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Home My WebLink About14789-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of, Occupancy No...z.~.47.~3 ......... Date July 25 ., 19.8.6. THIS CERTIFIES that the building ....Gree~'~ousD. ................................ 6865 BRIDGE LANE CUTCHOGUE Location of Property ~$$s~ County Tax Map No. 1000 Section ...B..4 ....... Block 01 .Lot 06.7 Subdivision SYLORET ESTATES ,Fried Map No..6.~90..Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... AP.¥i)-..],5 ....... , 19 .8.6. pursuant to which Building Permit No..Z..4.7.8.9. g. ............. dated ...~p.r.~.~..2.5 ................. 19.86.., 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 existing one family dwelli,n.~. The certificate is issued to MR. & MRS, J. KIRBY (owne.rXlg~~XXX of the aforesaid building. Suffolk County Department of Health Approval ........... lq./.~. ........................... UNDERWRITERS CERTIFICATE NO ................... .N./.~. ........................... Building Inspector Rev. 1/81 ~ORM NO. ~ TOWN OE $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~RIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14789 z Permission ~s hereb/granted to: ..... ................ .......~...~.~......L ~.~..~ .......................................... ~- .~.~.~...g~........t~..~....~.......~.~.~.~ ~ ~o .~~....~..~.....~..~.L~.....~-.. V 4 , ~, ~,, ._.. ,~ u~ ,VJ ,~ ~ ~'~ · at ~,e~,s~, ,oco,~d ot ..~..~..~.~. ........ ~~....~ ...... ~~...~.........~..:~.,... .................. : ................................................................................ Counb' Tax Map No. 1000 Section ....... ...C~.....~...,.~.... Block ....... ,,~,...~ ......... Lot No ....... ,(~--..~,.:..~. .... pursuant to application dat~cl ...... C~....)..~.. ...................... , 19.~..~.., and approved by the Building inspector. Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submittecl-J~=P~'~,~cctc to the Building Inspec- tor with the following; for new buildings or new use: I. 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 disposal-{S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commemial buildings, Industrial buildings, Mu(tipie 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. 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 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, Fees: 1. Certificate of occupancy $§.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date .......................... New Building ............. Old or Pre-existing Building .......... Vacant Land ............. Owner or Owners of Property ..~.~ .~. :~.-,~.'~.':~.~.. :~. .... ~:~-; co~.tv ~.x u., ,o. ~0~ s~o. .... S..-[ ....... ~oc~ ...~. ~ ......... Lot .... [:.k,./ . . s,~,,,~,o, :.~./:%:...(.(~:~ ............ ~,,~ ~ ~o. ~. ~.¢ .... ~o~ ~o..... :~ ........ Permit No./~.~')~ ~ ~ Date of Permit .Applicant ~ .... ......... · ~ :.,p · .~ .................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submittgd $ ..... ~ ..................... Construction on above described building and p~rr~i,t?meets all a.p,p.[]cable,c,odes and regulations, Applicant . ~.~ .:~. ............ ~:~.: ..................... BUILDING DEPT. ~ ~~~'~~ INSPECTION FRAMING [~"~AL REMARKS: -,, / --,I// * DATE INSPECTOR ,~. 765-~.802 BUILDING DEPT. INSPECTION ~]~FOUNDATION 1ST [ ] ROUGH PLBG. [ ]~FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL REMARKS: FOUNDATION {~st) FOUNDATION (2nd) 2 o ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: i..ANF LOT ~' o£ SYLORET E$TAT£S FILED dUNE 8, /..978; FILE N°- 6390 SITUATED AT CUI'CHOGU£ TOWIV OF $OUrHOLD SUFteOLK CO. IV. ~, pARK 8 PI"AY~RoUND CHICAGO TITLE INSURANCE CO. ' ~rH~L '~ KIRBY sealand II0 west mare st~,eet riverhead, new york 11901 (516) 3'69-1717 MAY 15, 1985 I dOB Nc' 85-869 1000-084-01-06.7 ~ SCALE: 1"=40' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .... ¢.X7'. .... 19 Approved ...O~....~..~'..., 19 g.