HomeMy WebLinkAbout15511-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Buildin§ Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z16299
Date October 19, 1987
THIS CERTIFIES that the building . .. ?.qo, ,1. ,a. qd.. re. nc, ,e ........................
3215 Little Neck Road Cutchogue
Locatmn of Property ............
........................... bl
House No Stree~J /-/am
County Tax Map No 1000 Section 1.0.3. ...Block . . .1.0 ....... Lot. 04
Subdivision ................ Filed Map No ..... Lot No ...........
conforms substantially to the Application for Bmldlng Permit heretofore filed in tins office dated
.... l-I o.v...I4 .... 198B pursuant to wt'ach Braiding Penn~t No 155I IZ
dated ...N oy emb e .r. 1.9, . .I 987.. was issued, and conforms to all of the requirements
of the applicable provlmons of the law The occupancy for winch this cert,ficate is ,ssued m ......
.Co.nstru.ct .an. zn. gr.qqn.d
The certificate m issued to LUKE
of the aforesmd building.
poo~ .~nd. f%n~. . ..............
VAUGHAN AND KATHLEEN VAUGHAN
~wne~ le~Tc~ ~7~e~"ff~
Suffolk County Department of Health Approval . . . Iq ./A .........................
UNDERWRITERS CERTIFICATE NO
N8339 15
PLUMBERS CERTIFICATION BATED:
Rev 1/81
FO~ NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERJ~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 15511, Z
Permission is hereby granted to: ~ ' ~ n . ,
..~.~ ~' ~.
........................
at premises located at ...~....~...I..~/. .......... & ................... :...
County Tax Map No lO00 Sect,on ...l...0....~., Block ........ .~.,.O. ...... Lot No.....~-.~. , .
pursuant to application dated .... ~~..../..,~. ....... , 19 ~.(~., end approved by the
Budding Inspector.
Building Inspector
Rev 6130/80
FORM NO 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCU
BLDG. DEPT.
A_~_.CT0_ WN o~ SOUTHOLO~
Instructions
A
This apphcation must be hlled in typew.ter OR ~nk, and submitted m~,,----~, to the Building Inspec-
tor w~th the following; for new buildings or new use:
1. Final survey of property w~th accurate location of all buddings, property lines, streets, and unusual
natural or topographm features.
2. Final approval of Health Dept. of water supply and sewerage dmposal--(S-9 form or equal).
3. Approval of electrmal installation from Board of Fire Underwriters.
4. Commercia~ buildings, Industrml buildings, Multiple Residences and similar buildings and instaJla-
tions, a cert~hcate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed s~te plan requirements where applicable.
B. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex~st,ng"
land uses.
1. Accurate survey of p~operty showing all property hnes, streets, buildings and unusual natural or
topographm features.
2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent mforma-
tion required to prepare a certificate.
C. Fees: Additions $25.00
1. Certificate of occupancy ~Tew Dwelling $25.Q0, Accessory ,$10.00 Business $50.00
2. Certificate ofoccupancy on pre-existing dwelling $ 50 00
3. Copy of cert~flcate of occupancy $ 5.00, over 5 years $10.00
5.updated C.O. $ 50.00 Date .....
NewConstruction ...... Old or Pr¢-ex~st~ng Budding .......... Vacant Land .............
Street Hamlet
Owner or Owners of Property ~,~/,~..~..~.~ .r- ...............
County Tax Map No. 1000 Section .............. Block ,~'~ Lot
..............................
Subdivision .......................... Fded Map No ........ Let No ............
Permit No ......... Date of Permit ....... Apphcant .....
Health Dept Approval .................. Labor Dept. Approval .......................
Underwrtters Approval ..................... Planning Board Approval ......................
Request for Temporary Cert~hcate ................. Final Cert~fmate .......................
Fee Submitted $ .......................
Construction on above described budding and permit meets all apphcable codes and regulations
Apphcant ........ ; ..............................
C.o, ??
OUNDATION (1st)
OUNDATION ( 2nd )
,OUGH FRAME &
FLUMBING
:NSULATION FER N. Y.
STATE ENERGY
CODE
ADDITIONAL 4MENTS
765-1802
BUILDING DEPT.
INSPECTION
] FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION ZND [ ] INSULATION
] FRAMING [~/]~ NAL
REMARKS:
DATE
INSPECTO~
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING ~~NAL (
REMARKS:
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [/?N~A~I.
TOWN OF SOUTIIOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN tIALL
SOUTIIOLD, N Y. 11971
TEL 765-1802
To Whom This May Concern,
We are unable to complete your Certiflcata
of Occupancy because of the following reasons.
/~/ An application for CerLificate of Occupancy
is not on file. ~>~c_~-am~d~
/Z/ No Underwriters Certificate on file.
/8/ The check ls(outdated/not on file.)
No Health Dept. Approval on file.
/Z/ No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit II / 3- ~_ _~ Z
Building Dept.
***/Z/ No Plumber Solder Certificate on file.
( all permits involving plumbing bclng
issued after April 1,1984 )
of Occupancy. Clear up
Thank you
hi
Approved
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N Y 11971
TEL.' 765-1802
Permit No J !$''~'ll ?~
Received ......... ,19..
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date N?. 14 86, 19.
