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Home My WebLink About16188-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17153 Date AUGUST 2, 1988 THIS CERTIFIES that the building Location of Property 725 House No. County Tax Map No. 1000 Section Subdivision ACCESSORY MASON DRIVE CUTCHOGUE Street Hamlet 104 Block 5 Lot 24 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 29{ 1987 pursuant to which Building Permit No. t6188Z dated JULY 8~ 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 ACCESSORY BUILDING. The certificate is issued to LEOLA D. ERICKSON (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A ' / B~din~ Inspector Rev. 1/81 I~ORM NO. S 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) Permission is hereby granted to: ,,~ ....~....~.~...~.........~.~..~ .............. ..... ..'7...~.....~.~...~.~ ............. ...~.~~....~.:~..:...u...~..~...cf.. ct premises located at ..~.~...~.........~..~....~...~.. ...................... ~ .............................. Coun,,,, Tax Map No. 1000 Sec,,on ..... .L.o.....Y.. ...... ~lo,:k ....... ..O....~'U..... Lot No....~.~ ............ and approved by the pursuant to application dated .......... Building Inspector, Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of al~ 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, 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: 1. Accurate survey of pzoperty 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. Certificate of occupamc¥ New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 5.Upctated C.O. $ 50.00 Date ................... ..ul %~.~?. Newt OhS t~r'uc~c±on ...... Old or Pre-existing Building ............ Vacant l-and ............. House No. Street Ham/et Owner or Owners of Property , ~C~ C~(>;J County Tax Map No. 1000 Section ...~.0~ ........ Block .... .5. ........ Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.. 1~.~.'~ .~.~. Date of Permit . .'].t.~t .~...-~..Applicant .... J~<q {~.. ~.~.....~..1~.~..~?..~J. ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... FeeSubmitted$.. I~~O V~C{~ .L~...~ Construction on above described building and permit meets all applicable codes and regulations. -~. ~. %~'~b~'- Applicant .................................................... TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR iLO. BOX 728 TOWN IIALL SOU I'I[OI.D, N.Y. 11971 TEL. 765-18O2 To Whom This May Concern, We are unable CO complete your Certificate of Occupancy because .of the following reasons. An application for Certificate of Occupancy is not on fil~.. / / :1:~ Underwriters Certificate on file. /~/ The check is(outdated/n_o.t on file.)~/~~ /~/ i:o ,qealth Dept. Approval on file. /.~/ r:o final inspection haa bean made. Please conta,ct our office on this Thank you for your - ' cooperation. matter. Buildin[; Dept. '~*/-/ No Plumber Solder ertlflcate on file. ( all permits involving plumbing being issued after April 1,1984 ) TOWN OF SOUTtIOLD OFf'ICI{ OF BUILDING INSPECTOR P.O, BOX 728 TOWN IIALL SOU FIIOLI), N.Y. I I~71 TEL 765-1802 To Whom This May Concern, We are urlable to complete your Certificate of Occupancy because .of the following reasons. /_-/ /_7/ An application for Certificate of Occupancy is eot On fil~. ?;o Underwriters Certificate on file. The check is(outdated/~__ot on file.)~/~~ ~:o !lealth Dept. Approval on file. t:o final inspect'ion ha~ been made. P]ea:3e contact: our office on this matter. Than'~' you for your cooperation. ~uildinq Permit tl Z ~ ( ~ ~ Z Buildin(~ Dept. ***/_-/ ~lo Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 TOWN OF SOUTtlOLD OFFICIi OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTIIOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. /~ An application for Certificate of Occupancy is not on file. /5/ No Underwriters Certificate on file. Tile check is(outdated/~ot on fil~.) /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit t~ I ~ .~_ ~._ ~__ Z BL]ilding [)opt;. ***/~/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is unlawful without a Occupancy. Please clear up this-matter so does not have to be taken. Thank you for your prompt attention. Certificate of that legal action UNDATtON (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 HALE NOTIFY 8OUTHOLD, N,Y, 11971 TEL.: 765-1803 Approved . ~ .... , 19~.]. Permit No. I .{,.t ! .~..~..~.. Disapproved a/c ..................................... * ~ ' ~ (BUildihg Inspector) · APPLICATION FOR BUILDING PERMIT CALL ............. · ' ' MAIL TO: Date ................... 19... 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~ppli- 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 g 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 insp, ections. .............. (Signature of applicant, or name, 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 ~..~, ./.?..~....z~ .~.~..~../¢....~..~./..(-/.~..'Y..O.~./. .~ .... ~..: ............. :i. ............ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL COI~,TRACTOR'S MUST BE S.LIFFOLK COUNTY L[CENfij]vVD Builder s License No./.~.O.~. '.~./f....,~..~./~. ?.x~. . .~. ?. {D t~Od>/~ Plu nber 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 ..... /.~ tqf.. ....... Block.. ~ ............ Lot .... .~.~ ........... 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 ..................................................................... b. Intended use and occupancy ............ '.?.~. · .l..~ .............................................. 3. Nature ofwork (check which applicable): ~.' .... ' ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost o · (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 mix~d occupancy, specify nature and extent of each type of use ...' .... ~ .............. 7. Dimensions of existing structures, if any: Front ..... Rear ....... Depth ............... Height ............... Number of Stories ............ ' ............ Dimensior~nl~l~ture~'ith alterations or additions: Front ................. Rear ............. De t ._.__.~.., v.,,~ .. . p h ................... i.... Height ...................... Numberof Stories ............ ~ ....... '.8. Dimensions of, e~utire new construction: Front .... ~. .... . ..... Rear_ ,. ~ ......... Depth ,../. .......... Height .... ~. ...... ...'Number of Stories . . [ ........ ~. ~.1~..'~..~.~. .................... 9. Size of lot' Front ' Rear..t~t~.l ~'~ [~.~i ? . - '~'~*h ........ ........................~[~ IT 'r ...... ~ ...................... .......... ............... 1 1. Zone or use district in which premises are situated .,~...%~.. ]~.%.~. ..... o.~I~. [~ I.~ ..... 12. Does proposed construction violate anv zoning law ..i'i'i' "i '" il : ~" . · .1'~ · ................ 13. W l lot be regraded ........ . .................... .~lL~[~4'~i~ bU~ov~d,from premises: Yes SNo 14. Name of Name of ArchitectOwner of premises . .i: ................ ~[r~t~"~ 'I~' '~' '~,] ~.ILL: _~-~' ~t[J a/~lU'~ ~I~?}~... Phone No ................. Name of Contractor ........ , .................. ~(~J, es~O.~. .............. Phone No ................ 15. Is this property locatedlwithin 300 feet of'~'tidal wetland? *Yes ..... No ..... · If yes, Southold Town Tr6stees Permit maybe required. PLO'F DIAGRAM ..' Locate clearly and distinctly all buildings, whether existing or proposed, an& 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 ~nterior or corner lot. 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 all statements cont¢ined 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 ~ ............ 4.~. ......... day of .................. , 19.2.~. HIIfN K. DE VOE, · .............. , ....... ," ..... NOT~W PUBLIC, State of I~w Yolk (Signature of aplldicant) NO. 4707878, Suffolk ~t11~1~0 Ii T~m Expires M~rch 30, l~..~.,/