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Home My WebLink About16148-zFORM NO. 4 TOWN OF 80UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17501 Date NOVEMBER 10, 1988 THIS CERTIFIES that the building Location of Property 8200 COX LANE House No. County Tax Map No. 1000 Section 84 subdivision ONE FAMILY DWELLING CUTCHOGUE, N.Y. Street Hamlet Block 1 Lot 30 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 18, 1987 pursuant to which Building Permit No. t6148-Z dated JUNE 29, 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 WITH DECK AS APPLIED FOR The certificate is issued to H. NORMAN McCULLOUGH III (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-115-9/8/88 UNDERWRITERS CERTIFICATE NO. N027972-AUGUST 16, 1988 PLUMBERS CERTIFICATION DATED 10/24/88-BAY PLUMBING & HEATING CO. Rev. 1/81 · Building Inspector FOB~ NO, ~ 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) No 16148 Z Date ........................ ~ .............. , 19.~..~. Permission is hereby granted to: ...~.:...~...~.~...~..~..~~...~ ....~./..~....~.~U~ ........................... ..~.~~......~..~..,...~,ud~..~. ........ ~...~......~.~. ................ : ........... ,, ........................................................................... County Tax Mop No. 1000 Section ...... ~ .... Block ....C}~d~. .......Lot No.~ ........ to application dated ....... ...~..,~&~tO,,~,..L.~. ................. , 19.~....'7.., and approved by the pursuant / Building Inspector, Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- [802 'LICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I laa=amma~ 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, ~ndustrial 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 featu res. 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. Cert{ficate of occupancy New Dwelling $25.0.0, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $100.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... ~.l~.~./.~ NewC°nst~'ucti°n ...... Old or Pre-existing BuiJding ............ Vacant Land ............. Location of ProperW . .~.~. ...................... ~w, ............... - . .. House No. Street let Owner or Owners of Property County Tax Map No. 1000 Section .~.~ .......... Block ..... { ......... Lot .... ~..~.. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ....~.~,.. ~ ......... Request for Temporary Certificate ..................... Final Certificate .... .-~%~ ....... ' Fee Submitted $ ............................. Construction on above described building and P.~~des and regulations. Apphcant..~//. ~¢. ......................................... Rev, I0-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. /~/~ (please print) Plumber ~ 7 ~[/~,~//}t ~ p. 1 int) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. , ~"~/ (plumbS' s d~nature) Sworn to before me this ~ ! day of ~,C~3~ , 19~ Notary Public,'O~~ County HAROLD COHEN ~t, OIARY ?USllC, State of Ne'~ ¥o~ ~e~m ~i~ Oecembe~ 3L ~9~% 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING ~.~INAL DATE/~/~/,~l~'// ...... INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ~ULATION [ ] FRAMING [~ FINAL REMARKS: ~ ~ ~ ,-,~'~~ ?~.. ~~~. ~ ~~ / 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROU/GH PLBG. FOUNDATION 2ND ~ INSULATION [ ] FRAMING , ,r ] FINAL REMARKS: DATE ? / I NsPEC'roR/.~,~"/ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [c~OUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING FINAL REMARKS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE~~//~r~ INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. [ ]/OUNDATION ZND [ ] INSULATION / FRAMING [ ] FINAL ,NsPEcTOR~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. t/FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: DATE 765-~.802 BUILDING DEPT. INSPECTION [~~OUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: ,¢:~./~ *~ INSPECTOR~ UNDATION UNDATION (2nd) UGH FRAME / PLUMBING S~LATI~ PER N. Y. STATE ENERGY CODE FINAL ~L COMMENTS: ,/ -. (/ (/ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:3 Approved . .~...,tr~'~.....~.~.., 19~. ?. Permit No..[ .~. !.q .~..~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .] [~... 3 SETS OF PLANS/ . . SURVEY ...... ~.. · CHECK .......... SEPTIC FORM ..... .