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Home My WebLink About14896-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... Z.~.4.8 ~ 6 ........ Date .... $ ~ p.t.e, r0 [3.e.r.. 1 ?., .............. 19 ~3.6. THIS CERTIFIES that the building..C 9~.t v. ~.t..~ka%~l~y..t.q. ~.~s.~ ~g .d..w~.l.l.~vg. Location of Property 2800 Pine Tree Road Cutchogue, N.Y. House A/o. Street Ham/et County Tax Map No. 1000 Section . 1 04 .Block 0 2 ..... Lot 1 4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated M~2.. ~ 5.~ .............. ,19~. pursuant to which Building Permit No .... 1.4. .8 ~.6.Z. ........... dated .. ~1 ~ y..~.5. ~ ................. 198. 5., 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 ......... ..Chimney to e.xisting one family dwelling The certificate is issued to Im e 1 d a C o r c o r a n ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ........ .N./.fi. .............................. UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 I~OBM NO. ~ TOWN O~ $0UT80£~ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14896 Z Permission is hereby granted to;_ ...... ........................ ~ ~, n /~ , I t ~ ~1_ I ..... ~9' .............. J ........ ................................................................................ ..... ../..c......~~.~.....~.~ ~ .. Count-/ Tex M~p No. ]000 Section ...... ~....0...~. ....... Block. ..... ..C~.......~... ..... Lot No..../...~.. ............. ~,r,~o~,t to op~,~otio~ ~oted ...... ~.......o~...~....S:.. ................ , ,~.~., and by the Building Inspector. 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 m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW with accurate location of ali 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 '~ 5. Updated C.O. $15.00 Date .... ; .~.~ ............. New Cons t~uction House No, Street ~ Ham/et Owner or Owners of Property . ~-¢...~'~ .............................. - County Tax Map No. 1000 Section . ./.~.z~. ........ Block .... #.2_~, ....... 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 $ · ,~.¢.~i ...................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 TOWN OF S0UTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Re: Imelda Corcoran To Whom This May Co~cern, We are unable o complete your Certificate of Occupancy because .of the following reasons. /--/~/An application for Certificate of Occupancy is not on file. /--/ No Underwriters Certificate on file. /_~/ The check is(~/not on file.)~,C~ /5/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # J_ ~ ~ ~ ~ Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) 765J.802 BUILDING DEFT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE, INSPECTOR FIELD INSFECTtON FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE COMMENTS FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined· j.~..c~.( .~'...., 19 .~.~. Approved Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT Application No .................. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary inspections. ................. (Signatf~e of applicant,~r name, if a corporation) (Mai~ing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ................................................................ (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....~. f'' Plumber s License No ......................... Electrician's License No. ~" Other Trade s L~cense No. t~--- Location of land on which proposed work will be done .................................................. ....~.. ~ .~. ~.) ........... ~/..~.. ~Z...'7.}~ ~'..~...~..~..~..~... ':' '~'; '~'~H'a'~'l'e~ ....................... ' House Number Street CountY Tax Map No,' 1'000 Section . .... I..0..~. ....... Block .... ~.~,- ......... Lot... !..4 ........... 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 .../-J. ~: .......................................................... b. Intended use and occupancy ..~2--~ro~, 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration. . ~.~...,~.,. Repair .............. Removal .............. Demolition .............. Other Work ~.,.,~y~...~. (Description) 4. Estimated Cost ....~. ?. P.: ............................ Fee . .~..~. :. [ ............................. (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 mixed occupan, , specify nature and extent of each type of use ..................... 7. Dimensions of existing structures if ansl~ ~nt. ~ .... ~._. Rear ............. Depth... Height ............... Number_i/II S~ ~'~'~~s~'X'~'..,~.'~ ............................... Dimensions of same structure ,w~l~"~. at Depth ............ ~,'~l~i~l~t ~'~- '"'~'~.~ · ~,~.~1~ .~.'~. ..... Number of Stories 8. D~mens~ons of enOre new~t~'cti0~ ~t~.'~ . . Rear ......... Depth Height ....... ~,~'~'r01~r~ ( ~.'~.2'~ .... ' .... - ............... 9. Size of lot Front ~..,a..~"~ 41[ .i~."1t~-~. ............ l~;~,it} ....................... 10. Date of Purchase ...~..-,~ Y~t[~ ~..~'. Name of Former Owner ............................. 11. Zone or use district in ..w~_~.~} ~e~tl~. .................................................... 12. Does proposed constructioh~t~~ ~t~ law, ordinance or regulation: ................................ 13. Will lot be regraded ..... '~? :4*2 ~ ........... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .c.~..'7... Address t,,~ Ph-'-~ ~,r,- · '/~ '~'~ ................ ~i ...................................... Name of Architect ...,,a .... ~ ............... Address ....... ,~, -~ ...... Phone No Name of Contractor .~..~- ~J .~.~ Address/ ~ f/~.' t~,~ Ph~n^ x~^'-~c~' 'd/'~,.~ ' ' ..... ..... ......... ........ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, 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 interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. APP~OV~O A~ FOLLOWI~}G ~NSPECT~O~S: 3, ~NSO ................................................. 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