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Home My WebLink About15326-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Cer'iificate Of Occupancy No ..... g. ~. 696P~ Date October 6 .............. : .................. 19 86 THIS CERTIFIES that the building Greenhouse addition Location of Pronertv .3.2.0 .Broadwaters Ro~d Cutchogue N.Y.. . -- "HOUS~ No. ' ................. . Stree[ .......... I ......... Ham/er County Tax Map No. 1000 Section 104 .Block 10 6 ........... · ....... Lot Subdivision. M/.q Nassa..u. Club Pvoperti~ 156 ..................... · nru~u ,,,,,~, No ......... Lot No. 183 conforms substantially to the Application tbr Building Permit heretofore filed in this office dated September 18 .............. t ...... ,19.. ursuant to which Building Permit No. 1 5 3 2 6 Z dated September 24 ,86, ............... 19.. 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 ......... Greenhouse addition to '~xisting one family dwellin~ The certificate is issued to ......... B..a.~.b. ara Kunen ....... /o¥,,'o), .................... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO Rev, 1/al Building Inspector 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. 15326 z Permission is hereby granted to: ...~..~..~......~: ............... ...~~.....~.:.....u...~ ~..s.~ ...... . at premises located at ..~...-~.~..~ ................................ ~ .................................................. County Tax Map No, 1000 Section ........................ Block ...................... Lot No ......................... the Building Inspector. Fee $..~.**.,'..~ ..... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Depertment Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR C[~RTtFICATE OF OCCUPANCY Instructions This application must be filled in typewriter 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 natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposel-(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 certificatb of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~roperty 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. 1, Certificate of occupancv 2. Certificate of occupancy on pre-existing dwe. llipg $15 ~ 0 0' 3. Copy of certificate of occupancy $1.00~ ~ . . r 5.Upda~,eG C.O. $15.00 Date . '-'t j.¥j~..~..~..- . t ............... NewCo~struc~o~ .. Old or Pre-existing Building ~ ................ Vacant Land ............. . - Location of Property ~ ..................... f ..... Hou~ No, Stoat Ham/et Owner or Own~rs of Pro~erty ................................................ .. ... . . . ~ou~ty Tax Ma~ Ho. ~000 Se~tio~ ............... Block ............... ~ot SuBdivision .~OB ....................................... ............. Viled Map No kot No Date of Permit ........ Applicant . .~~ ...... Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters A'pproval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..~'..0.(! ..................... . Construction on above described building and permit meets a~des and regulations. Ap. .............................. Rev. 10-10-78 7654802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL REMARKS:, ~)~ FIELD IN~gFECTION 1. FOUNDATION (1st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;i Approve~.W~..~...&.~., 19~.~,, Permit No. l .~.".~ .~.~..~. Disapproved a/c ..................... : ............ :. · (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typew~riter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. ~ icor~lo b. Plot plan showing location of I, ~ ;[~J[~l~k'~remises, relationship to adjoining premises or pubic streets or areas, and giv~g a det~led descri~ t of: ~ o~r~ must be drawn on the diagram which is pug of tMs appU- o. Th~ work covered by tNz ~ ~ a~ ?mmenced before issu~ce of Bugding Permit. d. Upon approval of this ~ ~ati, ~ ~ector wgl issued a BuildMg Pe~it to the applic~t. Such pe~it sh~l be kept on the premise~ ~ ~ ~~out tho work. e. No bugdMg shal~ ~ ~ n w~in p~t for any purpose whatever until a Ce~ificate of Occup~cy shall have been granted ~ ~ ~ng. ~ ~k~* ' APPLICATION IS HER~ ~ ~ ~;ldNg Dep~ment for the issu~ce cfa BMlding Pemit pumuant to the Building Zone Ordinance of tHe~ ~ '~ ~old, Suffolk County, New York, ~d other applicable Laws, OrdM~ces or Regulations, for the constmctioz ~ b, ~ additions or alterations, or for removal or demo~tion, as herein described. The applicant agrees to comply .wit.h~ ~applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premis~ ind in bttilding for necessary ins2ectigns. ....... ................... (Signature of applicant, or.name, if a corporation) ....... .......... (mailing address of applicant) State whether applicant is owner, lessee, agent, ~chitect, engineer, general co~t~~er or builder. ............. ............ ..........................*- .... N~eofownerofpremises .~.~ ~ --' ~ (as on the tax ro~s~JNG DEPARTMEIqT AT If applicant is a corporation, signature of duly authorized officer. F~t..OW~NG INSPECTIONS: FOUNDATIO~ ~O .............................................. FOR (Name and title of co~orate officer) 2 ROUG~ Builder's License No .......................... ~. F~NA~,. Plumber's License No ......................... ALL CO~}T~>CI'tON I. Location of land on which proposed work will bg done .................................................. House Number Street ......... h;~l;~ ......... Subdivision N~?}(}.U .G90.. P~'P.~. ~[¢.' ..... Filed Map No. t SC Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupanc~a*.~. ~.~[.~.. ~.~ ..... 3. Nature of work (check which applicable): Repair .............. Removal ... 4. Estimated Cost ~ O iI~.0(~ ; 5. If dwelling, number of dwelling units New Building . Addition .......... Alteration .. ......... Demolition .............. Other Work ............... . .~..~.~..~..~. , (Description) ................. Fee .. ' ........................ (to be paid on filing this application) ............ Number of dwelling units on each floor ............... If garage, number of cars ...... ! .................................................................. 6. If business, commercial or mixed 9ccupancy , specffy nature and extent of each type of use .................... 7. Dimensions ofexistingstructures,jifany: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................... ,. .................... ~t}' > ........ Dimensions of same structure with alterations or additions: Front . ./..~ Hi.. ....... Rear .. ].o~: : ........ Depth ..... lb...'~.' ........... . Height .. ~0. ~ ........ Number of Stories..[ ................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories ,. ...................................................... 9. Size of lot: Front ....... ~..~...; .......... Rear ...................... Depth ...... 9 .............. 10. Date of Purchase . .[~.~..I... '~'i ................. Name of Former Owner .]~C. ~e~. ~ ............ 11. Zone or use district in which premises are situated ................................................. 12. Does proposed construction violate any zoning law, ordinance or.regulation.. ~0 ........................... regraded ... ~0 .... ~ ................... Will excess fill bo removed from premises: . Yes (N~ 13 Will lot be 14. N~e of Owner of ~remises ~ '. I~ ~ .......... Address~ .~~...~;. Phone No.~ ~.~.~ ~ ..... ~ Nme of ~ .~O~f.~~g~.. Address .~ ~.~... Phone No ................ Nme of Contractor ,~a~&.. ~ .......... Addre~ ~ XP~Q¢~ ..... Phone No ................ 15. Is th~s property located ~h~n.l[00'~ fee~a t~t web,and? ~ Yea ..... No ~. * If vas, Southold To~ Trustees Permit ma r d~,~'~ Locate clearly and distinctly ~1 buad~gs, whethe~xis~p~sCd, ~lndicate ~1 set-back d~ensions from prope~:y ~nes. G~ve street ~d block numb r or description acc~ord~d~l~d ~ street nmos and ~nd~cate whe~er inte~or or cornerlot. ~ ~ ~)?,~ ~" STATE OF NEW YORK, !S.S COUNTY OF ~ ................ ., ..... .~ .(~.~('~.'b...~.. i. ~dkJL.~qQ'-.[~ ................ being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. 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 applicationi that all statements con~ained 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 i' O /D~ ~ , lANE ABRUZZ ........ ] .............. day o;. ~ .... 19 .~. ~d"O, Publl.o, rS!ate of N~w ¥o~ ~ ~ ,,~ No 52 4604994 Notary Publ~'c, ' ' X-'b f (Signature of applicant)