~. ...... CAUL . ?.~3.-: .~?~.. ./.q .... MAIL TO: Date .... ~-/1.7/. ......... 19 .~.7. INSTRUCTIONS a. Tins 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. o'. No building shall be occupied or used in whole or in part for any purpose whatever until ~ 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. ~ (Mailing address of applicfint) State whether applicant is~owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .~....J~.' ow:. ~c,~,~-,../~,[,.C~.{.~.k~ry~.~ ................................... (as on the tax ~oll 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 LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ....................... i. ~ocation o.and on which ~rop. os~ work will be done ..... ~ ~. c;~au tz~4z~ ~ ,a~-- ""'2"'2-;; ......................... .................. ............ ................. County Tax Map No. 1000 Section ...... .~.. 33.. Block ...... ,~ .......... Lot {)la .¥~. ............ Subdivision .~.~7~..~r.~.~... :¢( .~.c~ ................ Filed Map No .... .~...~.. ~(... Lot ................ (Na~e) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: "~" .. t??~.~.~.~.. . a. Existing use and occupancy ............... . .... b. Intended use and occupancy ....... ~. f~%~.~~..~.- ....... z~ ~.%..-~-~>.....~u,~:.~ .~.. 3. Nature of work (check which applicable): New Building .... ~t ..... Addition .......... Alteration .......... Repair .............. Remgval .............. Demolition .............. Other Work ............... ~ :,k~,~_ e~c~ (Desc on : 'm 41(-~. t,.,~:~t~. .'~.... Fee . .~.. 4. Lsn atedCost .... ~ .................................................. " (to be paid on filing this application) 5. If dwelling, number of dwelling Units ....... I ........ Number of dwelling units on each floor .... ~' I' t.,- ....... If garage, number of cars ........ ~[ ........................ : ..................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each'type of use a,,/o_ .......... 7. Dimensions of existing structur6s, if any: Front ............... 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 ...... /B.~.! ..... Rear ..... ~.. ~ ...... Depth .... ~.t ...... telght ..... ~ ...... Number of Stones ...... &'~... q.~,u.~,~.., ohr~'~., ............................. 9. ,Hze of lot' Front , ~, Rear .~(..~ .... /..> ............ · .... · ................. Depth ....................... 10. Date of Purchase . ~/.3!/.~.'~. ................. ;Name of Former Owner .~ .$¢, .t4,,C_,,J.,0_o,,~ .-~ .~.,.. 1 1. Zone or use district ih which premises are situated .']~ ................................... .~...~.. 12. Does proposed construction vio!ate any zoning law, ordinance or regulation: ..V'-~-~ ...................... 13. Will lot be regraded ~:~'-¢o~.:. ~.. o~0k-~,x~.. Will excess fill be removed from p/;emises: .~ Yes t'-kNo) 14. Name of Owner of premises ~'~ ~: .~-~LC-r~A ddre~s .O~ O.. ~...~-~ ~. Pt~nnem~o.-~.~.w..~{"J.r/..,C~..q>~,' Name of Architect ~,.~,~,~¢,,o~...-~',,,.~4~,~..~...~-Address ~...~d;..X. Phone No. ~.~.W Name of Contractor .~'. ............... Address ~".1o. ,ct~,~. ~,(~t~Phone No..~[~ .~."~.~.~;w,~ ~(~ 15. Is this property located Within 300 feet of a tidal wetland? ~Yes ..... No ..~.. · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM property lines. Give street an~er or description according to deed, and sh~,w _--i. -oornerlot. Locate clearly and distinctly all building, whether existing o}~proposed, and, indicate all se, t--back dli~iensions from and indicate whether SS COUNTY OF ..~12~x~-~~ FF~.' "- ...... · · .R..~ .~. q~..,w,*~-...g-,~-.q~,-.",~. ~/~ ............... being duly sworn, deposes and (Name of individual signing~contract) above named. says that he is the applicant He is the ....... ~ ....... .:... ......................................................... (Cont~act0~;, 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 all statements contained in this application am 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 b~ Notary Pub!lc', ............. LINDA J. COOPER Notala/PUblic, State of NewYor~ No. 4822563, Suffolk County(,4 Term Expires December 31, 19 ...... County ~....~...~ . (Signature of applicant) I I I ~ "] .oi ,I.t, ol'I/' 'hi U ,,5 0 Z 2: -...g L W"~,i' I ~3~t3