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Home My WebLink About14389-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THlS CERTIFIES that the buitding One family dwelling with attached deck 820 Glen Court Cutchogue, New York Location of Property ............................................................... ~/ouse No. Street Hamle~ County Tax Map No. 1000 Section ....0.8.3 ...... Block .... 0.1 ...... Lot ~ 7.2 ~9 Ri ~a..~! Fll dMapN 5060 N 1~ Subdivision.. . s u f f e o ........ Lot o. . conforms substantially to the Application for Building Permit heretofore fried in this office dated October 15, 19 85 gp 1/4389Z ......................... pursuant to which Buildin ermit No ...................... October 23, 85 dated ............................ 19..., 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 ......... One family dwelling with attached deck. The certificate is issued to JOHN R. DEMPSEY, INC. of the aforesaid building. 85-S0-135 Suffolk County Department of Health Approval .......................................... UNDERWRITERS cERTIFICATE NO P.e. n, .dj n.~ . PLUMBERS CERTIFICATION DATED September 17, 1986 Rev. 1/81 TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~4389'Z Permission is hereby granted to: .......... ..J..~z~..~ ...... ~,.~-..~.........~. ....... ~.~.......~.~:..~...~ ................... ....... ~.~.~:~.~,..~..~ ....... ./.~..~...~ ~ ~ ~ ' ~ z ~( .. to ................ ~~.~....~ .............. ~.~ .............. ~ ......... .~ ............................ at premises I~ated at ..... ~.~ ........ ~.....~~ ....... ~ ...................... .~ ................. ................................................................................................................. ~.~:~...~.,~ ............... ,- ~- ~Z~,~- ~.~.~ ....... ~.~.~ .............. ~......~ ................................... ~.~.L~ .... c~,w T,, ~, No. ~ooo s,,,o, ...~.~ ........ B~k ....g./. ........... ~o, No..DI..Z~.:~: .... Building Inspector, Fee $....,.,~..?.....~...?~.°... ? g nspec 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 This application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property, with accurate location of all buildings, property lines, streets, and unusual natural or topographic featu res. 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 end 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 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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5 .Updated C.O. $15.00 NewConstruction . .'~.. Old or Pre-existing Building $15.00 Date. N<~.'~.O'~ J~,,~.; .r~.,~ I J.~_~/..c~ ............ Vacant Land ............. Location of Property .... ~..~.(? ...... ,~.~..~.~. ............... ~ .................. House No, Street Hamlet Owner or Owners of Property .............. · ......................... - County TaxMap No. 1000Section ..... .~,,~ .....;. Block ......... ~ .... Lot ../.?....~.l~.. .... Health Dept. Approval ...~'~. .................... Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~ ........................ Construction on above described building and permit ~licable codes and regulations. ................. Rev. I0-10-78 ~0 ~ ~$~/~. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 725 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. ~please print) Plumber ~. (please' print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this Notary Public ,~County Notary Public ,~iELD INS[~ECTION ,~OUNDATION (1st) 'OUNDATION ( Pnd ) 2. ~(OUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY CODE FINAL 7ss.18o~ BUILDJNGI DEPT. ~ INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ] FINAL DATE.. 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [;/-] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 15T [ ] ROUGH PLBG. N 2ND [ ] FOUNDATIO [ ] INSULATION [] FRAMING [] FINAL 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING REMARKS: [ ] FINAL DATE, INSPECTOR 7SS.1802 BUILDING DEPT. INSPECTION [ 'I FOUNDATION ZST [ '1 ROUGH PLBG. FOUNDATION 2ND [XINSULATION / ~._FRAMING [ ] FINAL DA~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-180;3 ;xamined~/. ..... ?. ~ .., 19 ~.. ·5j · ,,roved x. ..... l ..TPermit )isapproved a/c .......... ~ ................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG DEP¥ TOWN OF SOUTHOLD Received ......... 7.,19 a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 its 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~tion. 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 ~all 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 '~all have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to lite uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or .egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. .... 