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Home My WebLink About14470-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.ZI6040 Date .A.ugus~: 12, 1987 THIS CERTIFIES that the building . .O.n.e..La.m.t3y' .a?.~33.~.~.. ....... '~,' .................. Location of Property 601 Cedars Road Cutchogue ~t3ds'e ~io~ .......................................... Street Hamlet County Tax Map No. 1000 Section . .1.0.9 ........ Block . . .0.5 ........... Lot ..... .2.2 .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November 6, 1985 .. pursuant to which Building Permit No. 1/4670Z. dated December 12, 1985 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 .d.w.e.l.l.i.n~g.,..t.w.o..c.a.r..g.a.r.a.g.e. and decks. The certificate is issued to JOHN RICHARD HAAS ..................... io¥.'o;. ................... of the aforesaid building. Suffolk County Department of Health Approval ...... .8.5.-.8.0.-.1.7.9..J.U. ly..1.0.,.. 1.9.8.7.. ............ UNDERWRITERS CERTIFICATE NO. Pending PLUMBERS CERTIFICATION DATED: June 16, 1987 William Wilsberg Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN HALL SOUTHOLD, I',1. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 14470~ Z Permission is hereby granted to:~ ....... ...~...-.....O..~...~.~.~......5.ZI ..................... ...... /~.~'~..~.~. ~-&..t. ~ -. ~.... ~. t..~ ..~. ~- to ....... ~.~..~.~..~.~.~.~..'~... ...... ~...U,.~ ....... ~..~...u~,L~....~......t~..~.~:. ....... (Z.....~ ......... at premises located at ~,(~,.~. ...... ,'~,,~..,."~,~.-,......(~,.~i'~...C{~. ,I~..,..~.F~.,i..,.~, ....................... County Tax Map No. 1000 Section ...L~....~. ......... Block ...~...~ ......... Lot No...(~...~...~-... ......... pursuant to opp{icotion doted ..~.~'~...~....~....., 19...~....~.,%nd approved by the Building Impectar. Fee $....~....~...~.... ~ Building Inspector Rev. 6/30/80 BUILDING DEPT, INSPECTION FOUNDATION XST ~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION /, [/.~'~"RAMING [ ] FINAL 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, andsubmitted m~ 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 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: Additions $25.00 1. Certificate of occupancv New Dwelling $25.O0, Accesaory.,,$ [0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 Zl.Vacant Lancl C.O. $ 20.00 ) ~.~. 5.Updated C.O. $ 50.00 Date.. ~? H. NewConmtruction . .~.... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~..~./. .... ~.~....~... ......... . . .~..~..,,t,?.~,~... House No. Street /Yam/et Owner or Owners of Property . .-'~'.~..~....~! .~/~?, .e,,?~.,. ,,~ ./? ................................ ,~. County Tax Map No. 1000 Section .... /..O..~. ...... Block ..... ~ .~.~. ..... Lot .... ~ ~ ........ Subdivision ................................. Filed Map No .......... Lot No .............. Permit No 0 '~. Date of Permit .Applicant .~.~. .~il.l? ~. Health Dept. Approval ~'*--~o ~ J ~ ~ ~ ~ ........................ Labor Dept. Approval ............. Unde~riters roval .......... Planning Boar roy ...................... '~ ~ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.'. ~ ................ regu lations. ..... ......................... FIELD INSPECTION 1. FOUNDATION ~ FINAL ADDITIONAL COMMENTS: FORM NO. 11 TOWN OF SOU~HOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY DEVELOPMENT PERMIT ~o c{7~ PeNnission is hereby granted County Tax Map No. 1000 Section ~ Block ~_ Lot ..~ pursuant to.application dated-------t~ ,~ , l~. and. approvod by the Building Inspector. Building Permit No. __/qz~70 z 4/80 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated . .~4...O'A'~...~..l~..''.~.. .'~.. [ .~.. · · .~.., 19 .~ ~ for pe~it to ~ ~ ~'~' · '~'~' ' ~(~'~ '%~ .~G~ (~/~ ... at LocationofProperty . . ~ ~.1. . . '.~:9 : ~. . . ~. ~'0~ . ~ ..... ~CI~.~O~ House NO. ' ' ' Street Hamlet co~.ty Za~ ~a~ ~o. 1000 S~=tio~ ...l ~ ..... mo~ ....O.~ ...... ~t .~ Z~& ....... Lot N~ ~ ~- - ~ Filed Map No .... - ............ Subdivision .................. is rcturned herewith and disapproved on the follow~g grounds ............ , ................... .... -~ ........... ~ . ~ ~ ~?~~..~ ....... ~' . ...... ... Z.~c.. Z~ o..~..o ~.. ~ .~t-..~...'