~. Permit No. ] .q. 7.~. ?..'~. , Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No .................. Date }k I ~ 19 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 appli- cation. c. The work covered by this application may not be commenced before issuance of Building Pbrmit. 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 $outhold, 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, ~u~ regulations, and to admit authorized inspectors on premises and in building for necessary in~p~ec~,io~s/) ..... ..... (Signature of applica~~/,a.._cor~ff..r~ation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,-'t .................................................. Name of owner of premises..tx . .., g..eeo ............................................ (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 .............. .~.. .................................. House Nmnber Street Hamlet County Tax Map No. 1000 Section ...... ?...~. ........ Block...~....O.. ! ........ Lot.~ ........ ·.t4 L..O~C T' ~.iS"~'~£ FiledMapNo. (q.~..~.~. ...... Lot /.?.'~..Z ..... 5. Subdivision.. / .......... (iq'a~;) ................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .¢. ~ ~, ' ................... d~J '~I~;' r ¢/~i:~'L~ '~ ............... b. Intended use and occupancy i.t~e... ?.,.c.~.¥~..~.y,.~..a.: ............... ~¥J~. '~'}~'?Y:.~:.:'.".' .":5 .............. 3: New Building .......... Addition....~.., .... Alteration .......... .................... Demolition .............. Other Work ............... ~ (Description) 4 .......................... Fee ...................................... (to be paid on filing this application) 5. fi~inbe¥ 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 ....'-~fT~... .... r ........ 7. Dimensions of existing structures, if any: Front....~i-~. ........ Rear .. ~(7~ ........ Depth '.. fl.. ~...T...7-..?.~.. tteight ...~ ........ Number of Stories L Dimensions of same structure with alterations or additions: Front . ~r~.f. ........... Rear . .~..~'~. ........... Depth:. ~.g ..... ~. ?'7.... ! Height P.<~. · ................ Number of Stories .......... tteight ../...~f. ......... Number of Stories .... ~ ii i'" . i'~' .......... .~ .i .......... __.......... 9. Size of lot: Front . ../.~ :.~... i ........... Rear ...... £.cff, .o. .......... Depth . ~f~..~..'2.. ~./,. ...... 10. Date of Purchase ...... i .................. N,~me of Former Owner ............... 11. Zone or use district in which pr~mises are situated .... /~¢~Jl;. ,., .1~..~ .~ ..~ ..... 12. Does proposed construction violate any zoning law ordinance or regulation: ....... ~ ?. ..... 13. Will lot be regraded .... '~' .~..i · .., ..... : .......... Will excess fill.be removed from premises: Yes (;~o ~ 14. Name of Owner of premises .'~, }{ ! (~ ~ Address ~,1~(~37 t3~¢¢~ ~-t~,-~ Phone No Name of Architect ......... i... Address ................... Phone No. Name of Contractor ~..c~..~.-. '.~: .~.'~-~;:: Address .[~.~ .~..%~.~. ....... Phone 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 interior or corner lot. dumber or description according to deed, and show street names and indicate whether STATE OF NEW YORK, iS.S COUNTY OE ....... t~ ....... .......... (~ja.~ ~ ~,~. · ~i~,~s~.;,~ ~,; .~.,,~, ;;a.~;~- ' -'-~ ~- --~'~- -~-~-~ ~,~,,~- ~-~ .......... being duly sworn, deposes and says that he is the applicant above nmed. Heisthe , . ................ ...... ~{ ........ '. (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is duly authorized to perform or have perfomed the said work ~d to m~e ~d file this application ;~ that all statements contained ~ this application are true to the best of his knowledge and belief; ~d that the work will be perfomed in the m~m: set forth ~ the application filed therewi~. Sworn to before me this /~ ~ ~ ~~ ....... 19~ ......... , .......... ~ ....day Nota~ Public ...... ~.~'' .... ~~ ~. .................. ~ '~g~~ (Si~ature of applicant)