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Home My WebLink About14572-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... ~.1fi. 559 ....... Date July THIS CERTIFIES that the building ..... .s.q r .e.e.n.e.d. 7.~.n.. p. ??.q h. ...................... Location of Property .. 5.50 ............. y.a.n..s ~.o.n. Rd . Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section ...... 1. 9.4...Block ....... 12 .Lot 9 Subdivision.. N~a~P..P.Q~4a.t..H..ap..A. ....... Filed Map No. 156 .Lot No. 195 conforms substantially to the Application for Building Permit heretofore filed in this office dated · .J..anu~.P. 7.2.1 ......... 19.8.6. pnrsuant to which Building Permit No ..... J .4.5.7.2..Z .......... dated ...... 3... Fol).r, cl~ ~'y..26 ..... 19..8 .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 ......... Screened-in porch addition to existing one-family dwelling· The certificate is issued to WILLIAM BRUNET ..................... ?o¥,'~;, ¥~&~o'~'~C/d~I9 ...................... of the aforesaid building, Suffolk County Department of Health Approval .. N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD 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) 14572 Z Permission is hereby granted to: .~.~.~....~....~..~..:. .... ~.-~....~-~...c~.~- ................ ~~......~..:.~ ........ .u..~.~..~ .......... ,o ..~~........~....,,..~...~..~....~...~....~~....~ ............................................................ ~..,.,~.o,~o, ...... ~ ......... ~~.._~ ............ ~~..~ ............... Coun~ Tax Mop No. ~000 Sectio, ...L..O...'[. .......... ~,o~ ..... l..~ .......... Lo~ ,o ..... ~ ................. pursuant toapplicationdoted ....~.~~:.;~.1 .................. , '~..~..., and opp~o~,~ by ,he Building Inspector. Fee $...~.~.,, :...~.,, Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY i 2 5 1986 ~. BLDG DEPT Instructions A. This 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: 1. Final survey of property with accurate location of alt 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 peoperty showing ail 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. C. Fees: ~r *~ C' ~ -4 / $- C O 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use tlC C,(~.~-'~L- I?~l~, ~:~ ~/~. O ' Z ~S'". 3. Copy of certificate of occupancy $1.00 Date., .~.r~e..2~. · .]-98~ ...... New Building ~ Old or Pre-existing Building Vacant Land Locatio~ of Property · .~,~.0 Ve. as~on ~o~d Hou~ No, Street Ham/et Owner or Owners of Property ~ ~.~. ~r~ ~ ............................................ Coun~ Tax Map No. 1000 Section [0~' Block [2 Lot .... Subdivision .~..~. ~..~ .~. ?P.[g~ ........ Filed Map No~ ........ Lot No .... [~ ...... Permit N~ .... Date of Permit ~/~..Applicant~ ~5.~q~e.~'. ~ ~,..~. ~.e~. ~,. Health Dept. Approval .~ .................... Labor Dept. Approval .... ~A ................ Unde~riters Approval ~ .................... Planning Board Approval .. ~/~ ................ Request for T~mporary Certificate ...................... Final Certificate . .~ .................... Fee Submitted $..~,O'0'· .~ ~. ~ ..... C~;:tructiononab~,,-~e~ribedbuilding~t~l/~odesand~, regulations. ' ' ~ ,, ~ , / ~ppdc~t . .~.J/~ .... ~e~e~ ........... R~, 10-10-78 FIELD INEFECT%ON COMMENTS FOU__ND~TIO__N ~ (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ CODE ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 ~r~...x~.~ ~lv . . Permit No. Approved ...... 7 .x(~. ..... 193{0 J.~.~ .7. ~ .'~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ~ 1'OWN OF ~OU~OL~, Received .......... ,1 9 · · · 3~z~ ~ Date ................... 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 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 regulation_s, and to admit authorized inspectors on premises and in building for necessary inspections, .