. ~.. ~~ ~ ..... RV 1./80 , TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date uilding Pe=it No. Owner (please print) · (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. LC:~ day of' , Notary P~blic, ~/~/~ County (plumber's sig~e; Notary Public 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;3 Examined .~.'~'".."'~: ^pproved~5.. ~.V. .... , ~9~mt ~o.. ~ ....... Disapproved a/~ ~ ~ ~~ ..~ (Building Inspector) Received ........... , 1 9 · · , APPLICATION FOR BUILDING PERMIT / Date ................... 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 r~ust be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commx~nced before issuance of Building Permit. d. Upon approval of this application, the Building Inspectotxwill 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 ~t 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 th~', 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 remora[ or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building co~, h/6~ing c/~e, ~1 regulations, and to admit authorized inspectors on premises and in building for necessary inspecti°.7.)..~.~. ~.,~/..~ .?:,?.e.x. .x. /./. f(4 ........... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0 ~d ~Z .... ~ .... ~ ......... .............. y .......................... / ............ ,. ~ Nmne of owner of premises ~- 0 ~//L/ t~ / ~/'/'~{~'~ (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 ................. Plumber's License No ......................... Electrician's License No ....................... 1. Location of land on which proposed work will be done .......................................... House Number Street Hamlet County Tax Map No. 1000 Section ' / ~ ~ ~ Block ~ ~ Lot. ~ ~ ..... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: occupancy .... (3. 5 ............... b. Intended use and occupancy ~/~ff~/~ J ~/~2~ F~/~ ~2/~ 3. Nature of work (check which applicable): New Building .......... Addition. ......... Alteration ........ Repair .............. Removal .............. Demolition .......... .... Other Work ............. ~ (Description) 4. Estimated Cost .................................... Fee ......... i ........................... ~' (tO b~ paid on filing this application) 5. If dwelling, number of dwelling units ............ Number of dwelling u~Its on each floor ................ If garage, number of cars ..... .~..13(. 0. ................... ~ .......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ..... } ........ Depth ............... Height ............... Number of Stories .......................... i ............................. Dimensions of same structure with alterations or additions: Front .......... i ...... Rear .................. Depth ...................... Height ...................... Number of Stories ........... , ......... 8. Dimensions of entire new construction: Front -gJ '. .... Rear...~.R.../: ........ Depth ....~ .......... ~ , Height .... Number of Stories T 9. Size of ot. Front ....... , .............. Rear ...... Date of Purchase . 7//°/°c~. . i ~a~e of ~ ......... i /~OY .~." ' ~ ~'g/~/' ' i .... I 0 .......................... ormer Owner i .......................... 11. Zone or use district in which premises are situated ....................... i ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..[ ............................. 13. Will lot be regraded ....... .y.~.S. ................. Will excess fill be removed frommremises: Yes 14. NameofOwnerofpremises ...~.9~..~..k/.~.~.~ ..... Address .P'.°.'.~.°.x.$.al~/tl½.W.r(ttf~l~:~t~oneNo.~.~.-.~.q~ .... Name of Architect ........................... Address ............. i ..... Phone No ................ Name of Contractor .......................... Address ............. ~ ..... Phone No ................ PLOT DIAGRAM Locate cleariy and distinctl,y all buildings, Whether existing or proposed, and, indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and st ow street names and indicate whether interior or corner lot. . ~ \ . / / STATE OF NEW YORK, COUNTY OF..5'.(ff...F.FP.z./~ ...... S.S ...... tLx/. 44P. . . . ............... being duly sworn, d~poses (Name of individual signing contract) above named· and says that he is the applicant He is the ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed th~ said work and to make and file this application; that all statements contained in this application are true to the best ofih~s knowledge and behef; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ day of ................ Notary Public, . ~?..... ~. '... ~..d<..~..d~..Ifll~ I~ ffi ~[ ........ County ~. 7~ (Signature of applicant) "' ' '-fl/,, Application Received_[' Dis~..Issued19 Permit FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT IN THE TOWN OF SOUTHOLD 1. Type o~ DeveLopment Propose_.~:~tructure ~includlng storage tanks Addition and/or Alteration ~ Pr~ow Base Flood Elevation Other (specify) 2. Elevation Data in relation to above mean sea level Of: (a) Lowest floor elevation, including basement ~ feet __ (b) In a V Zone, bottom of lowest structural member . feet __ 3. FIRM--Flood Insurance Rate Map, Zone designations 4. Owner of Premises O inches-~- inches 5. Location of Property: House # Street County Tax Map No., Dist. 1000, Section Subdivision Filed Map~ ~ Permission to be granted: Ne~ OWner Under Contract Lessee Contractor Phone ~ Name if not given above Mailing address 7. Approval from other(s) DEC l~ l/-l-~ Health Services Building Permit 14~7(~ .~ 8. I, New Owner~, before Permit is Wetlands ZBA Planning Board , the applicant, Under Contract__, Lessee issued: (Town Board) ~ ~ l~-- am the Owner__, Co-Owner , Agent , Contractor ~, and agree to comply with all applicable sections of the Code of the Town of Southold; County, and State and to admit authorized inspectors to premises 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 my knowledge and beli~and that the work will be performed in the manner set~k6-i~th in ~_-~pp~qation filed Notary Public Applicant's mailing address and phone # if not given above 11/85 FORM NO. 10 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-1802 P.O. Box 728 Southold, N.Y. 11971 Town Hall Main Road Southold,N.Y. ..AP~T,,ICA~TON FO~ nEVET,OPMFNT PF~MT? , - ~nstructions: The application to the Building Inspector includes (each · ~n duplicate) 1. FormlNo. 10 filled out in ink or typewritten, 2. Sur- vey of premises with i levat~ons above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Sbuthol~ known as "Flood Damaqe Prevention Law" of the Town of Southold. Th~ applicant must submit approvals that any other agency requires, i General Standards as ~:required in Section 46-17 of the law to minimize flood ~iamage: i A. Anchoring of ~structures, including tanks and mobile homes B. Use of constr'uction material and methods C. Design and lo'cation of utilities D. Subdivision proposal with.drainage, public utilities design and base flood ~'evations ~pecific Standards asI required in Section 46-18: A. Residential ~onstruction B. Non-residential construction C. Mobile homes I The applicant must s~bmit plans and specifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated abo~e the base flood elevation or; if permitted by the Federal Regulation, ~hat: 1. such structure is flood proofed in such manner that below the base flood level the structure is water tight with walls substantially ~nd impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of:!buoyancy, 3. applicant must submit certification by a registered professional engineer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Seuthold Code are satisfied. Coastal High Hazard..area (V.Zone) 46-19. Applicant shall submit plans, specifications including the required certifications and such other in- formation as the Building Inspector may require in that the provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural members of the lowest floor cannot be lower than the base flood elevation with all space below open except breakaway walls. Sand Dunes. If sandidunes exist on the premises and the applicant pro- poses to alter same, plans and specification must be shown in detailed nature of any altera 5ion submitted. Building Permit. A ~uilding Permit is also required for any structure. Both a Development a~d a Building Permit must be issued before any work can start in a special flood hazard zone. A written disapproval or a permit must be issue~ within ten (10) working days. During construct~o~,l the ~nspector shall be notified in time so he may make the required ~n~pect~ons. Upon completion, thel required certification of the final elevations and work must be submitted before the approval to use or occupy can be approved. (Fill put the form on the back of this sheet) 11/85