HomeMy WebLinkAbout14579-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. z-16077 Date August 19,. 1987
THIS CERTIFIES that the building ...... ~.C. 95.S.S. 9 .~Y..q~..~5.~. .......................
6880 Nassau Point Road Cutchogue, New York
Location of Property ~l[~s~ h]ol ....................... ~'t/e~f ....................... h~mtet
County Tax Map No. 1000 Section I I 1 .Block 15 . .Lot 51
Subdivision ?./.o..N.a.s.s.a.u..P.o.l.n.t..C.l.u.b..P.r.o.p......Filed Map No.. 1.5.6. .... Lot No. 130
conforms substantially to the Application for Building Permit heretofore flied in this office dated
January 12, 1986 pursuant to which Building Permit No. 1/45.79 g
February 27, 1986
dated .............................. 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 .........
ACCESSORY GARAGE AS APPLIED FOR
ARTHUR V. JUNGE
The certificate is issued to ..................... [oi;n.og,.~sl~c~;~rn~y: ....................
of the aforesaid building.
Suffolk County Department of Health Approval ......... .N./.~. ................ . .............
N82255/4
UNDERWRITERS CERTIFICATE NO ..................................................
PLUMBERS CERTIFICATION DATED:
Rev. 1/81
FOKM 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)
County Tax Map No. 1000 Section ...... I./.I............. Block ....... 1.~ ........ Lot No ...... .~.'~..;J ..........
pursuant to (mplication dated ..~.. ~.~....L..~.. ................. , 19.~....{S'., end approved by the
Building Inspector.
Rev. 6/30/80
-%
FORM NO. 6
TOWN OF $OUTHOLD
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 property with accurate location of afl 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-'~.xisting'
land uses:
1. Accurate survey of p~operty 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 buiMings.
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 $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5/00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00 ~'/'~'~"/''~''
5.Updated C.O. $ 50.00 Date .............
NewC°ns truc t ion ...... O~d or Pre-existing Building ............. Vacant Land .............
Location of Property... ,~,,, .~, .,~,.. ,,~(. ~"~¢~/~,/.. ~,1¢~.~,/. ~C~, ......
· ' ' Hamlet
HouseNo, , ,~,,,~,,'J~.~ ......... k
Owner or Owners of Property . ~.../~'.
V
County Tax Map No. 1000 Section ....... ~. (/. F ....Block... ~.~.. ....... Lot ...... ~).'~../~ ......
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. ~.¢.~..~'..~. Date of Permit .......... Applicant...~..~ ~.~... ~.. r..~..~..~J.(~..
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ................... Planning Board Approval .
Request for Temporary Certificate ..................... Final Certificate ...~....~ .........
Fee Submitted $... ~..~..~.. ;~'..4~/ ............
C°nstructi°n °n ab°ye described building anO~,r,m~i,~ets all. aP~l. ilabt codes and. , regulations.
Apphcant ,..~. ,~\V ~ .......
Rev. 10-10-78
¢o &
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX ~
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no. Iq~?~ issued to ~L~tN-~x~x_ \/~ 0xx~¢~.
on .,~./~)/~ for ~o.~. lis ~rompleted and
a final znspection hag ( I) has not (~) been done.
In order to complete this file, it is necessazy that
a Certificate of Occupancy be issued. Please fill out the
enclosqd form, return same to the above office with a check
for *lO,coo payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very trul
Victor Lessard
Executive Administrator
VL:gar
encl.
THE
1000460
a. te July
THIS CERTIFIES THAT
NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
8S JOHN STREET, NEW YORK, NEW YORK '10038
N 822554
only the electrical equipment as described belotv and introduced by the applicant named on the above appl~catlon number in the premises
Arthur V. Juv~ge~ 688 Nassau Point Rd., Cutchogue, N.Y.
inthefollowinglocation; [~ Basement ~ Istrl, ~] 2~d t"I. garage Section ato~k
wasexaminedon ~U~y g~. ~ ~7 and found to be in colt pllance u"th the require.~e~ts of· tt % Board.
Lot
FIXTURE
OUTLETS SWitCHES FtUORESCENT
DRYERS
FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS
DIMMERS
SYSTEMS
NO. OF FRET
PAATELBOA RDS:
E R V I C
OF Hi-LEG
E
6880 Nassau Point Rd. ,.
Per
~h~s certificate m t n t al red ' . .... ' '"~ ~' ' '
FIELD ',TION COMMENTS
F O U__N D A_T I O__N .-- (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
~ CODE
FINAL
ADDITION
L COMMENTS:
o 'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Received ........... ,19...