(/v.v'/r&96/~.~./7:. ~&.x..;./..~.e.: ............. (Signature of applicant, or name, if a corporation) .~ .7.r..27.: .~..,;?.../7. e.~..r. (,~.~e. :..~.e.~.~,o.& ././.~?.~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N me owner of premises ........ . ......................................... (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..~.~.~ .g.k~. ..... Int. .g'..~..J'~.(v.. Plumber's License No ......................... Electrician's License No ....................... LocationOther Tradeland'S LicenSewhichNO ...................... .~..~..O....~../~... of on proposed work will be done ..... ~..~ 1. .............. . . ......... House Number Street Hamlet . County Tax Map No. 1000 Section ... ff.q.~ ......... Block .... /.~. .......... Lot .... q. ' Subdivision. ~. f~.*..'c. ~.&~.. [~/: ....... Filed Map No .... (~ ...... Lot .... (~. ...... (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~Z .~: .... ~g~.C~ .................................... b. Intended use and occupancy ~? 9. 10. 11. 12. I3. 14. Locate clearly and distinctly property lines. Give street and block interior or corner lot. N4t~e of work (check wh~ pphcable): New Budding .......... Addition ....... ~teration .......... R~Fair '~'i'~'~'"~°~al .............. Demolition ............. Other Work ... (Desc~ption) [ ~2 .' '~ ?~.'3. :t~ ~'WO~ ~ I (to be paid on filing this application) If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage number of cars If bu~ness, commercial or mixe~ occupancy, speciy nature and extent of each type of use ..................... D~mens~ons of ex~st~ng stmcture~, if any: Front ............ Rear .......... De ...... Height /~ ~ Number of Stories D~ensions of same stntcture with alterations or additions: Front ~ Rear . ~P .......... Depth ..... ~..~.~f .... [.. HeiSt ....... /.~ ......... J~J ~u~be;~}~[~s .... [:[.~[.j...>,.:... Dimensions of entire new const~ction: Front ..... Hmght ...... (Q ....... Number of Stones . . .g .................................... ~. ............. Size of lot: Front ...... ~/.~ .~ ........... Rear ..... ~ ............. Depth . .~ ............... Date of Purchase ........... ~ .................. Name of Fo~r Owner .... , ........................ Zone or use district in which pre'mises are situated Does proposed construction violate any zoning law ordinance or regulation: ........ ~ .................. Will lot be regraded ......... ~..,~ ............. Will excess fill be removed from premises: Yes No} Nme of Owner of premises ~/l&.~...~F~.. Address ~ ~.~. ~qr~. ~.. Phone No ................ Nme of Architect . .~ ....... i ................. Address .... ; .......... ~; Phone No ................ PLOT DIAGRAM ~] build,ds, whe~er existing or proposed, and. indicate ~1 set-back d~ensions from number or desc~ption according to deed, ~d show street names and indicate whether STATE OF NEW, YORK, GOIj2~TY OF .,~, ·, .... rT, . ~.~. ~{~ .~.. (Name of individual sig¢ing co~tract) above named. ......... being duly sworn, deposes and says that he is the applicant He is the . .. ,1 (~(Contr_a.c~t ~r~g{~fi~',~ corporat~ '6 f~ etc.) of said owner or owners, and is ddly antho'6Ylr~r~e~':~ perfornC'or~p-~-~0-rrm-~ the said work and to m~e ana file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; a~d that the work w~l be perfo~ed in the m~nbr set forth in the application filed therewith. Sworn to ~efore me this ~~,8~MNMY~ ,' ' ' /' -- ~ignature of applicant) ] Term E~free Ma~h ~, i'" ,:: APPROVED AS NOTED ' BUILDING DEPARTMENT AT 9 AU TO 4- FOLLOWING INSPEC~ONS: I,~F~U~DA~ON ~ REQUIRED FO~ POURED CONCRETE 3~tNSU~TtOrJ 4~,FIN~L CC~S~UCTION MUST ~E COMPETE FOR A~[ CONSTRUCTION ~L ME~ ~ ~QUtR~ENTS OF ~E N.Y S~TE CONSTRUC~ON & ENERGY CO~ES ~OT ~S~NSIBLE ~R ~B~GN O~ CONSTRU~ION ERRQ~, ~UPANCY OR USE IS UNI.AWR& PaP_£~4 L