INSTRUCTIONS
a Tins application must be completely filled m by typewriter or in ~nk and submitted to the Bud&ng Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule
b Plot plan showing locat,on of lQ ~nd of bmldmgs on premises, relationship to adjoining premises or public streets
..~or-a~eas, and giving a detatled descnp~.'b~o,f layout of llgoperty must be drawn on the &agram which ~s part of tins apph-
c. The work covered by }ins al~phc~mon maj{47,o't be commenced before issuance of Building Permit
d. Upon approval of ting apphcat~on, the g~221 ,d. mg Inspector will ~ssued a Bmldmg Permit to the apphcant Such permit
shall be kept on the prermses available for msp%c~oh throughout the work. ~
e. No budding shall b~ occupied or used in whole or m part for any purpose whatever tmtd a Certificate of Occupancy
shall have been granted by the Bmldmg Inspector
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldmg Permit pursuant to the
Budding 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 w~th all apphcable laws, ordinances, building code, housing code, and regulatmns, and to
admit authorized inspectors on premises and m budding for necessary ~nspections.
(S~gnature of applicant, or name, if a corporatmn)
State whether applicant ~s owner, lesse~arcintect,
en~neer, general contractor, elecmcmn, plumber or bmlder,
Name of owner of premises ... Mr'. and MRS< Luke Yaughn
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builder's License No
Plumber's License No
Electrician's License No I227
Other Trade's License No 39-
Location of land on winc. h proposed work will be done
ltouse Number Street
lo3
County Tax Map No 1000 Sectiou
Subdlvlsloll
(Name)
L~ttle. neck P~ad. £utchogue
Hamlet
Block . t O Lot.
Filed Map No Lot
a Ex~stmg use and occupancy ~eslderK:e
b Intended use and occupancy S~lJll Paal 5"
mth. 5' w&lk around ce.ment deck D.en.cg. tp
2 State emstmg use and occupancy of premises and intended use and occupancy of proposed construction
3 Nature of work (check which applicable) New Building .... Additlon .... Alteration ....
Repmr ...... Removal . , · Demohtlon ............ Other Work ...........
18 x 36' smmlng pool ........................................ ~Descnptmn)
4. Esttraated Cost ...... $7,000 ................... Fee .................................
(to be pad on filing this application)
5. If dwelhng, number of dwelling units .......... Number of dwelling units on each floor ............
If garage, number of cars ......................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...............
7 Dimensions of existing stnlctures, if any Front.. I~0 ~ ...... Rear . .6.0. ' ........ Depth 30. .........
Height ...... Number of Stones . 1
Dimensions of same structure with alterations or addlhons' Front ........... Rear ............
Depth ........ Height ......... Number of Stones .................
8 Dimensions of entire new construction Front .... Rear ....... Depth ............
Height ........... Number of Stones ................................
9. S~zeoflot. Front...100.35 ........ Rear .100 ............... De"th 151. . .
10 Date of Purchase 84 ........ Name of Former Owner ....vO~.f¢ iOu:fg~ ............
11 Zone or use district m which premises are situated,.. Res ............ .... . . ..
12. Does proposed construction violate any zomng law, ordinance or regulation: NO ........................
13 Will lot be regraded .. no ........... Will excess fill be removed from premises, x~g No
14 NameofOwnerofpremlsesL[llqe ¥OU§hn ..... Address .1.1t. tle..Nk Rd.. Cut PhoneNo 7.34:6!42. ......
Naxne of Architect Address ...... Phone No .............
NameofContractor..$elf.]']]]il .. i Address .......... PhoneNo ...........
15. Is this property located withinl00 feet of a tidal wetland? ~ Yes ..... No .X.X.X..
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and dlstmctly all buildings, whether existing or proposed, and. ,ndlcate all set-back dimensions from
property lines. Give street and block number or descnptmn according to deed, and show street names and indicate whether
interior or corner lot.
"IMMEDIATELY,,
NC OSE Pool TO COD
~,~'OltE 'WATER
UPANoy OR
/iTH/s UNbl WFUL
OUT CERTIFi
OF OCCUPANcY 'C,4 TE
~OTl~ ~ILDING DEPARTM~ A~
FOLLOWING
F~NDA~tON ~O
~B PO~ED CONniE
ROUGH FRAMING &pLUMBING
~. FINA[ CoNSTRUCTiON MUST
BE COMPETE ~OR C.O.
A~ CONSTRUCTION sH~L
THE REQUi~ENTS ~ ~ N.Y
STA~ CONS~uc~ON
~D~ NOT ~S~NS~E
~IGN OR CG,~S~u~ON ~RORS
STATE OF NEW.YORK ....
COUNTY OE. ?.Lc~{.f~,L.~.~ . . ~-~
......
(Name of lndiv/dual s~gmng contract)
above rimed
.... being duly sworn, deposes and says that he is the applicant
He is the ...............(Co.tr.~...r'~ :~'*"~ ' ~'2~o;p orate ' ' o fha; r, "' etc,. '~ ..................
of said owner or owners, ~d ~s duly authored to perform or have peffo~ed the smd work and to m~e ~d file ~ls
apphca~on; that all statements contained m this apphcat~on are ~me to the best of hm ~owledge and belief, and that the
work will be perfo~ed m the intoner set for~ m the apphcatmn filed therewith.
Sworn to before me thD
....... ]?..~ .... dayof.. ~~ ,19~ ~ ~ ~
qota~ Pubhc ....... ~ ...... CounW
No~ Public, ~ ~ ~ ~ ~ /
No ~22563, Su~
TermE~tres~r3~, 1R ~ ?~