .............
- House No. 'S'tie3i .................
County Tax Map No. 1000 Section . . 1.0. ~ ....... Block 0 2 .Lot 2 2
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
...O.c.t.o.b..e.r..Y.,...1.9.8. Y.. pursuant to which Building Permit No. 16526 Z
dated .. O..c .t.qb. e..r..I.3. ,...I .9.8. 7. ....... 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 .........
HANDICAP RAMP AS APPLIED FOR
The certificate is issued to UNITED METHODIST CHURCH OF CUTCHOGDE, L.I.
..................... [o~n'~'r, '~;~'e'o'r 't3,;abD ......................
of the aforesaid building.
Suffolk County Department of Health Approval N/A
UNDERWRITERS CERTIFICATE NO. N / A
PLUMBERS CERTIFICATION DATED: N/A
R~. 1/61
~m NO. ~
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)
N~6526 z
Permission is hereby granted to:
~.~..~.9...! .........................................................
..~~,,a~...~.:~.,.J./..~..&.~~. .............. ;.. ~
,o .......................
at premises located at .,.c~...~..(,~..~....~.. ...... )~.~...~.,. ........ ~~-~.~.,.~ ......................
County Tax Map No. 1000 Section .... ~/..l~..~ ....... Block .......~...-~. ...... Lot No....~...-~.. ..........
pursuant to application dated ...... (~....~...~.....~ .................... , 19.~...~..., and approved by the
Building inspector.
tee $.~.~..: ..............
Building Inspector
Rev. 6/30/80
(~o
FOUNDATION
FOUNDATION (2nd)
ROUGH
FRAME &
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
/ /
INSPECTOR~
· FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT SEPTIC
TOWN HALL
NOTIFY
$OUTHOLD, N.Y, 11971
TEL.: 765-1803 CALL
MAIL
Disapproved a/c ..............................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BOARD OF HEALTH
3 SETS OF PLANS ]~;~[.
SURVEY
CNECK .......
TO:
Date ...~..drY.....9., ........ 1977.
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 code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
Robert Farktn, (Signature of applicant, or name, if a corporation)
President, Board of Trustees P. O, Box 701 Cutchogue NY 11935
(Mailing address of applicant)
State whether~ applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
~.Th.?~6pp~9~g~$~gb9~¥~9¥~gb~$~9¢$~f~6~$d~$~¢orp~r~t¢d.¢hur~h,.assisted.by.the.bui~der.
Name of owner of premises . . .U? .I.T~.D..METHODIST CHURqH...OF.. C..~.C. U99.~.,' .~, I, ..........
;rXx (as on the tax roll or latest deed)
If apviS~,ant is~a cor~sig_nature of duly authorized officer.
· /.~. (~. ;.[..~ '1' .~.~..6~..t.~....~-J,~.. ...... Rober~ Parkin, President; of Board of Trustees.
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No... Thomas. ~lacLeod..
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
·.. 29685.. Main. Road ............................................ C.u.t. qh.o. gu.e. .....................
House Number Street Hamlet
County Tax Map No. 1000 Section . . ./?..c3.. ........... Block .... ~ ........... Lot ..... ~..fi~. ..........
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 ....C.hurch ............................................................
b. Inte.nded use and occupancy .. Church../~..d~.~e.~.~.e.o~...~e..e-.&y .... .~.~?~.. ....................
3. Nature of'work (check which applicable): New Building .......... Addition ramp ...... Alteration ..........
P, epair ...,... ..... ... Rem6val .............. Demolition .............. Other Work ...............
i (Descrip~tion)
Estimated'Cbst ' $1100 00 ~ Fee
4 ·
: ' (to be paid On filing this application)
5. If dwelling, number of dwelling :units ............... Number of dwelling units on each floor ................
If garage number of cars '
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front.. 37: .......... Rear .... 5g: ....... Depth ...19.0:, .........
Ileight . Y .......... .: . Number of Stories .. PPg. o.bpy,e. ~9~j.nfl{i.t.ipp...: .......................
Dimensions'of same structure With alterations or additions: Front . 37. p.lp~..1~.! ..... Rear ... 5.6! ............
Depth...1.09.'. ~ Height same ... Number of Stories. o~e .....
Dimensions of entire new constrUction: Front .......... ' ..... Rear ............... Depth ...............
tleight ............... Number of Stories.. Vp. e~¢lo~ed, ad{til::[oo~ .................................
9. Size of lot: Front .... ~20.'..+/r.. filet . Rear.. 12.0 +/; feet Depth ~,Sp. f.e.~.t .....
10. Date of Purchase . 7.9¢.~9.b~ri .1.85.6 .............. Name of Former Owner . .H~rr;t~o*.~e. ood. ~if, ......
1 I. Zone or use district in which prcmmes are situated .....................................................
12. Does proposed construction vic!ate any zoning law, ordinance or regulation: ...n.o ............................
13. Will lot be regraded . P9 ..... ~ ................... Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ¢lll:¢h~gue. IJr~liced .... Address 29650. Maim gO ...... Phone No. ?~.~.-~93~ .......
Name of Architect ........ N~e.t.hpO;t 1~ .t . .C b p .r .e .h' .. Address ................... Phone No ................
Name of Contractor ...Tl~.orao~i .~¢I~9p~t .......... Address 2.195: .C.an3p..M.t.n99.1iL. Phone No. 29111.'5.~.8 .......
15. Is this property locatediwithin 300 feet of a tidal wetland? *Yes ..... No ..X...
· If yes, Southold Town Trustees Permit maybe required.
I PLO~r DIAGRAM
Locate clearly a~d distinctly al! 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 show street names and indicate whether
interior or corner lot.
The constructed ramp
will fit in one
cut out on the east
side of the building.
Therefore it will be
an extension of the
porch to the northeast
but it will not exceed
the northeast wall of
~he:existing kitchen
entry way by more
than:a foot.
Area of construction
marked in red.
"that certain piece and lot of land situated at Cutchogue in the Town of
Southold in the County of Suffolk aforesaid and bounded Easterly by land
of Josiah Albertlso~ Junior, Southerly by the highway, Westerly by a strip
of land three rods wide belonging to Cutchogue Cemetery, and Northerly by
a strip of land two rods wide belonging to the said William Harrison Case
the boundary line being designated stakes, containing nearly an acre be the
STATE OF NEgLYORK same more or less." NOTE: The church subsequently
COUNTY OF ~P~/~' i S'S purchased part of the land referred to as owned by
/j ..:..~._...../ ..... i Josiah Albertson Junior, and ts its own neighbor on the
.... . ./?..~fi~....~.: ~t.r,f. ...... ! .................... being duly sworn, deposes and says that he is the applicant
(Name ofmdlwdual .... mgmng" contract)
above named.
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this.
application; that all 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
............... ~':...,, .... day of~... ~ ................ 19...
Notal~ Public,....~.~...~...~.. County
Nowy0~ ............,....... ..........................
e0,,,ty (Signature of applicant)