4qb..n..It. :, .D. qm. pp.qy. ,..I,n. ,c., ................. (Signature of applicant, or name, if a corporation) PO Box 5, Cutchogue, N.Y. 11935 (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. qame of owner of premises .......... :..D.e.m. p .e.y 9: ....................................... (as on the tax roll or latest deed) f applicant is a corporation, signature off duly authorized officer. · .......... Plumber's License No. GeorFe Mart in el~ Paul Burns Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ' ~0 (C ~ Glen Court Cutcho~ue House Number Street Hamlet County Tax Map No. 1000 Section 83 Block 1 Lot 17 · 2 Subdivision... ~SSa..B~¢[~. .................... Filed Map No. 5060 Lot 12 (Nmne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vacant 2 and family dwe]2i ~ ~ b Intended use and occupancy one n 3. Nature of work(clieckwlilch' apphcable):;' New Building ..........xx . Addition.......... Alteration .......... Repair ~' '~ RemoraI Other Work ............... , ,, ~ -~ (Description) , 4 Estimated Cost ~'100 DO0 Fee ..................... : °', (to be paid on filing this application) 5. If dwelling, number of dwelhng t rots ........ .~ ...... Number of dwelling units on each floor ................ Z Car. bu~dt~i~ .~ .... II: garage, number of cars .................................................... occupancy,' sp'ecify nature and extent of each type of use ....... 6. If business, commercial or mixed .............. 7. Dimensions of existing structureS, if any: Front ............... Rear .............. Depth ............... Height...............NumberofSt°ries ........................................................ Dimensions of same structure wi{h alterations or additions: Front ................. Rear .................. Depth .................... !.. Height ~ .... '~'~ ~. ............. 1~. rNumber32 ' of Stories .......... ii .......... 8. Dimensions of entire new construction: Fr nt .................................. Depth 4.6 ' ........ pr3'. 2 9. Size of lot: Front ...1.~.Q ..... , ......... Rear .... 1.~2.' .............. Depth v8x .................. 0. Date of Purchase ...~2~.~ .... ! ........ ii ......- Name of Former Owner .J....Torr. egro. ssa ........... 1. Zone or use district in which premises are situated....r.e,s. 5..d.e.ri.~. g,'l. .................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: .... .rip .......................... 3. W~tl lot be regraded ........ .~ ................... Will excess fill be removed from premises: xx Yes No 4. Name of Owner of premises .. ?.'..D..e.m.p.s..ey.,..5.' .n.CAddress .2~. ~BX. 5.,.. Cu.%ch °Phone No. ?~4..~0.58 ..... Name of Architect .......................... Address ................... Phone No ................ Nmne of Contractor ........................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, wliether existing or proposed, and. indicate all set-back dimensions front ,roperty lines. Give street and block mmber or description according to deed, and show street names and indicate whether ~terior or corner lot. 35-L0~ ;TATE OF NEW YORK, S.S ?OUNTY OF ................ ......... ~9.hp..R.:..~.e.m. p~.e. 7.I ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) .bore named. te is the .................... 91.w.n ~:'.b.q ~-¢t.e.~7 ..................................................... (Contractor, agent, corporate officer, etc.) ,f said owner or owners, and is d01y autliorized to perform or have performed the said work and to make and file this pplication; that ~ail statements contained in this application am true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therew, ith. ;worn to before ~ ............ ..... , qotary Public,. , . ~, .~..O.(~..~ / ~... .............. Count.~ ....... . "' "' t' "x ' -(SignOre o, a,,phca,,t) / VACANT) 'N SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT, OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SEEVICES -- FOR 'APPROVAL OF CONSTRUC,TION ONLY DATE: N.s..Er..o.: ,, tT,%o ~'~' ~ APP~OYED: GREENI=0. R T t~W- YORK · t /'~(~ , , .x SUFFOLK CO. HEALTH DEPT. APPffOVAL ~ STAT~NT ~ INTENT / ~ THE WATER ~Y AND ~A~ DI~L GLEM C~I2T / SY~E~ F~' THIS 19~,45 ~ ~ LY, EN[)OF , ~ CONF~M ~ THE $TAN~R~ ~ T~ Ok z.Z;4iiOO ~q,3JJOS LICENSED LAND ~RVEY~5 ' GR~RT ~W Y~K , C II ;i (Z o OR PLUMBER CERTIFICATfO]~ ON LEAD CONTE~/T BEFORE CEBTIFIC-~TE OF OCCUPANCY SOLDER USED IN WATER .r :Vi CANNOT SUPPLY SYSTE EXCEED £/10 o.f 1% LEAD. If copper lublng is used for water distributing syslem; piping shall be of types K or L o~nn,I.y NOT'ID/ SUILDING DEPARTMENT AT 765qg02 9 AM TO ~t PM FOR THE FOLLOWING INSPECTIONS:- ]. FOUNDATION - TWO REQUIRED FOR POU~2D CONCRETE 2. ROUGH - FRAMING & PLUMBING LWI,qG i 1 -I