INSTRUCTIONS
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 Buildipg 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 r~egulations, and to
admit anth°rized inspect°rs °n prenlises and in building f°r necessary inspecti°ns' ~,~3~ZT~.aA ~ ~
(Signature of applicant, o~r na~; ~ '~)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nam~ of owner of premises ....... ~..~..~. [~ .k>..WT... V>....q .t.2 ~.~.~-~ ................................
(as on the tax roll'Or latest deed)
If applicant is a corporation, signature of duly authorized officer.
Plumber's License No .........................
Electrician's License No..~ [ .&].~-.. E .........
Other Trade's License No ......................
I. Location of land o/a which proposed work will be done ..................................................
House Number Street Hamlet
County 'fax Map No. 1000Section ....... I.l.I ..... ,~.. Block ...[5. .......... '... Lot...04./ ............
· . .~,~. ,&4..~., .~.?..~./~ .~Filed Map No [>~ Lot [~
Subdivision.. A./~ ~J~ t ~ O
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use ana occupancy ........... ~.~ ~.. 1~.~. (~ ............................
b. Intended use and occupancy ...... ~ ......... ~.~ ~.~.~..~...~.¢ ....
3. Nature of work (check which applicable): New Building '. Addition i Alteration
Repair .............. Removal .............. Demolition ............ i' "Other Work ...............
_~// i~6 (Description)
4. Estimated Cost 2. t.~.~'.~.lZ~.,. Fee .~. ~./--~
(to be ~aid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling unitd on each floor ........ ; .......
If garage, number of cars ........... .~ ................................ ...........................
6. If business, commercial or mixed occupancy, specify nature and extent of each typ~ of use .....................
7. Dimensions of existing structures, ifany: Front ............... Rear ........ j ...... Depth ..............
Height ............... Number of Stories ............................. ! ...........................
Dimensions of same structure with alterations or additions: Front ............. i .... Rear ..................
Depth ...................... Height .............. Number of Stories ......................
8. Dimensions of entire new construction: Front i i i ~ ....... Rear .... .<-~ ~'.. ......Depth ... ~.c//. .......
Height . . . P~>. ....... Number of Stories ......... ~ ....... ..~ ...... ! ...........................
9. Size of lot: Front.../.~.~ .?.~....,,~ ..... Rear ...... /..c-2..c-2.,..~'~. ..... Depth . .~ ~ ~', ...........
10. Date of Purchase ..... ~.l.q].. ~.~ ............... Sa~ne of F~rmer .Owner . 'i'/~' '~''" ' ~'.h .........
11. Zone or use district in which~premises are situated ...... R.,a~,~x//¢,~ f. ta.~-,..
12. Does proposed construction violate any zoning law, ordinance or regulation: ...
13. Will lot be regraded .......... ~ ............. Will excess fill lpe remover}i from premises: Yes~.
14. Name of Owner of pre.~_mises ~-~L4)g>.~-..~/..~. t~.~,Address ~..~'. ~.~. ~.q~.5~b ~,P.~. P.o~No. ~.~.~. .5. ~.C:>..._.~.
Name of Architect . ./.oOg..ri,~5.-~tt~f..~,~ 'Address~a,K. ~.~o~..g,4M?...~o't;~Phone No "
Name of Contractor · .~ff~/~. .................. Address ...... :::. :::.. :i:.. Phone No::::. ': .........
PLOT DIAGRAM
Locate clearly and distinctly all buildhugs, whether existing or proposed, and. indicate all set-back dimensions fl'om
property lines. Give street and block number or description according to deed, and showi street names and indicate whether
interior or corner lot.
NEW ¥OR , S S i
,
' '--~d~vi~'~~a'c'ti .......... being duly sworn, deposes and says that he is the applicant
~e is the ~
(Contractor, agent, corporate officer, etc.)
)f said owner or owners, ~d is duly authorized to perfom or have perforated the sald work and to m~e and file this
~pplication; that all statements conta~ed ~ this application are true to the best of his ~owledge and belief; and that the
~ork w~l be perfomed in the m~ner set forth ~ the application flied therewith.
~worn to before.me this
............. ?.~. ....... day of ..... ~ ........ 19 ~.~ } "i~j~
~lotaryPublic, ..~..~.~..~.~..U~.'.~~. ........ C°unty(-"Nk- /1 ~ ~'!~' I
Z '
OCCUPANCY OR
USE IS UNLAWFUL
WITHOUT CERTIFICATE
OF OCCUPANCY
3. tNSU Af 0'~ ~
TOWkJSF~ND ~ SOkl
UCTURAL
ETA I L5
.i. I 4.'-o'~d 7'~~/~"
i'0.0 i (4.,o7~9') (7.
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ELI TOWNSF_ND ~:50~
sc^ L~, ~'~. r~ r T s~T~ ~ or'
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