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Home My WebLink About15541-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... .g.~.5.4.5..2 ...... Date .. p.e.q .e.m.b.e.~...4., .................. 19.86 THIS CERTIFIES that the building ...... ./l.q q q .s .s.q ~. y. ~.?~ ~ ql ........................ Location of Property 315 Briarwood Lane Cutchogue, N.Y. House No. Street Harhlet County Tax Map No. 1000 Section 13 6 ..... Block 01 .L~ot 02 ~: " Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 4,. ..... 1,9 .~.6. pursuant to which Building Permit No. ~ 55.4. 1 g' dated D.c.c..e.m.b.e. ~...4., ................ 19. ~.6, 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 Accessor~ Shed The certificate is issued to MARY E. BOGAN (owner, ~eYo~ ~YL~b~ X X of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ................... ~ ./.~ ........................... Building Inspector Rev. 1/81 lrOR~ 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) NM 15541~ Z at premises located at ...~...~...~ ~ ..................... ................................................................................................... County Tax Map I~o. 1000 Section ....... /,,~ ..... BI~K .......~.] ......... Lot No ......~..~ ......... pursuant to application date~~....~ ............... , 19..~.~, and approv~ by the Building Inspector. Rev. 6/30/80 FO[tM NO, 6 TOWN OF SOUTIIOLD Building J-)apar tnlant Town Hall ~Joutbold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions '[Iris application must be filled in typewriter OR Ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: $. Final survey of property with accurate location o1 all buildings, property lines, streets, and unu~a~ natural or topographic features. 2. Final approval of HeaJth Dept. o1 water supply and sewerage disposal-(S-g form or equal). 3. Approval of electrical Installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings arid Installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the bulJdJng, B. Submit Planning Board approval of completed site plan requireroents where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featureS. 2. Sworn statement of owner or previous owner as to use, occupancy arid 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 occupancy $5.00 2. Certificate o[ occupaocy on pre-existing dwelling/ land use ~3. Copy of certdicate of occupancy $1.00 --Fre-Existing C.O. $15.OO Vacant land C.O. $ 5,00 Date..DecAmber..4,.¢&86 ..... New Building o .~CJ ....... Old or Pre-exl,sting Building ............ Vacant Land ............. New Yo.r.k Location oi Property ..... ~F.~.~QQ~ .~q9 ~ .C.u.~.qh.o.~u.e~ ~. ................................. House No, Street Hemle~ Owner or Owners of Property ~JqEY. E. Boqan County Tax Map No. 1000 Section . ....... Block .0. L..0.q ......... Lot ..... QQ2.,QQ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .............. ,. ~ ........ Planning Board Approval ...................... Request for Temporary Certilicate .................. ~Certificate Fee Submitted , .... t 5.0.0 / Construction on above sc ations. 6ARY FLAI~ 0LSEN, ESQ. .-.mlo.~s Main Rd. P. O. Box 706 Cut.chogue, New York 11935 OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & PLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined. ~..~.~..~.., 19~ c'--' ~.~...~ q , 19~. Permit No.1 ~-'~'~}];~C~ Approved ......................... Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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. 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 necessaryr_- -- J,~ --in'~ecti°ns' ~ / ' , , ' (Signature of Apl~a~_ e, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrtcmn, plumber or Name of owner of premises...~. ~..~.,.~1;~ ~ .~ ................................................ (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 ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done..~..~. · · .~-,-d. ~--4~-t,O~O ................... ........ ....... ................... House Number Street Hamlet County Tax Map No. 1000 Section ..... 1 .~..(,O, .l~..(~.. Block ..... ~..* .tied ....... Lot..~....t~) ...... Subdivision ................ (~q'a~) ................ Filed Map No ............... Lot . .: ............ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~.~X~) .......................................................... b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building ...~.~. .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost.. ~ t,~.~:~.: ."., :. ........................ Fee ...................................... (to be paid on. filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If.~,~a. ge, number of cars . . . :. .................................................................... 6. If.bu ' ."gi~co~mmercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimension"~xisting structures, if any: Front ............... Rear .............. Depth ............... H.eight ......~...~..... N~mber of Stories ........................................................ D~nsions of same st~,~ with alterations or additions: Front ................. Rear .................. D~. 2'".." ..... . .'"~....,.Height ...................... Number of Stories ...................... 8. ............... Rear ............... epth ............... Hei~~ .Number of'Slo~s ........................................................ 9. Siz~ ........... . .">~ar ...................... Depth ...................... 10. Date of Purc~~. · ..--:. ~ .'~,<kName of Former Owner ............................. 11. Z~t. ua?d...~ ............................................ 12. D~w, ordin~,n.~egulation: ................................ 13. W~!l_~exc~ be removed from premises: Yes No 14. Name o~d~ress ..... ~ ......... Phone No ................ Name o~ress . ........ ~ ..... Phone No ................ Name of Contractor ................... ....Address_._.....:...~....~-,~.....PhoneNo ................ 15. I~f f ~ ~idal wetland? * Y~ .... No ..... · If yes, Southold Town Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and blogk number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing 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 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... Notary Public .................................. County , _ / / , , (Si~ature of applicant)